Has Sir Keir Starmer thought of what a fully digitised NHS would mean for elderly patients? - Jayne Dowle

His excitable plan of “moving from an analogue system to a fully digital NHS” is also not much comfort to those people without state-of-the-art smartphones – and outside of Westminster, believe it or not, there are many, Sir Keir.

Or access to fast and regular broadband, a necessity to allow any app to function effectively, update regularly and work reliably. So that’s alienating millions of people on incomes so low that they can’t afford to be plugged in 24/7.

He mentions “careful management to ensure those who are less comfortable using technology are supported throughout and given alternative routes where needed”, but that sounds like a coda for confusion if ever there was one.

It’s brave of Starmer to be so forthright about tackling the NHS, and certainly not before time.

However, I’m sorry to say that this focus on digitising NHS services is dangerous and holds massive potential to backfire.

Instead of going deep and tackling the endemic issues – such as recruitment and retention of doctors and other healthcare professionals (and broaching Brexit, unavoidably), layers of bureaucratic NHS management, crumbling buildings, and underlying it all, the poverty that contributes to ill-health which in turn puts ever-increasing pressure on services – the Labour leader is offering a solution that will simply increase division and alienate those who need the most help.

He's saying that 30 million people signed up to the NHS app during the pandemic, and since then it’s sat idle. Labour’s plan is to harness its presence “for the good of the public”.

Yes, it’s true that ’30 million’ represents a lot of adults in the UK. And whilst the Covid-induced app has not exactly prompted a user-led revolution, it has been accessed by those who find it handy and convenient.

According to official NHS figures, in the year September 2021 to August 2022, 1.4 million GP appointments were booked via the app, and more than 19.3m repeat prescriptions ordered in this way.

It’s also proving a good route for people to express their wishes regarding organ donation; according to the NHS, 448,000 people used it to make such decisions between September 2021 and August 2022, representing a 69 per cent increase on the previous 12 months.

However, what Starmer’s fully-digitised plan fails to acknowledge are all the millions of appointments booked another way – typically by hanging on the phone to the surgery and begging, crying and pleading.

Oddly, it does not mention the frustration and anxiety of even securing a GP appointment at all. Waits of two to three weeks are now commonplace in many areas; an app is a bit of technical kit, not a magic wand. It’s not going to make it easier to see a doctor.

The whole plan sounds suspiciously like offloading a lot of the work that surely should be done by people. Is it an admission that the dedicated people who work in the NHS aren’t doing their jobs properly, or managed and led effectively?

If that’s the case, he should be considering how to maximise this asset instead of adding yet another project to the NHS to-do list. And he doesn’t mention the cost of going fully digital either, or the potential for job losses when in-person administrative roles are suddenly outmoded.

And this app certainly will need to be fool-proof. My own phone is full of apps and some are far more frustrating than others.

Starmer says digitisation will put in one place the opportunity to book appointments, use appropriate self-referral routes, get reminders for check-ups and screenings and receive the latest guidance on treatment. It would also, in his ambitious ideal, give us all routes into taking part in clinical trials.

If I was a mother with a sick baby running a temperature, I’d be really comforted by the fact that I couldn’t get my child in to see a GP for days, but should I have three weeks of my life to spare, I could have the opportunity of an all-expenses paid stay in a clinical trial facility testing some drug that might give me horrendous side effects.