Artificial Intelligence in Healthcare — [Ian Paisley in the Chair]

Backbench Business – in Westminster Hall at 1:30 pm on 5th September 2019.

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Photo of Henry Smith Henry Smith Conservative, Crawley 1:30 pm, 5th September 2019

I beg to move,

That this House
has considered involvement of patients in the use of artificial intelligence in healthcare.

It is a pleasure to serve under your chairmanship once again, Mr Paisley. I am delighted to have been granted this important debate, and I am pleased to see a number—particularly for a Thursday—of Members from all parts of the House present to take part. I declare at the outset that I am the chair of the all-party parliamentary group on heart and circulatory diseases. Earlier this year, the APPG conducted an inquiry, with the support of the British Heart Foundation, to better understand patient perspectives on artificial intelligence. It found huge potential for AI to transform the lives of those living with heart and circulatory diseases and a greater need for those affected to be included in discussions about the development and adoption of new technologies.

Before I go further, I want to speak briefly about what AI is. Put simply, AI is the term given to a set of computer actions that mimic human intelligence. Our report outlines that what separates modern AI, such as machine learning, from other types of computer program is that it can learn and improve at tasks. AI is particularly strong at finding patterns and trends in data that are not obvious through human analysis. I have mentioned machine learning, which is one type of AI. It is where algorithms—a set of rules that a computer uses to make a calculation—are used to look for patterns in data, and the computer then uses those patterns to make decisions. It looks for patterns in many different types of data, from scrutinising images to analysing genomic data.

Every day, we interact with something that uses AI. Whether it is entertainment, online shopping, wearable devices, virtual assistants, chat bots or advertising, the use of AI is ubiquitous. Whether it is through faster or more accurate diagnosis, more personalised treatment, better targeting of demand, improvements in service planning and delivery or better predictions, AI has the potential to touch all aspects of healthcare delivery and management.

Our APPG’s report, “Putting patients at the heart of artificial intelligence”, was launched in May this year. It warns that the spread of misinformation risks undermining public confidence in the use of AI in healthcare. The APPG has therefore recommended that policy makers, parliamentarians, the NHS, charities, healthcare professionals and the health technology industry should seek to engage and involve patients in the design, development and diffusion of AI. If they do not, developments in AI might not reflect the needs of the very people who could benefit from it.

It is important to ensure that fake news and the desire for a quick headline do not undermine the public’s trust and confidence in this important area of research and clinical practice. In a survey conducted for the inquiry, 91% of people with heart and circulatory diseases said that the public should be well-informed about how AI is used in healthcare. Some 90% believe it to be the responsibility of the NHS to inform the public about current and potential uses of AI in healthcare, and 48% of patients surveyed strongly support doctors using artificial intelligence technologies to assist them in diagnosing and treating heart and circulatory diseases.

Heart and circulatory diseases, including coronary heart disease, stroke and vascular dementia, affect millions of families across the UK. The halving of deaths from heart and circulatory diseases since the 1970s has been a major health success for the UK. However, such conditions still cause a quarter of all deaths in the UK and are the largest cause of premature mortality, particularly in deprived areas. Together, they make up the single biggest driver of health inequalities and cost the NHS in England at least £7.4 billion a year. As outlined in the long-term plan, it is the single biggest area where the NHS can save lives over the next 10 years.

In assessing the potential for AI, it is important to note the scale of heart and circulatory diseases in this country. The British Heart Foundation, which provides secretariat support to the APPG, reports that heart and circulatory diseases still cause a quarter of all deaths in the UK, on average killing one person every three minutes. The number of people living with heart and circulatory diseases also remains high, at 5.9 million in England. There are more than 42,000 premature deaths from cardiovascular disease each year in the UK. We must therefore utilise the enormous potential of AI across all areas to transform the way we prevent, diagnose, treat and support those living with or at risk from heart and circulatory diseases.

In my constituency of Crawley, 11,000 people were living with a heart and circulatory condition in 2017-18. Of those, 3,679 had coronary heart disease and 1,865 were living with stroke, 774 were living with heart failure and 1,985 were living with atrial fibrillation. In addition, 16,682 constituents have been diagnosed with high blood pressure, including me, and 7,555 with diabetes. While those numbers may seem high, the British Heart Foundation tells me that according to the quality outcomes framework data, Crawley is ranked 548th out of the 650 UK parliamentary constituencies for the prevalence of cardiovascular disease.

In communities around the country, including Crawley, one of the challenges of introducing AI into everyday practice in healthcare is its potential to exacerbate health inequalities. Age, ethnicity, and socioeconomic demographic factors can influence access to the best technologies. Access to new technologies is relevant because AI is currently being implemented in consumer-facing technologies, such as smartphones, which can help manage adherence to blood pressure medication, smart watches, which can track and analyse heart rates, and voice-activated assistants such as Alexa or Siri, which can act as useful reminders to take medications.

As I mentioned, the APPG on heart and circulatory diseases launched its report on AI earlier this year. Our group was grateful for the involvement and enthusiasm of the Secretary of State for Health and Social Care, who also took the time to speak at the report’s launch. Given the number of people in Crawley who have heart conditions, I wanted to keep local residents updated about my work chairing the group. Shortly after the report’s launch, I wrote in the Crawley & Horley Observer about the importance of tackling such conditions and reiterated the salience of the Department of Health and Social Care ensuring that some of this Government’s increased funding for our NHS is used to address the use of AI and its potential in the health service.

It was very much with that call in mind that, almost a month ago, I welcomed the Secretary of State’s announcement that £250 million is to be spent on the new national artificial intelligence lab to improve the health and lives of patients. The Department of Health and Social Care has said that the AI lab will bring together the industry’s best academics, specialists and technology companies. They will be working on some of the biggest challenges in health and care, identifying the patients most at risk of conditions such as heart disease. That will allow for earlier diagnosis and cheaper, more focused and personalised prevention.

The new national artificial intelligence lab will sit within NHSX, the new organisation that will oversee the digitisation of the health and care system in partnership with the accelerated access collaborative. One of the key recommendations of the APPG report is that NHSX should set up discussions with charities and the public to explore the views and concerns of patients about the use of AI in healthcare, and I would be grateful for the Minister’s assurances that through the development of the new lab, NHSX will be exploring the opinions of patients and thoroughly engaging them throughout that ongoing process.

In the past five years, we have seen AI go from struggling to identify images of cats to being able to identify skin cancer in histological sections of biopsies just as well as a team of specialist doctors with decades of combined experience. In debates on this topic, it is easy to discuss issues in what seem like abstract terms, but when patients go to see their GP, they want to see their GP. In such cases, AI could be used to create automatically the GP’s notes about their patient, reducing the time that the doctor will spend looking at their screen, for example.

There is also the issue of self-management. From dedicated apps that people use while going out for a run to the most basic step counters, more and more people use their own devices, on some level, to keep an eye on their health. AI can be used more and more in this area. Patients could use wearable devices and sensors to manage their condition at home and in the community instead of in hospital. AI systems could then monitor for unusual patient-specific patterns, such as a deterioration in a heart failure patient, and relay that information to a clinical team for further intervention. That also presents an opportunity to put patients in much better control of their care.

