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Planning a short-term pain doesn’t always mean there’s long-term gain

Published on 14 February 2022

"Real change will require policy that is consistent over decades." Paul Johnson in The Times on the balance between long-term and short-term policies.

In December MPs voted overwhelmingly in support of government proposals to make vaccination against Covid a condition of employment in the NHS. At the end of January Sajid Javid, the health secretary, announced a U-turn, only three days before the deadline for unvaccinated staff with patient-facing roles to have their first vaccine dose or risk losing their job. At the time, about 80,000 NHS staff had still to have their first jab.

The policy and subsequent U-turn caused huge upset within the healthcare sector. Some I have spoken to saw it as yet more evidence of a government flailing around without a clear sense of direction. Senior managers had invested huge amounts of energy into persuading colleagues to get vaccinated and felt that they had used up considerable amounts of goodwill in doing so. While many were relieved at the reversal in policy, they were frustrated, and exhausted, by the apparent flip-flopping.

Some I have spoken to are also, I think, quite irritated with me. My first response to a senior manager, the day after the change was made, was along the lines of: “Well, of course, couldn’t you see this coming, wasn’t it obvious?” Not the best way to make friends and influence people, perhaps, but the natural response of anyone who has thought at all about time consistency in policymaking. I don’t know whether it had been the government’s intention all along to follow this route, but had I been advising them on the best way to maximise vaccination rates among NHS staff, this certainly would have been an option I would have floated.

The problem: we want to maximise vaccination rates. We feel we have done all we can by persuasion. How about mandation, with the threat that your livelihood will be removed if you fail to comply? The risk, of course, is that tens of thousands, feeling very strongly that the state has no right to force them to be vaccinated, will defy the mandate, causing chaos in a health service already struggling to recruit and retain staff. So why not say you are going to mandate vaccination, get as many staff vaccinated as possible who can be swayed by that threat and then simply lift the threat at the last moment? That is one way to maximise vaccination rates without actually shooting yourself in the foot by losing huge numbers of staff.

As I say, I have no idea if this was the original line of thinking, either explicitly or implicitly. It is a risky strategy. It’s likely that some left the NHS before the end of January as a result of the threat. Trust between government and health service workers and managers will have been weakened further. And this is not a game you can play again soon. If a new variant, or a new virus, requiring vaccination comes along, any threats are going to ring hollow. But the end-game was surely always going to be a government backdown if the alternative was to lose too many staff.

These issues of time consistency come up all the time in policy, including through the pandemic. Whatever the merits of delaying or avoiding lockdowns, for example, it would be wise to recognise that there comes a point, if hospitals are overwhelmed and thousands a day are dying, that they become all but inevitable. Better, perhaps, to recognise that early on.

It is not only during a pandemic that governments have to wrestle with such issues. Why did the chancellor come up with the specific policies to try to defuse the energy price crisis that he did — the one-off rebate on council tax and the one-year reduction in energy bills? These are far from perfect policies, but a crucial element of his calculation will have been that these look like credibly temporary policies. Nobody expects them to be maintained indefinitely. The same might not be said for a cut in VAT or national insurance, or an increase in benefit levels, for example. Rishi Sunak will have remembered how difficult it was to reverse the £20 uplift in universal credit introduced in March 2020. However many times he insisted it was always intended to be temporary, the head of steam behind making it permanent grew to levels that meant he had to use considerable political capital to end it. In being more generous in the short term, he managed to look mean in the longer term.

Lacking credibility that it will be one-off is also probably the best argument against a windfall tax on the excess profits currently being enjoyed by some energy companies. Even if genuinely one-off, it could have adverse long-term consequences for the UK’s attractiveness as a destination for investment if people believe it, or something similar, will be repeated. I can’t say I find that argument desperately convincing. We have had windfall taxes before without, so far as I know, any evidence of long-term negative effects. And these really are excess profits in the economic meaning of the term. But it is a consideration to be weighed in the balance.

To end on another contemporary note, time consistency will make “levelling up” desperately hard. Real change will require policy that is consistent over decades. One reason why I rather liked the recent white paper was that it recognised that, had few short-term gimmicks and was focused on creating institutions, including through devolving power. These concerns were also presumably behind the startlingly ambitious “missions”, or targets, it contained. In the words of the white paper, policymaking will need to be “fundamentally reoriented”. Michael Gove’s legacy will turn on whether, whoever is in power, this fundamental reorientation happens and persists alongside these missions and institutions a decade hence. Long-term credibility is all.

This article was first published in The Times and is reproduced here with kind permission.