Healthcare at the Edinburgh Festival

Last year, the Wellcome Foundation inaugurated a programme at the Edinburgh Festival called The Sick of the Fringe (#TSOTF16) to explore some of the boundaries and synergies between the worlds of medicine and the arts.  Healthcare is a major issue in Scotland; barely a day goes by without an article in the national press about the impending obesity, stroke or heart attack crisis and the effect it will have on healthcare provision.  In the second year of TSOTF it was interesting to see whether it had started to have an effect.  There certainly seemed to be some progress in the way new writing tackled healthcare issues.

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Smart Meter Update

“Hello, this is the British Electricity Smart Meter hotline.  You are number two million, four hundred and sixty eight thousand, two hundred and twenty three in a queue.  We’re sorry your smart meter has disconnected you and that you have no electricity.  We are working to upgrade the firmware in all of our smart meters and hope to have your power restored sometime in the next six months.  Thank you for your call.”

It’s the scenario that no-one in the energy industry wants to talk about – the day that Britain’s smart meters go wrong or get hacked and millions of users lose power.  It will probably never happen, but some things have such appalling consequences that we shouldn’t design and deploy something that makes even that small probability possible.  But we have.  And nobody appears to have thought about making sure it’s possible to recover from it.

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The Barriers for Digital Health Startups

It’s over forty years since the first personal wireless telecare products came to market.  Over the years, along with many others, I’ve been writing about their potential and the opportunity they present to save healthcare costs and by extension, our healthcare systems.  Five years ago, many of us got excited when the Tricorder Prize was announced, with the promise of a Star Trek-like device that would diagnose multiple conditions being demonstrated by 2015.  That deadline has now slipped to 2017, but it’s not stopped a plethora of new healthcare devices being announced in the meantime, helped along by the twin vogues of crowdfunding and lifestyle.

So where are all of these digital health devices?  If you visit a hospital or GP, they’re mostly noticeable by their absence.  Startups are coming and going with ever greater rapidity, whilst healthcare costs grow relentlessly.   What is stopping digital health devices fulfilling their potential?  At the recent Future of Wireless International conference, I chaired a session with speakers from within the medical device community and working at the sharp end of healthcare, who shared their views about the challenges.  It was one of the most brutally honest and candid discussions I’ve come across, which deserves to be heard by anyone entering this market.  So here is a precis of their essential advice for any digital health startup.

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Brexit – a Tragedy of Shakespearean Proportions

Last Friday, many of us in the UK woke up to discover that our world had changed.  Despite every poll indication to the contrary, the country had voted to leave the EU.  There’s an irony in that vote – Tory ministers repeatedly berate our education system for not putting enough emphasis on Shakespeare.  The result showed that they have no room to talk, for as Coriolanus would have told them, the people have resoundingly spoken with the yea and no of general ignorance.

The question is, what now?  It has been a particularly nasty campaign, devoid of facts and based on the basest of emotions as rhetoric sank to the lowest common denominator, dividing friends and family in a manner which I have never seen before.  Truth has been a casualty, as has Jo Cox.  There is no question that many, assured by the polls that the result would be a vote to remain, took the opportunity to vote against the Government, attempting to bloody the eye of what is almost universally seen as a disconnected posh elite.  They were shocked to find that rather than pecking the eagles, the crows had ripped out their own eyes on Friday morning.

So what now?

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Squirrels, Grid Security and a Stuffed Rudd

Probably the most effective way for any terrorist group or belligerent power to cripple a Western nation and bring it to its knees is to destroy its electricity grid.  Without power, most of the infrastructure will crumble into chaos within a few weeks.  Manufacturing would come to a standstill, along with healthcare, transport, banking, mobile communications and retail.  That was seen in Iraq, where 70% of the generating capacity was destroyed during the Gulf war, in what has been described as a crime against humanity.  At that time, grid destruction relied on physical means – dropping bombs on power stations and sub-stations.  As we integrate more electronics and software into the grid, you no longer need expensive munitions to blow things up – terrorists can do it from a computer.

It’s two years since I last wrote about the cybersecurity issues within the GB smart meter rollout.  At that time the response from the industry was dismissive.  In the past six months, three things have happened which bring the risk back into focus.  We’ve seen the first major grid cyber attack in the Ukraine; secondly, smart home owners with Nest thermostats have discovered that firmware updates can stop them operating and the third is that reports have come in of smart meters in the UK which have stopped working.  None of that means our grid is going to be hacked tomorrow, but they all point out that what has been dismissed as impossible may not be quite so difficult as the industry and DECC would like to believe.  Despite that, heads are still firmly in the sand as the UK Government continues to press ahead with a smart metering programme that is not so much climate-friendly as terrorist-friendly.

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Smart Power, Smart Meters and Smart Batteries

This week saw the launch of a new report entitled Smart Power, which investigates the future of our electricity supply.  It comes from a new body – the National Infrastructure Committee (NIC), and highlights the hole in supply caused by the planned closure of two thirds of our existing power stations by 2030, providing recommendations on the changes that they believe are required to ensure security of supply.

Unfortunately it’s promoted itself using the old trick of highlighting its major benefit as saving consumers money, with the headline press message suggesting it could deliver them savings of up to £8.1 billion per year in 2030.

I wish that the sector could get over its fixation with these spurious claims, so that we can focus on the real problem, which is the lack of a joined up energy policy.  The “savings” in this report aren’t what a consumer would expect a saving to be, which is lower prices, but instead a potential reining in of cripplingly higher prices which would result from doing nothing.  In other words, if we spend a bit more to increase bills now, we might not have to spend a lot more as a result of a further decade of dithering.  It reminds me of the protection rackets of gangster Chicago, where shopkeepers were forced to pay off mobsters to prevent having their businesses destroyed.  Why the energy sector wants to continue with its amateur production of “The Resistible Rise of Arturo Ui” escapes me, but that’s clearly who the commission’s chair, Lord Adonis, is modelling himself on.  Cauliflowers all round…

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