Our inquiry heard from experts from the University of Cambridge and the University of Oxford, who told us that NHS health checks could be better at distinguishing the risk of different types of heart condition, to ensure that the most suitable treatment can be received by the patient. On 16 August, the Department of Health and Social Care announced a review of the NHS health check service, which is offered to everyone between the ages of 40 and 74 to spot the early signs of major conditions that cause early death, including stroke, kidney disease, heart disease and type 2 diabetes.

Although the NHS health check programme has identified more than 700,000 people at high risk of cardiovascular disease over the last five years and has saved an estimated 500 lives each year, the Department of Health is right that there is potential for people to benefit even more from an enhanced tailored service. The APPG’s survey of patients with heart and circulatory diseases found that 64% had at least some awareness of the potential future uses of AI to diagnose and treat heart and circulatory diseases. However, only 17% of respondents were aware of any current uses. That represents a huge opportunity to inform patients about the opportunities of AI.

People are becoming more and more wary about the use of their personal data. From cold calls to unsubscribing from mass emails, there is increased caution from people about giving up personal information. When it came to the APPG’s inquiry, however, 86% of respondents were comfortable with their personal health data being used to help better to diagnose medical conditions. Policy makers should feel confident that patients support the use of AI in healthcare if it is done to improve health outcomes.

Trust works both ways of course, and it is important that those implementing policy and programmes are open with the public about how their information will be used. That is why patients, and the wider public, should feel involved with not only the details of what their data will be used for but the wider work of the NHS to use artificial intelligence to improve our health service. In June, when speaking on the use of AI, NHS England chief executive Simon Stevens said that

“from April next year we propose to change the way we fund care so that NHS organisations who invest in this world-leading technology will be properly rewarded for doing so.”

I would be grateful for an update from the Minister on what form that is due to take. I am sure that such an update would be welcome if colleagues are to make representations with their own health authorities and trusts.

Our report raised the issue of what patients need to know. Transparency is welcome, and it is important to specify what type of transparency, as well as its intended outcome, in addition to being clear about for whom the transparency is intended. Transparency can include outlining why an algorithm was developed, what types of data were used, and how the development was funded. Some experts have argued that the black box of AI—the difficulty in understanding how AI models reach their decisions—is not really a problem at all, as humans are equally opaque in how they arrive at decisions.

However, the ability to scrutinise, conduct quality assurance, and undertake due diligence are important parts of regulating the health system and ensuring patient safety. In November 2017, the national data guardian for health and care, Dame Fiona Caldicott, told the House of Lords Artificial Intelligence Committee about the challenges of using patient data in technology, saying:

“What we have not done is take the public with us in these discussions, and we really need their views.”

That needs to be addressed. If patients are to trust the use of AI in healthcare, they need to know they are a vital part of the journey.

Our report also looked at the regulatory framework, and how the development of such technological innovations means that health systems are becoming more complex environments to regulate. At the same time, it is important that the regulatory burden is not added to, so that the spread and adoption of new innovations is not stifled. Our inquiry found that a

“balancing act between managing expectations and encouraging hope and enthusiasm is always challenging but nevertheless important. When we say patients should be informed and clear on what AI can do for the NHS, it is not a tick-box measure. It is to provide the clarity that is needed for better diffusion of AI.”

NHS England and NICE, the National Institute for Health and Care Excellence, should encourage the development and use of reporting standards for AI research, in order to provide best practice for artificial intelligence researchers. That could also lead to greater recognition of quality in AI research, particularly among the media, policy makers, clinicians and the public.

With regard to my constituents, I mentioned the importance of Government, policy makers and NHS staff, all of whom have an important role to play in supporting patients. I am also grateful for the secretariat support provided to the APPG by the British Heart Foundation, and I pay tribute to the charity’s hardworking volunteers, including those whom I have been pleased to meet throughout Crawley, and those at the British Heart Foundation shops located on Queensway and on the Broadway in my constituency.

There is much to welcome in the NHS long-term plan. Indeed, NHS funding will grow on average by 3.4% in real terms each year from 2019-20 to 2023-24, which is of course welcome. The current funding increase will mean that the NHS can lay further foundations for service improvements. Thanks to our NHS staff, millions more people are being treated every year. Although services return to Crawley Hospital—and I continue to call for even greater provision—it remains the case that the worst decision in the history of Crawley as a new town was the removal of A&E in 2005. Our constituents expect to see improved GP provision, reduced waiting times and enhanced frontline services.

The APPG on heart and circulatory diseases welcomes the great strides made in recent years to speed up the development and diffusion of AI in the NHS. The Office for Artificial Intelligence and the AI Council have huge potential to bolster the UK’s position as a world leader in AI as part of the Government’s AI sector deal. The Centre for Data Ethics and Innovation can also cement the UK’s leadership in ethical AI and ensure that society can shape the direction of travel and reap the benefits of AI, and we hope that those initiatives will continue to be taken forward.

The chief executive of NHS England has called for this country to become a world leader in the use of AI and machine learning, stating that exploiting the boom in AI technology can help meet the target in the NHS long-term plan of making up to 30 million outpatient appointments unnecessary, in addition to saving more than £1 billion in what would have been increasing outpatient visits. The money can be reinvested in frontline care and save patients unnecessary journeys to hospitals. That reminds us that patients must be at the heart of today’s debate, and hopefully future debates in Parliament on this issue.

Photo of Daniel Zeichner Daniel Zeichner Labour, Cambridge 1:48 pm, 5th September 2019

It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate Henry Smith not only on securing the debate but on his thoughtful and comprehensive introduction to an extraordinarily complicated subject that I suspect will require much more debate in this place in future. I chair the all-party parliamentary group on data analytics and represent a constituency that is, of course, well known for its health services, innovation and tech cluster, not just in the city but around it.

The issue is therefore close to my heart. When I was elected as the Member of Parliament for Cambridge, I never imagined that I would spend quite so much time on such issues, but there are many jobs involved and huge opportunities available, exactly as the hon. Gentleman said. However, I suspect that I will be slightly less optimistic than him, because as I have begun to look at the issue more closely, it has struck me, as he said, that the only way that we will make it work is by maintaining the trust of patients, which is difficult—particularly given the behaviour of some of the major tech companies. It is not a lost cause, in my view, but we are going to need a qualitative change in regulation and protection if we are to secure some of the benefits that have already been referenced. Every day in Cambridge, I hear about new innovations and developments that convince me and, I think, many others that we really are on the cusp of a technological revolution across a range of sectors. Everywhere one goes in Cambridge, one sees people working on the most extraordinary things, and the gains are potentially huge, not just for our citizens but across the world.

It is hard to explain a lot of this to the public. I feel that I am in a privileged position going around Cambridge; I sometimes feel that I am the only person who is seeing all the various things that are going on, and one of my challenges is to try to spread the word about all the stuff that is happening. My worry is that often it is poorly communicated and poorly understood, and that misunderstanding can easily lead to a public backlash. I read with great interest the report from the all-party parliamentary group on heart and circulatory diseases; a very distinguished panel of people was behind it, and I will highlight some of the crucial points.

