"Innovation" is an NHS buzzword. It shouldn't be.

Martha Gill's Irrational Animals column.

“Innovation” has been an NHS buzzword for quite some time. It’s how they think they are going to make money. The word peppers Andrew Lansley’s sentences and appears on every NHS website. It turns conference speeches into tongue twisters and makes job titles too long to fit on to name badges. But let’s cliché this down. Being innovative is like being a lady. If you have to tell people you are . . . you  aren’t. The NHS isn't.

Not that promoting innovation is a bad aim. One bright idea, one new drug and you can potentially generate billions. This is the thought in the minds of the policymakers who have directed several taxpayer billions to this end.

But here’s the problem. A great deal of the money has gone towards creating “facilitatory groups”, such as the National Institute for Health Research – boards that manage the interaction between NHS employees with the new ideas, and the companies that might want to invest in them. Yet the interaction is an unhappy one. The inventive employees must now fill out a vast amount of paperwork and jump over many more hurdles than they used to. The boards are large and unwieldy, absorb a huge amount of capital and are made up largely of ex-nurses, inexperienced in business and, by training, highly risk averse.

Being unwilling to take risks is all very well in patient care but it can lead to utter stupidity when it comes to investment decisions. This was perhaps best demonstrated in 2006 by the US economists Uri Gneezy and George Wu, in one simple, cruel experiment.

Participants were asked to state how much they would pay for a $50 book token, a $100 book token, and to take part in a lottery in which they would win one or the other. It turned out that on average they were willing to pay $45 for the $100 token, and $26 for the $50 token.

So far so predictable. But then, in the lottery, things became a little uncertain and the participants started acting ridiculously. Given a 50 per cent chance of winning the more expensive token and a 50 per cent chance of winning the cheaper one, subjects were only willing to pay an average of $16. This was a situation where the worst possible outcome was getting the less expensive book token, but they valued it less than one in which they were guaranteed to get that token. Madness. Unless people are experienced in business, the smallest whiff of uncertainty can completely unsettle them.

Selling out

But even when these inexperienced NHS boards do take a risk on an idea, they simply don’t have the capital to protect it properly. The new drug or surgical device is therefore sold off at a very early stage of development, relatively cheaply, to private companies. If it turns out to cure cancer, it is the that company profits, not the NHS.

Far from being a profit-generating “centre for innovation”, then, the NHS has become a feeding ground for lean, mean American companies who cherry-pick the best ideas and capitalise on the revenue. It’s time for the NHS to take a lead from the private sector where it counts. They need to stop investing in “facilitators” and start investing properly in ideas. That’s where the money is.

Photograph: Getty Images

Martha Gill writes the weekly Irrational Animals column. You can follow her on Twitter here: @Martha_Gill.

This article first appeared in the 23 July 2012 issue of the New Statesman, Israel: the future

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A new German law wants to force mothers to reveal their child’s biological father

The so-called “milkmen’s kids law” would seek protection for men who feel they have been duped into raising children they believe are not biologically theirs – at the expense of women’s rights.

The German press call them “Kuckuckskinder”, which translates literally as “cuckoo children” – parasite offspring being raised by an unsuspecting innocent, alien creatures growing fat at the expense of the host species’ own kind. The British press have opted for the more Benny Hill-esque “milkmen’s kids”, prompting images of bored Seventies housewives answering the door in negligées before inviting Robin Asquith lookalikes up to their suburban boudoirs. Nine months later their henpecked husbands are presented with bawling brats and the poor sods remain none the wiser.

Neither image is particularly flattering to the children involved, but then who cares about them? This is a story about men, women and the redressing of a legal – or is it biological? – injustice. The children are incidental.

This week German Justice Minister Heiko Maas introduced a proposal aimed at to providing greater legal protection for “Scheinväter” – men who are duped into raising children whom they falsely believe to be biologically theirs. This is in response to a 2015 case in which Germany’s highest court ruled that a woman who had told her ex-husband that her child may have been conceived with another man could not be compelled to name the latter. This would, the court decided, be an infringement of the woman’s right to privacy. Nonetheless, the decision was seen to highlight the need for further legislation to clarify and strengthen the position of the Scheinvater.

