Should we radically change the way money is spent on the NHS? 

Given the sainted nature of the institution and the precept that all care should be free at the point of delivery, little is likely to change any time soon. But the question of how the money should be spent could come under severe scrutiny. 

Put to one side the idea that there are simply millions of pounds to be delivered through efficiency savings; there may be some money but it won't be enough to alleviate the considerable pressures that will be brought to bear by a growing population of older people with increasingly complex medical needs. 

Nor is it likely that spending will increase through more taxation, at least not by much. Spending could keep pace with inflation but it's never likely to lap it. So, the present opaque postcode lottery will continue in some form just out of reach of reasonable scrutiny. 

The answer may be simpler: early intervention, diagnosis and treatment. 

We know that with most serious conditions early diagnosis increases the chances (not the certainty) of a positive outcome (the patient lives). The problem is that human behaviour being what it is, too many of us put off any medical intervention until the potential cost is massive and the likelihood of a positive outcome much reduced. 

But if we, as citizens, were obliged to be screened by AI for likely life-threatening conditions early (noting that algorithms can detect anomalies earlier and more successfully than humans in many cases), then a shift to early intervention could significantly reduce pressure on both health and social care budgets. 

Such a move would need effective communication and consent; communication to ensure that citizens understood the risks and benefits and consent because this would be skirting the edge of totalitarian thinking. 

How might it work? 

Imagine all adults were screened annually for a range of leading indicators of future disease. This could be done via nurse or physician associate-led consultations. This might be supplemented by data already held by tech companies via smartwatches. Following assessments and via GP practices (the funding for which would be bolstered via the resultant savings in secondary care, hypothecated in the first instance), patients (who might be totally unaware of the emerging threat to their health) would be treated early. 

The aggregated information would enable health leaders to understand trends, clusters and as a result better plan how to use the scarce medical and care resources. It would also enable them to understand emerging threats and to advise Government on potential changes in the regulatory environment that might also help to keep people as healthy as possible. 

One benefit of a nationally mandated programme would be to better guarantee an intervention likely to result in better health rather than a place on a waiting list. We already know that early diagnosis without early treatment simply increases the level of personal anxiety with no change in medical outcome. 

Of course, there would be a trade-off; citizens would have to surrender a great deal of personal information that is currently considered private. But the truth is that tech companies are already able to predict our healthcare conditions based on analysing our internet searches, social media posts and purchases. Facebook, according to Israeli historian Yuval Harari, knows more about us than our spouses. 

Another fly in the ointment will be the insurance sector which may want access to this data, enabling them to better understand risk. For some, this could mean lower premiums while for others (where serious and untreatable conditions are unearthed) the premiums could become unaffordable or even unavailable. 

Citizens armed with information about their actual present and future health conditions could then alter their lifestyle, diet and risks as a way of improving their own life chances. Those who given such insight continue to ignore the lessons might need to be additionally coached and supported. 

The Government, in the spirit of openness, would produce regular state of the nation health reports looking at the data, the healthcare sector's response and lessons which would enable further improvements in the way that health and social care money is spent – its own annual health check-up. 

If you have a left-shift view to share please contact l.peart@hgluk.com