Limits of the Numerical


About

An ISRF-funded research project
2015–2018
CRASSH, University of Cambridge

This project explores one of the most pressing sets of questions for modern social science and its relation to policy. What are the effects on a system of social policy when numerical quantification and evaluation is introduced into that system? How does the use of numerical evaluation exclude, trivialize or distort other systems of political, moral and social evaluation? What are the political and moral consequences of this shift towards numerical evaluation? These questions are addressed with respect to three distinct strands of social policy — education, climate change and healthcare — three areas where social science, policy and the gritty world of politics interact with intense urgency. 

International and interdisciplinary in its conception, each strand of the research will be conducted by a team from a different major research university — Chicago, Cambridge, Santa Barbara California. The Cambridge project will focus on healthcare, looking at the role of numerical quantification in the British National Health Service (NHS). In healthcare the UK has led the world in basing the allocation of scarce resources on quantitative economic models. From its inception, the National Institute of Health and Clinical Excellence (NICE) has assessed novel interventions in terms of Quality-Adjusted-Life-Years (QALYs). QALYs are now the prime means of evaluating decisions about resource allocation, yet there is no scholarly history of their introduction, nor any detailed account of their effects on the processes of healthcare. How did the dominance of QALYs come about? What effect does the use of QALYs have on the behaviour of actors within the hospital system? Furthermore, what are the philosophical underpinnings, implications and limitations of the use of QALYs as a method of evaluation? This strand of the project will address these questions using a unique range of interdisciplinary approaches in order to produce a fully articulated account of both the historical and anthropological details and the wider social policy implications of numerical quantification within the NHS.

Project Description

People

Research Team in Cambridge (Healthcare)

Dr Stephen John (HPS, University of Cambridge)
Dr Anna Alexandrova (HPS, University of Cambridge)

Research Associates in Cambridge
Dr Gabriele Badano
Dr Trenholme Junghans

Advisory Board in Cambridge

Professor Ash Amin (Geography, University of Cambridge)
Professor Simon Goldhill (CRASSH/Classics, University of Cambridge)
Dr Tony Lawson (Economics, University of Cambridge)
Professor Huw Price (Philosophy, University of Cambridge)

University of California, Santa Barbara (Education)
Professor Chris Newfield (Department of English, UCSB)
Professor Bishnupriya Ghosh (Department of English, UCSB)

University of Chicago (Climate Change)
Professor James Chandler (Department of English, Chicago)

Events

14 December 2015 - Limits of the Numerical in Climate Change, Health Care and Higher Education Policy
A one day closed workshop to discuss and debate the issues to be focused on in the three strands of this project.

21-22 July 2016 -  The Uses and Abuses of Quantification in Healthcare: interdisciplinary perspectives

A two day conference discussing how particular measures and models of evidence currently prevalent in healthcare have developed and  what the practical effects of the use of such measures and models are, and what philosophical issues  they raise.

16 December 2016 - Evidence under Challenge
A one day closed workshop engaging new directions in healthcare policy and regulation.