Examination of Witnesses (Questions 20-39)
MAVIS MCDONALD CB, PROFESSOR RON AMANN, DR DAVID SALISBURY CB AND MR STEPHEN CROWNE
MONDAY 21 JANUARY 2002
20. And the Policy Unit?
(Mavis McDonald) The Policy Unit at Number 10 is an extension of the basic support to the Prime Minister and the advice which he uses.
21. And the Performance and Innovation Unit?
(Mavis McDonald) The Performance and Innovation Unit is an in-house task force, as you know. Its role is carrying on with that but it also has an extra remit to help service the Forward Strategy Unit.
22. It says in the Report that the Forward Strategy Unit does "blue skies" thinking. When will we see some of this?
(Mavis McDonald) The "blue skies" work they are doing is policy advice to the Prime Minister, so that is private.
23. So we will not see it?
(Mavis McDonald) No.
24. But this whole report is about how you are supposed to be more open with people and involve people and how policy-making is much better if you involve stakeholders. You have got a whole unit that does blue skies thinking, so this is fundamental direction of government
(Mavis McDonald) It is a very small unit. The main work of the PIU, which has been working on futures with departments (most of whom have their own future strategy units) is well-known and has been going on for two to three years.
25. Does the Forward Strategy Unit at least work with government departments? Presumably it does not just give its advice to the Prime Minister?
(Mavis McDonald) No, it works with the government departments and draws down information from them and discusses it with them.
26. Is Lord Birt, to use a contemporary example, busy sitting down with the Secretary of State for Transport and Transport civil servants to talk about the future of transport policy?
(Mavis McDonald) I am not sure precisely how they arrange their meetings but they do work together closely.
27. You obviously did not hear the Transport Select Committee where the Transport Secretary was not overly impressed by the Forward Strategy Unit, but there we go! Can I turn to one of the examples the NAO uses when they look at four particular policies. We might as well look at the one the Cabinet Office runs itself, which is the Cabinet Office Women and Equality Unit promoting women's entrepreneurship, which is Appendix 5. It says that the impact of the policy is that they publish a document with the Swedish Government, they are going to develop a web site, and they are maintaining momentum. Do you think this policy meets all your criteria for cost-effectiveness?
(Mavis McDonald) That is the point at which the Women's Unit engagement, as it were, stopped and the Small Business Service actually took on the remit to drive forward the practical application of an approach to improving the number of women entrepreneurs on the ground.
28. It says here in Appendix 5, Paragraph 7 that the impacts of the policy are that they published a bench-marking document with the Swedish Government, a proposal to develop a new web siteand I do not even know if the web site is up and runningand they have maintained momentum through other departments' work programmes". Since this whole Report, and indeed your own Report, is about effectiveness of policy-making, do you think this has been a very effective policy?
(Mavis McDonald) I think it is a policy in progress and what the Women's Unit did was show from working with the Swedish Government (which has had some different approaches to this) ways in which you might take the policy forward, but they were working with the Small Business Service whose particular remit is to promote small enterprises, and the Small Business Service is now taking forward the practical proposals. Other ways in which the Women's Unit can supplement that is by the work they continue to do on equal pay gaps and access to financial facilities from banks and other lenders.
29. I am not entirely convinced yet. If we look at the NAO recommendations which are at pages 15 to 17, are there, for example, arrangements for monitoring performance and progresssince you say it is work in progressthat the Women and Equality Unit is making in its entrepreneurship scheme?
(Mavis McDonald) There are arrangements within the Small Business Service to promote the processes which the Women's Unit talk to them about. The Women's Unit is a kind of central almost policy think tank of its own on women's and equality issues. It would not expect to follow through everything itself, it works with departments and other agencies who have got a particular interest or particular responsibility for implementing policy and at a certain point would expect to hand over to them.