Maas’ proposal, announced on Monday, examines the problem carefully and sensitively before merrily throwing a woman’s right to privacy out of the window. It would compel a woman to name every man she had sexual intercourse with during the time when her child may have been conceived. She would only have the right to remain silent in cases should there be serious reasons for her not to name the biological father (it would be for the court to decide whether a woman’s reasons were serious enough). It is not yet clear what form of punishment a woman would face were she not to name names (I’m thinking a scarlet letter would be in keeping with the classy, retro “man who was present at the moment of conception” wording). In cases where it did transpire that another man was a child’s biological father, he would be obliged to pay compensation to the man “duped” into supporting the child for up to two years.

It is not clear what happens thereafter. Perhaps the two men shake hands, pat each other on the back, maybe even share a beer or two. It is, after all, a kind of gentlemen’s agreement, a transaction which takes place over the heads of both mother and child once the latter’s paternity has been established. The “true” father compensates the “false” one for having maintained his property in his absence. In some cases there may be bitterness and resentment but perhaps in others one will witness a kind of honourable partnership. You can’t trust women, but DNA tests, money and your fellow man won’t let you down.

Even if it achieves nothing else, this proposal brings us right back to the heart of what patriarchy is all about: paternity and ownership. In April this year a German court ruled that men cannot be forced to take paternity tests by children who suspect them of being their fathers. It has to be their decision. Women, meanwhile, can only access abortion on demand in the first trimester of pregnancy, and even then counselling is mandatory (thereafter the approval of two doctors is required, similar to in the UK). One class of people can be forced to gestate and give birth; another can’t even be forced to take a DNA test. One class of people can be compelled to name any man whose sperm may have ventured beyond their cervix; another is allowed to have a body whose business is entirely its own. And yes, one can argue that forcing men to pay money for the raising of children evens up the score. Men have always argued that, but they’re wrong.

Individual men (sometimes) pay for the raising of individual children because the system we call patriarchy has chosen to make fatherhood about individual ownership. Women have little choice but to go along with this as long as men exploit our labour, restrict our access to material resources and threaten us with violence. We live in a world in which it is almost universally assumed that women “owe” individual men the reassurance that it was their precious sperm that impregnated us, lest we put ourselves and our offspring at risk of poverty and isolation. Rarely do any of us dare to protest. We pretend it is a fair deal, even that reproductive differences barely affect our lives at all. But the sex binary – the fact that sperm is not egg and egg is not sperm – affects all of us.

The original 2015 ruling got it right. The male demand for reassurance regarding paternity is an infringement of a woman’s right to privacy. Moreover, it is important to see this in the context of all the other ways in which men have sought to limit women’s sexual activity, freedom of movement and financial independence in order to ensure that children are truly “theirs”.  Anxiety over paternity is fundamentally linked to anxiety over female sexuality and women’s access to public space. Yet unless all women are kept under lock and key at all times, men will never, ever have the reassurance they crave. Even then, the abstract knowledge that you are the only person to have had the opportunity to impregnate a particular woman cannot rival the physical knowledge of gestation.

We have had millennia of pandering to men’s existential anxieties and treating all matters related to human reproduction, from sex to childbirth, as exceptional cases meaning women cannot have full human rights. Isn’t it about time we tried something new? How about understanding fatherhood not as winning gold in an Olympic sperm race, but as a contract endlessly renewed?

What each of us receives when a child is born is not a biological entity to do with as we choose. It is a relationship, with all of its complexities and risks. It is something worth contributing to and fighting for. Truly, if a man cannot understand that, then any money wasted on a Kuckuckskind – a living, breathing child he could get to know – has got to be the least of his worries. 

Glosswitch is a feminist mother of three who works in publishing.