Medical Negligence & The Medical Innovation Bill

The Medical Innovation Bill often dubbed the Saatchi Bill, had potential to be the biggest change to medical negligence law that many would have seen, yet it was met with reluctance and hesitation. The Bill reached the final stage before royal assent, however Parliament prorogued and the Bill made no further progress. Then we saw it rebranded by Chris Heaton-Harris as The Access to Medical Treatments (Innovation) Bill who sought to take it through the House of Lords as a private member’s Bill. Once again, parliament session ended and the Bill did not proceed, but it raised the question of if we needed this Bill.

The Bill concerned itself with the test of reasonableness which all doctors must currently adhere to under the common law test of Bolam which was later added to by Bolitho. All doctors are subject to this test if faced with a medical negligence claim. To surpass the test, the doctor must show that they have acted in accordance with a practice accepted as proper by a ‘responsible body of medical men’. This test derived from Bolam and was heavily critiqued for allowing doctors to escape redress. Bolitho amended the medical negligence test slightly, in the sense that the doctor must also now provide a logical explanation for their disputed actions. These tests for medical negligence are often criticised as leading to an over cautious medical body of doctors, who are reluctant to try alternative treatments, or ‘out of the box’ treatments for patients, for fear of a claim of medical negligence, and so some shared the belief that new legislation should be implemented to allow doctors to avoid medical negligence claims when acting in good faith.

The new Bill would have enabled the Secretary of State for Health to create a database of medically innovative treatments. The database was set to contain records of successes and so in turn failings by doctors who use the innovation treatments listed.

Furthermore, the Bill would allow a doctor to deviate from standard practice if they could show that they had acted responsibly. The Bill in some ways can be shown to adhere to the old ‘Bolam’ test, in the sense that it would set out a series of steps that doctors can follow to show evidence that they are not guilty of medical negligence. One of which is to gain evidence from a ‘responsible body’ of medical opinion, who are in agreement to the doctor’s actions, and do not think that they were acting ‘irresponsible’. The Bill was not meant to replace the current tests for medical negligence, but rather provide an alternative means for doctors to escape liability for medical negligence when they have deviated from standard practices.

A common argument from those who oppose the Medical Treatments (Innovation) Bill is that they fear it would allow doctors to try experimental treatments, when there is already an effective treatment in place. This argument seems somewhat limited, as it is unlikely that the doctor could prove that this was indeed ‘acting responsibly’. There seems to be a lack of balance between both sides of the medical negligence scale, those doctors who crave the ability to deviate from standard practice but are reluctant to for fear of a claim, and the public who fear that this Bill will lead to more negligent treatment, and an unaccountable medical profession. Both the Medical Innovation Bills failed but it seems somewhat inevitable that this Bill will soon emanate once more.

China, the Innovation Beast

China, a nation that had dominated the world several times over the past thousand years, is on track to repeat history once again. Economic reforms introduced by Communist leader Deng Xiaoping in the late 1970s has propelled China to become a nation now deemed worthy to challenge the U.S. for the number 1 title. In 2017, PricewaterhouseCoopers (PwC) reports that the Chinese economy will overtake U.S as the largest economy by 2030. China had averaged a 10% annual growth from 1999 to 2008 and in recent years, hovered in the 6-8% range. With recent drives for technological innovations, we may see a growth in the figures and eventually, an overtake to be world largest economy.

“China has been long one of the richest, that is, one of the most fertile, best cultivated, most industrious, and most populous countries in the world.” Quote from Adam Smith magnum opus “The Wealth of Nation”. Indeed, over the past few years, China has taken concrete steps to made that a reality. In 2015, China announced “Made In China 2025”, a strategic blueprint that details the necessary steps to equip and transform the nation with local technological innovations and stage the Chinese equivalent of the Fourth Industrial Revolution. In 2017, China spending on research and development totaled $1.76 trillion yuan (USD $279 billion), a year-on-year increase of 14%. In fact, a term was invented to describe China’s unique innovation policy and its ability to drive innovation and technological advancement within its own geographical boundaries. Termed “Indigenous Innovation”, China has primed itself to be the next world’s capital of innovation and technology. Below are some of the reasons why China is able to or rather, will dethrone the U.S. within the next decade or so.

1. Size matters. China is a massive nation, whether its geographical size or population. While China and U.S are equally big at 9.3 million square km and 9.1 million square km respectively, China trumps (no pun intended) U.S with over 1.4 billion citizens, over 4 times the that of the U.S. China’s population high adoption rate for technology as well as its enclosed ecosystem has created a perfect environment for Chinese enterprises to grow and thrive. With over 772 million Internet users, China is a data haven. Furthermore, citizens in China have longed been known to be more permissive in the sharing of their personal data, a sharp contrast to the Western nations where personal data policies and regulations are strictly enforced. The recent Cambridge Analytica saga regarding Facebook’s user data highlighted the importance of keeping personal data private, but it is one that we may never see in China. However, reports of ’emotional surveillance’ being employed where employees’ brain waves are monitored in military sites and state-owned enterprises seems to have crossed the line in its latest efforts to monitor its people.