Ensuring that artificial intelligence really does enhance patient healthcare—and that it does not, as some of us fear could easily happen, get diverted on to a profit-seeking route—requires the following key elements: stakeholder engagement; an exact explanation of the risks and benefits; keeping researchers and academics involved; digital inclusion in general; proper development of policy, focusing on AI for public values; and the development of standards.

There are others, of course, working in a similar field. I am delighted to see present a fellow member of the APPG on data analytics, Lee Rowley. A few months ago he and my hon. Friend Darren Jones led a very good inquiry and produced, with a similarly illustrious panel of experts, an excellent report entitled “Trust, Transparency and Technology”. It is amazing how many people are working in this field at the moment. Part of that report—I suspect the hon. Gentleman will refer to it when he speaks—was focused on healthcare. He did the work, so I do not want to steal his thunder, but I will pick out a particular couple of things.

We drew on a 2018 survey by the Open Data Institute, whose statistics reflected those cited by the hon. Member for Crawley. Some 64% of consumers trusted the NHS and healthcare organisations with their personal data, which is more than the 57% who trusted their family and friends. Consumers also trusted the NHS more than they trusted their bank, the figure for which was also 57%; local government, for which it was 41%; and online retailers, for which it was 22%. I do not think they asked about the level of trust in politics; that is probably not recorded. Nearly half of respondents—47% of them—were prepared to share medical data about themselves. I have seen different figures, and I would also reflect on the fact that 53% were not prepared to share data. However, those people were prepared to share their data provided that it helped develop new medicines and treatments. In terms of the trade-offs for data sharing, they were most keen to participate when it was for medical research.

As we know in politics, however, trust is hard won and easily lost, and we have to be careful. A few months ago, I was asked to write a foreword to a report by the think-tank Polygeia, entitled “Technology in Healthcare: Advancing AI in the NHS”. The report is consistent with other work in this field and comes to broadly similar conclusions to those we have already heard. There is also a sense that NHS staff need to be closely involved in these developments, to ensure that they are not just kept informed but given a sense of understanding and confidence about how this can work. The black box algorithm to which the hon. Member for Crawley referred is still a little baffling and scary to a lot of people. If we are going to make this work, it is crucial that we consult, educate and take people with us. We must rely on the advice of medical and healthcare professionals, who are best placed to understand the concerns of both their patients and their colleagues.

We are constantly seeing new developments in the news. One of the joys of modern life is that when we go on holiday, we still watch our iPad. This summer I noticed the debate about DeepMind and its new ability to predict acute kidney failure; it wins an extra 48 hours by looking at huge volumes of data and doing the number crunching. That is bound to be a good thing but, typically, there were people who questioned the methodology and who raised concerns about unforeseen consequences. I also think there are some unforeseen consequences to these kinds of changes, and I will touch on one or two.

So far, I have been profoundly non-partisan and non-political, but I have to say that the new Secretary of State for Health and Social Care did rather wade in early on with his support for Babylon Health and GP at Hand. Those kinds of technologies provide tremendous opportunities but, as the hon. Member for Crawley said, such developments can be disruptive to the organisation of the national health service. There has been disruption to funding flows, particularly across London, and I hope the Minister will be able to reassure us about that. Simon Stevens made a commitment, but these changes are happening quickly and one of the things that we know about the NHS is that it is quite a tanker to turn around. Quick, unintended consequences are not always benign ones for the people on the receiving end.

The wider point, of course, is that some of us are worried that the NHS, which is free at the point of use, is being undermined by the creeping in of a potentially competitive system. That can be resolved in some ways: we can change the administrative structures, for example, and sort out the financial flows. My bigger fear relates to confidentiality and what is happening with patient data. It is frequently argued that the data will be anonymised, and this is where we get into the realm of the techies. Plenty of people have explained to me that it is possible to reverse that anonymisation process, because as clever as these machines are in terms of machine learning, they are also pretty clever at doing the reverse. I am now pretty much persuaded that there is no such thing as anonymity. We must face the fact that there are consequences to these tremendous gains, and think through how we should deal with some of them.

This does not necessarily matter. I remember years ago when, under the previous Labour Government, Alistair Darling unfortunately had to come to Parliament and explain that his Department had lost millions of people’s data. That week, everyone thought the world was going to come to an end, but it did not. An awful lot of data is out there already, which is not great because we do not know who knows what about us. That is not necessarily a disaster, but if data is being used for the wrong purposes, it could be very difficult. This is my key point, I suppose: I am afraid that the evidence from the big tech companies, as we see almost daily, is that they have been doing things with our data that we did not know about. That is a problem that we previously experienced with the Care.data failure in the NHS, which damaged public trust. It is absolutely essential that we do better in future if we are going to keep the public on board.

The report from the APPG on data analytics states:

“Key lessons from this failure are around data security and consent, and reinforce the need for proper public engagement in the development of data collection programmes, and gaining the right level of consent, if such consent is not subsequently to be withdrawn with major clinical and value for money implications. In the case of DeepMind, Dame Fiona Caldicott, the National Data Guardian at the Department of Health, concluded that she ‘did not believe that when the patient data was shared with Google DeepMind, implied consent for direct care was an appropriate legal basis’.”

There is a significant number of concerns and the issues are profound and difficult. We have a whole range of structures in place to try to deal with some of them, and I have huge respect for the Information Commissioner’s Office. The Information Commissioner frequently tells those of us who ask that office does have the appropriate resources. Given the scale and difficulty of the task, I must say that I find that hard to believe, because it is a very big task indeed. The hon. Member for Crawley mentioned the Centre for Data Ethics and Innovation, which is at an early stage. Frankly, it, too, will struggle to find the resources to meet the scale of the task.

I sat on the Bill Committee for the Data Protection Act 2018, which introduced the general data protection regulations. Some parts could have been strengthened. I tabled amendments that would have tightened up the assurance that research institutions must process healthcare data ethically for patient gain, but sadly, the Government chose not to adopt them. I hope that they might look at the issue again. A feature of the lengthy discussions in Committee, particularly in the Opposition’s observations, was that although the legislation is worthy, it felt like it was for the previous period, rather than the future, given the pace of change that we are likely to encounter. We were not convinced that it would keep up.

We need a much more radical set of safeguards. To stray slightly into the technical areas, when my local paper asked what my summer reading was going to be, it was surprised to hear that it was Shoshana Zuboff’s magnum opus, “The Age of Surveillance Capitalism”. It is a thought-provoking work and astonishing in the way she untangles the range of uses to which our data is being put every time we pick up our smartphone—or, in some cases, when we do not even turn it on. Many people are surprised to find that, far from being a phone, it is a tracking device. As she says, the question is not just who knows about us, but who decides what data is used, and who decides who decides what that data is used for. She talks about a shadow text, effectively; there is the data that we put on there and then there are all the connections that are made.

