ARCHIVE: first published by Open Democracy, September 2015
UPDATE: Tim Kelsey is now head of Australia's Digital Health Agency.
Tim Kelsey, the NHS’s man for all things data and digital, has had it in the neck a lot recently. Could this be why he is off to Australia to work for telecommunications giant, Telstra (more on them below)?
As the driving force behind the expensive, error-strewn care.data programme, Kelsey was always going to be a controversial figure. People are rightly concerned that this vast database of all our medical records, which was sold as benefitting the health service, would also be of huge commercial value to pharmaceutical companies, private health insurers and others.
A 2014 paper by Kelsey’s old employer McKinsey adds weight to the idea that the intention was always to commercialise our data. The paper reveals that one of the ambitions for care.data is to create “Product lines of data insight available to “customers’”. “Is there a product and a matching customer,” it asks, and “what are they interested in knowing?”
Pharma seems to be rubbing its hands at the prospect. A 2013 PharmaTimes conference called ‘Unlocking the meaning of NHS Open Data for your Company’ included a session on ‘Using Patient-level Big Data in the Sales and Marketing Department’. The event, which included advice for local pharma sales teams, promised to "unlock the benefits for your business" from access to patient data.
Kelsey got the backs up of privacy campaigners with his approach to patient consent and data security. His vision has been to “get the data out there”, regardless, it seems, of who uses it and why. He insists that if we want public services, it’s our duty to make our private data ‘transparent’ (transparent to whom, campaigners ask).
Like many huge NHS IT projects before it, care.data has now been given a ‘red light’ by the government’s major projects oversight body - meaning its successful delivery appears to be ‘unachievable’. The Health and Social Care Information Centre recently raised serious objections over care.data, too.
But, the legacy Kelsey has bequeathed to the NHS goes much, much broader than care.data.
He has also been a very busy man at NHS England, where he was one of only eight National Directors running the NHS.
Kelsey has been creating a consumer market for digital health services and products in the NHS. Things like ‘digital primary care services’ is what is going to take the strain off the NHS, he tells us. There are now, for example, ‘kitemarked’ apps that are designed to help patients manage health conditions. Health Secretary Jeremy Hunt is fully supportive, regularly proselytising about ‘21st century healthcare’ that will be ‘personalised’, ‘digital’, ‘transparent’, ‘24/7’, and ‘in the right place’.
What does this actually mean? Take the latest innovation from Ali Parsa (the man who gave us Hinchingbrooke). His NHS-accredited venture Babylon Health, plans to launch an artificial intelligence powered diagnosis tool for consumers to use on their i-Phones within a month. It is predicted to fail to diagnose accurately and could increase the workload of GPs. Serious concerns are being raised (in the US at least), about the value and safety of such tools. The hugely lucrative market mobile health services has been dubbed a ‘Wild West’.
It was not Kelsey’s job to heed such warnings, however. His role has been to build the UK’s market for digital health products and explicitly ‘drive growth for the UK’.
In this, he has been helped by his partner’s communication’s firm, ZPB. ZPB are well-connected – they partner the elite Cambridge Health Network (set up by a McKinsey director to ‘network’ elite NHS leaders with the private sector). They work closely with Kelsey’s old firm Dr Foster – editing their ‘Good Hospital Guide’, and using their data to promote the idea of ‘virtual wards’ in conjunction with private firms like Healthcare at Home.
In 2013 ZPB was commissioned by NHS England to help organise and run events to ‘stimulate the market’ in health technologies in the UK, at which Kelsey spoke. The NHS told us (in response to our Freedom of Information request) that ZPB was hired by NHS England’s ‘strategic systems and technology directorate’, although ZPB’s Alex Kafetz, wrote that the firm had been ‘commissioned by the NHS England patients and information directorate’ - which Kelsey heads.
Besides (possibly) hiring his wife’s firm to build the UK’s nascent health tech network, Kelsey has spent a long time hanging out with a global technology industry that is chomping at the bit for a bigger role in the delivery of healthcare around the world.
Which has no doubt helped recommend him to Telstra.
Telstra is Australia’s equivalent of BT and the country’s third biggest company. Like BT, it wants a slice of the huge global healthcare market. According to The Australian, Telstra has ambitions to turn its health business into a ‘serious revenue generator’, and a ‘billion-dollar-a-year business’. For example, a piece of ‘thought leadership’ published in 2012 with KPMG, described how Telstra is ‘harnessing its innovative capabilities to bring telehealth to the wider community.’
Telstra launched its healthcare division, Telstra Health, in spring 2013 to tap into the telehealth/eHealth market – think digital patient records, online prescribing, and ‘healthcare at home’ via phone, internet, ‘apps’ and other gadgets. It’s potentially hugely lucrative – the eHealth market is predicted to reach $26 billion globally by 2017. At the helm is Shane Solomon, former head of health at KPMG Australia.
In September 2013, Solomon and David Thodey, Telstra’s then CEO, came to Europe to visit ‘established eHealth organisations’ – including the NHS. Introductions were made by Mark “the NHS will be shown no mercy” Britnell, also of KPMG (who had been a Director at Kelsey's Dr Foster at the time it won a heavily criticised deal with the Department of Health).
Britnell wrote: ‘I shall let [Tim Kelsey] know that it would be worth a meeting given the importance of Telstra and their focus on healthcare.’ He copied in then NHS chief executive, David Nicholson to check his availability.
Kelsey met with Telstra the following week.
By December of that year, Telstra had secured the rights to provide Dr Foster products and services in Australia.
Fast forward a year to January 2015 and Kelsey was back meeting with Telstra to talk ‘data services’. In the NHS? In Australia? Who knows.
A month later, NHS England announced the nine ‘consortia’ of approved ‘commissioning services’ suppliers - who will from now on determine how and where a huge chunk of the NHS’s budget will be spent.
Dr Foster is a supplier to a third of these consortia.
A month later, Telstra bought Kelsey’s old firm Dr Foster outright for a reported £20-25m.
Telstra, through its acquisition of Dr Foster, had just entered the NHS market.
A few weeks later, Kelsey jetted off to Australia to discuss all things digital with leading Australian investors Mooroolbark Group, private hospital group UnitingCare Health, and his old employer, McKinsey. He also took part in a Health Roundtable of (mystery) attendees to discuss data and technology policy; attended Australia 3.0, which appears to be about ‘driving the innovation agenda’ to help Australia’s business compete; as well as ‘Code for Australia’.
It is not clear who has benefited more from these and other meetings: the NHS, Telstra, or Kelsey.
In May he was back down under discussing digital innovation with, you guessed it, Telstra.
And now, with the summer behind us, he is leaving the NHS to become Telstra’s commercial director.
With Telstra now an established supplier to the NHS, some might see it as a reward.