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The Guardian - UK
The Guardian - UK
Business
Phillip Inman

If you let Google have your data, why not the NHS?

The NHS app visible on a phone screen held in someone's hand
Health secretary Wes Streeting is anxious for people to use the NHS app to streamline service provision. Photograph: Kirsty O’Connor/PA

The government will need to intrude into people’s lives more than ever to cope with spiralling demands on the state’s finances. In the transition to greener technologies, the need to track who is emitting carbon and where they are doing it will only intensify.

Last week’s announcement by the mayor of London, Sadiq Khan, that he is employing more people to monitor cars coming into the ultra-low emission zone (Ulez) to make sure they are fined is another example of big brotherism that his counterpart in Manchester, Andy Burnham, decided Mancunians would not countenance.

The tracking of Britain’s vehicles is a matter for agonising discussions among Whitehall officials, who want to oversee a switch to electric cars, but know that if they are successful much of the £25bn paid each year in fuel tax, and the 20% slice of VAT applied to fuel sales, will be lost.

When electric cars dominate, the chancellor will need to find an alternative source of income, and that may have to come from the satellite surveillance of zero-emission vehicles, and not just in London. If this direction of travel is inevitable, the 7p-a litre increase in fuel duty expected in the budget on 30 October could be a last hurrah.

The same imperative applies to the efficient use of public services, which is another troubling subject for civil servants. They want to reform the way services are delivered and welfare is paid against the wishes of large minorities that object to, or want to avoid, state surveillance.

Health secretary Wes Streeting needs everyone to have a smartphone and the NHS app to streamline services that are costly when provided in the analogue world. Streeting is also wrestling with acute staff shortages, and better use of technology will help him overcome that. If UK households offer their information to the NHS in the way they do to Google et al, health service provision could be cheaper and more effective. And the health service could be a testbed for a national ID card that allows for the digitisation of more areas of government, reducing costs and tackling fraud.

Keir Starmer has shied away from a discussion about the impact of digital communications on a population that treasures a (false) sense of liberty from fending off government intrusion.

Instead, he has disturbed libertarians by accepting the Tory sugar tax and backing Sunak’s proposed ban on the sale of cigarettes, which was included in June’s king’s speech.

Starmer, like Tony Blair before him, is not from the libertarian wing of social democratic thinking, and for understandable reasons. Both of them want to control people to make sure they do the right thing. Starmer has shown how far he is prepared to go down this road with support for a ban on smoking outside pubs and restaurants, where there is scant evidence of harm to others, but good evidence of harm to the user.

What would help would be a government that made more of an attempt to both promote the state as a worthy and safe recipient of individuals’ digital information, and mounted a defence against data intrusion by the private sector.

As my colleague Martha Gill wrote last week, the main aim of companies, from the newest startups to major multinationals, is to get us all addicted to their products. It is the private sector that wants to use and manipulate digital information much more than the state could ever conceive of doing.

They are developing the most sophisticated ways to entice us and keep us buying again and again, soaking up our disposable income and all too often making us either physically or mentally ill. Starmer might have a difficult time taking on the food industry, or even the gaming industry, when these are economic bright spots. That doesn’t mean he shouldn’t try.

Britain is very good at the marketing and sale of things that are bad for us. The food industry is by far the largest sector of the manufacturing industry, generating more employment and income than car making.

Dr Chris van Tulleken, the author of the bestselling book Ultra-Processed People, is among an increasing number of experts with lots of evidence to show that a growing number of sophisticated marketers, using all the digital leverage available, can to get us hooked in a way that is bad for the individual and the economy.

At the moment we are drifting into an era when we allow private sector control while shunning government attempts to navigate a digital future.

Sadiq Khan’s Ulez experiment is a halfway house. The government should sell the idea of going all the way. It’s all coming down the track – cybercurrencies and artificial intelligence. We need to allow governments, and not Google, to control it.

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