Staggeringly, huge amounts of information are being held about all of us that we do not have any access to—that we do not know about. At the moment, those companies consider that it belongs to them. We have to change that, because I think if it is about us, it belongs to us. That is a huge challenge, because if it were to happen, it would fundamentally challenge the business model of those hugely fabulously wealthy tech giants, which are hardly likely to give it up easily. The only way to tackle it, however, is through Governments and regulation. I hate to mention the issue of hour, but that is one reason, of course, why those companies dislike the European Union—because we need large organisations to counter the giant power that we face.

We have a fantastic opportunity, particularly with our national health service, which, as is often observed, has access to huge amounts of data that no other health system in the world has. In this country, we have the fantastic raw material and a fantastic data science industry. We have the expertise and the knowledge. We also, just about, have the good will of our citizens. We have a great opportunity, but we will need much tougher regulatory frameworks to unlock that potential in the right way. I fear that, so far, compared with what we have to do, we have merely been tinkering.

There are huge opportunities. I have raised a range of issues that go beyond the immediate ones. I hope that Parliament will find an opportunity to have those discussions in the period ahead. If I were asked whether we are in a position to meet the challenge, I would say, “Not yet.” I do not think it is impossible, but it will be difficult, so it is vital to start the discussion. I thank the hon. Member for Crawley for giving us the opportunity to do that today.

Photo of Lee Rowley Lee Rowley Conservative, North East Derbyshire 2:03 pm, 5th September 2019

It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate my hon. Friend Henry Smith on securing the debate. He is a doughty champion and campaigner for this area of public health policy. It is great to have the opportunity to talk about it and the innovations and where it can go in the long term.

I congratulate the all-party parliamentary group on data analytics for its sterling work on this important report, which brings together a substantial amount of work and demonstrates the possibilities for the country and the sector to make progress in the coming years. I also welcome the Minister to her new role and I look forward to the work that she will be doing in this and many other areas—hopefully for longer than the coming days. I hope to see her in her place for many years to come.

I welcome the debate because it is a massively important subject for our country and the health of our citizens. It is a pleasure to follow Daniel Zeichner, who highlighted some of the work that I have been involved in, in a tiny way, over the last few months. I thank the APPG for its kindness in allowing me and Darren Jones to do that. The commission that we co-chair, which looked into the importance of ethics in the aggregation of data and the use of technology, brought it home to me that we need to have more discussions such as this and that it is important for public policy to focus on these things.

I also welcome the debate because, for once, we are not talking about Brexit. It is a fantastic opportunity not to do that. I slightly regret bringing it up, but I will do it anyway. For me, this is the kind of debate that will be transformative for the people in our society and communities over the next 30 years. It will transform the royal hospital that serves my constituents in north-east Derbyshire and the hospitals in Sheffield, in the same way that automation, artificial intelligence, big data and machine learning will transform my local economy and the skills we need to teach in my local schools. If there had been more such debates, instead of the ones we have seen in the last few days, Parliament would have been in a healthier place in the last few months.

AI has the potential to be hugely transformative, as I saw as part of the commission. We need to look at it more, not just in healthcare but in education and elsewhere. Again, I congratulate the APPG on the report, which is a great start in the area of healthcare, but that is an area about which we have to be incredibly careful, as the hon. Member for Cambridge has eloquently outlined—much more eloquently that I can. Our population has trust in our healthcare systems and is willing, at the moment, to innovate in those areas, but those things are hard-won, are not particularly guaranteed and will be easily lost if we are not careful. The worst situation that we could end up with is one where there is huge potential in the area but we are unable to do anything because people do not wish it to be utilised or do not have confidence in it being utilised in the way they want.

I am pleased by some of the statistics in the report, particularly the level of confidence that is already there. Some 85% of people support in principle the use of artificial intelligence to move that area forward and 86% of people are willing to have their anonymised data shared. The hon. Member for Cambridge has already outlined, however, the challenge with that, because we may all like the idea of our data being shared as long as it is anonymous, but it is almost impossible to anonymise it. There are numerous reports that say that it takes only a few data attributes in the same area, even with a population dataset that is not particularly large, to retrofit them and work out where the data has come from and, ultimately, who the data points in it are. That is a challenge that we have to get over if we are to innovate, develop and utilise the technology.

Other aspects of AI’s use concern me greatly, such as security. We have to make sure that we consider security, whatever we are using AI technology for, whether in operations or additions to people. There is also a question about the development of the technology. We have a trade-off to make in which, as the hon. Member for Cambridge rightly said, the development will be judged and accelerated or decelerated by our appetite in this country for how we use data, what we do with it, what consent we have behind it and what the population are willing to do.

Countries elsewhere in the world do not have the same structures, rules, morals and ethics that we do in relation to the usage of data. We see that already in other areas. In China in particular the Government use personal data for the control of their citizens and people are incredibly uncomfortable with how that data is used. We have to create a framework around that. I am a small-state Conservative who believes in as little regulation as possible—not no regulation, as I believe in regulation where it is appropriate, but not in significant amounts. This is one area where, while I am not necessarily convinced that we need lots of regulation, we need to talk about what the regulation is and where we ultimately want to get to. The creation of the Centre for Data Ethics and Innovation is positive. I know the Government, the Secretary of State and the Minister are working hard on this subject, but we need to have more conversations about it. This is a great start. I really welcome the debate and the report.

I have a personal interest, too. My father had a double heart bypass a number of years ago, after a heart attack. Luckily, he came through that. He is now busy doing whatever he is doing today—decorating or whatever. He would not be here today without the innovations of the last 40 or 50 years. I want to make sure that other people’s dads and mums are here in the next 50 years, because of this kind of technology, so long as it is used properly. The APPG is doing sterling work in ensuring that that is the case.

Finally—not to go back to Brexit!—my last point is that we need more of this sort of debate, please, and less of what we have had in the last few days in the other Chamber.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 2:10 pm, 5th September 2019

I apologise to the Minister and all hon. Members for not being here on time. I was in the main Chamber, as I had a business question that I wanted to ask the Leader of the House. I apologise for my late arrival. I hope that everyone will be happy with me speaking, having arrived more than 10 minutes late.

It is a pleasure to speak on this matter. I thank Henry Smith for bringing forward an issue on which he and I are much in tandem in thought, deed and speech, as so often; today is another one of those occasions. It is also nice to see the Minister in her place. I promise not to ask any questions that will throw her off guard, as I did yesterday. That was not intentional, by the way; I just wanted to add to the debate. I hope to get a response on that question at some time in the future. No doubt, if we have the opportunity to have debates in Westminster Hall, the Minister will be in a position to answer many of my questions. I also thank the hon. Members for Cambridge (Daniel Zeichner) and for North East Derbyshire (Lee Rowley), as well as those who will follow me, for their contributions.

Mr Paisley, you know that I am not au fait with computer technology. I honestly cannot use a computer. My children can, and my grandchildren can, but this auld boy cannot. It is one of those things. When someone relies on the staff in their office to do all the computer work, perhaps they do not have to. It is only in the last few years that my colleague and hon. Friend Gavin Robinson, in this very Chamber, taught me how to text; I learned to text just over two years ago. So I have advanced greatly in my aspirations, although I suspect that others will say that if that is all I have done, I have not done very much!

