Despite the immense issues raised by the process of automating healthcare, the coronavirus outbreak accelerates the urgency of the discussion.
The Coronavirus pandemic, dubbed the largest disruption to daily life in peacetime Britain, continues to tornado across the UK and take with it the lives of our loved ones and neighbours before their time. If the NHS wasn’t already plagued enough by decades of cuts and workforce shortages, Covid-19 presents itself as the biggest fight to the sector in a generation.
Although 20,000 retired doctors and nurses have valiantly marched back into the trenches, the coronavirus battle remains uphill: there are 122,000 care worker vacancies alone, and a similar gap of 44,000 nurses and 11,500 doctors. In light of this, it certainly seems short-sighted of the Government to design an immigration system that drives qualified medics away – even when the world isn’t in the throes of a global emergency. Yet this is exactly what the post-Brexit blueprint achieves: migrant carers simply won’t qualify for a Tier 2 Work Visa come January 2021 while exorbitant visa fees and ramped-up red tape may serve to jeopardise NHS recruitment drives.
Yet instead of pragmatically approaching the needs of the healthcare workforce, the Government has emboldened its far-fetched vision of a robotic healthcare system. £250m and £34m have so-far been invested to support the mission as the Government reiterated its stance in February by instructing employers to “adapt” to this new technological world where reliance on cheap migration is ground to a halt. As a result, 47% of carers feel the lack of visa routes will harm the sector, yet more fear that their jobs will become displaced by robots.
Automation impinges on women hardest in not only terms of job losses in the first wave but how the technology is executed. Consider the disparity between the tech world and the social care workforce; one is dominated by men and the other by lower-paid and oftentimes unpaid women. How then could the tech giant in Silicon Valley ever begin to imagine what sort of ‘care bot’ a carer needs to shoulder some of the burden – especially when those ensnared in the physically-demanding and emotionally-draining work on minimum wage are rarely afforded the luxury to participate in AI manufacturing?
But that’s not the only concern born out of a lack of women in the tech world: algorithms have been proven to absorb the ingrained biases around sex and race of its makers while others fear AI could similarly become riddled with ableism too. One report by DotEveryone explored that AI runs the risk of missing what the research group calls “the last ten centimetres” – the stretch of work only visible to those familiar with the job. An example of failing the ten centimetre test would be in voice-controlled smart speakers that function as medicine reminders for the vulnerable – it may seem revolutionary through the eyes of the designer, but an Alzheimer’s patient may be alarmed by an inanimate object speaking to them while patients who have lost their voice, have speech difficulties or learning difficulties may struggle to command AI into action using the buzzwords it understands. The move towards artificial intelligence risks becoming a sorely missed opportunity whereby it exacerbates such inequalities and falls flat when trying to attract its target audience.
Even more pressing matters are found in the altruism, or lack thereof, of care robots themselves. AI is still miles away from grasping the basic skill needed for the job; it cannot adapt to the unpredictable environment of care work nor grasp the nuances of human emotion and speech. And it still needs a human to plug it in, install it, refresh it when it crashes, charge its batteries and pay the bill. Then there is the dignity and privacy qualm too: should a vulnerable child be in a state of undress around a camera-fitted and potentially hackable device? How many people would truly feel comfortable having a robot help them over a flesh-and-blood hand to hold? According to one survey by the European Commission, only 26% of participants said they wouldn’t mind receiving robo-care if they were in a hospital or care home.
However, while the crux of this debate lies in the need for more human contact, not less, the coronavirus pandemic is accelerating the case for AI in healthcare.
Without a doubt, FaceTime, Skype and over-the-phone diagnoses have dulled the pains of self-isolation and social distancing and, quite literally, saved lives. In China, technological assistance has become paramount in eliminating the spread of infection: robots in one smart hospital in Wuhan outnumbered doctors, delivering medication, patrolling the corridors, cleaning infected areas and even entertaining the patients with dance classes all while keeping healthcare workers safe from exposure to the virus. All across the world, robots are pictured disinfecting the streets, monitoring people’s temperature, dispensing hand sanitizer and even cooking and delivering food. As Orwellian it may sound, other apps have been tracking people’s whereabouts and marking individuals who are unsafe to travel.
Even before Covid-19, care robots have been trialled to great success. The Shin-tomi nursing home in Japan uses a four-foot tall humanoid, Pepper, to entertain its residents and fulfil other mundane duties. Another, Paro, a cuddly toy seal, has been able to comfort those with dementia and depression. Others are still in the making but suggest similar outcomes; Tree, a moveable screen anchored to the ground, grants the frail some independent mobility; Kirobo comforts those without children and RoBear can physically lift patients from wheelchairs to beds.
With every passing day, we see our NHS staff running – bereft of protective equipment – into the arms of danger. Imagine if the UK had similar AI mechanisms that could physically shield them from harm.
Yet the problem remains that the UK Government has gravely overlooked the major benefit of AI: it should supplement and support workers, not stand in their place. Now, the biggest battle for AI remains in public confidence, confidence that has waned in the Government as it remains blinkered by its idyllic vision of Little England as a barricaded fortress that has been purged of migrant workers. The suggestion that robots can supplement “low-skilled” migrant human care is just another kick to the teeth – and when the UK is running low on resources and needs all the help it can muster, is now the time to be pursuing such a divisive political ideology?
This article has been written by Olivia Bridge who is a political correspondent for the Immigration Advice Service; an organisation of UK and Ireland immigration lawyers that is offering free immigration advice to NHS workers amid the coronavirus pandemic.