Nat Wei: To make lockdowns a thing of the past, we need a smart revolution in healthcare

26 Jul

Lord Wei is a Conservative member of the House of Lords. He is a co-founder of Teach First, a social entrepreneur, and a former government adviser.

Enough is enough. We need to start planning not to go back to the pre-pandemic normal, but for a different world in which we seek to both maximise our freedoms, but where lockdowns can really become a thing of the past, or at least become very unlikely or unnecessary.

Why have we put ourselves in a situation in which our economy, education system and healthcare service shuts down the moment we are at risk of filling 30 thousand beds? Surely it would be better to move diagnosis and treatment of healthcare problems away from hospitals, so that we can get scanned and diagnosed from the relative safety or our houses, porches, or high streets, and indeed to have specialist centres for minor operations, leaving hospitals to be the places where only the most sophisticated and complex operations take place.

To get to this point will require rethinking our system, with perpetual trials offered to citizens to test the latest technology (and even some treatments) in the home or nearer to it, to more quickly identify what is wrong with patients (something which can take many half or all day trips to A&E currently or video or other calls or weeks waiting for GP appointments).

We also need incubators based in centres adjacent to hospitals similar to those in Israel where these technologies and systems are able to be rapidly prototyped, developed and tested, including those in hospitals themselves to help make pathways and operations faster, safer, and less costly to manage.

And finally we need to have a special embedded agile group of healthcare workers, a kind of Teach First force for the NHS front line if you like, whose job as trained medical care workers and nurses would be be to find novel, better ways of organising our health better, starting with supporting us all in more imaginative rather than coercive ways to eat, sleep, and exercise better, to manage our own health and lifestyle rather than outsourcing it to A&E, and to problem solve where bureaucracy or ignorance is getting in the way of good, responsive treatment.

With such a force we could also simulate daily or weekly the next pandemic, or drone attack, or climate disaster, and rehearse drilled solutions before they happen rather than belatedly and on the fly.

All of these measures would not just build longer-term resilience, but help cut down the huge waiting lists now and into the future, and save money at a time when we will need to manage our finances very carefully, as well as avoid future lockdowns due to the bottleneck of NHS and social care capacity.

To have three lockdowns is regrettable, but to go through three winters knowing we may have to shut the country to save the NHS is unacceptable. Despite the success of our vaccination programme we are not out of the woods yet. Thousands of viruses are out there waiting to leap into humans as we expand as a human race into territories historically only occupied by animals, whose diseases we haven’t adapted enough yet to be immune to.

There remain variants that could develop in the young unvaccinated and in less well vaccinated countries which can partially evade our current individual and herd immunity, both of which are not yet perfect. And then there are other asymmetric threats that could fill our hospitals as our climate changes and geopolitics continues to causes tensions.

It would be wise now to be prepared and get ahead of the curve rather than assuming this was just a one off, and just hoping for the best as we approach each new winter. Only this way can we preserve our freedoms while enabling our healthcare system to adapt and bounce back stronger.

Nat Wei: Ministers need to prepare now for the next sudden crisis – and trust people more as they do so

12 Jan

Lord Wei is a Conservative member of the House of Lords. He is a co-founder of Teach First, a social entrepreneur, and a former government adviser.

Readers of my blog and ConHome will know that I have been a big advocate for using the crisis that is upon us to build a more resilient Britain – given that there will be many twists and turns both with the virus, and the many other shocks ahead as the climactic, geopolitical, and online environment convulses in the years ahead.

As a party, we will need to adapt to a world beyond politics as usual; as a newly sovereign nation again, we will need to use our new freedoms to pivot, and as a world we will need to become more resilient, and learn that the last nations standing will be the winners.

So what can we do to get ready, and how could the Prime Minister and the Government facilitate this shift from dealing with the immediate emergency, helping get the country out and back out the other side, ready for the next asymetric shock ahead of us? How can we, having had our Dunkirk and being now, as it were, in the midst of the health equivalent of the Battle of Britain, get ready for the rest of the war and get back on the front foot?

First, we need to get the messaging right. It should be based on studies with prisoners of war that show those that survived best were given neither false hope, nor a message of doom, but realistic expectations.  What we will face will take time, indeed years, to overcome – but overcome it we eventually will.

Saying the pandemic will be over by next Christmas or the summer is setting ourselves up for a fall. All it would take would be a new harder still to treat variant, or some non-health shock such as a war or unrest, to knock us off course. Better to let people know that we need to adapt to the new reality, and start the journey to learning to live with the virus, even once vaccinated.

Second, we need to reform the NHS. At present, we have a National Covid Service, but regular healthcare, as we have known it, is not really functioning. We need to create a new layer of home-based and mobile van unit-based healthcare on demand, shrink the larger scanners and machines that we keep in hospitals to eventually even become the size of a smartphone, and enable consultation, tests, and even treatment to happen either remotely, or away from hospitals, so that we can get waiting lists down.

We need to further empower our heroic front line workers and patients to self-manage as much as possible away from the bottlenecks we have seen that occur all too often in the NHS machine. And we need a Nurse First recruitment programme, to develop the agile on the ground leaders of our future decentralised healthcare ecosystem – one that can help reduce the need for people to have to go to hospital, and go beyond the bureaucracy to find resources from private, civic, and other channels to help prevent and treat illnesses proactively, holistically, and innovatively.

