Essay

Change

Digital

19 March 2024

9 min read

Time to strike a match under the social media titans

Smartphone boycotters can learn from the match girl strike and other historical protests.

Abigail Frymann Rouch

Abigail is a journalist and editor specialising in religious affairs and the arts.

A black and white image of Victorian women and a man standing together looking serious

Sarah Chapman and the match girls strike committee.

Wellcome Collection, Public domain, via Wikimedia Commons.

Meta's assets totalled nearly US$230 billion last year; Pinterest’s were over $3.5 billion and Beijing-based ByteDance, parent company of Tik Tok, was valued at $220 billion. Between them they have attracted billions of users, and, enabled by the spread of smartphones, transformed the way that young people especially communicate, spend time alone and carry out friendships.

But parents’ concern at the impact of what their children are viewing, and the tech companies’ slow responses to a drip-drip-drip of teenage deaths linked to harmful online content, have pushed parents’ patience to the limit. In the last month an estimated 20,000 have joined a grassroots protest group – Parents United for a Smartphone-Free Childhood – whose founders are hastily developing a campaign strategy.

This pushback against the march of big tech cannot come soon enough, and if well co-ordinated it could finally give parents a weapon: their numbers.

The stats are becoming all too familiar – half of nine-year-olds own a smartphone and 68 per cent of children as young as three use it to get online. Drill down and it gets more startling: according to a Statista survey of 13-17-year-olds, 30 per cent of TikTok users had seen sexualised images or been trolled anonymously on the platform in the previous month; 14 per cent of respondents who visited YouTube had recently seen “violent or gory” content, and 10 per cent of respondents “had seen images of diet restriction on Instagram”.

But these aren’t the only forms of online harm. I attended a meeting recently in the Palace of Westminster where one speaker argued that just as bad, especially for teenagers, are the algorithms that promote content that leads to peer comparison and discontent, which niggles away at contentment and self-confidence.

The age checks on which they rely will be brought in by the tech companies, who thus far haven’t proven the most trustworthy partners on child safeguarding.

Some of these hi-tech problems will require hi-tech solutions and new laws. But might there also be some far older wisdom that could help us a society chart a course to a safer online experience for young people?

The Government’s finally passed Online Safety Bill marks a pushback, making the tech companies legally responsible for keeping children and young people safe online. It mandates platforms to protect children from “harmful or age-inappropriate” content such as porn, depictions of violence, bullying, and sites promoting anorexia, and platforms will face tougher scrutiny of the measures they take to ensure under-13s can’t have social media accounts.

However, these changes won’t take effect until part way through 2025; the age checks on which they rely will be brought in by the tech companies, who thus far haven’t proven the most trustworthy partners on child safeguarding.

What are parents to do? And increasingly, employers and economists? After all, youth mental health experts were quick to point the finger at social media following the Resolution Foundation research that found five per cent of 20 to 24-year-olds were economically inactive due to ill health last year and 34 per cent of 18 to 24s reported symptoms of mental health conditions such as depression or anxiety – a reversal from two decades ago, when they had the lowest incidence of such disorders at only 24 per cent.

The Department for Education wants heads to ban mobiles in school, which some already do. But what about outside school hours? As one participant and parent at the meeting asked, “Isn’t the genie already out of the bottle?”

Molly and Brianna were not just vulnerable teenagers – they were victims of the powerful machinery of Third and Fourth Industrial Revolutions.

A couple of voices suggested young people needed an engaging real-life alternative to their screens that involved learning to take risks, such as rock-climbing. Another added that young people are too protected in the real world and not protected enough online.

One woman who has felt the sharpest cost of this inadequate protection is Esther Ghey. I would have hoped that the tech companies would be quick to change the ways their platforms work once they knew about the harmful material that her teenager Brianna was able to view online and the violent material her killers were able to discuss online.

But then I hoped the same after 14-year-old Molly Russell took her own life in 2017 having viewed content promoting self-harm and suicide on Instagram. Instead, her family were made to wait two years for Meta, parent company of Instagram, to provide evidence for her inquest. Representatives from Meta and Pinterest apologised at the inquest, five years after her death. Big deal.

Parents can – in theory – enact all parental controls offered by their internet provider, limit screen time and ban phones from their children’s bedrooms at night, although setting and reinforcing boundaries can be exhausting. Esther Ghey said Brianna’s phone usage “was a constant battle between me and her”. Other parents may lack the capacity to, or just not feel the need to, carry out such measures. And it only takes one child to share material for it to become a problem for a whole peer group.

It’s a good step that phones are entering the market that are designed to be safe for children, with parental controls and minimal access to the internet. But they don’t get kids rock-climbing (or your wholesome outdoor team activity of choice), they still normalise children’s phone use, and they require parents to spend more time monitoring their own phones to check their children’s usage.

So what’s to be done?

Molly and Brianna were not just vulnerable teenagers – they were victims of the powerful machinery of Third and Fourth Industrial Revolutions, the rapid advances in tech that have taken computers from the office to the pocket and loaded them up with the capability of dozens of devices combined.

