Obamacare: Cash poor, health poor, digital poor. Can we help? Yes we can

A few bugs in the Obamacare website is not the real story here. It’s the fact that, according to Pew Internet, 48 million Americans don’t use the internet at all and millions more can’t do online transactions. Tinder Foundation is a UK non-profit with a proven solution to help millions to get online and use Government services. A year ago I would have said that our success wasn’t relevant to this story unfolding over the pond but now I know that it is – the stats tells the story. In the US and the UK the people who are offline are basically the same demographic and have the same barriers: 50/50 of offliners are over/under 65 years of age; around 40% live in households on very low incomes; and about 50% have a low educational attainment (no high school diploma in the US and don’t have 5 GCSEs in the UK). Lack of perceived relevance and not having the skills to use the internet are the two main barriers. If the problems are the same then the solution could be too.

The correlation between those who are the ‘digital poor’ – who don’t and can’t use the web – and poor health is huge. Just looking at life expectancy is a clear indicator: in London the average age at death ranges from 71 in Tottenham Green to 88 in Queen’s Gate and in Washington DC life expectancy for the poor is 71 years and for the education professional it’s 83 years.

The cost of healthcare is not something we have to worry about in the UK, we’re lucky to have the NHS so much so we often take it for granted. If you fall ill in the US it’s down to you to foot the bill – unless you have health care insurance. It is estimated that between 32-50 million Americans don’t have any cover and with the average visit to the emergency room costing £780/$1,265 it can be expensive. Unsurprisingly the number one reason for bankruptcy in the US is health care costs. So Obamacare is there to help people who are cash poor, and who will in all likelihood suffer health inequality, and will also suffer digital exclusion.

Tinder Foundation is lucky to be working with NHS England to tackle the ‘digital poor’ so that they can benefit in the drive for better health information, health prevention, and more conversations about health – all to be online. Our work with our 5000 hyperlocal partners in the UK online centres network will increase the web literacy for those digital poor so that both have the skills to use it and know that it can improve their and their families’ health. Tie that together with essential tools such as the free Learn My Way online courses helps people to learn as well as local partners to track that learning using the data analytics. I think this is a model that could help Americans to not just register for Obamacare but also to access online information to keep them healthy too.

We’ve helped over 1 million people at a unit cost of £30/$50, and I know our model could work for much higher numbers of people where there is a collective will to make it happen. This kind of effort, at the kind of scale that’s needed, takes time, fantastic partnership building on the ground, and persuasive and focused leadership.

It’s easy to see that the introduction of Obamacare should benefit millions of people. Stop talking about the bugs. Bugs in a website are a temporary problem and I’m sure there are hundreds of programmers busily fixing it right now. It’s the 48 million Americans who don’t use the web that is a more difficult problem to fix.

Carnegie UK Trust turns 100


Last week the Carnegie UK Trust celebrated its 100th birthday. And boy, did it celebrate in style, with a week-long party in Edinburgh featuring some amazing exhibitions, dinners and the awarding of the Carnegie Medal of Philanthropy.

We were celebrating the amazing generosity of some extremely rich people, who obviously have lots of much more selfish choices on how they spend their money. My main take away was that giving happens in all kinds of ways, I heard that of the £10bn given to good causes each year in the UK “only” £1.5bn come from £1m++ donors which means the majority are given by sponsoring your friend’s fun run. We discussed the huge value of giving time, services in-kind, as well as giving food to the food bank and clothes to the charity shop. The challenge of course is working out how this giving makes the most positive impact on our society; it’s not about making us feel good it’s about making a change to the status quo where the status quo isn’t providing people in our country (and our world) access to their basic human needs of a safe community, a home to live in, food and water, friendship and happiness, and of course education and fulfilment.

