Reflections from a Nuffield Bioethics Parliamentary Fellow

Guest post by Stephen Barrie

In September 2015 I began a Parliamentary Office of Science and Technology (POST) fellowship, funded by the Nuffield Council on Bioethics. I was faced with the 3-month task of researching, interviewing experts, summarising and condensing ‘Global Health Inequalities’ into four sides (plus references) for a general parliamentary audience. It involved research across a wide range of fields, including the Millennium Development Goals, the Sustainable Development Goals, global healthcare, impact evaluation, international agreements, treaties and policy making. This was a fascinating, if daunting task.

POSTnotes are researched, scoped and refined through close collaboration with staff at POST, and interviews with leading figures are a key part of the process. In this case interviewees included the The Department for International Development (DFID) Chief Scientific Officer, researchers at the World Bank, Chatham House, various NGO’s and UCL’s Centre for Health Equity. The aim of a POSTnote is to be independent, balanced and accessible, and the range of interviewees one has access to, all of whom are invited to peer-review the note, certainly encourages this.

POSTnotes are an interesting format: They are widely regarded as authoritative and influential, and rumour has it that members of both Houses can be seen brandishing them during debates. They are, however, quite a different exercise from philosophy, my own discipline. Due to their brevity, they necessarily leave some important ideas unchallenged; for example, when writing about the severity of global health inequality, the WHO believe 400 million people lack access to essential health services. However, if we are going to treat that figure as meaningful we need to ask: What counts as essential?; What counts as lack of access?; And how are figures extrapolated to include hard-to-measure populations? This and similar figures are probably broadly reliable, and are certainly useful, but the form of the POSTnote dictates that they are cited without further explanation as to the method by which they were derived. POSTnotes thus sit perhaps somewhat uneasily between journalism and critical or scientific thinking.

This is not to criticise POST – a policy briefing of this kind, approaching a topic so broad, could not possibly do justice to all the scientific and conceptual complexity involved. However, it does underline the need for wide expert consultation when writing such a short and potentially influential document. There is a reason why peer review is the gold standard in academia, and POST follows a robust consultation process, making excellent use of a wide ranging network of the leading thinkers and practitioners in the UK.

There are other challenges too. POSTnotes are impartial and are not supposed to recommend policies, in the sense that they aspire to reflect a balance of expert opinion in an area. This kind of impartiality might be unhelpful if widely held views turn out to be mistaken, and the approach to policy can be challenging, particularly when substantial ethical concerns are raised about current or proposed practice. However, these restrictions are important because it is a difficult enough task to condense the available evidence on an issue into four pages without seeking to do justice to the pros and cons of different policy options.

This was an excellent opportunity not only to work on a fascinating project, but to get inside the ‘bubble’ of Westminster. It was very interesting to learn about the ways in which information and expertise flow into parliamentary work. I was able to attend a good sample of All Party Parliamentary Group meetings, some parliamentary debates, select committee hearings and conferences in Parliament (including a conference run by POST on research impact and parliament). The role of the Commons library was a noteworthy surprise, as it is the main source of briefings for MPs on any and every topic. POST stands out from the library briefing process, however, by dedicating a Fellow to work on one area for a full three months.

I would thoroughly recommend the Fellowship – the opportunity to work with experienced policy advisors at POST, to delve into a new and interesting topic with the help of face to face conversations with world-leading experts, and the general opportunity that working in and around Parliament presents is great fun and a wonderful learning experience.

POSTnote: Global Health Inequalities is forthcoming. To sign up to POST’s mailing list email post@parliament.uk with the subject line: join POST mailing list. POSTNotes are published open-access here: www.parliament.uk/post