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World

What the Babylon scandal tells us about the British government

30 October 2023

5:00 PM

30 October 2023

5:00 PM

One of the consistent themes of Dominic Cummings’s kamikaze mission to reform the machinery of the British state was that we urgently needed more politicians with backgrounds in science, maths and engineering, and fewer with 2:1s in PPE.

As he argued, the latter sort (see also: historians like Dom, classicists like Boris Johnson and pompous English graduates like me) are very well equipped to get themselves into a position of power, what with their networks of university chums and ability to produce plausible bullshit to a deadline. But once they get there they are out of their depth amid problems that require systems thinking, numeracy, the ability to weigh probabilities, technological literacy and so forth. Reality being, as a rule, less forgiving than a hungover Ancient History tutor, and vibes being a less good guide to it than a close-up understanding of how stuff actually works.

Wouldn’t it make sense to say an absolute no to letting private companies mark their own homework?

I don’t find myself in agreement with everything Dom Cummings has said or done (who does?). But on this particular issue, I think he may have been onto something. And if the collapse of Babylon Healthcare isn’t what’s sometimes called a ‘teachable moment’ in this regard, I don’t know what is.

Babylon what?, I hear you ask. Well, quite. You’ve never heard of this company, but it’s had £22 million of your money over the last three years. It promised to use the wonders of AI to ‘revolutionise healthcare’ and create a ‘doctor in your pocket’: a chatbot that would diagnose patients better and faster than any human doctor (thus taking pressure off waiting lists). The then health secretary Matt Hancock (PPE), known to have a fanboyish weakness for anything involving an app, was particularly smitten. He even wrote gushingly for Babylon’s advertorial supplement in the Evening Standard (then editor: George Osborne).

Babylon picked up a number of NHS contracts. It was allowed to ‘self-declare’ that it met the NHS’s standards (spoiler: it didn’t). And when someone who knows about medicine tried to point out that the supposed AI miracle worker had a record of diagnosing a heart attack as a panic attack or an ingrown toenail as gout, the company dismissed him as a troll.


Long story short, the ‘AI’ wasn’t AI (the original backend for the doctor in your pocket was an Excel spreadsheet of standard if/then medical decision trees, and they consistently oversold its subsequent improvements). The whole thing was eyewash, or AIwash if you prefer, and after briefly parlaying its supposed track record in the NHS into a US stock market valuation of $4.2 billion (£3.5 billion), the company has gone phut and been sold off for scrap for less than £10 million.

It seems, from where I’m sitting, that the whole sorry and dangerous story is a symptom of arts graduate politicians being idiotically dazzled by the idea of technological miracles and prepared to take any old rubbish on trust if the two letters ‘AI’ are involved. Because, y’know, vibes. (In fairness, I should add that Dom Cummings himself also seems to have been a bit taken in, serving as an advisor to Babylon in 2018.)

If I can be forgiven an aside, I think there’s another conversation here to do with the wisdom of outsourcing quite so much tricky stuff to the private sector without much oversight. Ideologically speaking, the right loves doing this and the left hates it, but my point isn’t an ideological one: clearly we quite often have to. And clearly the way we’re doing it leaves a certain amount to be desired.

It’s currently being reported, for instance, that the jaw-dropping overspend on HS2 may have been made much worse by the company building it deliberately underestimating projected costs again and again, so as to get the green light for the next bit. (This, they deny, and who am I to disbelieve them: but something seems to have gone wrong somehow.) When a whistleblower warned the government this seemed to be happening, apparently, Matt Hancock (gosh: him again) waved it away by saying forecasting this sort of thing was always ‘complex’ – our old friend government-by-vibes.

The vibes are, we should note, sometimes further muddied by the friendliness of these companies. The Babylon people, and their investors, reportedly donated about a quarter of a million pounds to the Conservative party and had 17 meetings with government ministers. And we’ll remember, too, the many many companies during the Covid pandemic whose chumminess with ministers found them nudged into the VIP lane to supply protective equipment whether or not they had any experience whatever in the field of medical procurement.

Remember that bloke who was friends from the pub with (my word: him again) Matt Hancock?

So, how do we prevent this sort of thing happening over and over again? Obviously not putting Matt Hancock in charge of anything except eating kangaroo bums ever again is a good start, and one we seem to have made. We can share Mr Cummmings’s hope for some MPs for whom statistics, computer code and the like don’t have the awe-inspiring power of Elvish sigils in a Tolkien adaptation.

But failing that, wouldn’t it make sense to say an absolute no to letting private companies ‘self-declare’ (ie mark their own homework)? Would it not be possible to get civil servants with surveying and engineering expertise to go through the numbers before rather than after some arts grad minister signs off another vast chunk of public cash on the next leg of a public infrastructure project? And to make it an inviolable condition of getting any government contract to build tech that fully salaried HMG civil servants with suitable technical expertise be given unfettered access to your source code to check your app is what you claim it is?

If ‘commercial confidentiality’ makes that unacceptable, and an NDA won’t satisfy you, fine: go sell your revolution to someone who’ll take your boosterism on trust, and good luck to you. But there again, I’m an arts graduate so what do I know?

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