Technology | The Guardian

About 10,000 writers including Kazuo Ishiguro, Philippa Gregory and Richard Osman join copyright campaignThousands of authors including Kazuo Ishiguro, Philippa Gregory and Richard Osman have published an empty" book to protest against AI firms using their work without permission.About 10,000 writers have contributed to Don't Steal This Book, in which the only content is a list of their names. Copies of the work are being distributed to attenders at the London book fair on Tuesday, a week before the UK government is due to issue an assessment on the economic cost of proposed changes in copyright law. Continue reading...

Social media company tells MPs of continual fight against state-backed efforts, with Russia being most prolificElon Musk's X said it had suspended 800m accounts over a 12-month period as it fights the massive" scale of attempts to manipulate the platform.The social media company told MPs it was continually fighting state-backed attempts to hijack the agenda on its network, with Russia the most prolific state actor, followed by Iran and China. Continue reading...

Lawsuits come after Pentagon labeled Anthropic a supply chain risk', a decision the company says is unlawful

Nscale's AI project still in use as depot ahead of pledged completion date - with planning permission filed after Guardian's inquiries

Exclusive: Rented datacentres and supercomputer' site that's still a scaffolding yard raise questions for Starmer's push to mainline AI into veins of economy'

AI feature generated offensive posts about Diogo Jota and the Hillsborough and Munich disastersLiverpool and Manchester United have complained to Elon Musk's X after the Grok AI feature made offensive posts about Diogo Jota and the Hillsborough and Munich disasters.The posts were generated when users asked the AI tool to make hateful posts about the two football teams. Continue reading...

Standoff with DoD over Claude chatbot reignites debate over how AI will be used in war - and who will be held accountableUntil recently, Anthropic was one of the quieter names in the artificial intelligence boom. Despite being valued at about $350bn, it rarely generated the flashy headlines or public backlash associated with Sam Altman's OpenAI or Elon Musk's xAI. Its CEO and co-founder Dario Amodei was an industry fixture but hardly a household name outside of Silicon Valley, and its chatbot Claude lagged in popularity behind ChatGPT.That perception has shifted as Anthropic has become the central actor in a high-profile fight with the Department of Defense over the company's refusal to allow Claude to be used for domestic mass surveillance and autonomous weapons systems that can kill people without human input. Amid tense negotiations, the AI firm rejected a Pentagon deadline for a deal last week, in a move that led Pete Hegseth, the defense secretary, to accuse Anthropic of arrogance and betrayal" of its home country while demanding that any companies that work with the US government cease all business with the AI firm. Continue reading...

New research suggests tech behind AI platforms such as ChatGPT makes it easier to perform sophisticated privacy attacksAI has made it vastly easier for malicious hackers to identify anonymous social media accounts, a new study has warned.In most test scenarios, large language models (LLMs) - the technology behind platforms such as ChatGPT - successfully matched anonymous online users with their actual identities on other platforms, based on the information they posted. Continue reading...

The long-running series in which readers answer other readers' questions ponders the hypothetical reactions of eminent historical personages to today's Trafalgar SquareThis week's question: which are more like life, novels or films? If William Shakespeare - or Florence Nightingale, or Attila the Hun, or Julius Caesar, or Jane Austen, or Pocahontas - was dropped in Trafalgar Square, London, what would they find most unusual? And how would we explain it to them? Giles, SuffolkSend new questions to nq@theguardian.com. Continue reading...

Exclusive: Witchcraft, spirit possession and spiritual abuse' offending typified by sexual abuse, violence and neglectChatGPT is driving a rise in reports of organised and ritual abuse, UK experts have said, as survivors of satanic" sexual violence use the AI tool for therapy.Police say organised and ritual abuse, and witchcraft, spirit possession and spiritual abuse" (WSPRA) against children, is under-reported in the UK. There is no modern-day charge that covers it specifically, but such offending is typified by sexual abuse, violence and neglect involving ritualistic elements - sometimes inspired by satanism, fascism or esoteric religious beliefs - to control victims. Continue reading...