I am not all that au fait with computers, but the presence of modern technology in science and medicine has saved billions of lives and can only be lauded, especially when it is matched with the brilliance of the human mind and human hands—the skill of the surgeon, the knowledge of the doctor and the care of the nurses. All those things coming together are a very important combination. Putting patients at the heart of artificial intelligence is what we are discussing.

The background information on the debate we received pointed out in its news section various articles in the media where the NHS and all those with health problems can see the benefits of artificial intelligence and healthcare. As the hon. Member for Cambridge mentioned, it can be used to tackle staff shortages. We can also use it to address and help those with kidney problems. That is an issue very close to my heart: my nephew had a kidney transplant, so the issue of kidney problems is real for me and my family.

Other articles note that artificial intelligence could “restore the care” in healthcare, that scientists claim to have developed the world’s first AI vaccine, and that smart tech can help people with dementia. How real that issue is in my constituency. Over this last period of time, I have noticed that many more people with issues with dementia and Alzheimer’s are coming forward to make me aware of their problems. It is a terrible disease to watch, as it greatly changes lives.

The role of technology is ongoing and vital to a vibrant NHS, but we can never be in the position whereby it overtakes a doctor who can act on experience hand in hand with their medical knowledge. We need to have both the human element and the artificial intelligence aspect working together as we move forward.

I welcomed the Government’s announcement of 8 August 2019, in which they outlined some £250 million of investment to help establish a national AI laboratory, which would sit within NHSX. That money is incredible. They also purposefully set aside money within that; the Office for Life Sciences has established five centres of excellence in digital pathology and radiology with artificial intelligence, supported by an initial £50 million industrial strategy challenge fund investment and a further £50 million to scale up funding from the Department of Health and Social Care.

The centres are working with NHS and industry partners. We cannot do anything if we do not have partnerships, one of which I will give as an example later on. Those partners include innovative small and medium-sized enterprises, and they are working to develop pioneering artificial intelligence-enabled pathology and radiology tools. We need the NHS and partnerships with universities and business to ensure that we can move forward and that we can all benefit.

I read an interesting article that highlighted the fact that medical imaging—where AI can be trained on thousands of scans—has led the charge. This is marvellous technology; clinical trials have proven that it is as good as leading doctors at spotting lung cancer, skin cancer, and more than 50 eye conditions from scans.

If we can advance medical expertise and knowledge, let us do that and encourage it. It has the potential to allow doctors to focus on the most urgent cases and rule out those who do not need treatment immediately, or identify where a minor treatment would do. Other tools have been developed that can predict ovarian cancer survival rates and help to choose which treatment could and should be given.

Diagnosis is, of course, important. Artificial intelligence has the potential to transform the delivery of healthcare in the NHS, from streamlining workflow processes to improving the accuracy of diagnosis and personalising treatment, as well as helping staff to work more efficiently and effectively. With modern AI, a mix of human and artificial intelligences can be developed across discipline boundaries to generate a greater collective intelligence.

I laid an early-day motion this week—I am not sure whether hon. Members have had a chance to look at it; I would encourage them to sign it. Mr Paisley, hailing from Northern Ireland, as I do, will understand its importance. It is about Queen’s University in Belfast, which is doing some fantastic work addressing cancer issues. The EDM says:

“That this House
congratulates all of those involved at Queens University, Belfast for its breakthrough early research findings on discovering a biomarker panel for ovarian cancer that may be able to detect epithelial ovarian cancer two years earlier than existing testing methods;
thanks those who work so tirelessly to bring about such a difference to lives of people throughout the globe;
and expresses pride in one of the foremost medical research universities in the world.”

Queen’s University is doing tremendous work, as are other universities. A number of my friends over the years have had ovarian cancer—I am sure others here will have also had that experience. Unfortunately, the diagnosis of ovarian cancer is often, “Go home and get your affairs in order.” There is a limited time to live. That work will hopefully predict ovarian cancer two years in advance of what we are able to do now, and is a fantastic, tremendous breakthrough. We welcome it. It shows that partnerships between the health service, universities and big business can make things happen.

As I said, I want to ensure that there is hands-on, human co-operation with AI methods of diagnosis, and another concern I have is safeguarding information. It is important that we protect people in the process. There are people who pride themselves on hacking information from Government services, just for the joy of knowing they have outsmarted them. There are also those who do it to garner information for nefarious use. We had a breach of information in this place that led to my staff’s home details being leaked, which we took very seriously. How much more serious would that be for vulnerable, ill people?

Any investment in AI within the NHS can go hand in hand only with top-level data protection and cyber-security, especially when we bear in mind that in May 2017—it will be real to many of us in the House, and indeed to almost everyone in Westminster Hall—the NHS was hit by a large-scale cyber-attack that disrupted hospital and GP appointments. It was high level, very disruptive and clearly down to someone intentionally disrupting what took place. It is a tight rope that we walk, and I believe that it can be walked. I ask the Minister to assure us that security is a priority in any use and sharing of patient data that is essential to the use of artificial intelligence in the NHS.

I believe we must move with the times and use all tools at our disposal to diagnose early, which allows more effective treatment, and we also need to ensure that our medically trained professionals are on hand and using the tools, and that they are not being replaced by such tools. In some of the futuristic films that we see—I am not sure whether anyone watches them—the robots take over. Everything happens. That is not a society that I particularly want to see. I want to see us working hand in hand with AI, and I want to see the human input into that. Finally, we need to ensure that all information is safely shared.

We recognise the investment by the Government. Let us not be churlish—the Government have made significant progress on this issue, which I welcome, but I also want to ensure that some of the things that hon. Members and I have brought to the Minister’s attention are responded to. I believe the investment by the Government will be money well spent, if we safeguard each aspect of it.

Photo of Lisa Cameron Lisa Cameron Shadow SNP Spokesperson (Mental Health) 2:21 pm, 5th September 2019

It is an absolute pleasure to serve under your chairmanship, Mr Paisley—I believe it is the first time I have done so in Westminster Hall, which is particularly pleasing to me. I thank everyone who has taken part in this excellent debate, and I particularly thank Henry Smith for securing it. I think the one thing on which we can have cross-party agreement is that the more debates we have in which Brexit is not the focus, the better. I am sure we could all go through the Lobbies to agree on that.

This is such an important debate, and I think the public and many of ourselves as MPs are just beginning to catch up with how important it is, which is why I am particularly pleased that the hon. Member for Crawley secured it. He linked technology, the NHS and artificial intelligence in such a detailed speech, and he chairs an important all-party parliamentary group. We can see that technological advances are saving lives on the frontline, which is tremendously important to people right across the United Kingdom. That is why we cannot over-focus on this issue. More and more debates will be about it in so many different domains, particularly in health.

The hon. Gentleman brought up an important issue: education of the public, which will be absolutely key going forward. It is such a crucial issue for us all to consider, because it is not just about medical and healthcare professionals becoming educated, and perhaps their training changing over time to incorporate all these new techniques and procedures, and about how the world is becoming much more digitalised, with 5G and so on coming on stream; it is also about public understanding and ensuring that the public are involved in their healthcare going forward, and that they are absolutely able to engage with it.