30. All I have got to go on is appendix five which says that they have had virtually no impact at all. They have published a benchmarking document with the Swedish Government. They have a website, maybe you can tell me whether the website exists or not. Then there is a nebulous thing which says: "they have maintained momentum through other departments' work programmes". What I want to know is whether this thing has been a complete waste of money. Since this is the only policy in this document which the Cabinet Office themselves actually run that we are looking at, it is reasonable to ask you do you think it is one of the likely costs and benefits of this Unit and are there regular policy reviews? Indeed, if the policy has not worked as intended, departments may need to terminate this policy.
(Mavis McDonald) I think that we will have better data coming through from the Small Business Service on that particular aspect of their work, which is women and entrepreneurship. They continue to do what they very successfully did, which was highlight differences in pay and differences in pay in relation to occupation. There continue to be the Office of National Statistics figures on pay gaps, indeed a new series is due to be published shortly. They use that to demonstrate where there are changes and how effective they are being.
31. I am not actually talking about the Unit itself, I am talking about the Cabinet Office, its entrepreneurship scheme run by the Unit which is one of the four things that the National Audit Office looked at as well as a DEFRA scheme and a vaccination scheme and the literacy.
(Mavis McDonald) I think what the NAO study did was looked at a particular case study of policy development which the Women's and Equality Unit was working on. The follow through on that is being taken forward by the Small Business Service.
32. If we look at table 15 on page 32 there is a very helpful table there which has the four things they looked at. Everything on the meningitis C vaccination and the National Literacy Strategy got a double tick. The Arable Stewardship Scheme, with the exception of two things, did not do badly. The Women's Entrepreneurship Scheme is the least successful of those four policies. Do you agree with that?
(Mavis McDonald) That, we knew, was the NAO's view. We did discuss it with them at the time and we did explain to the NAO that just stopping with the Women's Unit was not necessarily going to give you a full picture but it gave you a snapshot.
33. The possibility of terminating the policy is on the cards?
(Mavis McDonald) No, no. I think what we need to do is show what the Small Business Service figures demonstrate to us and then do an evaluation of how successful we are being and the reasons why the policy may not be being successful.
34. My question is whether you see it as the NAO says, having the components to act where value for money is threatened. I would suggest from what I have read value for money is threatened.
(Mavis McDonald) What I would say in response is that I do not think there is evidence in this Report which will show you whether in fact there have been any changes on the ground or not. What it showed you was kicking off the thinking about a policy, finding out how other people do it and listening to people on the ground about what they found was limited access to some of the services that male entrepreneurs have got and putting together a package to take that policy forward which is now being taken forward by the Small Business Service and will need evaluating. It will be evaluated on their figures but it is too soon yet to say whether they have had any success or not. I do not think the NAO in this table were trying to make that judgment, they were just judging it against criteria for the way in which we develop the policy.
35. Could I turn to a more discourteous subject:- risk. I read Professor Hogwood's paper which I thought was very interesting. I should declare some kind of interest in that I was the Departmental special adviser at MAFF during BSE so I bear the scars of risk assessment. . .
Mr Steinberg: So you are to blame!
Mr Osborne: I will ignore the comments from opposite! What I am interested in is there have been a whole series of failures by all kinds of governments, Conservative and Labour Governments, from salmonella, BSE, GM foods arguably, in which there was a failure to communicate the concept of risk to the public, and indeed also, since we have got Dr Salisbury with us, the MMR vaccine which is the current subject of public controversy. What work is being done in the centre of Government about communicating risk when you deal with very complicated scientific subjects here but which may directly affect people's health or the health of their children? What work is done to learn lessons from these kinds of scares, if that is the word?
(Mavis McDonald) I think there are two areas of work that are being done with the central focus. One is the PIU study, which I mentioned to you earlier, which will look hard at how you communicate and ways in which you might communicate and also Professor King, the Chief Scientist, has just done a review of his predecessor's assessment of how to handle scientific risk and is doing a stock take with departments of how they promote the knowledge of science through the departments so that they have the capacity and skills to make better assessments. There is work going on there post Phillips, as it were. I do not know whether David would like to add to that about the work of your unit?
