Wednesday, 21 October 2020

Would it be the same if we knew their names?


A few years ago, I found myself sitting through a meeting of a scrutiny committee at a local authority as the members were looking for potential savings. The officer leading the discussion took them through the committee's KPIs, of which there were something like 76 (a sure sign of a lack of prioritisation and focus – no-one can seriously manage anything against a list of targets that long). Anyway, the officer pointed out that in some cases, the authority was outperforming its targets and that this had a cost. On one KPI, for instance, the Welsh Government had set a target of 80%, and the authority was achieving 95%. This, said the officer, was an opportunity to save money; by reducing the level of achievement from 95% to 80%, resources could be allocated to other activities with no penalties being imposed. It’s a classic example of how a target which is probably intended to set a minimum level of service ends up setting the maximum as well.

This rule has a more general application. Let's take, as a not-entirely-random example, an outsourced track and trace system in England which has a target of tracing 80% of contacts and telling them to self-isolate. It’s easy to see how a company providing such a service will (if you’re lucky – it really depends on whether there are any downsides to the company from failure) strive to achieve the 80%, but it has no incentive to go beyond that. Indeed, over-performing would lead to extra cost with no extra income, thereby hitting profitability. The public health requirements may well see 80% as a minimum requirement for getting things under control, which is probably why it was set at that level, but the profit motive turns it effortlessly into a maximum. It means, in effect, that England is only even attempting to catch 80% of those infected, and the other 20% (plus any margin by which they don’t even achieve the 80% target) of contacts will be allowed to spread the virus freely.

There are implications for Wales given the long and porous border with England: even if the Welsh system is doing better (and it is, albeit far from perfect), being in an open union with a country which has consciously decided to let the pandemic rip at a rate of about 20% of its potential makes it difficult to control the virus here. A short, sharp lockdown is a reasonable response, and is being widely supported, but its effect will be widely undermined unless the Welsh Government takes the opportunity to work out a longer term way of living with an irresponsible neighbour unwilling to take the necessary steps itself. That should have happened during the last lockdown, but didn’t. I can understand that Drakeford et al might truly not have realised just how irresponsible Johnson and pals would be, but they have been slow to react as that level of irresponsibility has been increasingly revealed. And they are hampered by the lack of powers, particularly financial powers to support people and businesses, a factor which does not fill me with confidence that they will be able to take all the necessary actions after the short lockdown ends, even if they wanted to.

The Tories, perhaps inevitably, have reacted by opposing the lockdown, claiming that the WHO have said that lockdowns merely delay things and are not a solution. This is a deliberate misinterpretation of a rather more nuanced stance by the WHO, and would be more credible if they were offering an alternative approach which didn’t start and end with ‘do as the chief incompetent says’. But even if they were right in saying that a lockdown only delays things, what do they really mean by that?

There has been an estimate (and yes, I know that there are always problems with the accuracy of any estimates) that around 1,000 lives would be lost in Wales between now and the end of the year without the lockdown. In a strict sense, given that human mortality is always 100% eventually, it would be accurate to argue that those deaths are not avoided by a lockdown, merely delayed. (The same is true, incidentally, for all medical interventions for all diseases. No lives are ever truly ‘saved’; they are merely extended.) Treating people as just numbers and statistics makes it easy to forget that these are real people with families and friends: we just don’t know which 1,000 people it would be. But if we did, if we could put names and faces to them, would the Tories still be willing to say to them and their families that it’s better for the economy for them to die before Christmas than after? Because that, ultimately, is what saying that a lockdown ‘only delays’ the spread of the virus actually means.

Drakeford has a weakness in his reluctance to demand sufficient autonomy for Wales to be able to take the necessary steps to protect Wales and her people, but at least he’s not completely heartless as the Tories seem to be.

1 comment:

dafis said...

Given the lack of precise knowledge about Covid, and the tendency of a proportion of the population to disregard any rules preferring to be guided by their own incontinent lifestyle choices, I think that Drakeford has performed quite well. His mild bland form of delivery is "just what the doctor ordered" especially when one might have earlier watched the pompous Boris and the hysterical Hat Mancock rattling off their daily dose of superlatives.

The performance of the London regime serves to gives us all a warning of what can happen when people of an authoritarian tendency are given free rein in a situation that lacks clear definition. They lash out and dash about like a sack load of demented hopping frogs. Had some of them worked for a living, say in manufacturing industry, they might have recalled being trained in the use of various quality and performance improvement techniques which require diligent observation and scrutiny of information so that processes can be corrected, fine tuned,instead of random flitting about from one technique to another. There again did any of these dopey articles ever do a proper job ?