Amazon and the NHS: taking us into the future, or 1984?

The below was written for The Confederation of British Surgery, who aimed to develop a politically agnostic piece to generate interest for its members – surgeons across the United Kingdom.

Read the original on their website here.


1984 – Pete Majarich

Irrespective of party politics or where one stands on the election results, it is no less than shocking that the country was last week apprised that, as part of a contract with the Government, Amazon has been given free access to healthcare information collected by the NHS.

While the Times, in breaking the story, revealed that the material excludes patient data, this action could allow the multinational technology company to make, advertise and sell its own products. More disturbingly, responses to freedom of information requests demonstrated the contract will also allow the company – which is worth $863bn USD and is owned by the world’s richest man – access to information on symptoms, causes and definitions of conditions, and “all related copyrightable content and data and other materials”.

The online retailer is the world’s largest online marketplace, AI assistant, and cloud computing platform, which in recent years has expanded its subsidiaries to include film and television production and distribution; publishing; and AI software.

Among various controversies, Amazon has been criticised for their technological surveillance overreach; a hyper-competitive and demanding work culture that can be seen as harmful to its employees; tax avoidance; and anti-competitive practices. It is therefore with good reason that the contract is being judged by some as irresponsible, as it will enable the company to create “new products, applications, cloud-based services and/or distributed software”, which the NHS would not benefit from financially. It can also share the information with third parties.

While the issue is complex and the response has been divided, some surgeons have expressed concerns about the research they have conducted being potentially misused by the tech giant – and the tech community’s response has not provided significant reassurance to either the medical community or to the British public.

According to Berlin-based tech expert Mathana Stender;

“The sensitive data holdings of a national healthcare provider like the NHS are a form of ‘critical social infrastructure’, yet they’ve been handed to a foreign company that’s both a defence contractor and targeted advertiser.” 

NHS GP David Wrigley asked whether the questions asked via Alexa would be encrypted and who would store any data relating to patient queries.

While the New Scientist’s deputy news editor Jacob Aron called the “fuss” “ridiculous,” stating “It’s just a Google search you talk to, and at least people will get NHS [information],” there are many in the tech community who believe that it may be – at least on first glance – controversial and potentially harmful.

Still others have warned that Amazon is known to have major ambitions in the healthcare industry, and it is not yet known what kind of precedent this contract will set. According to WIRED UKhowever, just because patient data isn’t currently being sold, doesn’t mean it won’t be a possibility in the future.

Finally, there is concern about whether this will in fact reduce the pressure on NHS workers – who may have to manage more serious complications in the event of misinterpretation, misdiagnosis or patients’ failure to follow up in-person where necessary – or whether the advice delivered by AI might be accessible, or appropriate, for all patients.

CBS welcomes Surgeons’ opinions on this issue – join the discussion and make your voice heard on Twitter and Instagram at @UKSurgeons, or by joining us on the LinkedIn page. 


CBS Blog December 2019