Like Jim Shannon, I am a real technophobe. It took me over a year to try to pay for things by tapping a debit card on machines in stores. Now, I love it. I probably do not even carry any money now, but at first I was so anxious that I would be walking about and having money removed from my bank account that I avoided using it. That is one of the concerns about the technology. It is about bringing the public and those of us who, unlike my own kids, have not grown up with such technology as the norm.

We have to get people on board and ensure that, across the lifespan, people can really benefit from the digital revolution that is happening, and that people do not become more isolated and left out of society because they are left behind. That is important for their physical health—monitoring prevention and so on—and for their mental health, in terms of feeling really engaged and involved in society. We have to integrate all this with the professionals in our healthcare settings, with the public being a key focus.

As has been said, artificial intelligence will be so crucial at every step of the patient’s journey. It will include prevention—we have already heard about some of the developments. There is some amazing work being done at Queen’s University Belfast on early prevention, detection of ovarian cancer—my goodness, how life-saving will that be?—and early interventions, not just for physical health, but for mental health. I am very keen for us to look at how we can engage more with AI and digital technology, perhaps in relation to depression, anxiety and how patients can monitor their mood, and at how technological advances can promote what we want to do: achieve parity of esteem for mental health services and physical health services. There is also treatment and recovery. It will be about prevention, early intervention, treatment and recovery, and the technology will be crucial at every step of the way.

I was pleased to hear Daniel Zeichner talk about developing standards, because everything in healthcare is about developing standards, best practice and guidelines, and that is what fosters the public’s faith in the work that we do. Our NHS is so loved right across the United Kingdom. When private companies bring their expertise in research and technology into such a beloved institution as the NHS, it is extremely important that the public have a sense of those companies’ remit and the sensitive nature of the data, that protection and security issues are addressed, and that standards are of the utmost importance for maintaining that.

Lee Rowley, too, spoke of the importance of security and international collaboration and research. Again, we have to think about other countries and how they manage data. We take part in lots of clinical trials—I am going to mention the EU, then move on to talk about, more broadly, the situation internationally. We have to look at developing standards commensurate with those of other countries, and we must at least know the limitations of the collaboration that can be undertaken when it involves our NHS and is about our patients’ data. He also mentioned his personal family circumstances and how important the advances have been for his own family and their healthcare. It is always very poignant to have that personal experience to bring to debates, and to speak about the impact that has made.

I looked around a few times just as I sat down, and I thought, “Why is the chair behind me empty, and where is the hon. Member for Strangford?” Then I turned round again a third time, and there he was. He never fails to take part in as many debates as possible in the House of Commons, and to ensure that his constituents are so well supported and their issues addressed at every step of the way. I am pleased that he recently learned to text, because it sounds like he is similar to me in being trepidatious about technology. Both our examples show why we have to educate the public and try to ensure that we all become up to speed with the technology. I mentioned the wonderful facilities at Queen’s University Belfast, where I was going to go and study before deciding to stay at Glasgow University; when I was training as a clinical psychologist, I had also applied to Queen’s. I could have gone to Queen’s if I had not gone to Glasgow, so I have always had a soft spot for it. I am delighted that its research is formative and will make such a difference.

From my experience of working in health, I know that computer programs managing data are very important, but the systems do not link up. For instance, health boards pay millions of pounds for systems that work for child services and for adult services, but the data cannot be transferred between the two. Children become adults, so how do we merge the data across their lifespan? Will the Minister look at that issue? For most people, transferring data seems commonsensical, but it is not happening in practice. Aligning it better would save a lot of money; we should not have to change systems that have already cost the taxpayer millions of pounds.

I was pleased to secure a debate on smart cities just before the recess, in which we talked about 5G. Driverless technology will enable ambulances to get to incidents much quicker when we have 5G technology and the next industrial revolution—this technological revolution—happens. I would be interested to hear from the Minister how 5G fits in with the issues we are debating and the advances that are being made. Where does she see the future lying?

I have spoken about this issue with some international delegations, particularly from Japan and China. We talked about the fact that technology and artificial intelligence have had an impact on social care. Robotics is being used in care homes—for example, robots can remind patients to take their medication. I would be interested to know a bit more about how we are linking to our international partners. We must collaborate safely in a way that enables patients in social care and the NHS to benefit from technological advances.

We have talked about how important this technology will be for surgical procedures. That was described very well. I agree wholeheartedly that there must be a partnership between robotic techniques and skilled clinicians. That is what the public wants, and that will always be the safeguard as we take these issues forward.

On the issue of prevention, smartphones and smart watches, technology has had a massive impact on reducing missed appointments in the NHS. Sending patients a text to remind them to come to appointments saves money and clinicians’ valuable appointment time.

Social media must be responsible when it comes to health. Through its technological advances, it is already playing a huge part, but young people in particular often get inappropriate information from websites that are not properly regulated. The large companies must take much more ownership of those issues. I have discussed these issues with Facebook and Twitter recently. There are sites that tell people how to develop an eating disorder or harm themselves. We must look at regulating them further. Will the Minister address their impact on mental health? Will she think about not just mental health treatments that we can develop through technology, but about how we ensure appropriate regulation is in place for sites not managed by our NHS or professionals and are causing harm to the public?

I am pleased to say that Scotland is to have its own £15.8 million AI health research centre based at the University of Glasgow. It will be a genuine collaboration between NHS research and other industries. We are keen to ensure that all partners are involved and that we can generate the very best practice in technology and healthcare.

Photo of Julie Cooper Julie Cooper Shadow Minister (Health and Social Care) (Community Health) 2:35 pm, 5th September 2019

It is a pleasure to serve under your chairmanship, Mr Paisley. I thank Henry Smith for securing this debate on a very important subject. I welcome the Minister to her place. I, too, am very pleased to be talking about something other than Brexit. I thank all hon. Members for their informed contributions, and I pay tribute to the hon. Members for North East Derbyshire (Lee Rowley) and for Strangford (Jim Shannon) for sharing their personal family experiences. As Dr Cameron said, that always adds poignancy to debates and keeps us rooted in reality. I thank the APPG on heart and circulatory diseases for its excellent report, “Putting patients at the heart of artificial intelligence”, which I thoroughly enjoyed reading. I learned a great deal from it.

This is a fascinating debate. When Charles Babbage created the difference engine in the 19th century, he could not have envisaged where modern computing would take us. We are living in a brave new world. We are in the midst of a technological revolution that is already massively transforming our lives. Artificial intelligence is already widely used at our airports and in our homes. Virtual care assistants are being trialled, and driverless cars will soon be a common sight on our roads. It would be strange therefore if we did not take full advantage of the contribution that AI can make to healthcare.

There are many different types of AI. I am not a scientist and do not understand all the complexities of AI—although I can text—but I do understand that it involves a computer equipped with a sophisticated algorithm capable of analysing thousands of sets of data. A computer learns patterns from the data and is able to make predictions based on it. The more data the computer has, the smarter it gets. Tasks that require extraordinary attention to detail, such as radiography, diagnosis, robot-assisted surgery, administration and many others, can be transformed using AI. The prospects are exciting. The ability to deliver early and speedy diagnosis and to develop personalised treatment plans is welcome in a health service besieged by unprecedented demand, long waiting lists and staff shortages.