Oh, and we should break up the replacement for Public Health England, and create more move-on accommodation and key healthcare worker housing near hospitals or on hospital grounds – increasing capacity now before the next winter peak comes.

Finally, we need to trust people more, and stop looking to politicians, ministers, and even government to always have the solutions. There is a dangerous trend during this emergency to hand over draconian powers to those in charge, which is in one sense understandable – we are in effect at war right now – but we have not got effective mechanisms in place for the rest of us to suggest, test, and scale up solutions that can pick up the slack where government cannot presently help.

How can we make online learning more effective, so that state school pupils and families have connectivity and equipment and can create truly compelling online experiences for students, rather than trying to do what has been done face to face online, which doesn’t always work (like running a TV show like a radio disc jockey)?

How can we enable more government services to operate remotely and yet securely. (Word on the street is that it is still impossible to get a new national insurance number from DWP)?

How can we enable Parliament to meet virtually not just through Zoom, but in more interactive ways that more adequately recreate the peer to peer connectivity that we used to have when meeting physically?

If the Government admitted that there are areas in which it needs help, and created with business and civil society more environments with those of us on the front line to incubate solutions, we might be able to get ahead of the curve more – especially in matters that need addressing six, 12 and 18 months ahead, beyond the day to day short-term news cycle and immediate health emergency.

We have been able to move so fast to come up with the vaccine, harnessing collective efforts beyond government.  We can do it in these many other areas as well.

We need to build back stronger, literally so we can be more resilient to future shocks. We need to stop thinking normal will ever truly return – at least the one we knew in 2019. We are in a different operating environment now. With more agile institutions, more far-sighted planning, and a greater involvement of non-government and private actors, we can get through this, just as we have got through previous crises, whether during world wars or terrorist attacks.

To my fellow Conservatives and to the Government: harness the wisdom that is out there, and let your colleagues in and beyond Parliament help you, rather being tempted to think we are here to hinder you. Gather suggestions and ideas, and encourage challenge, like John F Kennedy, Churchill and others before them. And together we will come out of the other side ready for anything.

Nat Wei: Forget moving Parliament to York. It should go fully virtual and innovate to save money.

24 Jul

Lord Wei is a Conservative member of the House of Lords. He is a co-founder of Teach First, a social entrepreneur, and a former government adviser.

There has been a lot of talk about sending Parliament to York, as a means to reconnect with the public. While it is only right to review the cost of moving Parliament out for refurbishment, my sense is that moving to York is actually not radical enough given what we now know is possible – having moved to hybrid sittings as a result of Covid-19.

Shifting to York, a fairly affluent city in the North, would be costly, at a time when the country can little afford it. Whether it will allow people to feel closer to their politicians is not clear.

What might be better, cheaper and more radical would be to enable Parliament to meet virtually using future technologies such as augmented and virtual reality, wikis, breakout lobbies and Committee rooms that the public can visit, observe and participate in.

These technologies will mature in the coming five years or more, and will be much cheaper to implement than a temporary or permanent move to elsewhere in Westminster, York, or anywhere else.

In fact, why not go a step further and harness this opportunity for the Mother of Parliaments to find new ways to engage the public – not just every five years or through the mob that social media can currently represent, or even through petitions?

Why not use this season to accelerate, incubate, and innovate around concepts such as mass participatory budgeting, or betting with real or fake money on what policy ideas will work, or on mass legislative amendments clearly marked with explanations by those in the country and those who need to convey what they think the impact of law and legislation might have on their industry, geography, or lives?

Such lawtech or regulationtech could in turn be harnessed to enable other countries, places and movements to experiment with democracy in different forms, whether representative or direct, whether by seeking to explore whether ideas would be popular, or whether give those ideas a high probability of succeeding or not.

Data, where shared, on whose predictions and votes were actually accurate or prescient, indicating a high degree of judgement, could highlight which citizens might do well to become MPs or peers in future, rather than just relying on the current party selection processes which can be too much of a closed network at the best of times.

Where the private sector has established what are called prediction markets, where – say – employees at a firm bet on the quarterly sales figures of that company weekly or monthly, the market overall learns over time to get to within about two per cent accuracy.

Imagine how many billions could have been saved if there had been such a prediction market in place when Gordon Brown or another leader claims to be able to use tax credits to halve child poverty by 50 per cent by 2020?

Imagine if some of the funds saved could be used to establish low-cost smartphone and Internet-of-things-based ways of assessing if policy actually worked after it has been implemented – so we can all make smarter decisions in future, and learn in real time even where ideas haven’t worked.

Moving Parliament full stop physically could be a costly mistake.

Let’s go online, and have revolving pop-up events around the country if you must (Foster and Partners modular pop-up Parliament concept previously submitted might be modified to enable this) but accelerate the development of the technology so that we can get as close virtually to really being physically together as much as possible.

By using bottom-up innovation this wouldn’t need to cost more than £50 to £100 million to develop. It would certainly cost many, many billions less than moving everyone to York or somewhere else and back.