The CEO said he cut the company's workforce by 4,000 people - almost in half - because of gains in AI productivityMark remembers the first time he wondered whether he was teaching Block's AI tools how to do his job - and maybe even replace him. He was at his fintech company's extravagant anniversary party last September. As executives led a presentation on the productivity benefits of a new internal AI tool, Mark, who worked in the product department, discussed his worries with colleagues. While he wasn't sure what would happen in a few years, he told a co-worker sitting next to him that for now, there was no way the technology was so advanced that it could move the business forward without employees like him to help drive vision and strategy.These AI tools were not proactive. He had to tell them what to do. Block still needed him, he thought. Continue reading...

Tech policy professor who served in US air force explains how a feud between an AI startup and the US military illuminates ethical fault linesAnthropic's ongoing fight with the Department of Defense over what safety restrictions it can put on its artificial intelligence models has captivated the tech industry, acting as a test of how AI may be used in war and the government's power to coerce companies to meet its demands.The negotiations have revolved around Anthropic's refusal to allow the federal government to use its Claude AI for domestic mass surveillance or autonomous weapons systems, but the dispute also reflects the messy nature of what happens when tech companies have their products integrated into conflict. The Pentagon this week declared Anthropic a supply chain risk for its refusal to agree to the government's terms, while Anthropic has vowed to challenge the designation in court. Continue reading...

Iran's targeting of commercial datacentres in the UAE and Bahrain signals a new frontier in asymmetric warfareIt is believed to be a first: the deliberate targeting of a commercial datacentre by the armed forces of a country at war.At 4.30am on Sunday morning, an Iranian Shahed 136 drone struck an Amazon Web Services datacentre in the United Arab Emirates, setting off a devastating fire and forcing a shutdown of the power supply. Further damage was inflicted as attempts were made to suppress the flames with water. Continue reading...

The intensified use of artificial intelligence, and rows over its control, demonstrate the need for democratic oversight and multilateral controlsNever in the future will we move as slow as we are moving now," the UN secretary-general, Antonio Guterres, warned this week, addressing the urgent need to shape the use of artificial intelligence. The speed of technological development - as well as geopolitical turbulence - is collapsing the distinction between theoretical arguments and real world events. A political row over the US military's AI capabilities coincides with its unprecedented use in the Iran crisis.The AI company Anthropic insisted that it could not remove safeguards preventing the Department of Defense from using its technology for domestic mass surveillance or autonomous lethal weapons.The Pentagon said it had no interest in such uses - but that such decisions should not be made by companies. Outrageously, the administration has not justfired Anthropic but blacklisted it as a supply-chainrisk. OpenAI stepped in, while insisting that it had maintained the red lines declared by Anthropic. Yet in an internal response to the user and employee backlash, its CEO Sam Altman acknowledged that it does not control the Pentagon's use of its products and that the deal's handling made OpenAI look opportunistic and sloppy".Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here. Continue reading...

Platforms include YouTube, TikTok and Instagram as communication minister says our children face real threats'Indonesia will ban social media for children under 16, its communication and digital affairs minister said on Friday.Meutya Hafid said in a statement to media said that she signed a government regulation that will mean children under the age of 16 can no longer have accounts on high-risk digital platforms, including YouTube, TikTok, Facebook, Instagram, Threads, X, Roblox and Bigo Live, a popular livestreaming site. With a population of about 285 million, the fourth-highest in the world, the south-east Asian nation represents a significant market for social networks. Continue reading...

Ministers urged to abandon plans to let tech firms use work of novelists, artists and writers without permissionThe UK's creative industries must not be sacrificed in the pursuit of speculative gains in AI technology, a House of Lords committee has warned, as the government prepares to reveal the economic cost of proposals to change copyright rules.A report by peers has urged ministers to develop a licensing regime for the use of creative works in AI products and abandon proposals to let tech firms use the work of novelists, artists, writers and journalists without permission. Continue reading...

In his new book, the celebrated author explains why we need consciousness hygiene' to defend ourselves from AI and dopamine-driven algorithmsEach day when you wake up, you come back to yourself. You see the room around you, feel your body brush against your clothes and think about your plans, worries and hopes for the day. This daily internal experience is miraculous and mysterious, and the subject of Michael Pollan's new book, A World Appears.It also may be under siege, Pollan said. He recently suggested that people need a consciousness hygiene" to defend our internal world against invaders that are trying to move in. Our ability to sit with our thoughts and perceive the world, he argues, is increasingly disrupted by algorithms engineered to tickle our dopamine receptors and capture our attention. Meanwhile, people are forming attachments to non-human chatbots, projecting consciousness on to entities that do not possess it. Continue reading...

