Sunday, 18 February 2018

Children living the Good Life and a Computer that says 15 are Born every Minute

It was 34 years ago when I moved from Wales. At the time I had a small holding and for 10 years, I lived the John Seymour dream. It was a time before we had mobile phones, computers and electric self-driving cars. John Seymour was the Father of self-sufficiency and in 1976 published his guide to making it happen. It became my bible. Billy my parrot (now aged 22) once had a go at chewing the books spine, but despite the damage he inflicted, it is still one of the most precious books in my collection. During those years I learnt to milk goats, make cheese, use a chainsaw, keep and breed chickens, grow my own veg, and surprisingly rear peafowl. I also became a proud Father to 4 of my 5 children. They also got to live the John Seymour dream. They chopped wood, plucked the Christmas turkeys, and thrived on a 101 variations of meals where the central ingredient was runner beans.

They also went to school there and were taught in Welsh and English. I didn’t, and like some kind of post-colonial dinosaur, I only learnt a few words of Welsh. ‘Mae hyn yn wisgi dirwy’ – ‘this is one very fine whiskey’ (try Penderyn if you don’t believe me) and ‘Diolch yn fawr ’ – ‘thank you very much’. There may have been some odd curse words I picked up along the way, but they are now long forgotten. I was drawn to this memory last week as I listened to the debate on the radio about the stalled Northern Ireland Assembly (‘Tionol Thuaisceart Eireann’) talks. The sticking point appeared to be the recognition of the Irish language as an official language. The debate was all about dual language road signs, teaching children using the Irish language in schools, the unwarranted expense and so on.  The arguments for and against sounded very familiar to those I had heard in Wales all that time ago. Unfortunately, now as then, there is very little evidence to really support either side’s assertions. I guess a case of watch this space. After so many achievements it’s sad that no progress appears possible.

I thought it was also sad that another area of great progress, the development and use of technology in health care had also got such a bad press recently. It stemmed from a claim made by Professor Harold Thimbleby, Professor of Computer Science at Swansea University in a lecture he gave with Professor Martyn Thomas, a visiting professor at Aberystwyth University. They claimed that more than 900 deaths a year in the NHS could be attributed to poor technology. It was a claim that was challenged last week by Will Smart, Chief Information Officer, Health and Care in England, NHSE. He noted that the professor’s paper did not draw upon systematic research that might show a causal relationship, but appear to have relied on US data on preventable deaths, which was then extrapolated to the UK. At the very best this is poor science. There are too many variables that would need to be taken into account before one could have confidence that technological system defects and inefficiencies are as likely to cause serious injuries or deaths as other preventable adverse events.

The NHS looks after more than a million patients every day. The demand for health and care services is not abating. Arguably, new technology, particular advances in digital applications, are making it possible to keep meeting these increasing demands, and maintain patient safety and the quality of care provided. The evidence of digitisation is that it reduces drugs errors, improves continuity of care and saves lives. Last week the Journal of Medical Internet Research published a review of the literature (from the last 5 years) that showed a strong link between health information technology being harnessed and improved and positive clinical outcomes. And if you want to see some really good examples of such improvements go to the NHSE GlobalDigital Exemplar web page.

The other area health information technology has helped us is in providing us accurate and contemporaneous data on what is happening across health and care services. The wonderfully named Public Health England Syndromic Surveillance Summary, published every week keeps us informed of all kinds of changes. I now know for example, that last week GP consultations for Scarlet Fever rose, and are above seasonal norms, whereas GP consultations for flu are decreasing. NHS 111 continued to see a rise in calls about sore throats, particularly for those aged 5 -14 years old. However, the most unsurprising set of data released last week also came from NHSE. They noted the romance of Valentine’s Day (last week apparently) leads to a ‘mini baby boom’ 9 months later. It was the first time they had published such an analysis, which showed that conceptions over this week are 5% higher than any other time of the year apart for Christmas. However, the analysis also showed that the passion was short lived. Two weeks later, conception rates reach an annual low! But last week, NHSE officials declared that the analysis proved ‘love is most definitely in the air’ or as they say in Wales ‘cariad yn sicr yn yr awyr’.