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# 5 Is innovation a good thing?

Engaging potential recipients of digital innovation in health and social care is an important part of developing new ways of supporting people. This is the central ethos of services which provide integrated health and social care. For example, Recovery Colleges integrate with many services to provide the optimum care for people experiencing mental health issues. During recovery, recipients of this care are considered as ‘experts by experience’ and recruited to co-design and deliver future services. While such services have been highly beneficial for many, innovation can also come with a high degree of uncertainty.

Indeed, since many innovations in health and social care are now being implemented and many more are planned, it is difficult to ascertain whether the innovation will either be an improvement or be effective in meeting the health and social care needs of the population.

There are several examples of innovations which have been considered beneficial for the whole population, yet remain highly controversial. For example, in 1905, Alfred Binet, a psychologist, and Théodore Simon, his research assistant, developed a series of tests known as the Binet-Simon scale to ascertain children’s intelligence. The main aim of the test was to differentiate between children considered ‘normal’ compared with those labelled as ‘retarded’ and to separate the two, with the latter being housed in institutions. This was considered to be beneficial for society (Gabriel and Simon, 2016); however, Canadian researchers McGowan and Westley (2015) argue that Binet was influenced by genetics and pedagogy.

Herbert Goddard adapted the Binet-Simon scale for use in American schools and, later, Stanford University Professor Lewis Terman, a fan of eugenics, adapted the scale to measure adult intelligence. As a consequence, several US states introduced compulsory sterilisation to prohibit ‘undesirable’ or ‘feeble minded’ people from reproducing (McGowan and Westley, 2015). While medical technology had made sterilisation safe, to contemporary ethicists it was unethical practice. However, at the time Terman and others believed they were doing the best for society.

What is considered a problem and what is considered a solution changes over time. Contemporary approaches to supporting children with learning disabilities value independence, inclusion and wellbeing (Gabriel and Simon, 2016). The focus of the next activity gives you an opportunity to explore some examples of a health or social care innovation.

## Activity 4 Innovation: beneficial or controversial?

Search the internet for examples of innovation in health or social care. You might like to search in a particular area of practice that interests you or in your community. Write a short paragraph describing the innovation and include the URL (web address) for the example you have chosen. Add to your paragraph one thing you find interesting about the example you have chosen.

(A text entry box would appear here, but your browser does not support it.)

### Discussion

Here is an example: The use of insulin shock therapy to treat schizophrenia and drug addiction seems highly controversial. The therapy was developed by Polish researcher Manfred Sankel in 1933 and was used until as recently as the 1950s. It involved injecting the patient with large doses of insulin which caused convulsions and resulted in the patient being in a coma for up to 100 minutes. The procedure ended by giving the patient a glucose saline solution intravenously through the stomach.

There were complications with the treatment since epileptic seizures occurred during the early stages of the procedure prior to the onset of a coma. However, seizures occurring during a coma are more dangerous as this requires the treatment to be withdrawn with immediate effect. The consequences are such that the patient either takes longer to recover or experiences severe shock, or both.

The therapy is considered controversial because there is no robust evidence to indicate that it was efficient or that it worked. Insulin therapy did have a higher success rate among patients who had been ill for less than two years as this is when a spontaneous recovery could occur anyway. However, at the time there was no other treatment available to administer to schizophrenic patients and this was therefore seen as something which could be beneficial. It remains a controversial treatment because it could lead to irreversible coma and, in severe cases, anoxia (this is a condition where the body is not getting enough oxygen, resulting in the patient writhing about and in vascular shock). Milder cases were typified by temporary paralysis of some limbs and confusion. Some patients were in a state of unconsciousness for days following the treatment.

While some innovation is considered beneficial and even essential, it can also cause harm if misused. Innovation can also be disruptive, disintegrating old systems in favour of the new. This can potentially mean the end of someone’s role, an institution or a service model. Innovation creates both winners and losers – it can improve the lives of many, but it can also exclude groups and communities and undermine institutions that have previously been highly valued.

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OpenLearn - Innovation in health and social care: social and historical
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