Interview: Professor Heinz Wolff, the Inventor of Bioengineering

Sixty years ago, Heinz Wolff invented bioengineering. Now he has invented an entirely new approach to elderly care — a system that relies on man rather than machine

November 2016

Words by Katie Puckett

Professor Heinz Wolff works in a building that bears his name, surrounded by a lifetime of his own inventions — machines for Antarctic explorers, astronauts, soldiers, divers, people with disabilities, people with arthritis. Now aged 88, the father of bioengineering still comes to Brunel University in west London five days a week to continue his pioneering work.

Wolff coined the term bioengineering in 1954, to describe the application of engineering principles to biological and medical challenges. His first invention, straight out of school in the immediate aftermath of the Second World War, was a machine that could count blood cells automatically. He went on to spend 30 years at the Medical Research Council, to chair a committee advising the European Space Agency on the uses of micro-gravity for scientific research, and to co-found the British-Soviet joint venture that sent Britain’s first astronaut to the Mir space station in 1991. Back on Earth, he has spent several decades developing assistive technology to support the care of elderly and disabled people.

But Wolff’s current preoccupation is not a scientific problem but an economic one: how cash-strapped Western societies can afford to care for a much larger elderly population, as life-spans lengthen and birth rates fall. And for the first time in his long career, he doesn’t think technology can provide the answer — a shift in thinking that he has compared to a religious conversion.

“I came to the conclusion that if you’re having to care for a large number of elderly people who were not necessarily in total control of their cognition, then technology wasn’t going to be an awful lot of use. What you wanted was humanity. Care is really inseparable from the action of people with hands, and sympathetic ears and empathetic minds.”

Technology can make the work of carers easier, but it can’t replace care: “Of course there’ll be new inventions, but I suspect we have reached the limit of biological acceptance of some of the new technology, that it’s overtaking us. This may be a function of my age — not approving of all this newness and putting more emphasis on human nature.”

Portrait of a man with a blue shirt and glasses in an atelier

A matter of give and take

Wolff’s big idea is Give&TakeCare, a reciprocal time-banking scheme in which people give up several hours a week to look after a local elderly person, earning credits that will pay for their own care in later life. It’s a deceptively simple idea, but making it into a sustainable business model has taken years of calculations, and problem-solving as complex as anything he has done. Working with a Brunel colleague, Dr Gabriella Spinelli, he has secured a government innovation grant of more than £1m (US$1.2m) to make the scheme reality. A team is in place, a community interest company has been set up and they have cleared many administrative and regulatory hurdles. The next step is to sign up 6-10 charities to give a “soft start” to the scheme at a local level, and the first few have just come on board. Within two years, Wolff hopes it will be self-sustaining with 50,000 “partners”, though the real goal is to get to 1 million by the end of 2018 — only as a nationwide scheme can the full benefits be realized.

“If you analyse what we’re doing, it’s really a confidence trick … but it may save the National Health Service as we know it”

Existing health and social care systems will not be able to provide a decent quality of life for frail elderly people — only a moneyless system will be able to meet society’s needs. Or as Wolff puts it: “If you analyze what we’re doing, it’s really a totally moral confidence trick. We are making people work an extra four or five hours a week so they are actually paying for their own care in advance — it’s a new resource which wasn’t there before. What we’re doing may even save the National Health Service as we know it.”

Remaining at home is vitally important as people age, Wolff believes. His wife of 62 years died in 2014, having suffered from symptoms of dementia, a trauma from which he is still recovering. “To be a sole carer of somebody where logic no longer works, where you can’t say ‘If so-and-so, then so-and-so will happen’ — it was a very difficult time in my life.” Joan’s illness was not the reason for his epiphany, but it has perhaps contributed to the zeal with which he has approached G&TC. They downsized too late, he says, when they were about 80. “We should have done it 10 years earlier. My wife was desperately unhappy. Everything was strange. The washing machine became an enemy because its dials were different, and even the layout of the flat became an enemy because the bedroom wasn’t where it ought to be. That absolutely convinced me that staying where you are is as big a contribution to your quality of life as anything else.” G&TC’s strapline is “familiarity breeds contentment”.

But he feels that the importance of independent living is overplayed: “Independence can be next-door to loneliness. You can be totally independent but also extremely lonely because you never actually see anybody.”

Wolff’s goal is rather more ambitious: to rebuild the community support systems that have been ruptured as people work longer hours and live further from their families. Traditional volunteering has declined, but appealing to people’s “enlightened self-interest” could help to swell the ranks once more. That said, to get off the ground, G&TC will not only have to recruit the masses who don’t do voluntary work, but to reconcile the minority who do to getting something in return — in this sense, it is revolutionizing the idea of charity work twice over.

Wolff doesn’t think there is necessarily a tension in a more caring society that is founded on self-interest: “These things are not mutually exclusive. Even such a primitive thing as bringing up your children — you love your children but it’s probably a little bit of self-interest as well.” Volunteering, altruism and philanthropy are all admirable things, he says, but they will not be enough on their own. “By 2020, there will be 2 million people in the UK over 65 who have nobody nearby — no children, no wives, no siblings — and that’s terrible. What is going to happen to those people if something like Give&TakeCare didn’t exist to recreate a proxy family?”

