Babylon – a beguiling curse?

‘Your merchants were the great men of the earth, because all the nations were deceived by your sorcery’ – Revelation 18:1-24

The bedrock of general practice – and indeed the NHS itself – is that all of us will need healthcare at some point in our lives, most of us will not need it for most of our lives, and if everyone contributes via their taxes when they are earning none of us should be left without adequate healthcare when we need it.

This means those who are in need are supported by those who are not, in the wisdom that sooner or later those who do not need help will do. If only with the coming frailty of old age, and all we have to do to know that is live long enough.

NHS funding is predicated on this simple wisdom. Most GP patients do not need to see their GP, and GPs are given funding per head on that assumption. Those relatively few patients with complex health needs thus have that care funded by the contributions for those who do not currently need it – in the wisdom that sooner or later, they most certainly will.

Any system that siphons off the relatively healthy patients – and their funding – might, you would have thought, have been transparently wrong. That would leave GPs with dwindling funds to care for those patents with the most demands. A one-way process to neglect that is both unfair and corrupt. You would have thought wrong.

Babylon Healthcare is offering GP consultations via a smartphone with their ‘GP at hand’ service. Patients who register with this service are de-registered from their current GP. Which on the face of it simply transfers patients between GPs. But imagine if a frail, elderly patient with complex health needs were to be taken to a new GP, asked to register – and was refused. No grounds given. Then a young, fit patient from the same current surgery walks in  – and is welcomed. Wouldn’t anyone suspect the new surgery was filtering out patients who were likely to have greater healthcare needs? Would anyone regard that as acceptable?

Yet that is what Babylon healthcare (set up by Ali Parsa founder of Circle) is doing. It will be delighted to take on your care unless you are:

1. Women who are or may be pregnant
2. Adults with a safeguarding need
3. People living with complex mental health conditions
4. People with complex physical, psychological and social needs
5. People living with dementia
6. Older people with conditions related to frailty
7. People requiring end of life care
8. Parents of children who are on the ‘Child at risk’ protection register
9. People with learning difficulties
10. People with drug dependence

i.e. you have to be healthy and only those with increased health needs are left with the GP who will have lost the capitation fees for the healthy people who have transferred. Which is unsustainable. Which, of course, fits perfectly with the view that this government – in allowing schemes like this to undermine and weaken our NHS – has privatisation at the heart of its agenda.

It is wrong. It will always be wrong. It needs to be stopped.

Peter Trewby
Treasurer, DFNHS