The theme for this year’s WORK conference in Helsinki was Real work in the virtual world. Through a series of well-chosen keynotes, different aspects of digitalised working life in a neo-liberal society were discussed. Four of them were particularly relevant for the digitalization of healthcare.
Lilly Irani opened the series of keynotes by questioning the importance that innovation has in the minds of policymakers. She pointed out that the innovation hype promotes certain activities and reduces the importance of others. While innovation is said to be good for the future of the world, Irani argued that what ultimately is promoted are innovations that can profit companies, rather than everyday innovations that do not bring monetary profit. Also, the innovation hype builds on an image of mankind, where the creative man becomes more and more brainy, and the fact that the emotional, relational and physical needs are quite as important as they were in the stone age is forgotten. It is not difficult to relate her talk to the introduction of more and more expensive innovations into healthcare.
Allison Pugh’s keynote on connective labour was even more to the point for those working on IT in healthcare. She made a clear distinction between emotional/relational labour and connective labour. She defined connective labour as work that builds on creating a relationship, rather than just being kind to (sometimes aggravating) people: while it is enough for a flight attendant to be nice, a good teacher or nurse needs to create a mutual relationship to be able to do their work properly. Pugh criticized the digitalization of connective work, pointing out that it means trying to schematise complex human relationships, and, necessarily, crucial elements are left out. Connective labour is mostly performed in the public sector, where budget cuts are common, and digitalization is used to enable them. Pugh criticised the argument that digitalized services are better than no services at all – the alternative of letting public services cost more is left out from that argument. She concluded with a question whether human contact will be a luxury for the wealthy minority, while ordinary working people will have to do with digital services. It is not difficult to associate to several phenomena in the Swedish society – from meeting answering machines when trying to access public services to the increasing number of social services in Swedish municipalities that automate their assessment of individuals’ need of income support.
Valerio de Stefano talked about digitalisation and labour law. He pointed out that in the panic of losing jobs because of digitalisation, little attention is paid to the quality of jobs that are still there. He talked in particular about the increased governance and surveillance of workers that is enabled by digitalisation, leading to a hectic work pace and psychological discomfort and illness. How workers in Amazon warehouses wear wristbands that record all their activities in their daily work of dispatching orders was an illustrative example – but even if healthcare staff do not wear wristbands, the possibility of control and governance is built into a number of digital tools that are used. De Stefano concluded by calling for unionised activities to regulate the harmful effects of digitalisation.
Ilona Gershon discussed the effects that the new kind of working life has for our identities. She made an interesting reflection how the short time contract economy influences our self-images, and makes labour market relations more disrupted all over. Loyalty is not particularly valued but, rather, staying with the same employer is seen as something almost suspect. While this mentality has been slower to come to the public sector, it can now be seen even in healthcare, with doctors and nurses doing ‘gig jobs’, most often through a manpower agency. Gershon discussed the loss of tacit knowledge and expertise, as well as the instrumentalization of human relationships in this kind of working life.
Thus, the WORK conference provided talks from four researchers well worth getting better acquainted with, for anyone interested in IT in healthcare. More can be found at http://workconference.fi/work2019/work2019-conference-highlights/. Next WORK conference will be in 2021.
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