Imaginaries of AI in the NHS implications for data justice in healthcare

Rorison, Isobel 2025. Imaginaries of AI in the NHS implications for data justice in healthcare. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

The NHS generates some of the richest longitudinal health datasets in the world, across a diverse population, collected from cradle to grave. Government and industry argue that access to this data is key to the UK’s technological and industrial futures. As citizens’ personal data moves beyond the remit of their healthcare providers our understanding of the potential opportunities and risks must be recalibrated. This research looks beyond the often-normative concerns presented of a binary trade-off between privacy and commercial exploitation in discussions of harnessing NHS data. A multimethod approach is employed to consider what the pursuit of social, economic and geopolitical goals through the capitalization of NHS data will mean for citizens. This research combines: a) an examination of the political economy of healthcare data to expand our understanding of the common goods offered by a turn to AI in healthcare; b) an analysis of government policy to highlight the drivers and motivations behind the socio-technical imaginaries of healthcare data in the UK; and c) a case-study of the introduction of AI into NHS radiology services to detail the implications of the operationalisation of these policies. The analysis draws on qualitative document analysis and interviews with 19 experts in the field. I detail how health data is being transformed into both a public good and economic resource, highlighting the tensions between these roles in the perception and implementation of datafication. Questions of justice permeate, concerning rights, equality, democracy, and the distribution of financial benefits. These activities rely on speculative and unsubstantiated assumptions of their power to improve healthcare, drive economic growth and compete in global AI markets, reflecting broader socio-economic agendas that prioritise technological solutions to social issues. By expanding our understanding of the issues at stake for citizens, alternative imaginaries of healthcare data and AI become possible.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Journalism, Media and Culture
Subjects:	H Social Sciences > H Social Sciences (General)
Date of First Compliant Deposit:	29 May 2025
Last Modified:	29 May 2025 12:57
URI:	https://orca.cardiff.ac.uk/id/eprint/178562

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