I was already very interested in the work of Andrew Carnegie before I made the trip up to Edinburgh so to be asked to speak at the Public Libraries seminar was a real honour. Knowing how passionate Carnegie was about libraries as a result of being starved of books as a child, I wanted to ensure I made a good job of it – thinking deeply about the needs of society for a 21st century Library. You can find the transcript of my speech in my last blog post. I also enjoyed the speeches from the other speakers in the session, particularly Liz Macdonald, Senior Policy Officer at Carnegie UK Trust, who used the words of Andrew Carnegie himself to illustrate his passion for libraries; “let there be light” he quoted, or even had engraved above the door to his libraries, and he literally meant it putting huge glass atriums into the libraries to aid reading by natural light when the norm was reading by candle light. Martyn Wade asked for a move to “one Library” which deserves more time. And Louise Overgaard, from the amazing library in Aarhaus, Denmark, talked about the future of libraries and the maker movement.

The celebrations included a fascinating exhibition about the life of Andrew Carnegie. I especially enjoyed seeing the first ever known pre-nuptial agreement from 1877 to ensure his new wife supported his ambition to give away his fortune for good causes and she signed away any rights to his estate. There was also an impressive Warhol exhibition, and a bagpipe playing robot!

The Carnegie Medal of Philanthropy is a highly prestigious award which is awarded biannually to those who use their private wealth for public good, and this year – as in previous years – the recipients were all very worthy of the recognition. The 2013 recipients were Her Highness Sheikha Moza bint Nasser, Dr. James H. Simons and Marilyn H. Simons, Dmitry Borisovich Zimin and Dame Janet Wolfson de Botton on behalf of the Wolfson Family, as well as Sir Tom Hunter who rather charmingly described himself as ‘chuffed to bits’ to have received the medal. You can find out more about the great work of the winners here.

Listening to the thought provoking words by keynote speaker Pierre Omidyar at the awards ceremony, about optimism and philanthropy, I understood that the first step to making change is believing that you can make change.

Re-imagining Carnegie: Libraries for the 21st Century, Helen Milner

This is the transcript of my speech I made today (16 October 2013) as part of the Andrew Carnegie International Legacy events taking place in Edinburgh:

In order to prepare for today I literally imagined myself sitting with Andrew Carnegie talking about how he could make the greatest impact on today’s society by leveraging his billions. I’m sure I would have liked him, I too am a positivist and a modernist. But I’m pretty certain he wouldn’t want to ‘save the libraries’ – at least not save the libraries as a 20th century construct. He would agree this is time for revolution not evolution.

The fundamental problem is that most people think of libraries as being about a building with books in it. Indeed Andrew Carnegie is himself credited for inventing self service stacks – better access to books, for browsing and discovery. As a poor bobbin boy in 1849 Carnegie shamed his local library in Pennsylvania to let him use it for free as the common practice then was to charge $2 and he couldn’t afford that. And it’s this bobbin boy – or his 2013 equivalent – that I’m imagining as a user of a 21st century library.

But let’s not forget that Andrew Carnegie’s passion was the power of access to information – indeed information you can browse and discover. In 2013 is that only possible in a building with books in it?

Before you think I’m here as a hater of libraries, I’m not. When he was four I asked my son what his favourite place in Sunderland was, he said the library. When I was a teenager the library was the place that gave me free and non judgemental access to classical music, jazz, as well as Leonard Cohen and the Sex Pistols – my home was full of books but not of music. And I work with thousands of libraries in my day job.

So, what is a library? For me, it provides:

  • fulfilment

  • opportunity

  • a safe haven that doesn’t judge

  • and it’s free and universal.

Well, you’ve all got a mobile in your pocket that does that.

The internet provides fulfilment: you can read a book, write a book, write a blog, watch a film, upload your own film, research your local history or family tree, create, share, converse. Last night in the Warhol exhibition here at the Scottish Parliament, there were lots of signs that said ‘no photos’. It beggars belief that in 2013 that matters. Why do I need to take a photo? I just made a digital note of the name of a picture I liked on my phone and googled it later and posted a link of it on facebook to share it with my friends.

