It’s a familiar thing, wishing others health, wealth and happiness, others may wish it for us and in private moments we may even wish it for ourselves. I just recently had a birthday. Increasingly often at birthdays and I confess at reflective moments between birthdays I picture myself as a teenager sitting in class, doing the maths and calculating that by 2010 I would, with a bit of luck, arrive at a great age and achieve the status of pensioner. Well I did, and I count my blessings. So far my health has been good, my wealth is adequate and I have few reasons to be unhappy.
Before I share my thoughts about the future I would like to say something more about happiness and a happy life. The Chinese have a view on this subject. Happiness they suggest depends upon three things:
- Having good health
- Having a project (a useful and fulfilling way to spend time)
- Having someone to love (and be loved by)
Combining all of this leads me to a new wish for others and myself. The wish becomes, ‘good health, a satisfying way to spend your time and someone to share love and care’.
And so moving to thinking about the future. At this point I must define for whom my words are intended. That’s easy. Everyone who has birthdays and in reflective moments counts their blessings, makes wishes about the future or is reminded, particularly at ‘big birthdays’ that they may be drifting towards decrepitude, but hopefully not too soon. Those birthdays and reflective moments may relate to one’s own life or the life of someone else; an ageing parent, sibling or friend. Perhaps the thoughts are about someone younger with a chronic health condition. Maybe it is that isolated neighbour that we nod to once or twice a year.
Thinking again about that day in my teens when 2010 would herald the arrival of ‘great age’, I now think as I walk down any high street during the working day when most younger people are in school, college or their place of work, ‘my, how many seventy, eighty and ninety something’s are out and about today going about their business’. Now I do the maths again and think, ‘in 2030 I might be enjoying great happiness’. Who knows?
I am an optimist so I must challenge myself with the question, ‘between now and 2030 what must I do to maintain good health and a satisfying way to spend my time and continue to have someone with whom to share love and care’? And how do I answer myself? Put simply – do not assume or expect that the state provision will necessarily provide the answers.
If I make it to 2030 it is pretty certain that the state will have been forced to come clean and admit that state provision will be a ‘no frills safety net level of service’. It seems to me that a good part of the time between now and 2030 will elapse before the UK economy has ‘recovered’ – whatever that might mean. Whether we expect growing GDP or a model based much more on contentment than on endless acquisition of stuff, it will take a generation.
So what must I (we) do? Rely less on state health and social care and take more personal responsibility for our own health and wellbeing. Let us imagine that in terms of bricks and mortar we are on a long slow trajectory of convergence with the developing world. They may move to a small number of centres of excellence linked to their swelling populations by technology enabled remote diagnosis. Economies of scale may drive UK healthcare to fewer larger centres of excellence and expertise with the diagnostic equipment based in GP practices linked wirelessly and providing images and vital signs data to the remote specialist. So what part will we play? We will purchase for ourselves or our loved ones, pieces of home based or wearable consumer ware to record data about our blood pressure, blood sugar, blood oxygen and levels of activity. We will subscribe to services and send this data routinely to our GP practice or bypass the GP and send it directly to entrepreneurial clinics for diagnosis or confirmation that our self-managed heath regimes involving diet, exercise and medication are working for us. Our gym exercise machines will send their recorded data to the GP or entrepreneurial clinic too. Who will pay for these services? We will if we choose to. If we don’t opt to pay for these services for ourselves or our loved ones then we must expect the ‘no frills safety net level of service’. The paid for services option offers us many advantages. We choose what we monitor and how often, we choose who to send the information to as there will be many and various ‘cloud based services’. These services will be offered by specialists around the world, breaking the NHS monopoly on healthcare. Imagine that a chronic illness previously managed by the NHS is no longer a government/DH/NICE priority and waiting lists for that condition are allowed to grow much longer as rationing kicks in. A Google search reveals that a clinic in Geneva, a specialist in Washington DC, BUPA, an entrepreneurial Veterans Association facility in Atlanta and a clinic in Melbourne Australia offer a range of services related to the chronic illness in question. Sharing your own data gathered by you in your own home with consumer electronics and compiled on a platform device such as a smart phone, tablet, laptop or dedicated wearable device disguised as jewellery could get you inexpensive personalised advice by return.
Monopolistic behaviour is frowned upon and regulated against in supermarkets, banking, transport, fuel, and energy and telecoms utilities. Monopolies are generally seen as economically inefficient or denying consumer choice. Why not in healthcare?