(Dr Salisbury) I am happy to, Chairman, if you would like?
(Dr Salisbury) We deal with communicating risk the whole time and the areas which we have to consider are the reality of the risk in terms of both the burden of a disease and the alternative that we are offering in terms of prevention. We have to think about how we can communicate that to both health professionals who in turn will be communicating with parents and to parents themselves. We have to be informed as best we can on particularly the public's understanding of risk. For the best part of a decade now we have twice a year been doing a sample done through market research of a thousand mothers of young children who are asked core questions on their understanding of risks of disease and their concerns about, for example, risks of vaccine. We use that knowledge in our own communication strategy when we create new materials to take to the public. Any materials that we prepare we pre-test with the target audience to be sure that they have understood the messages that we wish to communicate. So we have a wealth of experience of both preparing materials, refining materials, in the light of public attitudes and equally from background material to their understanding of risk. In terms of the realities of risks, we clearly work very closely with the scientific community so that we have got a very good understanding of the scientific risks.
36. I have only got a couple of minutes, if I can just interrupt you there. Is there a danger that we are overly reliantthis sounds strange to be overly relianton scientific evidence? I have learned this from my BSE experience. Ministerial decisions were entirely based on scientific advice that there was no risk to human health and that informed BSE policy making for a decade. Suddenly the scientific advice changed and, of course, the whole policy ethics changed. The argument before the scientific advice changed, very briefly, was that "You could not, Minister, introduce this new regulation because it would be judicially reviewed and people would say there were no grounds for it because the scientific advice was not justified". Has Civil Service thinking moved on a bit, and maybe ministerial thinking as well, from just relying on scientific advice and a sort of rationality which does not take into account the irrationality of the public?
(Mavis McDonald) One of the things the Phillips Report made quite clear, and which the NAO Report reinforces, as does the Professor's appendix, however good the analysis, whether it is risk or anything else, there is an exercise of judgment required in these decisions at the end of the day. That judgment has to be explained and defended and in most cases it would be for ministers, on advice, to take. There is no substitute for having to make a choice. I do think one of the things post BSE, and I am sure David would agree with this because we actually worked together on foot and mouth in the summer as well, is the perception of displaying to the public the range of known risk is actually becoming much more embedded in our thinking about how you communicate risk. If you look at, for example, mobile phones and the advice that is given, then that is an area where people really do not know very much so the spectrum of that had to be run through and sorted out before it was given out. At that stage, what you are doing is allowing people to trade off risk and make their personal choices.
37. If I could ask Dr Salisbury a final question about the MMR vaccine. Again, I declare an interest in that I have got a six-month-old baby and I am having this debate over the MMR vaccination, as I imagine every parent in the country is having. Is there ever a trade-off between the public good and the individual good? For example with MMR, it is sometimes put to memainly by my wifethat it may be good for the public in terms of overall public health if you give three vaccines as one in terms of cost, but there is also the fact that not all parents are going to have all three vaccines if they were split, and you are at least ensuring that the largest amount of the population is immunised against these three diseases. However, if you had a very responsible parent who was going to have the three vaccinations, it would not necessarily be good for them to have the MMR vaccine. I do not know if you want to tell me about the MMR vaccine, but is there a trade-off between public good and individual good?
(Dr Salisbury) I think the first response is that any vaccine is designed to protect the individual and the greatest beneficiary will be the individual and the purpose of vaccinating individuals is to protect them against the target diseases. There are some individuals who cannot be protected because of the diseases that they might have. For instance, children with leukaemia do not get live virus vaccines and so they are personally at risk if other children infect them. But the beneficiary for the greater part is the individual. The only time when that is not quite as clear is in the case of the rubella vaccine, where rubella (or German measles) is a relatively mild disease in the person who catches it, unless they happen to be female and pregnant. And since many young children (if they were not immunised) would catch rubella, and have mothers who may be pregnant, and have mothers whose friends may be pregnant, there is a longer arm public good that is wider than just the protection of the individual. The programme is essentially designed to benefit individuals. There comes a point when if you achieve high enough coverage of a vaccine you can stop the chain of one person risking another and then you get an amplification of the benefit, but the prime beneficiary is the individual.
