Professor Bellis, thank you. It is a genuine privilege to be here today as a guest of the World Health Organisation and Safety 2010’s other sponsors.
Can I repeat the thanks of Earl Howe again, on behalf of the UK Government, to all delegates at the conference this week, many of whom have - I know - travelled an incredibly long way to share their knowledge and expertise with colleagues from around the world.
It is our pleasure to welcome you all to London and I sincerely hope the next three days are both useful and interesting. As you know, we are honoured to have an incredible number of extremely eminent academics, experts, policymakers and professionals attending and speaking at the conference. Can I pass on my thanks to them also? As well as to Liverpool John Moores University, to the Department of Health, the European Union, the Health Protection Agency and everyone else who was involved in getting this fantastic event up and running.
Over the last week or so, there have been some very public reminders in the UK about the importance of the work you do to prevent injury, with the tragic death of two girls from London - one in a boat accident and another in a fall from a block of flats - reinforcing to all of us who are parents that the things we love most can be stolen away from us at terrible speed. And reminding us also, I think, that there’s very little in life that’s more important to us than the kind of inner security that comes from knowing your family is safe when you leave them to go into work. Of feeling confident enough to walk down the street without glancing over your shoulder to see who’s behind you. Or simply, perhaps, of believing tomorrow will be much the same as today.
As you know, however, such confidence can be illusory and is not earned easily. It requires us as citizens to feel empowered, to feel in control of our environment and to feel prepared to face those ‘known unknowns’ - to quote Donald Rumsfeld. Most of all though, it depends on our assessment of risk - the extent to which we measure the likelihood of something going wrong - and the degree to which we fear loss.
The question I’d like to answer today is the extent to which Government can give its citizens that greater confidence - and more specifically, how we should approach that issue of risk. On the face of it at least, there is a huge amount of danger in our lives. Whether it is risk from violence, accidental injury, disease, bullying or any number of other aspects of the society we live in. In the UK, as with much of the world, the traditional means of minimising that risk has sometimes been characterised as one of knee-jerk reaction. Something happens and the government of the day hastily introduces a brand spanking new programme, law or organisation to deal with the perceived threat. Sometimes - undoubtedly - that action was necessary and appropriate, sometimes not. But the point is that by its very nature it tends to be reactionary. Partly because it is politically very difficult not to be seen to be doing something. Partly because it is in all our natures to fear risk and attempt to minimise it.
Many of you will, I’m sure, have read Steven Levitt and Stephen Dubner’s book Freakonomics. In one of the chapters they talk about the ‘perfect parent’ and make the point that families are bombarded with very different, and often contradictory advice about how to bring up their children and minimise risk to them. They include a quote from the American risk consultant Peter Sandman, who says: ‘Risks that you control are much less a source of outrage than risks that are out of your control’.
They also make the point that there is often a huge discrepancy between the risks we perceive as being of the greatest threat, and the risks that actually offer up the gravest threat. Levitt and Dubner use the example of swimming pools in the States and gun ownership. They say that the chances of your child dying in a house with a swimming pool are far greater than the chances of your child dying in a house with a gun. As they put it, the ‘likelihood of death by pool and death by gun, isn’t even close’.
We are, in other words, generally speaking, very poor risk assessors. The fact is, swimming pools are more of a threat to our children than guns - but we fear guns far more. And we sometimes find it difficult to assess risk simply because we are given too much information. We have access to so much advice - from so many sources - that it is almost impossible for us to gauge the best way of avoiding injury or accident. For example, if a study from New Zealand is to be believed, if you drive a silver car you are far less likely to be involved in a serious accident than the driver of a white, black, red or green car. Or, if you are lucky enough to be a Hollywood star, you might be worried to hear that being nominated for an Oscar runs its own risk. Apparently, those who are nominated but don’t win, have an average life expectancy that is two years less than those who are nominated and do win.
In the UK, some of those disparities in risk are, however, altogether more serious. Poorer children, for example, are much more likely to be involved in accidents. With young people from the most deprived families 13 times more likely to die from accidents, and 37 times more likely to die in a fire than the children of professionals.
The sad fact is that, as a result of these hugely complex relationships between risk and general information overload, governments have not always got it right when they try to improve safety. Rather than listening to experts, professionals and academics, they’ve often targeted resources poorly by basing decisions on the fear of risk itself, rather than the evidence.
Here in the UK for instance, we have produced huge great rule books and guidance seeking to cut a path through that miasma of information, but we haven’t really done enough to think about how accessible it all is. That has led, unfortunately, to perhaps even greater fear and concerns over whether childhood in particular has become too ‘bubble wrapped’. With society so risk averse that the rough and tumble has been taken out of children’s play, making us less resilient and less attuned to recognise the real dangers than actually surround us. This despite the fact that we know risk aversion is actually a problem in itself. With scientists telling us it blinds us to the real dangers around us, and that overprotective parenting can actually hamper a child’s cognitive development rather than encourage it.
Symptomatic of this counterproductive risk aversion was, I think, ContactPoint, a UK database of all 11 million children in the country, which was designed to alert social workers and other professionals to where a child might be in danger. We decided to close it down because it treated the collection and computerisation of data almost as an end in itself - even when it then impedes the time and capacity of the professionals to interpret and act on that data, and make the interventions that make the real difference to a vulnerable family.
I would argue that huge systems like Contactpoint - which provide little tangible benefit and often only lead to a false sense of security and complacency - have the potential to do far more harm than good. Instead, Governments should be looking to use the best scientific evidence, and best possible analysis, to manage risk rather than to try and do the impossible by taking responsibility for every citizen’s personal safety. That approach has been tried - and it’s failed time and time again - precisely because it encourages individuals to slough personal responsibility for their actions, and in the process actually exposes them to far greater danger.
You know better than I do that we cannot, unfortunately, create a risk-free society. What we can do though is equip citizens to protect themselves from harm by providing better information, better systems and better procedures. In short, by empowering and trusting individuals to take control of their lives and by being smarter about risk and how we handle it from a public policy perspective.
This is why the UK Government is taking a new direction: stressing both the importance of personal responsibility and of making the right interventions, rather than making decisions based on fear itself. Most importantly, we are encouraging greater personal and community freedom among citizens through our Big Society plans, which stress the importance of individuals taking more control over the world around them - but also highlight the need for each of us to be vigilant and aware of potential dangers.
In addition, we are carrying out a review of health and safety law through Lord Young, which will look at how we protect people without wrapping business in red tape. That report is due out very soon, and is expected to look at how we can curb the very worst excesses of the compensation culture that has grown up in the UK, with, for example, the possibility that schools might no longer be liable for injuries to children on school trips unless there has been a reckless disregard for safety.
We are also undertaking a review of social work practice in the UK, which will set out the obstacles preventing improvements and consider how we can get better early intervention, how we can trust professionals more, and how we can remove unnecessary bureaucracy from their jobs.
And, finally, we are radically changing the way we engage with families. Recruiting thousands more health visitors, who can work with parents at both the pre- and post-natal stages. Helping them to manage risk sensibly and without the fear, by empowering them with professional, knowledgeable advice on parenting.
This help will be particularly targeted at the most vulnerable communities - a point that is, I know, of particular importance to this conference and its focus on equity.
But it remains important nevertheless, to recognise that risk, and the fear of risk, is something we all feel. Our job in Government is to try and make sure every community feels safer by giving greater support and better quality information, so that all families are equipped and resilient enough to protect themselves.
The work that you are all doing is putting that goal within reach for perhaps the first time. On behalf of my Department and the UK Government, let me thank you again for the incredibly valuable work you are doing, and for raising the profile of this most important of areas right around the world.