When I look forward I recognise that a time may come when my health needs are such that I cannot manage them on my own. That is why I should and must make choices and depending upon my financial situation I may have to resign myself to a ‘no frills safety net level of service’. Hopefully that day may be delayed by means of technology that enables family and friends to become my first line of carers. Maybe by 2030 ‘social networks’ will have matured to enable a more serious offering including mutual support related to health and wellbeing and involving expert communities.
So in this model of healthcare our own home becomes our ‘personal hospital ward’ in our familiar surroundings, cleaned to our own standards, avoiding infections, things done at times that suit us, no need to travel park and sit in waiting rooms. We have access to personal data, can show it to whomever we choose, can take it with us or access it on holiday if the need arises. Downside – none that I can see, and by 2030 technology literacy, availability and cost of the technology and services will no longer be an issue so all will enjoy the benefits.
That takes care of good health for the moment. What about a satisfying way to spend time. First there is the activity of managing your own health, which should be a satisfying use of time sitting somewhere between healthcare and a pastime – let’s call health-time. Being part of an expert community contributing their health-time learning and stock of management and inter-personal skills would be very rewarding. Sharing the community’s findings and experiences would boost health education and on the political level, democratise healthcare, reducing the power of ideological politicians and health professionals in our lives. Personal freedom and independence will increase.
Moving on to think further about opportunities for rewarding ways to pursue ‘a life enhancing project’, there is enormous scope for innovation in technology and software development and applications, and the creation of radical new service models. There will be a place for specialist healthcare business incubators – these will certainly allow people to employ themselves in a satisfying use of their time.
For the established third sector players such as The Alzheimer’s Society, Age UK, Diabetes Society, and British Heart Foundation as well as commercial players such as Private Health Insurers the journey to 2030 offers endless creative possibilities for technology and services. To bring the technology and service innovations to fruition, supporting areas of activity offering a satisfying use of time (paid or unpaid) will include:
- Awareness raising
- Events organisation
- Hosted services
- Product and service review
- Epidemiology studies
- Insurance services
Volunteering to create and run community based, not for profit entities, providing independent living support e.g. concierge services, one-to-one befriending, stimulating activities, clubs, lectures and so on will provide a new form of community action for those looking for useful ways to spend time while creating life enhancing opportunities for the participants. For me this exemplifies true social networking of the face to face variety but of course ‘social networking’ in the smart email sense will be a valuable enabler, contributing to supportive and stimulating communication.
Perhaps the most difficult element in this discussion is ‘someone with whom to share love and care’. We have touched on ‘love and care’ at the community level, but what I am really talking about here is something else. People who have spent years or decades together as husband and wife or mother and daughter for example, may have a third player in their lives. I refer to chronic illness, physical or mental, or progressive infirmity with ageing. The latter is almost certain to increase if life expectancy outstrips improvement in quality of life. If 80 doesn’t become the new 60, in the way that 60 has become the new 40, then a longer life might become a more difficult life. In this context continuing to love and care for a life partner when the carer is ‘showing signs of wear and tear’ presents its own problems. Experience to date tells us that this can be unspeakably demanding. Perhaps respite care will become a widely available option – who knows.
So there might be two individuals living together, mutually caring, each with their own needs. Additionally there is the case where one of an elderly couple passes away or goes in to full time residential care and the remaining person, still living independently in their own home needs a remote family member to become their carer at a distance. Either way we must develop technology, devices and services to support the carers and cared for in these situations. As we move towards 2030 the population providing and needing care will be more and more technology savvy so excuses about inability or unwillingness to take up offerings won’t be a valid excuse for not providing them. I firmly believe that in terms of technology understanding and use, savvy 80 will absolutely be the new 60.
Being able to continue to love and care for life partners is prized and deserved. The Chinese have it right and with the ability to live independently (not relying on state and institutions) loving and caring is at the heart of what it means to have a happy life. So come on you technologists, psychologists and gerontologists, be happy but do it together! At the moment the 3millionlives initiative provides a helpful context intended to encourage ideas and innovations for self-help and wider take up of technology in health and social care.
So in summary all of the aforesaid leads me to conclude that to achieve good health, a satisfying way to spend time and having someone with whom to share love and care as we journey to 2030 will be a multi-dimensional, multi-disciplinary challenge. That is why we should create a new multi-dimensional, multi-disciplinary special interest group (expert community) to debate and realise the ideas that I have proposed.
The bio-tech and medical devices community (One Nucleus) the collaborative academic and clinical community (Cambridge University Health Partners, CUHP), the wireless technology community (Cambridge Wireless), the new community forming around Addenbrookes Bio-Medical Campus are together a rich seed corn for the formation of that new special interest group.
Written by David Cudby, Founder of Networks for Independent Living, July 2012
The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.