Plans for agentic shopping assistants are under way at Australia's major companies. Guardian Australia tested the technology after a string of mishaps

Nintendo Switch 2; Game Freak/Omega Force/Nintendo

They claim to fix fine lines, blemishes and redness - but which stand up to scrutiny? We asked dermatologists and put them to the test to find out The best anti-ageing creams, serums and treatmentsLED face masks are booming in popularity - despite being one of the most expensive at-home beauty products to hit the market. Many masks are available, each claiming to either reduce the appearance of fine lines, stop spots or calm redness. Some even combine different types of light to enhance the benefits.However, it's wise to be sceptical about new treatments that are costly and non-invasive, and to do your research before you buy. With this in mind, I interviewed doctors and dermatologists to find out whether these light therapy devices work.Best LED face mask overall:

Quality camera, good software and long battery life, but you should just buy the Pixel 9a insteadThe latest smartphone in the lower-cost A-series Pixel line shows what makes Google phones so good, while undercutting the competition on price. The problem is that it differs little from its predecessor, which is still on sale.Priced from 499 (549/$499/A$849), the Pixel 10a is more like a second edition of last year's excellent Pixel 9a. The two phones share the same Tensor G4 chip, not the newer G5 in the rest of the 799 and up Pixel 10 line; the same memory, storage and cameras; the same size 6.3in OLED screen, though the Pixel 10a reaches a higher peak brightness making it slightly easier to read outside. Continue reading...

Fredrik Gertten travels the world meeting activists who have had enough of corruption, kleptocracy and structural inequality - while Bregman's nuggets of wisdom are a joyBicycling Dutch historian Rutger Bregman does not identify as an optimist. He says that optimism makes people lazy, complacent that history is going in the right direction. Instead he describes himself as a possibilist", a believer in the possibility that things can be different. Bregman is interviewed in this film about corruption, kleptocracy and structural inequality. The director is documentary-maker Fredrik Gertten who travels the world meeting activists who have had enough.First, the cold hard facts. Journalist and corruption expert Sarah Chayes, a former adviser to the Obama administration, does an impressive job summarising her analysis of global kleptocracy. In Malta, the son of the murdered journalist Daphne Caruana Galizia, killed after exposing corruption at the highest levels of government, investigates the new scandal of golden passports". The film's main focus is activism in Chile and the US. Amazon workers in New York unionise (and have a good laugh at their boss Jeff Bezos's trip to space). In Chile, feminists march and climate activists go into battle against mining companies responsible for drought. Continue reading...

Companies will pay for upgrades and new electricity generation in agreement to mitigate concerns of rising billsGoogle, Microsoft, Meta, Amazon and several artificial intelligence companies signed a pledge at the White House on Wednesday to bear the cost of new electricity generation to power their datacenters.The agreement is meant to help mitigate concerns that big tech's datacenters are driving up US electricity costs for homes and small businesses at a time the administration of Donald Trump is seeking to curb inflation. Continue reading...

CEO's claims come amid increased scrutiny of US military's use of the technology and ethics concerns from AI workers

Twitter investors allege the billionaire publicly derided the social network to sink its stock price and buy it at a bargainElon Musk took the stand on Wednesday in a trial brought by Twitter investors, who allege the billionaire committed securities fraud as he was buying the social media company in 2022. The class-action lawsuit alleges Musk agreed to buy Twitter but then waffled for months, attacking the company with the goal of bringing down the stock price to get a better bargain.After contentious legal wrangling, Musk did eventually buy Twitter for $54.20 a share, his original offer, totalling around $44bn. Musk testified on Wednesday that he didn't realize his attacks on the company, mostly done via tweet on Twitter itself, would lower the company's stock price or hurt its investors. Continue reading...

Lawsuits and slander claims fly in IG Metall's battle with Elon Musk over employment rights and conditions

Dassault Aviation says 100bn project may soon be dead' if Airbus will not agree on how to share workloadFrance and Germany's next-generation fighter jet project could soon be dead", one of the two companies tasked with delivering it has warned, amid a worsening corporate rift over who gets to build the aircraft.Dassault Aviation, France's leading warplane maker, said Airbus's defence arm - which represents Germany and Spain - needed to cooperate on the 100bn programme otherwise it would collapse. Continue reading...

