Bringing medical humanities into public policy

In the summer of 2011 Natalie Banner undertook the first Wellcome Trust Medical History and Humanities fellowship at the Parliamentary Office of Science and Technology (POST), researching the issues around the UK’s ageing workforce. Here she reflects on her time spent in Westminster, what she learned and how the humanities, science and policy interact.

POST exists partly to provide independent analyses of scientific issues that may otherwise be out of reach to an audience unfamiliar with scientific methods and analysis of evidence. Few Parliamentarians have scientific training – indeed most university-educated Parliamentarians come from a humanities background. What benefits, then, could accrue from enlisting a humanities scholar among scientists?

I was interested to learn what this combination meant in a policy environment and what value an academic background in the humanities could have in the context of report writing for Parliamentarians. There was also a broader question at stake here about the relation between the sciences and humanities, and academia and policy.

My research at POST addressed issues concerning the ageing workforce in the UK. As we live longer, the age profile of the workforce is increasing and more people will face pressure to work later into life, for various reasons (predominantly financial). With recent debate over the reform of public sector pensions, which has been highly controversial, numerous policy-relevant questions arise across a broad range of fields. These range from how employers may adapt to the ageing demographic of their workforces; the influence of stereotypes about older workers (both positive and negative) on employment and training prospects; how individuals perceive retirement; what challenges or barriers they face to staying in work or finding new employment, and; how health status affects one’s capacity and willingness to work beyond retirement age.

One potentially explosive issue was that of proposed increases to the state pension age, raising women’s state pension age to equal that of men’s and increasing both to 66 by 2020. Whilst the economic argument in favour of extending working lives is, at the population level, very strong, it invokes a huge range of reactions from potentially affected individuals, despite evidence that the current generation approaching retirement age are likely to live longer and experience a longer retirement than their parents. The significant social inequalities that exist in health in later life are just one factor differentiating those who may be capable of working later into life from those who may not have this capacity.

While other policy issues researched at POST belong squarely in the domain of science and technology, the ageing workforce leant itself more to research from a humanities perspective. Essentially, this topic provided an excellent example of the myriad ways scientific understanding and advances, in this case in medicine and healthcare, ergonomics and occupational psychology, can impact on individuals in different ways that may not be visible at the level of policy. There are also widely differing discourses about the very concept of retirement, what it means to people (a deserved break at the end of a hard working life or being thrown on the scrap heap?) and how ageing and health are interconnected with personal attitudes towards retirement and drawing a pension. It is an emotive, personal and politically fraught concern which impacts individuals in very different ways, and it felt important when conducting the research to convey a coherent and ultimately humanistic narrative of the issues being addressed.

I could not bring knowledge expertise as such to research, but rather a more general set of skills that proved valuable in picking apart the complexity of the issue and pursuing important lines of questioning. For example, training in the humanities equips one for independent and open-ended research, critical thinking, and being comfortable with broadening out one’s scope of enquiry rather than being focused on problem solving within a particular area of expertise. This broad scope seemed essential for tackling an issue as expansive as ageing and employment.

Bioethics has led the way in demonstrating the utility of a philosophical perspective on important areas of medicine and health policy, particularly as technology advances into ethically challenging realms. For example, UK policy on reproductive rights has been greatly influenced by the input of moral philosophers Baroness Warnock and Jonathan Glover. The medical humanities are broader in scope, being a loose aggregation of disciplines explicitly geared towards applying historical, narrative and philosophical analysis to the practice of medicine and understanding the experience of illness and health. As I settled into my research at POST it was interesting to see a definite role for an understanding of ageing and health that went beyond biomedicine and population level statistics on disability and retirement due to ill health, reflecting, from within a policy context, precisely the purpose of the medical humanities.

During my time at POST, I attended sessions in the House of Commons and the Lords, as well as numerous All Party Parliamentary Group meetings on topics including intergenerational justice, the progress of the controversial Health and Social Care Bill, and the government’s intention to measure national wellbeing. I also interviewed a range of experts in various fields from academia, business, government departments, management, economics, gerontology and occupational psychology.

As an academic researcher with limited previous exposure to Parliamentary processes and policy discussions, the experience has broadened my engagement with the potential practical implications of my day-to-day research in the philosophy of psychiatry. This is not to instrumentalise such research by implying it has value only through its application to policy or practice, but rather to suggest that there is something to be said for opening up academic skills and expertise to policy audiences, keeping both the outputs of academic research and academics themselves connected to public life, and, indeed, to each other across disciplines.

There are therefore substantial reciprocal benefits of a scheme such as the Wellcome Trust’s POST fellowship scheme, particularly for early career researchers for whom such an opportunity offers not only an insight into the parliamentary and policy world but also the potential to reflect on one’s own research skills and expertise in a non-academic context. The realisation that the skills one acquires as an academic researcher have potential application beyond one’s own field of specialisation is a valuable one, that has certainly influenced the approach I take to my post-doctoral work and plans for my future career (and the imposition of strict deadlines for the publication of POSTnotes also enhances one’s time management skills with remarkable effectiveness!)

Dr Natalie Banner is a Wellcome Research Fellow at the Centre for the Humanities and Health, King’s College London.

The Wellcome Trust Medical History and Humanities fellowship is open to second or third year PhD students and first-year postdocs funded by the Wellcome Trust’s Medical History and Humanties schemes. Find out more on the Wellcome Trust website. This post first appeared on the Wellcome Trust’s blog.
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