AI is a game changer for the NHS and healthcare in general. The UK has the potential to be the world leader in digital-assisted healthcare. In our lifetimes, there will come a point when conditions like cancers and strokes can be pre-detected instantly from simple scans, enabling the patient to get the very best early intervention treatment. Only this week, researchers at Oxford University reported that they have developed artificial intelligence that will be able to detect, from a scan of an apparently healthy individual, heart attacks that are 10 years away.

We must be careful, however, in enabling this revolution. Technology is a double-edged sword, and for every monster it destroys, it has the potential to create one in its place, as my hon. Friend Daniel Zeichner reminded us. We must be grounded in reality. It is easy to get excited about a vision, but we must keep bringing ourselves back to what it means to real people, and what the potential dangers are. We must proceed with caution. Above all, we must ensure that AI is not something that is done to patients. We must proceed with an engaged and well-informed population. Legislation and regulation must keep pace with scientific innovation. No one wants to see unnecessary regulation. I note the points made by the hon. Member for North East Derbyshire.

It is absolutely vital, however, that the regulation is adequate and keeps pace. Above all, we must protect patient safety. We must act sensibly and legislate robustly, with proper scientific input to ensure that changes are to the benefit and not the detriment of patients. Patients must be kept at the heart of the changes and we must retain their trust, which, as other hon. Members have said, is hard to gain but easily lost.

If patients are to trust and fully embrace this revolutionary transformation of care, they need full explanations and to understand what is involved. People need to understand, for example, that artificial intelligence will not replace their GP with a robot, but will mean that a GP session may be recorded and transcribed by computer, which then produces a diagnosis. We need to pay special attention to the needs of the vulnerable, elderly and, in particular, the mentally ill. We must make it plain to patients that AI is not and never will be a replacement for human health professionals. It should always be clear that AI is not a means of providing health services on the cheap, but a way of enhancing diagnosis and treatments to assist, not replace, well-qualified health professionals.

There are obvious implications for data protection and the misuse of data. Although ideas such as allowing Amazon’s Alexa to use NHS 111 information to guide patients to the most effective non-emergency treatment are beneficial, the idea of inadvertently letting such companies have unfettered access to patient records, which they could use for other unconnected purposes, is clearly unacceptable.

We must ensure that patients know that our laws protect them from predatory companies. All data used in the NHS—even if through third-party contractors—must stay within the NHS. If we are to embrace this revolution, it must be patient-focused and not a market-centred approach. AI must improve life outcomes and not be used to sell diet pills in the name of healthcare. Patients and medical professionals must be properly educated in what AI will mean for them, and both should be involved as much as possible in the design process.

Artificial intelligence can bring many benefits, but its use in healthcare brings significant challenges. We have nothing to fear from embracing it, as long as all provision is properly regulated in a way that protects patients without stifling continued innovation—there is a fine balance. The key is to ensure that health professionals are involved in every stage of development and, most importantly of all, that the NHS ensures that patients are fully informed and engaged.

The APPG concluded:

“Meaningful, early and proactive engagement on how AI is used in healthcare is essential for effective implementation and sustainability.”

That is well put and I agree. Unless patients are fully engaged, AI will just not progress in the way that it could and opportunities will be lost. I hope that the Minister will outline the Government’s plans for implementing the report’s recommendations. Will she reassure us that the NHS will lead on this with all its resources, ensuring that patients are at the heart of this exciting new technology, and that all patients, irrespective of their socioeconomic background or personal ability to access technology, will be able to benefit?

Photo of Nadine Dorries Nadine Dorries The Parliamentary Under-Secretary for Health and Social Care 2:43 pm, 5th September 2019

It is a great pleasure to serve under your chairmanship, Mr Paisley. The debate has been really interesting, particularly in the light of the number of Members who stood up and admitted that, although they could not send emails, only recently learned how to text and do not use contactless payment cards, they were very much in support of the potential of AI technology and what it can offer patients, healthcare settings and the public at large.

AI is exciting and innovative. I have been in my Department only a few days and I have learned some more from this debate. I hope to have some answers for hon. Members, every one of whom gave an example of the exciting breakthroughs and areas of application of AI, as well as of what it can deliver for patients. That is incredibly exciting.

I thank my hon. Friend Henry Smith for securing this debate. He made the point about misinformation and fake news. We need more of these debates because Westminster Hall, and this place as a whole, is a good forum to knock down those myths, get rid of fake news and stop fearmongering about the use of AI, because journalists who are interested in AI will follow these debates and quote what hon. Members say. We should have more debates on this subject in future.

Artificial intelligence has the potential to make a massive difference to health and care. There are significant opportunities to save money, improve care and save lives. AI technology could help personalise NHS screening and treatments for cancer, eye diseases and a range of other conditions, as well as free up staff time.

Almost all health and care services can benefit from AI in some way, but realising its potential for our health and care system depends on the involvement of patients. We are committed to working with patients to ensure that they understand and are involved in the decision making about how we use AI to deliver the impact that we both want and need.

I will give a few examples of how AI is working. Some patients have already benefited from it, as hon. Members have highlighted. John Radcliffe Hospital in Oxford has developed a system that uses AI to improve detection of heart disease and lung cancer, as the shadow Minister mentioned. Currently, 20% of heart scans result in a false positive diagnosis, and the subsequent 12,000 unnecessary operations cost the NHS about £600 million a year. The potential financial savings are huge.

Another fantastic example of the use of AI is that of Moorfields Eye Hospital’s implementation of the DeepMind AI algorithm for retina scans. The AI can correctly recommend patient treatment referrals, to the same or better standard as world-leading doctors, for more than 50 sight-threatening eye diseases. Tens of thousands of scans were taken of people with both healthy and diseased retinas, and DeepMind developed software that could detect—long before a doctor could—sight-threatening diseases and the patterns that lead to them. That is just one example.

The use of AI goes further than just diagnostics. NHS 111 online, once fully implemented, will automatically triage patients by using AI technology. The system sends patients to the most appropriate care setting and reduces unnecessary A&E visits, meaning that patients can access the care that they need faster.

We must make best use of the available resources within the NHS to harness the full potential of AI, which relies heavily on enormous amounts of data to learn and become effective at its task. That data must be shared safely, however. Health data that is shared fairly, ethically and transparently has the potential to improve outcomes for patients, improve the efficiency and efficacy of the NHS, and underpin the next wave of innovative research taking place in the UK.

To help the NHS and researchers share health data in a safe, secure and lawful way, the Government have committed to developing a policy framework that sets out our expectations for how the NHS should engage with researchers and innovators when entering data-sharing partnerships. That builds on the work of the code of conduct for data-driven health and care technology. We are committed to involving patients and the public in the development of that policy. That is key and comes back to the point made by Daniel Zeichner. Patients must be at the heart of and engaged in projects, understanding how their data will be used in future and reassured of its safety.