Chairman: Thank you very much for that very clear and interesting answer. Brian Jenkins?
38. I have made a big list here of the questions I wanted to ask and I will show you it! Mrs McDonald, when I read this Report it was very interesting to read the individual cases but it is almost like looking at the symptoms rather than the cause, is it not? If you look back at policy-making in its entity and the size and the scale of government, you realise that the interacting parts are just too large to pull together, there are too many obstacles, and we are never going to have an optimum situation or best fit, so we have got to go for second best arrangements. I would rather like to know how you are tackling this. There is a horrendous problem across government with the various departments working at different speeds with different levels of staffing abilities and different levels of commitment to it. What is the biggest problem you face in trying to implement a policy that cuts across several departments?
(Mavis McDonald) I do not totally accept your underlying analysis. We have to strive to do the best we can and I do think continual assessment of the interactions is one of more difficult aspects of policy-making across the board. The picture is never static either. The other thing you have to feed in is what is happening around to change your perceptions of what will work, what will not work, what does count and what does not count. There are events that change things that you might not have planned into it. There are two things that, in my view, are particularly critical at the moment. One is that the combination of the standard process of clearing policy through Cabinet, which is well established, plus the embedding of the PSA approach to setting strategic objectives and embedding that with a formal monitoring system, has given us a more robust underpinning than we have had for some time to pick up what is working and what is not. I am not saying that is ideal. I do think you have to work at this whole area continuously. The other thing is that we are really focusing thinking on how we might make a policy work much more thoroughly as part of the policy development in the way in which you present the options and choices to Ministers than maybe we have done in the past. What we can do in the centre is to draw attention to promote best practice, and the departments have the key responsibility for ensuring that they have clarity of objectives that support what Ministers and the Government as a whole want to do, and that they follow through. The work that we can do from the Cabinet Office and the Treasury is supporting, monitoring, challenginga variety of functionsdesigned to try and help stop things falling through gaps, to pick up new developments as they emerge early enough to take into account, and to try and be aware of the fact that we need to change ourselves and our skills to deal with new issues that come up as they arise.
39. There are one or two issues you have bought up there. One is the common use of the term "policy". We have got Ministers and they come to Parliament and they go to the country and they tell us "this is the best thing since sliced bread", and they tend to oversell rather than undersell the aspects of what can be delivered with regard to any new policy and then we have to deliver it and monitor it. So it is the delivery and monitoring side that is probably more important with regard to value for money and this report; is that true?
(Mavis McDonald) No, I think there is a balance there. In particular, we have a formal responsibility as policy is developed to ensure that it is not blatantly mad, if I can put it like that, and it is not going to waste public money. There is a role and always has been for the Civil Service to make that assessment. If I can ask Ron Amann to join me in answering your question because quite a lot of the work they have done with Ministers has been about how they develop awareness with those kinds of interactions.
(Professor Amann) I would like to pull this together and come back to the very, very interesting question you raised, that all this seems so very complicated and difficult that one does not know how to tackle it. It is difficult and what is required is a culture change. I think just trying to sum up the strategy of something like this, we now have a very large pool of best practice. The NAO Report details some of that, the CMPS Report adds to it. There have been many studies over the last two and a half years which we can look at. We know basically what is wrong with the system. We are generating good practice from departments through surveys. The question is what do we do with this knowledge now that we have got it? I think we basically want to do three things with it. We want to use it to shape leading edge training so that the circles of civil servants in the future are transformed, we want to use it to design departmental improvement programmes of the kind that the Office of Public Services Reform and the Prime Minister's Delivery Units are developing, and we want it to build a network of policy-makers themselves, because it is their interchange and the vivid experience that they can communicate that is really important for bringing in culture change.