Over the years, one of my favourite
pastimes has been people watching. From Spain to Singapore, France to Finland
and Australia to America, I have sat at pavement cafes and bars and watched the
world go by. It’s better if there are two of you. Sitting together, you can wonder
why that man has a frown, that woman a smile, that young couple walking but not
talking, and so on. This kind of people watching might also include commentaries
on clothes, shoes, hair styles and guesses as to where they might have come
from or are going to. Of course, some readers might see this pastime as somewhat
voyeuristic and intrusive, and I guess up to a point it might be so. However,
my people watching is simply observing everyday folk doing everyday things, and
I think I do this without any infringement of their privacy.
Of course this is not always the
case. The usual explanation of voyeurism is the sexual interest in or practice
of spying on people engaged in intimate behaviours that are usually considered
to be of a private nature. Voyeurs generally observe others in private and not
in a public place. I was surprised to find that voyeurism is classified as a
mental disorder in the Diagnostic and Statistical Manual (DSM). There is
another more sinister type of people watching, and that is the type often
portrayed in stories of dystopian societies.
Now I have yet to see the TV adaptation
of Margaret Atwood’s The Handmaid’s Tale, but I guess I will at some stage do
so thanks to catch up television. I have, however, read both Aldus Huxley’s
Brave New World (first published in 1932) and George Orwell’s Nineteen Eighty
Four (first published in 1949). These are all examples of dystopian novels.
They are all set in some fictitious future, and all three books feature real-world
issues such as politics, religion, ethics, society, technology and psychology. These
same world issues are as pertinent today, as they were when these books were
first published.
Today many of the terms used in
these books, particularly 1984, are part of contemporary language: Big Brother,
thought-crime, newspeak, and Room 101. Indeed I used the term Big Brother just last week when I went to collect my new car. I was taking out some finance to cover
the value offered for my old car and the cost of the new one. Long gone are
that days where you were required to produce three recent pay slips, and proof
of address and so on. Now it is all done by computer – even the signing of the contract
was done electronically. What piqued my anger was to get onto the finance form
and complete the application, I had to first answer five questions. I was asked
for the first two initials of someone who I might have a mortgage with; the
last five digits of one of my bank accounts; length of time living at my current
house; and a couple of others.
Each of these questions had five
answers for me to choose from, and only one was right of course. The salesman
thought my irritation at being asked these questions was strange. He said they
(the finance company I hope) could see everything about my finances, where I
banked, mortgage, shopping bills and any and all aspects of my financial health
and well-being. In these days following the recently updated General Data
Protection Regulations (GDPR), I was appalled that anyone should have unauthorised
access to personal data in this way. It really did feel like Big Brother was
watching me. As I wanted to take my new car home, I had no real choice but to
go along with it.
The experience made me ponder a
couple of things. What other information about me was being held without my knowledge?
Amazon send me recommendations based on my recent browsing history, with
everything from books to garden furniture. Every month Tesco send out money
saving coupons for me to use based upon what I had purchased in the months
before. If I use certain hashtags, the number of followers on twitter goes up
(or down). Which when you stop and think about how much of our lives is lived
through online and smart technology, is a very frightening thought. The other
thing to cross my mind was given the financial sector could collate, analyse
and act on my personal finances and spending habits, why hasn’t the NHS managed
to do the same with my health records and life style choices? Or maybe they
have, and simply not told me!
Way back in 2016, a five-year allocation
of £4.2 billion was made available for information technology development. 50%
of this was ring-fenced for existing programme up-grading or replacement; the
other half for new programmes. It is not enough money of course, but it is
enough to make a start. There is a NHS IT Strategy which has five aims: empowering
people to maintain and manage their own health, illness and recovery; supporting
clinicians in delivering high quality care at all time, particularly developing
electronic records to help share patient information; to integrate services
across health and care; managing the health care system in a way that reduces the
burden of data collection, supports quality improvement and enables complex modelling
for health and care planning; to create a future where the NHS becomes world
leading in genomics, big data analysis and keeps the British public’s
confidence.
To deliver all of this, there is
the small problem of having a secure network infrastructure, which can support
data collection and dissemination, and an ecosystem for folk to control their own
data and as such allow the NHS to access this data in much the same way as the banking
sector does. With such an IT enthusiast as the new Secretary of State for
Health and Social Care Matt Hancock, I might just get Amazon to send him a copy
of Orwell’s 1984 – he might find it a useful reminder of what to avoid.
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