Evidence-based policymaking

The shouty left are far more likeable than the New Labour ‘left’ or the Tory right in general, and their opinions on the things that really matter – murdering foreign civilians, locking people up without charge, banning freedom of speech, and such like – are generally spot on.

However, one way in which they drive me mad is their refusal to accept actual evidence as a factor in decisionmaking and policymaking, in areas where the goal isn’t contentious but the ways to achieve it are.

This is best exemplified by anyone who calls for water utilities to be taken back into public ownership, as the public sector authorities in Scotland and Northern Ireland provide a poorer service than the private sector English water companies at about the same cost.

But another good example, spotted by Rick at FCFT, relates to the different policies adopted toward the NHS by the English, Welsh and Scottish governments (FT article, registration may be required).

The introduction of targets for NHS waits in England, followed by more choice, competition and greater use of the private sector, has been highly controversial. While the impact of choice and competition in England is not yet clear, “the terror of targets” worked, according to Carol Propper, a professor of health economics at Imperial College London.

After rises in NHS funding, “waits are down in all three countries”, she said. “But they have come down much faster in England.”

The English NHS is hitting a maximum 18-week wait for treatment that Scotland will not achieve until 2011.

Waits are worse in Wales, and a few years ago a Welsh Audit Office report noted that the poorer overall health of the Welsh population did not explain the performance. Northern parts of England, it noted, had similar health status “but have consistently delivered more healthcare at lower cost”.

In other words, the much-reviled NHS internal market and targets, as one might expect given that markets and targets do have an impact in pretty much every other area of life, has worked better at delivering improved outcomes in England than the traditional centralised NHS model has at delivering improved outcomes in Wales and Scotland.

Like the water example, this is unlikely to change the Shouty Left’s minds. Shame there isn’t some kind of Evidence-Based Party to support – just right-wing ideologues who happen to be right in the cases listed above, and left-wing ideologues who happen to be right on other things.

5 thoughts on “Evidence-based policymaking”

  1. I'd vote for the EBP if there were one. But many things are down to value judgments and guesswork, so that doesn't really solve the problem – you still have to argue about what the government 'should' or 'should not' do, e.g. the whole 'war on drugs' nonsense.

    The pro-legalisation campaigners split into two camps, the 'shoulds' (who are doing it on basis of personal opinion, which is just as valid or invalid as the personal opinions of the bansturbators) and the EBP, who say that whether or not drugs are harmful or enjoyable is actually irrelevant – the key point is that making them illegal just makes things worse for everybody, not just those who enjoy taking them.

  2. I sympathize with the idea, but I think there are a number of obstacles.

    First, as Mark says, even if there is agreement on evidentiary matters, there is still the matter of normative statements – "should"s – on which there will be considerable disagreement within the EBP.

    Second, the much more complex nature of the social sciences compared with the physical sciences means the design and interpretation of experiments (not to mention the problems with data-mining for "natural experiments") are much more complicated. It think it was Humphrey Appleby who offered four generic criticisms of any study that could be made without reading it.

    Third, evidence is often used as window dressing for normative statements – this happens in every contentious policy debate from guns through crime to abortion. It's the difference between using statistics as the building block of an argument, and using them to construct a facade.

    The best test of how someone is using evidence is to ask, is the evidence were otherwise, would they change their minds? So if they took they cited evidence that "1 in 10 people are affected by bicycle theft", and it subsequently emerged that 1 in 100 actually were, do they say "bicycle theft wasn't as big a problem as I thought", or "you are trivializing the hurt to bicycle owners with your fascist mathematics"?

  3. I'm looking forward to JB's response to Edmund's last question (in the context of the ire which JB provoked for questioning Amnesty UK's statistic saying that ten per cent of all women were victims of domestic violence).

  4. Err, "agree wholeheartedly". Wasn't the original post one about how pissed off I am about people who I agree with on most fronts failing to appreciate data…?

  5. Um. Just spent a while typing a long response and then realised that Mark and Edmund had said most of it already.

    Social policy is laden with value judgments, and the same evidence can point to two contradictory policies depending upon the values of the person assessing that evidence.

    Plus, when it comes to social policy, there tends to be great disagreement about what actually constitutes "evidence".

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