Fraud and incompetence

In a long and readable blog post Dr Malcolm Kendrick summarises his findings:

The point I am trying to make is that the only certain lesson we can learn from Covid-19 is that science, especially medical science, snapped and broke. My current thinking on Covid-19 – and other important issues, Dr Malcolm Kendrick, 7 October 2025

Incompetence is part of the reason; fraud is another. Dr Kendrick quotes Natalie Rhodes:

If you search for scientific research articles with COVID-19 in the title, you’ll see more than 17,000 articles published since the start of 2020, but this vital research is being undermined by weak or even fraudulent research practices. Perhaps the highest profile example so far is the Surgisphere case which saw a small US company seemingly fabricate a database, the data for which was purportedly from the medical records of nearly 100,000 COVID-19 patients treated in 167 hospitals. Was the Surgisphere case a one-off? Or does it highlight the bigger systemic problem of research fraud?, Natalie Rhodes, Transparency International, 8 July 2020

Confirming this, Vince Bielski writes:

After journals published fake papers, however, the paper mills saw the opening and pounced, accounting for nearly half of new submissions. In a corrupt echo of Moore’s Law, a 2024 study concluded that the number of suspected paper mill articles has been doubling every 18 months, “far outpacing that of legitimate science.” Paper Chase: A Global Industry Fuels Scientific Fraud in the US, Vince Bielski, RealClear Investigations, 8 October 2025

In parallel with our economic system that doesn't do much for well-being, our legal systems that no longer deliver justice, our policing that no longer reduces crime (pdf), there are grounds for believing that our global organisations are similarly dysfunctional: the UN bodies aimed at peace and climate accomplish very little. My thinking is that this is because we fail to reward outcomes. We measure success in the world of medical research by looking at the numbers of papers published or citation indices. We measure success in other areas by the resources devoted to organisations and policies that attempt to achieve what we say we want. So we end up with economic growth that devastates the environment while benefiting only the very rich; we focus on greenhouse gas emissions without actually reducing them, still less doing anything to slow the rate of climate change. 

Surrogate indicators in medicine are measurements or signs used as substitutes for direct clinical outcomes that show how a patient feels, functions, or survives; it is always better to target outcomes directly but it is not always possible in medicine. In policy, though, it is what we need to do, otherwise it's too easy, as we see, for organisations to become corrupted, to swerve away from their original, (stated) intent and to focus almost exclusively on their own goals; pre-eminently self-perpetuation. 

A Social Policy Bond regime would start by specifying exactly which outcomes we need to target. These outcomes should be broad and meaningful to ordinary people. They should themselves be, or be inextricably linked to what we want to achieve. In health, then, rather than tout increased spending on health services as an indicator of how sincere we are in wanting to improve society's health, we should be targeting an array of indicators that actually measure health: longevity, infant mortality, quality-adjusted life years etc. (See my long essay here on applying the Social Policy Bond concept to health.) Similarly with climate change, crime and war - about all of which I have written pieces that are freely available via the Social Policy Bonds home page. 

Discounting our future

When people say that the Social Policy Bond idea is unrealistic and I think of the decades that I've been trying to promote it with little success, I need only remind myself of the grotesque, disastrous ways in which policy is currently made to remind myself that the bonds do actually have a contribution to make. 

For example: discount rates. Geoff Mann writes:

The rates at which we currently practice discounting mean that the long-term future of humanity, the living world, and the planet itself is not metaphorically but literally valueless. The price of tomorrow, Geoff Mann, reviewing Discounting the Future: The Ascendancy of a Political Technology by Liliana Doganova, 'New York Review of Books', issue dated 23 October 2025

As Mr Mann writes, the choice of discount rate that policymakers use can hardly be overstated.

The 7 percent discount rate - commonly used by the Trump administration...- means that our welfare today should be valued at six times that of people in 2050. ... We have unilaterally indebted future generations (and the rest of life on earth) to the present, and the discount rate is the interest we make them pay on a debt we have fabricated out of nothing but our own narcissistic accounting. 

'Motivated reasoning' is 'a cognitive bias that influences people to favor their existing beliefs, affects decision-making and critical thinking.' It seems to me that using a discount rate to evaluate the long-term impact of policies, and which discount rate to use, are a form of motivated reasoning. If people in government or elsewhere wants a project to go ahead, they'll choose a high discount rate; if not, a low discount rate. 

Most democratic governments have a short time horizon, so that long-term goals, such as the survival of humanity can optionally be valued at almost nothing when it suits their purpose. A high discount rate is one way in which policies are made that would be unpopular if people knew the facts. The opacity and sheer length and tedium of the policymaking process are others. All this means that only powerful and already-wealthy interests can afford to follow and influence the process. Currently, policies that have long-term implications are a by-product of politicians' numerous short-term calculations. The results are plain to see: at the global and national levels, a despoiled physical and social environment and a growing potential for military conflict. I don't believe that most people would choose these outcomes, and that is why I advocate that our long-term goals need to be expressed in terms that ordinary people can understand so that we can, if we wish, participate in choosing and prioritising them.

A Social Policy Bond regime would begin with broad goals that are meaningful to ordinary people: the over-riding goal would be the survival of humanity. Precise definitions would be the subject of debate and discussion between experts and the public. National goals could include a healthy population, a cleaner environment and reduced crime. All would have to be sustained before people would be rewarded for achieving them: the goals would all be long term in nature - a contrast to the wild and deadly short-term thinking that permeates the current policymaking environment.