The internet provides opportunity:

  • access to all of the jobs in Edinburgh, in Scotland, in the UK, in Europe, in the World

  • better access to information for homework, for research

  • ease to start a business – to research need, to search for competitors, to register your company.

The internet is fulfilling, rewarding, and challenging. The internet is free and universal.

But!! Two big buts.

1. Where is my guide and my helper on the internet? Where is the person I trust to support me and point me in the right direction?

2. And, in the UK 11m people can’t use the internet. In the US that’s 69m. In the world it’s 4.6bn. 4.6bn people who can’t use the internet in the world today in 2013.

That’s my day job – to help the 11m in the England who can’t use the web – and we’re doing well so far, we’ve helped 1.16m in the past three years in England through working in partnership with 3000 public libraries and 2000 hyperlocal community centres.

Public libraries AND community centres providing free access and support to anyone and everyone. Helping them to learn basic digital skills using our free online courses and a common learning platform, with staff and volunteers there who you trust to help and guide you. Over 1m people have benefitted from this in the past three years.

The power of the internet is that it can inspire, fulfil and entertain. The internet provides people with opportunities that are different (better) to those offered, perhaps even imagined by, parents and peers. You could say that the internet is much like the library of the 19th century.

My fear is that we’re rebranding libraries not re-imagining them. We’re building amazing buildings and putting other things alongside our books, but somehow “Library” doesn’t seem to be deemed the right word anymore. At the wonderful Chattanooga Library the cool stuff is done on the “4th Floor” – “a public laboratory and educational facility with a focus on information, design, technology, and the applied arts. The 14,000 sq foot space hosts equipment, expertise, programs, events, and meetings that work within this scope.” While “traditional library spaces support the consumption of knowledge by offering access to media, the 4th floor is unique because it supports the production, connection, and sharing of knowledge by offering access to tools and instruction.”

In England 10% of the Libraries are now community run. I wondered if they are therefore a hotbed of innovation where communities are challenging the 19th and 20th century norms of what a library should be. Sadly not. Or not yet anyway.

Two great examples.

In Huddersfield, UK, the Chestnut Centre is a library and cafe by day, but “once the library closes in the evening the centre will transform into a cinema” putting “the Chestnut Centre at the heart of culture and arts in our area”. Isn’t it still the library after dark when the cinema is on?

And there’s a new “library/hack/maker space” in St Botolphs, Colchester built in the old bus station waiting room – driven by innovators – not by, but “in partnership” with Essex Libraries.

These examples are amazing, really amazing, showing how libraries can re-invent themselves. And, Louise has also spoken about her great Arhaus example. Fantastic work.

But the most exciting innovation I’ve heard in the past year is “a community library point” in Philadelphia where a community centre has a big fat fast broadband cable coming to it – from the city library – and that was called “a community library point”. It is free information and fulfilment coming to a disadvantaged community via the internet. And it is called a library. No books, just the web … in a community centre, with wonderful people to guide and support. The community centre knows the people who live in that community, so they can design and provide the services they need. They can do it better with faster and cheaper bandwidth.

Maybe the best thing about libraries is the brand.

But some libraries are not great, in fact some are quite poor. They don’t ask their communities what they need. They don’t innovate. They don’t think about how to attract the local young ‘bobbin boys’ (like the young Andrew Carnegie) to their services. They are stuck in the past.

And in some local communities it’s the local community organisation or community centre (not the library) who is the heart of local services to meet local needs, not just run for this generation’s Andrew Carnegies but by them. Why are they not worthy of being in this new movement of what we could call a Library?

If Andrew Carnegie was here and asked me if he should spend £1bn on saving the libraries and £1bn next year and the year after that. I would say No. But that’s what the UK Government is spending now, every year.

But I would say yes to the £1bn – and that’s our fear, if we say that libraries aren’t good enough then the money will be whipped away from us and not spent on fulfilment and opportunity for all.