To support the NHS in embedding the framework in practice, we will also set up a national centre of expertise. The centre will sit in NHSX and provide hands-on commercial and legal expertise to NHS organisations to support them in reaching fair, ethical and transparent agreements for data. Although AI has been the subject of much speculative reporting, on both benefits and risks, we know that it will bring big changes to the way in which care is developed and experienced.

While we promote the latest data-driven scientific advances in healthcare, we must always ensure that patient data is respected and properly protected. Data is vital to the delivery of safe and high-quality care, but we need to ensure that an understandable and trusted system is in place, which patients can be confident will protect their data. The Government are clear that patient data will only ever be used and/or shared when anonymised, or with the consent of the individual, unless for direct patient care. That is an important point and one that almost everyone made.

We have therefore put in place several safeguards, including legislation such as the Data Protection Act 2018, enacting GDPR; data and cyber-security standards applicable across the health and care system; and legislation that is under way to put the National Data Guardian on a statutory footing to provide an independent and authoritative voice on how data is used across the health and care system. We have also launched the national data opt-out, which gives individuals’ choice of how their data is used beyond their individual care. That gives patients choice, which is important.

In some instances, it will be appropriate for patient data to be shared for secondary purposes, such as when consent has been given on behalf of the patient, or there is an overwhelming public interest in sharing. The National Data Guardian is supporting work with NHSX to clarify and update guidance on the lawful use of patient data to support the understanding of the public, clinicians and industry. We do not want to hinder the progression of innovations, but all patient data should be handled with the respect and care that the public rightly expect.

We are also very aware of the ethical issues that can be raised by artificial intelligence at a personal, group and system level. Bias is a current common issue with the use of AI, and we must curtail any bias within algorithms by ensuring that the data feeding them reflects our diverse population and range of health economies. Initiatives such as DeepMind’s ethics and society research group and the Partnership on AI, which counts IBM, Microsoft, Facebook and Amazon among its members, show that industry is alive to the issues. We are already taking steps to ensure the safe development, deployment and use of AI, and the published code of conduct for data-driven health and care technology that I mentioned earlier encourages technology companies to meet a gold-standard set of principles to protect patient data to the highest standards.

NHSX announced that it would set up an “AI lab” to bring together the industry’s best academics, specialists and technology companies to build groundbreaking diagnostic tools and treatments in line with the NHS’s priorities. NHSX is delivering the Prime Minister’s grand challenge mission to use data, artificial intelligence and innovation to transform the prevention, early diagnosis and treatment of chronic diseases by 2030.

The NHS AI lab will harness the power of data science and AI to continue the UK’s great tradition of using evidence-based decisions in health, public health and social care, and to position the NHS as a world leader in artificial intelligence and machine learning. It will collaborate widely to identify impactful ways to improve the NHS through more sophisticated use of its data. Once identified, the lab will develop, test and deploy early-stage software solutions to be handed over to the NHS to implement at scale.

The operations of the AI lab will align to the core values of the NHS. Most relevant to this debate, the AI lab will protect patient privacy—to go back to the substantive concern expressed by the hon. Member for Cambridge in his speech. The AI lab will sit within the NHS and will protect patient data. It will also guarantee that the value of the healthcare data is retained by the UK public.

As well as ensuring that the technology meets the highest standards and sufficiently stringent regulation, we must ensure that the public are aware of that technology. The public must understand the principles well enough to be confident in a particular technology’s capabilities, irrespective of the statistical evidence supporting it. For the NHS to maintain the confidence that the UK public place in its brand, it must ensure that the apps and data-driven technologies that it recommends are examples of the best practice, not simply in transparency but in what they do and where the personal data goes.

There is now an opportunity for the UK to do that well, making the UK’s standards for MedTech an international benchmark, strengthening the position of digital health in the UK and enabling it to make great leaps forward. As I mentioned, the National Data Guardian and NHSX will work together to produce clarifications on the circumstances in which it is appropriate to share data. We recognise the findings of the “Putting patients at the heart of Artificial Intelligence” report produced by the all-party parliamentary group on heart and circulatory diseases and its calls for greater public engagement to avoid a souring of opinion on AI. We will continue to engage patients in the design and development of AI, where appropriate, and to raise the profile of the effectiveness and efficacy of using AI to provide health and care.

I will now go on to the points made by Members and their requests for reassurance. My hon. Friend the Member for Crawley asked how an NHS organisation investing in the new technologies would be rewarded. We are investigating how best to do that by engaging with commissioners, clinicians, business and academics. We will announce more detail in due course.

The hon. Member for Cambridge asked for an assurance that the additional NHS funding that has been announced will go ahead. Yes, the additional funding will go ahead, but we are still investigating how best to distribute it. My assurance to him is that, yes, the funding will be distributed. He himself highlighted the complexity of ensuring the fair distribution of such funding.

My hon. Friend Lee Rowley mentioned mitigating the risks. I hope that I covered that in my speech. A huge amount is going into mitigating such risks. For example, the Information Commissioner provides anonymisation guidance. I also refer to the points I have already made about NHSX.

The Scottish National party spokesman, Dr Cameron talked about mental health and patients. This morning, I heard about a great example of AI helping a patient suffering with dementia. It is being used to track normal movement and behaviours. When something different or unusual happens in the home to cause concern, an alert is sent out to a first carer who can be on the scene immediately. That is another great use.

The hon. Lady also asked what we were doing about 5G. I will not try to wing this one, but will simply repeat the answer that my officials gave me word for word: we are working closely with the Department for Digital, Culture, Media and Sport, which is leading test beds—is that right?—for 5G in Liverpool and Birmingham, showing how it can improve access to services and exchange of information between patients and clinicians.

The hon. Lady also asked about international collaboration. NHSX will engage with the World Health Organisation through the Global Digital Health Partnership, and the Medicines and Healthcare Products Regulatory Agency has a strong tradition of international engagement with both the US’s Food and Drug Administration and the European Union, which is key to solving difficult regulatory questions.

In conclusion, I reiterate that AI’s potential to transform the way in which we deliver health and care in the UK is huge. Advancements in diagnosis, treatments and prevention facilitated by AI will provide frontline NHS staff with more time to spend providing care to those who need it most. Through our involvement in the Prime Minister’s grand challenge, the AI lab and our work with the National Data Guardian, we will raise the profile of AI as a health and care project, and ensure that the public are fully aware of both its benefits and the expectations they should place on the NHS.

In the last few seconds, would my hon. Friend the Member for Crawley like to wind up?

Photo of Henry Smith Henry Smith Conservative, Crawley 2:59 pm, 5th September 2019

Thank you very much again for your chairmanship, Mr Paisley.

I sincerely thank the hon. Members for Cambridge (Daniel Zeichner), for Strangford (Jim Shannon), and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), my hon. Friend Lee Rowley, and the Opposition spokesman, Julie Cooper, for their contributions to this important debate. I congratulate the Minister, and I welcome her to her well-deserved position.

The key word I heard was “trust”, and as we go forward with AI, we need to instil that for patients.

Motion lapsed (Standing Order No. 10(6)).