2. Support from the Chinese government. Policies such as China’s 13th Five-Year Plan (2016-2020) and Made In China 2025 are strong evidence of China ambitious plans to establish itself as the world leader in the technology leader. Subsidies, low-interest loans and tax breaks are some of the support tech firms are expected to receive as part of China’s plan to propel research and innovation within the nation. Furthermore,

Instead of having Western companies such as Google, Facebook and Twitter thrive, the Chinese government nurtured domestic firms through protectionisms and huge subsidies. Local tech giants such as Baidu, Alibaba, and Tencent, commonly referred to as BAT, were able to grow under the sheltered environment and having the whole Chinese pie to themselves. Since then, these companies have expanded overseas through acquisitions and setting up of research and innovation centers, a move that many nations have deemed to be a blatant act of ‘tech importation’, aka transfer of technology.

3. Lastly, it is simply sheer ignorance about China. Indeed, many who have little awareness of today’s China would still perceive it as a “copy-cat” country thrives on manufacturing counterfeit goods and “Made-In-China” products for the outside world. The fact is that they are now producing innovation leaders and are the ones to beat. A prime example is Shenzhen, which has evolved along the way to become its own innovation hub. Referred to as China’s Silicon Valley for hardwares, Shenzhen houses many of the companies that produces the tech product we see today, from drone producer DJI to iPhone manufacturer Foxconn. It has positioned itself as a hardware and IoT hub for many electronics manufacturers and a hotspot for Chinese tech startups. Ignorance used to be bliss when one can freely enjoy the low cost of manufacturing in China; ignorance is now a looming threat of takeover.

“China has a fairly deep awareness of what’s happening in the English-speaking world, but the opposite is not true.” Quote by Andrew Ng, co-founder of Coursera and one of the pioneers in Artificial Intelligence.

The future will be one dominated by technology, and China has prepped itself to be a part of the future. President Xi Jinping knew the difficulties of sustaining China’s economic growth and understood the potential of technology to scale to millions of enterprises and remove inefficiencies while benefiting the end-consumers.

However, it will be na├»ve to conclude that China will overtake U.S. simply on the basis of superior technology. The possibility of a trade war between the U.S. and China only benefits China, for it has the advantages of economies of scale and a single, independent market. The ongoing trade surplus with the U.S is evident of U.S. reliance on China goods, and a trade war will only harm the country with price hikes in consumer goods. The trade surplus for the first quarter of 2018 spiked nearly 20% to hit $58.25 billion, citing the possibility of a trade war. Furthermore, China has been extending its economic and political influence with the Belt and Road Initiative (BRI). Expected to cost over a trillion dollars and impact 60% of the world’s population, the BRI is the largest undertaking by the Chinese since the Great Wall of China. All signs point to the fact that China has the money, technology and influence to take over the world.

All in all, China has evolved from a nation of imitation to one of innovation, from one of producing products to one of inventing products. China is the elephant in the room that the Western counterparts have chosen to take it for granted for decades and ignore its uprise. Perhaps it is time for the world to take a good look at China and ironically, replicate what they are doing now. For the U.S, cooperating might be the best, and only way of going forward.

Organizational Structure, Creativity, Innovation

Organizational structure can inhibit or foster creativity and innovation. The problem with organizational structure though, is that it is resultant of many factors, including history, organic growth, strategy, operational design, product diversity, logistics, marketing, client base, supplier base and so forth. Therefore, what managers need, are not recipes for complete structural change, but insights into the properties of fostering structures that can be adapted into the existing structure.

To start, it is useful to analyse the preferred structures against the not so preferred. There are many definitions of types of organizational structure, but one example is:

a) Mechanistic structures (generally not preferred) – includes centralised control and authority, clearly defined tasks, vertical communication links, obedience to supervisors, rigidity and inflexibility.

b) Organic structures (generally preferred) – decentralisation of authority, tasks loosely defined, horizontal communications, greater individual authority, flexible, adaptable.

Experience shows that the above can be misleading. For example, flat organisations are generally preferred and hierarchical ones not preferred, however, even flat organisations are in reality hierarchical.

Importantly, if we have a mechanistic structure, what factors allow us to move in the right direction without wholesale change?

Some answers include:

a) Direct communication links to decision makers.

b) Communication and information flow between departments.

c) Tangible progression of ideas from problem to solution, product development to commercialisation.

d) Creative teams working outside but linked into the organization, whose culture, processes etc diffuse into the existing structure.

These and other topics are covered in depth in the MBA dissertation on Managing Creativity & Innovation, which can be purchased (along with a Creativity and Innovation DIY Audit, Good Idea Generator Software and Power Point Presentation) from http://www.managing-creativity.com

Kal Bishop, MBA

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