We want the £1bn investment – but to be spent in a different way:

  • yes, to a community space where people can meet and feel free and not judged

  • yes, to access to information and entertainment in many many media

  • yes, to programmes to make sure that everyone knew that they could achieve new things beyond the knowledge of their peers

  • yes, to excitement about learning

  • yes, to people there to guide and support if needed

  • yes, to making sure the internet and internet skills are freely available for everyone in our society.

  • To quote Andrew Carnegie: Yes it should all be “free to the people.” And free to all, not just those who are library members.

Yes, most importantly, to much more, and much better partnerships between local organisations who are serving each community.

And yes to being bold about challenging ourselves more, affecting more change, working faster and harder so that everyone can achieve their potential.

Please get in touch if you’d like to continue this conversation.

Get online week – Let’s get digital!

Today marks the start of our seventh national Get online week, and at Tinder Foundation we’ve been getting into the Let’s get digital theme, and indeed, the Let’s get digital groove! I can only apologise for my part in this film… 

Whilst this tinyslice of Get online week might make me (and unsuspecting viewers) cringe, looking back over the last seven years I’m pretty proud of the campaign.

When it all started back in 2007, no-one had ever tried a mass-marketing approach in promoting digital to the digitally excluded before. We knew that to make it work, there needed to be local events which were marketed locally to the third of the British population who weren’t online. Together with the UK online centres network, we stepped up to the plate, and Get online day was born.

The day soon became a week – and seven years on it’s still going strong – and is a key part of the digital inclusion calendar. in 2013, we’re now talking about the final sixth of the population left offline, and the campaign now caters for the more deeply excluded as well those who still aren’t making the most of digital technology. And this year we’ve got the support of the Skills Minister Matthew Hancock, who said: “The modern world and workforce is becoming increasingly dependent on the internet, yet there are still 11 million people in the UK without basic digital skills. If we are to compete in the global race then we must have an IT and digitally literate population. This is why we are supporting Get online week to help people work more effectively, communicate better and make sure that Britain stays ahead in a digital world.”

This year, another 700 centres have taken up the Get online week challenge, and over the next week will deliver thousands of events helping tens of thousands of people. They’ll be taking our ‘Let’s get digital’ message out into local communities, and using our new ‘Let’s get digital’ taster course (available on www.getonlineweek.com) to engage people.

We’re always learning more about the digital divide (as I blogged about here) but we don’t always think about is how it feels to be left out, so in preparation for Get online week this year we decided to ask that very question. New learners in UK online centres reported feeling ‘isolated’, ‘embarrassed’ and ‘frustrated’ before finding their way into a centre. Interestingly, the two biggest impacts of being offline were reported as “missing out on family news” and “not being able to access online bargains”.

This kind of insight is key in bringing digital exclusion back down to a personal level, and it’s at the core of how we’ll be starting all of our ‘Let’s get digital’ conversations. UK online centres are experts in identifying the often very personal trigger points that can switch each individual from non-use to use. And I strongly believe everyone everywhere has a trigger. It might be wanting to see pictures on Facebook, or wanting to compare car insurance prices at a glance. For Colin, one of our previous Get online week visitors, it all started with wanting to get his shopping ordered online and delivered to his door.

This week, I’m looking forward to seeing the Get online week campaign hit the digital trigger for even more people up and down the country. You can keep up with latest Get online week news with hashtag #GOLW13, or by visiting www.facebook.com/ukonlinecentres.

Happy Get online week No. 7 everyone, and the best of luck to all the centres taking part.

September/October – party time!

The end of September/beginning of October was officially party time for me – party conferences that is!

Okay, so it may not be everyone’s idea of fun, but I very much enjoyed myself and left very impressed with both Labour and Conservative thinking on all matters digital.

