Tony Blair’s NHS dream? Fewer GPs, more chatbots

LONDON — Tony Blair proposes closing most local GP surgeries and replacing them with super primary care centers, a leaked report shows.

The former prime minister’s report envisages a radical overhaul of the NHS, calling on the U.K.’s new Labour government to consolidate GP practices, grouping patients based on healthcare needs rather than geography.

“The traditional model of 10 minutes with a doctor to discuss one problem by the time you’re already sick persists in some places, but increasingly practices are adopting a [population health management] approach,” Blair’s report says.

Blair remains close to the Labour Party leadership and has touted artificial intelligence as a silver bullet for ailing public services, government inefficiency and a stagnant economy — messaging echoed by Cabinet ministers since the election.

Blair’s report says that at present, most primary-care networks look after populations of between 30,000 and 50,000, but that NHS England should take steps to increase that figure to 250,000.

“In time the primary-care landscape would change to one with far fewer groups of primary-care practices – and meaningful choice for patients over which group they register with,” the report says. 

POLITICO obtained copy of the report, which was published on Friday apparently by accident, before it was deleted from the Tony Blair Institute’s website. The institute published the report Monday evening after being contacted by POLITICO

The report also advocates creating a centralized store of digitized health records that could be used to power “AI doctors” that would interact with citizens through a chatbot.

Blair’s think tank, the Tony Blair Institute for Global Change, is backed by tech billionaire Larry Ellison who has pledged a total of $375 million over the years. Ellison’s cloud computing company Oracle is in one of the sectors benefiting from an AI boom and has a commercial interest in digitizing health records.

The report received input from an employee in Oracle’s health division, and other health tech companies.

Health campaigners say the proposals would preference GP “chains” run by private companies.

“On substance, Blair wants Labour to close your GP and have you talk to a chatbot instead,” said Sam Smith at Medconfidential, an organization that campaigns on issues related to health data.

“’Far fewer groups of primary-care practices’ likely needing to be run by larger healthcare corporations … will translate into fewer GPs,” said Diarmaid McDonald, director of Just Treatment, an organization that campaigns against NHS privatization.

“Rather than seeking to cut costs using wholly unproven and overhyped AI tools that seem designed to further open up the NHS to large corporate profiteers, patients want to see the investment in the health service that would mean they can see a GP — a human that knows them, and has time to listen, when they need help.”

The TBI did not respond directly to questions relating to the leaked report, but instead pointed to a supporter of its work currently working within the NHS.

Fiona Edwards, CEO of Frimley ICB and Chair of the Thames Valley and Surrey Partnership Board which manages  the care record and population health system for citizens said: “We spent over five years building our data and population health platforms and they are fully embedded in many of our care pathways. We are seeing substantial patient and organizational benefits from data driven initiatives and they are at the heart of our transformation programs. 

“It is obvious we need to build from what we have rather than starting again with a new national scheme and the expanded uses detailed in the TBI report are natural and much needed extensions to the work we are doing.”