Democratic rematch in Durham-area district draws focus to fight over AI datacenters increasingly shaping US elections

Lawsuit is first wrongful death case brought against Google over flagship AI product after death of Jonathan Gavalas

Oxford-based firm has raised $103m for commercial development of software for self-driving industrial vehiclesNvidia is investing in the British autonomous driving startup Oxa, alongside backing from the UK's National Wealth Fund, in a boost to the country's technology sector.The Oxford-based company, which has developed software for self-driving industrial vehicles, said it had raised $103m (77m) from investors to focus on commercial solutions for that software, as well as its physical AI and robotics technology, and to push on with its global expansion plans. Continue reading...

As a historian, I've studied the major consumer boycotts of history. We can take down ChatGPT and send a powerful signal to Silicon ValleyOpenAI, the company behind ChatGPT, is on track to lose $14bn this year. Its market share is collapsing, and its own CEO, Sam Altman, has admitted it screwed up" an element of the product. All it takes to accelerate that decline is 10 seconds of your time.A grassroots boycott called QuitGPT has been spreading across the US and beyond, asking people to cancel their ChatGPT subscriptions. More than a million people have answered the call. Mark Ruffalo and Katy Perry have thrown their weight behind it. It is one of the most significant consumer boycotts in recent memory, and I believe it's time for Europeans to join. Continue reading...

CEO cited AI advances in cutting 4,000 workers, but a weak crypto market and declining stock price may also be at playJack Dorsey cited AI as the driving force behind cutting 40% of his company's employees, but other factors such as a weak crypto market, overstaffing and a declining stock price may also have motivated the move.Last week, the financial technology company Block announced that it would lay off 4,000 of its 10,000 workers. Dorsey, Block's CEO, said in a letter to shareholders that advances in AI have changed what it means to build and run a company". Continue reading...

As hundreds of schools implement an automated monitoring tool, educators say that students can find talking to a chatbot more natural' than confiding in a human Produced in partnership with EdSurgeThe alert came around 7pm.Brittani Phillips checked her phone. A middle school counselor in Putnam county, Florida, Phillips receives messages from an artificial intelligence-enabled therapy platform that students use during nonschool hours. It flags when a student may be at risk for harming themself or others based on what the student types into a chat. Continue reading...

ChatGPT owner's CEO says it will bar its technology being used for mass surveillance or by intelligence services

Speed and scale of US military's AI war planning raises fears human decision-making may be sidelinedThe use of AI tools to enable attacks on Iran heralds a new era of bombing quicker than the speed of thought", experts have said, amid fears human decision-makers could be sidelined.Anthropic's AI model, Claude, was reportedly used by the US military in the barrage of strikes as the technology shortens the kill chain" - meaning the process of target identification through to legal approval and strike launch. Continue reading...

I was a newcomer, negotiating all of usual classroom difficulties for the first time. Throwing AI into the mix felt like downing a coffee in the middle of a panic attackTwo years ago, at the age of 39, I began training to be a school teacher. I wanted to teach English - to help young people become stronger readers, writers and thinkers, with a deeper connection to literature. After 15 years of working as a freelance writer and as a novelist, I felt confident that I had something to offer. But the further I progressed in my training, the more uncertain I felt. One particular question taunted me for my lack of an answer. What to do about artificial intelligence?The immediate dilemma: what does it mean for English instruction that all pupils now have access to free online chatbots that can produce fluid, fairly complex prose on demand? This question sits atop a teetering pile of timeless pedagogical quandaries: What are we actually trying to do in school? How should we go about doing it? How do we know if we've succeeded? I was a newcomer, negotiating all of this for the first time. Throwing AI into the mix felt like downing a coffee in the middle of a panic attack. Continue reading...

Claude climbs to top of app store charts in US and UK after being blacklisted by Pentagon over ethics concernsThe AI model Claude has surged in popularity after being blacklisted by the Pentagon last week over ethics concerns.Claude climbed to the No 1 spot on Apple's chart of top free apps on Saturday in the US - dethroning OpenAI's ChatGPT, just one day after the Pentagon tapped OpenAI to supply AI to classified military networks. The bot's app climbed the iPhone app charts in the UK but did not beat out ChatGPT. Claude also raced up the Android charts in the US and UK, though ChatGPT reigned supreme, according to data from Sensor Tower. Continue reading...

