Interview: Shaping the future – The Actuary

Futurist Ray Hammond talks to Stephen Hyamsabout revolutions in healthcare, the future of work and cryptocurrencies

05 DECEMBER 2019 | STEPHEN HYAMS

Ray Hammond has a long record of accurate foresight about the future, such as identifying the coming importance of the internet shortly after its launch.

How did he become a futurist?

It happened by accident, he says. After finishing with journalism, I wanted to become a writer. During a small book tour in San Diego, I met the well-respected futurist Alvin Toffler. We kept in touch and he encouraged me to broaden out beyond technology, which was then my focus, to understand the way that todays trends may shape reality in 10 to 20 years time.

The future of health

Hammond is excited by the current revolutions in healthcare, of which he expects digital health to havethe earliest impact. Within 10 to 15 years, perhaps30% of hospital inpatients will be at home in bed but monitored so thoroughly that its almost as if they were in the hospital, he says. A team of mobile nurses will take care of their physical needs. Its also going to have a profound impact on the way drugs are developed, because drug companies can use the data that flows back from digital devices to learn how were responding. Eventually, it will be as if every patient is taking part in a real-time clinical experiment.

DNA-based and stem cell medicine will also play a significant role during the next five to 10 years. For privacy reasons, it will take a while for people to accept having their DNA stored., says Hammond. For many people, DNA stands for do not ask. Once the benefits of DNA analysis are understood fully, the word will spread and, with full consideration for privacy and data protection, DNA-based medicine will be an enormously powerful tool. He cites the detection of genetic abnormalities in the earliest stages of embryonic development during pregnancy as an example.

Its early days for stem cell medicine, but Hammond predicts that it will become very important within 10 years. It seems to have so many applications, a bit like penicillin, and promises to deal with lots of diseases that are currently intractable. Using stem cells from ones own body avoids the risk of rejection. Im certain that in 10 years time we will be taking organs off the shelf, or theyll be grown to order for us.

Hammond believes two other healthcare revolutions will have longer-term implications. The first is nanoscale medicine, which he believes will have a huge impact, but not for another 20 years. Manipulating molecules at the nanoscale level will enable the production of drugs designed to produce specific proteins that are tailored for certain illnesses. Nanoparticles are currently being developed for the targeted delivery of drugs, while there is some research involving nanoparticles that seeks to develop a vaccine for influenza. Hammond believes the other healthcare revolution will be in gene editing to enable removal of damaging pieces of DNA from a patients tissue but care is needed to avoid it affecting the germline, for fear of unintended consequences.

Healthcare outlook

What will be the collective impact of these developments? During the next 20 to 30 years they will transform healthcare, and I think it is likely we will see a return to higher rates of mortality improvements in the UK, following the period of lower rates seen during the past few years.

Hammond is excited by two recent pieces of research into anti-ageing, one of which removes senescent cells from the body. These cells are widely believed to contribute to ageing. The other work involves therapyto reprogram genes to reverse the ageing process.

In human trials, there have been some startling achievements in a single year, 70% to 80% of the patients had their biological clock reversed by two and a half years, he says. The results were so stunning that the researchers have easily been able to raise the money to carry out much wider trials. Until a year ago, I was highly sceptical about rejuvenation and life extension, but not any longer. By 2030 or 2040 I think we could see some patients extending their lives as healthy centenarians. Within the next 20-30 years, Hammond also thinks that most types of cancer will be controllable, as opposed to being cured.

How can we meet the cost of healthcare for an ageing population? During the next 10 years it will be a problem, but there are indications that things will improve significantly, mostly thanks to digital technology, says Hammond. The key is 5G networks, which will be super-fast and reliable, with instant, real-time responses and no bandwidth problems. This will facilitate distributed care, in which many patients are monitored from their homes, thereby taking the pressure off hospital space. The healthcare revolutions will mean fewer people in hospital, and for less time.

The collection and analysis of healthcare data is developing fast, and it must remain secure for people to remain comfortable in providing it. Could insurers seek to use the data for underwriting purposes? There are currently legal barriers to the discriminatory use by insurers of DNA information, while they are also no longer allowed to ask the catch-all question of whether there is any other information that would be relevant.

Digital monitoring devices will not be for everyone, while those who do use them will need clear instructions explaining that they are not fully accurate and no substitute for proper medical advice.

Robotics will have developed to the point where most of the non-medical tasks in a hospital are handled by machines, Hammond says. For example, a robot nurse in triage could perform standard tests before passing the patient to a doctor, if necessary. Remote robotic surgery will also become very efficient oneeye specialist in London might be treating people anywhere in the UK, or around the world. Another interesting development is the growing use of virtual reality as an alternative to conventional anaesthetic.

Technology and work

Will robotics and automation put jobs at risk? During the next 15 years, there will be a lot of disruption in the workplace, says Hammond. Peoples roles will change, and retraining will be needed, but there will still be a lot of demand for human employment. After that period, Im not so sure; by the mid-2030s I think robots will be so ubiquitous, powerful and capable that a lot of human endeavour will not be needed. Robots will be increasing productivity to such an extent that society will have enough money to give to people who are not employed.

Such a fundamental change brings challenges, though. For many people, work is part of their identity, and when theyre denied it an important part of their life disappears, Hammond says. I dont have the answerto that, but Im worried.

Part of the solution is to recognise and pay for carers in the family, and Hammond predicts there will still be plenty of demand here. Robots will empathise and form attachments, but when real help or comfort is needed,I think well want a human for the foreseeable future.

I ask about the impact of artificial intelligence (AI)on replacing human work. Today AI is, at best, as intelligent as a rodent. I think it will be at least 30 years before AI is a threat to humanity in terms of its decision-making capabilities.

Cryptocurrencies and cash

Hammond expects blockchain technology, invented for the cryptocurrency Bitcoin, to have a huge and wide-ranging impact. Blockchain will be everywhere for example, managing patients in hospitals, or the assets and policies of an insurance company. The biggest drawback is its high energy demand, but there have been recent breakthroughs in that respect.

Cryptocurrencies do not need an issuing bank or government to authenticate them, as they are self-authenticating, so this poses a threat to the conventional banking industry and national sovereignty over finance, he continues. I dont see it happening on a big scale within 10 years, but in the longer term, if political will allows, there is no doubt that cryptocurrencies will replace fiat currencies.

Does this signal the end of cash? In my 1983 book Computers and Your Child I predicted there would be no cash in society by the year 2000, Hammond says.I was looking at the technology, and in that respect my prediction could have been correct, but I was forgetting human psychology. People like to feel they hold cash.I think cash will still be around in 10-15 years, but very much reduced.

I conclude by asking Hammond what his biggest concern for the future is. Climate change, with the extreme weather events that are going to become more frequent and severe and continue for at least the next30-40 years.

What excites him the most? The continuing improvement in human health. I love the idea of looking to a future where most serious illness is eradicated, with far less human suffering.

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Interview: Shaping the future - The Actuary