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PUBLIC HEALTH

COVID-19: Is Government really led by the science?

Jason Lowther argues that building in practical knowledge from councils and emergency planners could help avoid recommendations that prove impossible to implement effectively.

In the midst of the EU Referendum campaign, Michael Gove famously commented that ‘people in this country have had enough of experts'.. No longer. Fast forward four years, Gove (and every other minister) is sharing press conferences with professors and claiming to be ‘led by the science'. But with the UK topping the European tables of COVID-19 deaths, what does that actually mean?  And is ‘science' the only type of knowledge we need to make life-saving policy in the COVID-19 crisis?

Making policy is difficult and complex - particularly in a crisis, and especially one caused by a virus that didn't exist in humans six months ago but has the potential to kill millions. The information we have is incomplete, inaccurate and difficult to interpret. Politicians (and experts) are under huge pressure, recognising that their inevitable mistakes may well cost lives. My research has shown that even in more modestly stressful and novel contexts, policy makers don't just use experts to answer questions, but also their public claims to be listening to experts are useful politically. Christina Boswell identified the ‘legitimising' and ‘substantiating' functions of experts. Listening (or at least appearing to be listening) to experts can give the public confidence that politicians' decisions are well founded, and lend authority to their policy positions (such as when to re-open golf courses).

COVID-19 is a global issue requiring local responses, so the spatial aspects of using experts and evidence are particularly important. Governments need to learn quickly from experiences in countries at later stages in the epidemic, including countries where historic relations may be difficult. Central governments also have to learn quickly what is practical and working (or not) on the ground in the specific contexts of local areas, avoiding the vain attempt to manage every aspect from Whitehall. My research shows that the careful use of evidence can help here, developing shared understandings which can overcome historic blocks and enable effective collaboration. But in COVID-19 it seems central government too often is opting out of building these shared understandings. Experience in other countries has sometimes been ignored. Vital knowledge from local areas has not been sought or used. Instead of transparently sharing the evidence as decisions are developed, evidence has been hidden or heavily redacted, breaking a basic principle of good science and sacrificing the opportunity to build shared understandings open to critical challenge.

What counts as ‘evidence' anyway? Different professional and organisational cultures value different kinds of knowledge as important and reliable. In my work with combined authorities, I found that bringing mental health practitioners into policy discussions had opened up a wide range of new sources of knowledge, such as the voices of people with lived experience. And, carefully managed, this wider range of types of knowledge can lead to better decisions. The Government's network of scientific advisory committees, once we finally were told who was involved, seems to have missed some important voices. The editor of the Lancet, Richard Horton, argued that expertise around public health and intensive medical care should have been in the room. I would also argue that having practical knowledge from local councils and emergency planners could help avoid recommendations that prove impossible to implement effectively. As Kieron Flanagan has noted recently, we learned in the inquiry into the BSE crisis that esteemed experts can still make recommendations which are impossible to implement in practice.

Making a successful recovery will require government quickly to learn lessons from (their own and others') mistakes so far. Expert advice and relevant data should be published, quickly and in full – treating the public and partners as adults. Key experts for this phase (including knowledge of local public health, economic development, schools, city centres and transport) should be brought into the discussions as equal partners – not simply the ‘hired help' to do a list of tasks ministers have dreamt up in a Whitehall basement. Then we can have plans that are well founded, widely supported, and have the best chance of practical success. Our future, in fact our very lives, depend on it.

Jason Lowther is Solace deputy spokesperson for evidence-based policy, and director of the Institute of Local Government Studies (Inlogov) at the University of Birmingham (but not representing the views of the university)

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