The rapid rollout of datacenters across the US is creating a divide between municipal governments and residentsWilmington, Ohio, resident Quintin Koger Kidd was so concerned last June with his local public officials' alleged misdoings - open meeting violations and other discrepancies - that he filed a complaint in court to have the mayor and city council members removed from their posts.When Koger Kidd later heard that the city supported plans by Amazon Web Services to build a $4bn datacenter on 500 acres (200 hectares) south of town, he was aghast. Amazon has sought a tax abatement that would see its datacenter exempt from paying property taxes for 30 years in exchange for the funding of local schools and infrastructure projects. Continue reading...

Since 2016, the cosy, inclusive, non-heteronormative escapism of the beloved farming sim has inspired a community of devoted fans, and helped it shift 50m unitsWhen farming sim Stardew Valley first came out back in 2016, most of us saw it as a modest indie hit, offering charm, wit and a beautiful little world. Ten years later, this tiny indie has sold nearly 50m copies. If you haven't played it yourself, you've probably seen someone playing it on the train (or, in the case of one of my musical theatre castmates, in the dressing room between scenes). As we discussed on the Tech Weekly podcast shortly after its launch, this calming game about tending crops and animals and relationships with neighbours rejuvenated the entire farming/life sim genre. To this day, I still get press releases promising that some upcoming cosy game or another is the next Stardew Valley.While developer Eric ConcernedApe" Barone now has a small team to help with periodic updates, the original game - his first - was all his own work, from the distinctive pixel art and animations to the soundtrack that has since toured the world in concert. Unable to get a job after university, he'd started his own project inspired by the Harvest Moon series (now called Story of Seasons). One notable addition was the inclusion of queer romance options. The ability to pursue a romantic relationship with other townsfolk is a key part of the game's popularity - as demonstrated by the thousands who tuned in to a video from Barone revealing the identities of two new marriage candidates - and the fact that all potential spouses are available to the player character regardless of gender has helped the game garner a dedicated queer fanbase. Continue reading...

AI is transforming our world. Accepting independent oversight is the least companies can do to protect our rightsThe speed with which AI is transforming our lives is head-spinning. Unlike previous technological revolutions - radio, nuclear fission or the internet - governments are not leading the way. We know that AI can be dangerous; chatbots advise teens on suicide and may soon be capable of instructing on how to create biological weapons. Yet there is no equivalent to the Federal Drug Administration, testing new models for safety before public release. Unlike in the nuclear industry, companies often don't have to disclose dangerous breaches or accidents. The tech industry's lobbying muscle, Washington's paralyzing polarization, and the sheer complexity of such a potent, fast-moving technology have kept federal regulation at bay. European officials are facing pushback against rules that some claim hobble the continent's competitiveness. Although several US states are piloting AI laws, they operate in a tentative patchwork and Donald Trump has attempted to render them invalid.Heads of AI platforms like OpenAI's ChatGPT and Google's Gemini say they care about safety. But owning the future of AI means pouring billions into models that not even their creators fully understand, and making choices like adding ads - and the capabilities that the Pentagon is now seeking from Anthropic - that raise risk. Anthropic, which styles itself as the most conscientious frontier AI company, says its model is trained to imagine how a thoughtful senior Anthropic employee" would weigh helpfulness against possible harm. The directive echoes criticisms levied years ago over Silicon Valley companies that shaped the lives of users worldwide from insular boardrooms. Consumers don't believe they are in good hands. Fully 77% of Americans surveyed last year think AI could pose a threat to humanity. Continue reading...

Our new free course AI for the People will show you practical ways to work with AI -without giving up judgment, privacy or your humanity

Trials to form part of three-month consultation on Keir Starmer's plans to tackle negative effects of smartphone useHundreds of teenagers will be enlisted to trial social media bans in the coming months with overnight digital curfews and daily screen time limits also tested as part of Keir Starmer's plan to crack down on the negative effects of smartphone use.The trials will be part of a three-month consultation launched this week that could lead to an outright ban on social media for under-16s similar to that introduced in Australia. Ministers have said they are ready to toughen laws just six months after the introduction of child protection measures in the Online Safety Act. Continue reading...