The family GAT

These new families will be founded on exchanges between neighbours. For every hour of care that a partner provides to an elderly person living nearby, they earn “GATs” (give and takes) for an equivalent amount of time to spend on whatever they need in the future — time being a currency that is immune to inflation. These are held in their own care savings account. To ensure the safety and stability of partners’ savings, G&TC is intended to be self-contained and completely independent of any government, commercial interest or charity.

The country would be divided into localities of 5,000-10,000 homes, in which Wolff estimates 10% of households would be in need of care. For each locality, there would be between four and six organizers who match caregivers and receivers by needs and availability, and are themselves paid in GATs. The scheme will not run on thin air of course: there will be a small annual membership fee of £2-5, and every time someone spends a GAT, they pay a nominal sum of about £1 — much less than the market rate for an hour of care. This would be used to pay G&TC’s running costs. To capitalize the system at the start, people in need of care will be issued with free GATs — just another form of quantitative easing, Wolff says.

There’s a lot of data processing, he says, but not as much as you might think. Let’s say people are matched for a trial period of two weeks: “At the end of the fortnight, either they say ‘We can get on with one another’, or ‘I can’t stand the woman, can you introduce me to somebody else?’ So let’s assume it’s alright, and they are now becoming friends, and one day the caregiver says ‘Look, do you mind having your breakfast a bit earlier on Wednesday, my son’s going on a school trip and I’ve got to see him off?’, and the care receiver will say ‘Of course’. These are micro give and takes which never touch administration, but show how a society is growing and people are beginning to behave towards one another like they would in a community.”

People could be care givers and receivers at the same time: “If you’re a bed-ridden lady who needs seven hours a week or more, but is marvellous on the phone, she might be assigned a couple of lonely people, and she can earn herself GATs by chatting with them twice a week. As long as there are people who need something you can provide, say being able to play chess. If all a person really wants is for somebody to give him a game of chess three times a week, alright, Give & Take Care will produce that. I don’t quite know who earns the GATs. Whoever wins the game perhaps — so you’re gambling with your GATs …”

A key aspect of G&TC is the UK’s 6.5 million informal carers who already provide 70% of elderly care for relatives. With the agreement of the regulator, the Care Quality Commission, they will be able to earn up to five hours’ credits a day if they join a local charity as a partner. GATs do not have to be redeemed in the same locality, and they could be donated to relations in greater need.

The social engineer

Engaging, genial and completely at ease with cameras and microphones, Wolff is a consummate communicator, with 25 years of television behind him and many more on the after-dinner circuit, though these days he says he tends to wilt after 8pm. For the generation who grew up in the 1970s and 80s watching the BBC, Wolff is not just the archetypal “mad professor” with his twin shocks of hair and colourful bowties, he is the original on which the image is based. He is still regularly spotted in the street and people recognize his distinctive German accent on the phone too — “even on a cold call!”

“If you want to popularize science, you have to somehow get people to like you. This doesn’t mean having a Nobel Prize or being the world’s best, but to get a bit of empathy. I always imagine my audience as having horses’ ears that are directed towards me, and if I lose them, they turn away from me and I have to do something to get them back. This is why I never use scripts, because that would prevent me from looking at the audience and seeing what impact I’m having.”

He invested his speaking income in the stock exchange, and used the proceeds to fund his institute at Brunel, which has always been self-financing, as well as the early development of G&TC before its grant funding came through.

Wolff clearly has a flair for business, like his father — a frustrated chemist but successful businessman, who deployed creative accountancy to help Jewish refugees escape Nazi Germany. “There was a Catch-22 situation, where you weren’t allowed to take any money with you, but most countries wouldn’t let you in unless you had some money. My father invented a number of ingenious ways of allowing people to build up balances abroad. I cannot imagine what he was thinking of, but I was present at some of these discussions and therefore knew a great deal about financial vocabulary at a very early age.”

“I’ve preached to students that if you’re reasonably intelligent, intelligence is a bit like money, you can use it for almost any purpose”

After a lifetime spent working on technological systems, how does developing a human system compare? “Well I think, because of my lack of experience and the fact that you have to interact with a lot more people, the social bit is harder. But I’ve preached to students that if you’re reasonably intelligent, intelligence is a bit like money, you can use it for almost any purpose. I think it’s a mistake to say that your intelligence will only work for the reproductive processes of earthworms, that you’ve been created for that particular objective in view. It’s often a tiny change which diverts your interest from one subject to another. I wouldn’t have minded being a lawyer.”

From The Possible, issue 01

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The question Wolff is most often asked is what guarantee people have that their GATs will be honoured when the time comes. Record-keeping and storage are obviously important, he says, but that’s not enough. “The only guarantee is that the next generation, not having been brought up with the expectation that the state will look after them, will not be entirely feckless.”

This is why persuasion and promotion will be key to the success of G&TC, not only now but for generations to come. Creating the “more caring, more community-oriented society” that he envisages is nothing less than a feat of social engineering. Wolff already has an illustrious legacy, but this may be his greatest achievement yet.

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