Bethany Morris explores the consequences of failures in healthcare tech, from vulnerable key workers to limiting COVID-19 infection

This article on healthcare technology was written by a correspondent for the Immigration Advice Service, an organisation of immigration lawyers in the UK and Ireland that is currently offering free legal advice to all NHS staff amid the coronavirus pandemic.

In the centre of Wuhan where COVID-19 first emerged, cases have topped 80,000 and the death rate stands at 3,285. As the spike in confirmed cases and deaths slowly begins to decrease, one hospital’s reliance on artificial intelligence to provide relief to staff and patients may present the answers that countries across Europe are racing against the clock to seek.

Inside the hospital, Cloud Mind Robots patrol the hallways, monitoring patient temperatures and flagging those at risk, measuring heart rates and blood oxygen levels, administering medication and cleaning infected areas – highlighting failures in healthcare tech in other States. Many patients have even enrolled in exercise classes led by the automated care givers. As Bill Haung, the CEO and founder of CloudMinds states, “robots do not carry diseases, and robots can be easily disinfected”.

Such points are irrefutable, and suggest that during times of international health crisis, the deployment of automated care givers may help to relieve the strain on frontline staff whilst protecting their health and well-being, and that of patients too. With the UK Government advocating the replacement of migrant care workers with care bots, so far investing around £34 million to the cause, is the shift towards an automated health service beneficial to patients and staff alike, or does it present more problems than it does solutions?

Immigration limitations for care workers

In January 2021, the UK’s new immigration system will come into force, seeing workers who earn less than £25,600 denied entry to the country. In 2018, the Office for National Statistics found that 1.9 million people were employed in the UK healthcare system with around 6% being EU nationals. A vast majority of these work in the care industry with an average salary of just £16,000 per year. Under the new immigration system, care workers will not be eligible for a General Work Visa and are offered no alternatives, unlike NHS staff who may marginally benefit from the NHS Visa.

The assistant general secretary of UNISON, Christina McAnea, fears these plans will “spell absolute disaster for the care sector” with figures already estimating that the industry could face losses of 460,000 workers.

With such drastic staff shortages paving a clear pathway for the rise of automation, implementation appears to be somewhat of a doubled-edged sword. Although care bots would plug the workforce gap that the immigration system will leave, such shortages needn’t exist if the system could focus on maintaining jobs. The failures in healthcare tech include the failure to consider pre-existing workers. In short, the gap will be filled, but EU nationals will unnecessarily pay the price for this at a time when their work is more valuable than ever.

If we do see a rise in AI in healthcare, what are the advantages?

Broadly speaking, AI comes with various benefits that wouldn’t otherwise exist in human workers. No need for food, sleep, lunch-breaks or concerns over a lack of availability; care bots are essentially a bottomless, non-stop workforce leaving humans dispensable and at the mercy of our own needs.

Ara Darzi, a surgeon and former health minister, has called for “full automation” of “repetitive tasks” in the UK’s health and care services. Such a move could see the NHS free up to £12.5 billion of staff time and generate a £6 billion productivity gain. The Institute for Public Policy Research (IPPR) has claimed that robots in the care sector can help residents “get out of bed, to wash and dress, to eat and drink” and assist “with mobility and social engagement”. Although on a physical level, automated care givers will have no issue in attending to the needs of humans, one over-arching issue is the concern over a lack of empathy. In a system with empathy at its core, this presents a whole host of issues and with tasks that require emotional intelligence, context and a rapport with patients, technology may fail to live up to the human standard of care.

However, care bots like Pepper, a four-foot automation of a human being, may help to alleviate the concerns over AI’s lack of empathy. In Tokyo at the Shin-tomi nursing home, Pepper uses a screen on his chest to perform everyday gestures, tell interactive stories and engage in basic conversation, all whilst allegedly “recognising the principal human emotions and adapting his behaviour to the mood of his interlocutor”. The robots’ ability to detect its user’s mood and suggest activities and games appropriate these emotions may be good news for those with mental health issues, particularly the elderly, with the Mental Health Foundation estimating that around 22% of men and 26% of women aged 65 and over suffer with mental illness.

Last summer, Prime Minister Boris Johnson announced £250 million towards the use of AI in the NHS. This February, the Home Office solidified the move, instructing employers to “adapt” to a future of automation as a supplement to cheap EU labour.

Such investment and advocation for AI has caused a political divide in the UK, with MPs such as Yvette Cooper expressing concern that the rise in automation will lead to millions of job losses, with more than six million workers already fearing that their livelihoods will be lost and their positions replaced by automated workers. Another concern is the number of women who may find themselves disproportionately impacted by the implementation of care bots. According NHS Employers report ‘Gender in the NHS’, 77% of the workforce are women and statistics from PwC estimate that female workers could be most affected by automation over the next decade.

COVID-19 and failures in ethical technology

As the UK moves from suppression to mitigation to control the spread – and panic – of coronavirus, should we begin to implement the use of AI to stamp out the virus?

In Israel, the MI5 equivalent are beginning to trace those it suspects of having the virus through their phones. In Singapore, “enhanced surveillance” is being used to screen all patients with pneumonia and those with a suspect infection in hospitals, and phone apps such as AliPay and WeChat have allowed the government to track citizen movement and even grade their health; the colours yellow, green and red were used to do this, which would determine if people were permitted to cross check points. To some, these measures are a dystopian nightmare, but to others, they offer peace of mind and an extra layer of armour to help battle the pandemic. With concerns over breaches of privacy, biased algorithms, job losses and a lack of empathy in care, do the pros of AI outweigh the cons at a time of international crisis?

Although implementation of healthcare tech offers a dynamic and measured approach to revolutionising healthcare, perhaps greater consideration is needed for vulnerable workers before a balance can be struck between the maintenance of certain roles and the automation of others.


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