The long-running series in which readers answer other readers' questions asks whether we could cope with a world where computer gave up saying no ...This week's question: what if Shakespeare were dropped in modern-day London?After years of computer saying no, and giving us all migraines and premature grey hair, I'm starting to worry that computer - or rather AI large language models like ChatGPT and Gemini - are taking too much of a fancy to playing nice and saying yes. I confess to using both of these programs, but I've noticed that, well, it's as if they're trying to please, with statements such as, You're absolutely right, Jeff," and That's pretty much right." Often, when I ask, Would you mind thinking for a bit longer on that?", I then get another response saying: Jeff, you're absolutely right, again, to query that result. It turns out I was a bit hasty in my reply ..."If the world runs even more on information filleted out from the sump of the internet by LLMs, what are the consequences? Can we look forward to a future in which AI is more concerned with appearing sympathetic (getting good reviews?) than being factual? Er, a bit too human? Jeff Collett, Edinburgh Continue reading...

The record sum paid at auction for a rare example is part of a boom in trading cards - and the prices can be staggeringFor 12m, you could buy a seven-bedroom mansion in Hampstead, north London, or a Bugatti La Voiture Noire, one of the world's most coveted sports cars, with a few hundred thousand quid to spare. Alternatively, you could blow it all on a Pokemon card.This is what AJ Scaramucci, son of financier and former White House communications director Anthony Scaramucci, did earlier this month when he bought the world's only Professional Sports Authenticator (PSA) 10-graded Pikachu Illustrator card, one of the rarest and most coveted Pokemon cards ever, at auction. The seller, YouTuber, wrestler and occasional boxer Logan Paul, made a mighty profit after flipping the card for about 8m more than the 3.9m he originally paid for it in 2021. Continue reading...

CEO Sam Altman claims military will not use AI product for autonomous killing systems or mass surveillanceOpenAI said it had struck a deal with the Pentagon to supply AI to classified US military networks, hours after Donald Trump ordered the government to stop using the services of one of the company's main competitors.Sam Altman, OpenAI's CEO, announced the move on Friday night. It came after an agreement between Anthropic, a rival AI company that runs the Claude system, and the Trump administration broke down after Anthropic sought assurances its technology would not be used for mass surveillance - nor for autonomous weapons systems that can kill people without human input. Continue reading...

As Pokemon turns 30, we would like to hear what the franchise means to youIt is 30 years since the game Pocket Monsters was released for the Nintendo Game Boy in Japan. Many more video games, trading cards, toys, an animated series and films followed as the franchise became a worldwide hit. With this in mind, we would like to hear what Pokemon means to you after three decades.If you're having trouble using the form click here. Read terms of service here and privacy policy here. Continue reading...

With original dialogue in Turkish, this shuffling of potential partners in a sequence of meaningless encounters ranks with the finest auteur moviesI spent Valentine's Day not with my wife but with 18 Turkish women. No, wait, I can explain. It's a new game called Speed Dates - Winter Edition, which I only chanced upon when I searched Winter Games" on Xbox Live hoping for some Olympics fare. And boy, did I find it!The game is in Turkish, with English subtitles. It already feels arthouse; like those films Channel 4 used to show with a red triangle in the corner of the screen. Continue reading...

OpenAI-powered assistant will help to understand overall service patterns', company says, as move sparks backlashFrom hospitality workers to retail employees, the exaggerated customer service voice", often mocked in internet memes as wildly different from someone's real voice, has long been a cultural trope. Fast-food giant Burger King is now taking that voice one step further, saying it will detect whether employees are using words like please" and thank you" through the assistance of artificial intelligence.On Thursday, Burger King announced it is rolling out a new AI chatbot connected to employee headsets at hundreds of locations in the US as part of a platform called BK Assistant, powered by OpenAI, the maker of ChatGPT. Continue reading...

The UK will phase out traditional home phones by 2027, but the switchover has been stressful for some. How do you feel about the change?UK telecoms companies are retiring traditional landline services and replacing them with internet-based home phone connections.The industry has set a deadline of January 2027 to complete this switch with roughly 3.2 million homes still to move over. While the digital switchover has been straightforward for most households, for some vulnerable customers, such as those with telecare devices, it has been very stressful. Continue reading...

Study finds ChatGPT Health did not recommend a hospital visit when medically necessary in more than half of cases