Make innovation more equitable to restore trust in experts

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In the past year, since the arrival of Brexit and Trump, much has been said about public trust in science and experts.  Below is my take on it.  In an article published in Research Fortnight in November 2016, I argue that people aren’t abandoning rationality, they’re challenging the world that science and technology has helped to create:
In my day job I study public attitudes to new technologies. But for more than 10 years, I’ve lived a double life as a local councillor. When colleagues repaired to the pub, I went to advice surgeries and residents’ meetings, listening to my neighbours’ daily troubles.

It was perhaps an unusual, and certainly stressful, way to spend my spare time, but it has given me an insight into the lives of people who will never set foot in a university, and a first-hand view of whether, in Michael Gove’s phrase, people in this country have had enough of experts.

Rather than irrational people ignoring the facts, I saw people reacting to the evidence around them. Regardless of what statistics, economists and politicians were saying, they were finding that life hadn’t become better.

Look back on the interviews in the run-up to the European Union referendum. Time and again, “ordinary” people expressed the same sentiment: if being in the EU is so great, why am I not feeling the benefit? If being in Europe boosts our economy, why am I struggling to make ends meet? If Europe offers jobs and opportunities, how come I am stuck with minimum-wage and zero-hour contracts? And if Europe makes us safer, why do I feel less safe?

Any growing suspicion of experts is likely to have had less to do with disrespect for authority or a move away from truth and rationality, than with a dissonance between what the experts were saying and peoples’ experiences.

In this context, the Brexit vote—and the wider draw of the extreme left or extreme right across Europe and the United States—is more than a sign that scientists need to defend their territory. People may not be rejecting expertise or the principles and value of science, but they are definitely challenging the kind of world we have built and are building with science and technology. This is something we need to come to terms with and address.

Globalisation, liberalisation of capital markets and the decreased power of trade unions have all contributed to creating an economy that leaves large numbers of people undervalued and disenfranchised. But evidence is growing that science and technology has also played a significant part.

Think about how antibiotics have transformed healthcare, the way cars have changed the shape of cities, and how the internet has changed business, work and even friendship. The modern world and its institutions have been powerfully shaped by science and technology.

These effects aren’t equally spread. High-paying tech companies are staffed mostly by men; to install solar panels, you need to own your own home; modern medicine makes rich nations healthier, but has little impact on the diseases of the poorest.

It is easy to see these as purely political problems of deployment and regulation. But this raises two difficulties for science.

First, in my research I have found that the public see the downsides of science and technology as inherent parts of the research. Suggestions that these can be separated out and regulated elsewhere are unlikely to cut much ice.

Second, even economists are beginning to point out that the problems of an increasingly polarised economy—particularly those stemming from digital technologies, such as the difficulty of taxing the biggest tech companies—don’t look like they’ll be solved with the taxation and worker-subsidy policies of previous ages.

So what can we do? To begin, we need to increase our understanding of the economic effects of particular technologies, and work out how to account for these effects during the R&D process. Ideas around research ethics or responsible research and innovation will help here, but need to go much further.

Beyond that, we also need to rethink the economic models behind science and innovation policy, to start to pay attention to the spread as well as the size of the economy that we are building. We can no longer afford to assume that a rising tide raises everyone’s boat.

This requires the re-examination of ownership models and technology transfer. The gains of technology should be shared more equally among customers and employees, as well as investors and innovators.

Science and innovation have transformed many lives for the better. But to keep public support for the Enlightenment values that underpin such amazing developments, we need to make sure that the benefits of science and technology—and the economy and world we are building with them—are shared fairly.

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Save our Hospitals – my letter to the IRP

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The A&E units (and other services) in the four hospitals local to me in West London are threatened with closure.  An independent panel is currently reviewing the NHS’s decision and will report to the Secretary of State for Health by September 2013.  

I feel strongly that the proposed closures will put lives at risk.  Here is the letter that I have submitted to the review – please join me in objecting by emailing your comments to info@irpanel.org.uk

To: The Independent Reconfiguration Panel, 6th floor, 157-197 Buckingham Palace Road, London

Dear Sir,

I would like to register my objection to the current proposals to close the accident and emergency units at Hammersmith, Charing Cross, Ealing and Central Middlesex Hospitals and ask you to reject the proposed closure.

My initial concerns about the proposals related to the impact it would have on myself and family.  Closing these A&E units will mean that our nearest emergency unit will be in St Mary’s, Paddington, which is at least 30 minutes drive away – and longer during heavy traffic.  Should anyone in my house suffer from a suspected stroke or heart attack, where time is of an essence, then this delay in reaching hospital could have fatal consequences.

In the last few months however, I have been going door-to-door, taking to many local residents across Hammersmith and Fulham and Ealing and Acton about the proposals.  The stories I have heard have persuaded me even further that the planned closures will put unnecessary worry and pressure on local residents, put the remaining services under undue strain and put lives at risk.  In particular, it has been the poorest and most vulnerable residents – those with sick or disabled children and the elderly – who are most worried about the plans.  For instance, I met one elderly woman who faces three bus-rides to get to the nearest A&E unit.  As her nearest A&E and GP surgery are already working beyond capacity and therefore cannot offer regular appointments to her, she is currently relying on her local vet to change the dressings on a wound she recently sustained.  This is a shameful story of the NHS in the 21st Century but is sadly only likely to be replicated if the proposed closures go ahead – three whole London Boroughs will be left without a major hospital.

 Finally, I understand that a number of clinical arguments have been put forward in support of the proposed closures.  While I appreciate that access to specialists is an important factor in the quality of emergency treatment, I am confident that you will agree that access to specialists must be balanced out with access to resources overall – and in a timely fashion.  The current A&E services are stretched, with waiting times already on the increase.  It seems difficult to argue that this can be anything but worsened by closing further units, not to mention the additional pressure that will be put on the ambulance services.  Furthermore, if there are strong clinical arguments, I hope that you will question the clinicians as to why these proposals were not put forward prior to 2010, when there was significant investment in the NHS. The coincidence of these clinical arguments with the desire to dramatically reduce costs undermines their credibility. 

 Far from being in the clinical interests of the West London population, the current proposals represent a significant downgrade in health services to the area, put forward in light of a desperate desire to cut costs quickly.  They are proposals that have little support in the community and which will put lives at risk.  They should therefore be firmly rejected.

 Yours Faithfully

Melanie Smallman