Much of my time in both Brighton and Manchester was spent, unsurprisingly, at fringe sessions which talked about digital strategies and priorities.  It was great to hear so many people discussing digital inclusion, and recognising the lack of basic digital skills as an issue which affects multiple policy areas.  That’s a massive step forwards from just a few years ago, when my party conference experience was spent fighting digital inclusion’s corner!

Welfare reform was obviously a huge area of discussion that affects many of our hyperlocal partners and their users.  And, due to our recent NHS contract, I also found myself listening to many conversations about the potential of technology to help NHS staff and patients.

I was particularly impressed with Stella Creasy MP (@stellacreasy) at the Brighton conference. She spoke eloquently about the use of digital for preventative care in the health service.  She argued that we need more imagination about the potential for technology to drive better services, and used an example from her own constituency.

In one hospital in Creasy’s constituency there are 56 people in hospital – not because they’re ill – but because their care at home isn’t sorted out.  Each person in hospital, costs the NHS £264 per day, so for these 56 people that’s costing the NHS £15,000.  It’s not about the money though, it’s about the person and making sure they get the care they need and in a place that most convenient for them; technology can help us to put people first.  Creasy said she wanted to see more done to reconfigure public services with the individual at the centre, driving up the quality of information and support, underpinned by digital – saving time and money as a by-product.  “How can everyone be part of our future, and then how can technology help us?” said Creasey.

I attended a similar debate at the Conservative conference in Manchester a week later where Chris Skidmore MP called for “a personal revolution not a public service revolution”.

All of this debate and deep thinking made me wonder if the real beauty of use of digital in public service is how it can bring solutions together to focus on the needs of the person, and I sketched this picture in my pad as I listened:

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With our new NHS England contract in mind, it became very clear to me that digital really can put the control back into the hands of citizens and patients. For the most vulnerable and those with the most health inequalities, that’s highly valuable.  The potential for the general population is also enormous.

In fact, if we can design a future where we use data to see what our health issues may be down the line, we can use digital to find out what lifestyle changes we should make, and manage our own health much more effectively.  The results in terms of illness prevention – and in reducing health service intervention – could be a real game-changer.

And surely that’s a good enough reason for anyone to party.

Latest stats news – 5% increase in internet use in last two years

This is a very big day for data nerds like me who love evidence that helps us make great decisions!  Two big digi-inc reports have been published, telling us loads more about who’s online, how, what they’re doing and why.

Yesterday BBC/Ipsos MediaCT released new data that shows 11m people in the UK don’t have basic digital skills – meaning they either have never been online or can’t do four basic digital things (such as send an email or do a simple search). The 11m is broken down as 61% (6.71m) have never been online and 39% (4.29m) have been online but in a very basic way. (Media Literacy: Understanding Digital Capabilities.)

Today the OxIS Report 2013: Cultures of the Internet has been published. This report is published every two years so it’s a great source to identify trends in internet use and non-use.

My top take-out headlines:

  • Non-use of the internet has declined substantially during the past two years – 18% in 2013 compared to 23% in 2011.  That’s an increase of 5% in just two years.

  • Of the 2,083 internet users in the OxIS 2013 sample, only 34 own a tablet but not a PC showing how tablets are complementing rather than replacing computers.

  • Increase in internet use in Britain occurred across all age groups, life stages, and educational categories.

  • The most positive change was among the lowest income groups. This accounts for most of the increase in internet use between 2011 to 2013.

  • There was also 11% increase in use by the disabled.

  • Increased up-take by those without an educational qualification, and individuals who have retired, are also positive steps toward closing digital divides.

  • The use of social networking has plateaued at 61% of internet users (about half of the overall population).

The OxIS report looks at the breadth and depth of use across a number of new ‘user’ categories, with those who use the web the most recognising the greatest benefits.

I’m sure I’ll be blogging more about all of this as there is some great analysis coming out to read and reflect on!  Well done to Grant Blank, William Dutton, and the team at OxIS for their fantastic work.