Molly’s father Ian has teamed up with Esther Ghey to work together on holding the tech companies to account. And thanks to Parents United for a Smartphone Free Childhood, other parents now have a way of voicing their fears in a co-ordinated way, to try to prevent the next disaster. Organisers Clare Fernyhough and Daisy Greenwell estimate that already some 20,000 people have joined, from every county across Britain. This is an online campaign for an online age: it was sparked by a post by Greenwell in the fertile soil of Instagram, and communities are organised into WhatsApp groups. Nonetheless, the pair are encouraging parents not to give children smartphones until 14 and social media access until 16, and they have put together resources to help members urge headteachers to restrict, and other parents to delay, smartphone usage.

Examples like William Booth are a reminder that, when it comes to systemic challenges, individuals are not without agency.

But what if these steps aren’t enough? History recalls some impressive David-vs-Goliath campaign victories that could be of use here. In the first Industrial Revolution, exhausted and overworked women and children lost limbs and even lives in the newly invented machinery. According to a landmark report commissioned by the House of Commons in 1832, these workers were often "abandoned from the moment that an accident occurs; their wages are stopped, no medical attendance is provided, and whatever the extent of the injury, no compensation is afforded." Years passed from the creation of these voracious machines to reformers such as Lord Shaftesbury, a politician driven by his Evangelical Christian faith, passing laws to cap children's hours at 58 hours a week and introduce other safeguards.

A few decades later, the Bryant and May match company was employing hundreds of East End women to make matches using white phosphorus, which can cause phosphorus necrosis of the jaw or Phossy Jaw. The employees formed a union and went on strike; the Salvation Army, led by William Booth, another social reformer inspired by his Christian beliefs to help people in poverty, set up their own factory in 1891 offering better working conditions including the use of less toxic red phosphorus. Although their factory only ran for 10 years, the episode spelt bad publicity for Bryant and May and a ban on the use of white phosphorus in matches followed shortly after.

A Salvation Army match box.

A yellow and red vintage match box laid out flat.

'Light in Darkest England.'

Examples like William Booth are a reminder that, when it comes to systemic challenges, individuals are not without agency. But other chapters in history underline that one person’s vision or persistence may need to be amplified by scale to be taken seriously. Had the civil rights activist Rosa Parks, who in 1955 refused to give up her seat for a white passenger, boycotted the buses alone, the authorities in Montgomery would have shrugged their shoulders. But when 40,000 other Black passengers, led by Rev Martin Luther King, joined her, the authorities could not afford to ignore them.

So how do these three stories relate to young people’s social media use?

The harmful effects of social media are a global issue, and if tech companies boast revenues greater than the GDP of several countries, governments may need to work together to get them to listen. And any calls from governments for better regulation and self-policing will be amplified if backed up by millions of parents.

Perhaps we’re seeing the start of this: if the thousands of Parents United for a Smartphone Free Childhood can grow in number and start conversations with schools and other parents, then the demand for smartphones and their dominance of some young people’s lives can be challenged. Such conversations can’t come soon enough. But how can parents make themselves heard? And what do nineteenth-century industrialists, East End match girls or 1950s African Americans have to do with it?

The parallel, in Christian jargon, is the undervaluing of the human person. The tech companies do not just exist to help us stay in touch with our friends or look cooler. So bear with me, if you will, for a thought exercise.

In short, and I wince: adults’ relationship with smartphones needs to be rethought just as much as children’s.

The Shaftesburies of our day need to ensure existing laws are applied, that the tech companies’ promised age controls are water-tight, and harsh penalties are applied for platforms that fail to take down harmful or illegal content. The William Booths need to provide alternatives to dopamine-inducing social media, that affirm the value of each young person and teach them to manage real-world, appropriate levels of risk. Hence the suggestion of rock-climbing or similar. And could we also imagine social network being conceived, funded and constructed on European soil which takes the wellbeing of its users seriously? And some form of online policing?

In the meantime, the Rosa Parks of our age – which is all of us social media users, and Parents United for a Smartphone Free Childhood could lead the way – must consider investing in a dumb phone and enacting a smartphone boycott, at least outside our professional lives. The half of nine-year-olds who reportedly own smartphones can’t buy or fund them themselves; therefore, pretty much half of parents of nine-year-olds have passed theirs on or bought new ones and kept paying the bills. That gives them leverage.

Leading by example would also mean parents swapping their own smartphones for dumbphones – at least in front of their children. An old laptop could be kept in the kitchen for searches that then become public, functional and brief – just like twentieth-century dips into the Phone Book or Yellow Pages. Smartphone ownership could be seen as a privilege of maturity like drinking, learning to drive and (previously) smoking, and doom-scrolling in front of children blacklisted. In short, and I wince: adults’ relationship with smartphones needs to be rethought just as much as children’s.

The reforms of Shaftesbury and others and the ban on white phosphorus helped lay the foundation for today’s health and safety laws. The bus boycott was a key step in the Civil Rights Movement’s long and hard-fought journey towards equality.

The tragic, needless loss of the lives of Brianna and Molly (and, sadly, others) must lead to laws and a wider social rethink that lay the foundations for a safer, more grown-up, properly regulated, internet age. We need to set ourselves on a course from where future generations will look back aghast, just as we do on child labour or white phosphorus or racial segregation, and ask, ‘What were they thinking?’

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.