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The Policy Ask with Christina Pagel: “There is no compelling reason to make it harder to vote in the UK”

The eminent professor and member of Independent Sage on voter ID laws, the ageing population, and what the UK can learn from Norway's social care system.

By Spotlight

Christina Pagel is professor of operational research (a branch of applied mathematics) at University College London (UCL), where she uses mathematical tools to support the delivery of health services. Her current research includes: investigating and communicating outcomes in congenital heart disease; using physiological data and mathematics to support clinical decision making in intensive care; and improving services for children with complex health needs, including transition from child to adult intensive care services.

How do you start your working day?   

I have a very consistent start! I normally wake up a bit after 7am; do Wordle, Worgle, and Quordle in that order; check my emails and the day’s news on my phone; say hi to the cats (and to my husband); do some form of exercise; have breakfast and coffee; then start work.

What has been your career high?     

I spent a year in Boston, US in 2016/17 on a Harkness Fellowship in health policy and practice, together with 15 other international fellows. It was brilliant for many reasons but four big ones stand out: learning about other healthcare systems gave great insight into the NHS and its potential future; stepping into the (US) politics of health policy for the first time (especially in Trump’s first year) was entirely fascinating; being out of day-to-day academic life gave me time to take stock of what I wanted from my career; and making new international friends who were inspiring and amazing (we still meet up for European getaways years later).

What has been the most challenging moment of your career?   

In 2013, some work I did and was proud of led to the (temporary) closure of a hospital paediatric cardiac unit. It came about through a combination of misunderstanding and misuse of my work and caused a mini media storm, which was my first experience of that. I was horrified.

That episode changed the way I saw my role as an academic – it was no longer enough to do “good work”. I also had to take responsibility for its implementation and communication. Since then, I have worked closely with clinicians, patients, families and commissioners to ensure that my research is used appropriately and understood, including its limitations.

If you could give your younger self career advice, what would it be?    

I’ve thought about this a lot because I have given quite a few career talks in my time. There are three top things. Firstly, working with kind, reliable, fun people is worth its weight in gold. Keep your academic soulmates that you come across close, and design future research that lets you work together. Magic can happen that way! Working with people you don’t like or who are obnoxious is rarely worth it, no matter how “brilliant” they may be. Secondly, be humble – don’t charge into new projects thinking you have the solution and ignoring other voices. But thirdly, don’t be too humble – be willing to take risks of working in areas out of your comfort zone if you are convinced that they matter.

Which political figure inspires you?   

None of the big names. I am more inspired by those who go out of their way to advocate for others, tackle injustice or stand up for truth in the face of disinformation, often at great personal cost. So for instance, many of the previous winners of the Sense about Science John Maddox Prize inspire me, such as Dr Eucharia Oluchi Nwaichi, a biochemist engaging communities to fight pollution of the Niger Delta, or Professor Dr Bambang Hero Saharjo in his fight against illegal fires used in the palm oil industry in Indonesia.

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What policy or fund did the Conservative government get right?   

It’s not well known, but the Down’s Syndrome Act of 2022 was a really significant step forward in integrating services for people with Down’s Syndrome across health, education, social care and housing domains, and from childhood into adulthood. I’m currently co-leading a project which aims to improve services for children and young people with complex health needs more broadly, and we are looking closely at this act as an example of how legislation can support service improvements.

And what policy should the new government scrap?   

The Elections Act of 2022, specifically the voter ID laws. There is very little electoral fraud in the UK, and so no compelling reason to make it harder to vote in the UK. The legislation disproportionately affects minorities and those on lower incomes. Additionally, the specific forms of ID allowed (e.g. senior bus passes are allowed but not youth ones) clearly prioritise one party’s voter base over another’s. To me, making it harder for people to vote who are more likely to support a specific party is an anti-democratic move.

What upcoming UK policy or law are you most looking forward to?  

To be honest, I am simply happy about a change in government. The former government seemed to give up on developing, let alone implementing, any kind of policy agenda that seriously engages with many of the “wicked problems” that the UK faces, including climate change, the cost-of-living crisis, regional, generational and other inequalities, the criminal justice system and an ageing, increasingly sick population to name a few. The country can’t afford to sit in this limbo while things get worse. The emphasis so far on expertise and competence in ministerial roles is very welcome.

What piece of international government policy could the UK learn from?   

Social care, particularly for our vulnerable elderly population, is in crisis. I witnessed this first-hand as my dad spent the last year of his life in a care home. Outside of residential care, the UK relies on “task-based care” for the elderly at home, which is overstretched, understaffed and underfunded. I’d like to see us explore Norway’s approach, which prioritises well-being and resilience alongside physical health. For instance, we could learn from Norway’s Dementia 2025 plan, which explicitly aims to reduce physical and social barriers to enable people with dementia to participate more fully in society. However, adopting a Norwegian-style system in the UK relies on finding a sustainable funding solution.

If you could pass one law this year, what would it be?  

I would like to see strong new legislation on party and campaign financing, and an effort to tackle disinformation and election interference. Our system was built for a pre-internet age and we are subject to individual donors having outsized influence on party policies. With the rise of increasingly authoritarian populism across the world, I believe we must take active steps to protect our democracy.

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