Bye Bye Babylon

Overhyped by Hancock...and by me

Here are a few things to be wary about when assessing a young tech company. If the Health Secretary hails its product as “revolutionary” start worrying. If the CEO says its mission is “to put accessible and affordable healthcare into the hands of everyone on earth”, sound the alarm over such hyperbole. And if the company appears in a BBC Six ‘O’Clock News report as an example of where AI is heading, then run for the hills.

The company I am talking about is Babylon Health which went into administration this week to the surprise of, well, nobody. It has been heading downhill fast ever since that quote from the CEO Ali Parsa in 2019, which came as Babylon raised new funding at a valuation of more than $2 billion. Matt Hancock’s boosterism for the company now looks ridiculous, and as for that BBC reporter who put the company on the news with its whizzy AI diagnosis tool, well I’m afraid that was me and I should have known better..

In 2021 Babylon arrived on the New York Stock Exchange via one of those complex SPAC manoeuvres which never seemed to end well, and promptly lost 90% of its value within a few months. The shares have been virtually worthless since May and now have been delisted by the exchange .

After that report on the Six O Clock News, I did soon begin to have doubts about Babylon. Its chatbot , which was supposedly able to perform better than GPs in an exam, was slammed as dangerously inaccurate in its diagnoses by a persistent critic Dr David Watkins.

The GP at Hand service, giving patients who left their regular NHS surgery easy access to a video appointment with a doctor, did appear genuinely innovative. But by creaming off young professionals and leaving the more costly elderly patients to the traditional GP it was always bound to run into political difficulties. In any case, was a programme that would have to employ more and more expensive doctors as it grew ever going to be much of a moneyspinner?

But it was a call I took in the early months of the Covid-19 pandemic from a Babylon insider which really opened my eyes. Why, he asked, was a company which aimed to be a global healthcare leader taking advantage of the government’s furlough scheme to lay people off? Surely this was a time when a pioneer in remote treatment and the use of AI in healthcare should be growing ? The answer, said the whistleblower, was that the furlough scheme was being used not as it was intended as a job retention scheme but as a convenient and cheap way to downsize a business where the sums did not add up.

As I had suspected the GP at Hand service did not scale - the more patients it took on, the more likely it was to lose money - the chatbot was a bit of a gimmick and the whole focus was now on selling rather ill-defined AI products to American insurance companies. What was even worse was the atmosphere inside the company - “dissent is not tolerated and is crushed. Criticism of the leadership on slack is censored, critics are reprimanded, all leading to a toxic atmosphere of fear and sycophants.”

By the Spring of 2022 Ali Parsa himself was confirming that Babylon was struggling to make money from the NHS and was switching its focus to the US. Now a plan to restructure the business and return it to private ownership has fallen through, the money has run out, and the hunt is on for anyone that will take on GP at Hand which still has 100,000 patients on its books.

So what should we learn from this disaster? Not, as some campaigners will say, that no commercial business should be allowed anywhere near the NHS. There was some good solid work at GP at Hand on giving patients a flexible and approachable service. Many users loved it and love is something that rarely comes the way of hard pressed NHS surgeries.

But the fall of Babylon is more evidence that there is often little substance behind the hype about AI in health. The wider tech sector is full of big personalities making outrageous claims about changing the world and sometimes that pays off - but when it comes to health a more serious and sober approach is needed.