What do we mean by ‘Nation’?

I arrived in Edinburgh this summer to join the DARE team, and as 2024 starts to draw to a close I’ve been reflecting on how my work has been taking shape. My brief is to think about data, care, and learning as they relate to ‘Nation’, and this first phase of my Fellowship has been spent considering how the idea of ‘nation’ bounds my work, developing an understanding of Scotland’s health and care data ecosystem, and building a relationship with the organisation where I plan to conduct my fieldwork.

The DARE project is already comprised of four scales of attention (Home; Hospital; Nation; Policy), and scale will also be significant in the way I think about ‘Nation’. My first instinct is to bound my work geographically within Scotland, where the DARE team is physically based: a Devolved Administration where health and care fall largely under the purview of the Scottish Government (the Scottish Parliament at Holyrood is just a short walk from the DARE office). But a ‘Nation’ is many things, none of them straightforward: a unit of governance and administration; a geographical area; an abstract idea; a cultural reality; a nineteenth-century European invention that requires constant maintenance [1,2 ]. Beyond that, should my focus be on the co-constitution of Scotland and its citizens through health data practices? On health data as part of “state-istics”, governance, and nation-building? On Scotland’s position (and self-positioning) within a competitive global health data ecosystem? Will it be possible to think cohesively about health data practices across individual citizens, communities, regions, nationally, and internationally, all within the same project? These questions remain open: for now, I am hopeful that the boundaries of my project will suggest themselves as I find and follow threads in my fieldwork.

Scotland’s health data ecosystem is shaped by a constellation of governance, research, and commercial interests, by its health and care history, and by the population’s perceived health needs. Embracing this complexity and interconnectedness, I find myself drawn into the web of public, private, and third sector organisations advocating and innovating across Scottish health and care in pursuit of powerful data imaginaries. What are the futures of data, care, and learning that are imagined and enacted within these organisations? How have they constructed problems in digital health and care, and how do they seek to solve them? How are partnerships formed and sustained between them? And how do the realities and rhetorics of Scotland as a nation relate to their work as they negotiate across a range of promissory spaces?

To begin to answer these questions and formulate others, I will be following the work of a research and innovation organisation collaborating across academia, industry, the public sector, and the third sector on digital health and care in Scotland. By diving into the field I hope I can tackle Scottish digital health and care innovation from the middle outward, following lines of enquiry out from an organisation thoroughly entangled in a complex innovation landscape. I expect that following digital innovation in action will elucidate some of the tensions and opportunities, conflicts and resolutions that emerge as different visions of health and care data meet and develop into specific configurations. 2025 will tell.

References

1.           Scott JC. Seeing Like a State : How Certain Schemes to Improve the Human Condition Have Failed. Veritas Paperbacks. Yale University Press; 2020.

2.           Anderson B. Imagined Communities: Reflections on the Origin and Spread of Nationalism. Verso; 1983.

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