The role of evidence in policy formation and implementation

September 9th, 2013 at 10:00 am by David Farrar

A very good report on the role of evidence in policy formation and implementation from Sir Peter Gluckman. I am a fan of more use of evidence based policy.

Sir Peter notes:

All of this occurs within a complex and uncertain environment where human responses and decision-making are influenced by many factors other than well-informed knowledge. Indeed, as I have stated previously, my view is that quality evidence should be seen as base knowledge on which, in a democracy, multiple values and associated perspectives must be overlaid. However, where evidence is conflated with values, its power is diminished. Where evidence is not considered properly, the risk of less than desirable policy outcomes is inevitable.

For instance, it is possible for the research process to be corrupted by inputs that are not objective, or by the failure to recognise personal biases in bringing forward evidence. Researchers can become impassioned advocates for a cause that their expertise could meaningfully inform dispassionately

I can think of a number of areas, such as public health, where researchers are impassioned advocates to put it mildly.

They key recommendations are:

  1. Develop a standard set of protocols across government regarding obtaining expert scientific advice;
  2. Extend the use of Departmental Science Advisors (DSAs) more broadly across government;
  3. Use the community of DSAs and the Chief Science Advisor to assist central agencies with longer-term planning, risk assessment and evaluation;
  4. Improve and make more explicit the use of government funds for research to assist policy formation;
  5. Provide greater transparency regarding the use of research-informed data (or its absence) with respect to complex and controversial areas of decision-making where the public is directly or indirectly consulted.

I like the idea of each principal agency having a Departmental Science Advisor.

Using science for good

April 5th, 2012 at 2:00 pm by David Farrar

The PM announced a significant funding and policy package yesterday around teenage mental health. An extract from his speech:

Even a mild mental illness can have a big impact on a young person’s life and on those around them.

In my time as Prime Minister I’ve seen the impact of youth mental illness all too often.

I’ve met teenagers suffering from depression who can’t see a path forward.

I’ve met gay and lesbian kids who are struggling with their sexuality and suffering from anxiety issues.

And I’ve met parents who have lost a child to suicide. These are good, everyday Kiwi parents.

When the worst happens and a teenager takes their own life, those left behind have a heavy burden to bear.

Our youth suicide rate is alarmingly high.

They say the worse thing in the world is outliving a child. Even worse than that must be, when the death is from suicide. The trauma it leaves behind with family and close friends is massive, and scars for life. It is one reason why suicide is generally such as extremely selfish act. But sadly, sometimes seems a logical option to a desperately unhappy person.

Anyway what I found interesting and encouraging was the words from Sir Peter Gluckman on the package:

The announcement today of a very significant package of initiatives aimed to improve the quality, and the effectiveness of the delivery, of mental health services to young people throughout New Zealand is both important in its own right and also a demonstration of how evidence and expert advice can be used effectively to improve policy formation. …

The origin of these initiatives is an exemplar of how policy formation in complex areas can be based on informed scientific advice. In 2009, the Prime Minister asked me to consider the problems associated with the transition through adolescence. Rather than undertake a superficial review, I embarked on a 18-month project that eventually involved more than 30 New Zealand experts and several international contributors. Intentionally we produced a report, entitled Improving the transition, that stayed focused on the scientifically robust evidence and avoided opinion and anecdote. Among its findings were significant concerns about the provision of mental health services to many young people. Following this report, the Prime Minister initiated an officials group to consider what could be done, taking into account the advice from our report, and their work was subject to iterative review by an expert group chaired by myself. It is primarily from that process that the initiatives announced today emerged.

This is an excellent way to do policy, with a robust science based approach.

I’ve seen policy formulation done many ways. I’ve been in rooms when we have brainstormed election policy. I’ve seen policy changed unilaterally to fit an advertisement (rather than vice-versa). One won’t always be able to do policy as described above, but it is an ideal to aim for in many portfolios.

But what about the cost

June 2nd, 2011 at 12:00 pm by David Farrar

Claire Trevett in the NZ Herald reports:

A report from the Prime Minister’s chief science adviser says raising the drinking age to 21 and increasing alcohol prices are two of the most effective ways to address youth drinking problems.

Professor Sir Peter Gluckman yesterday released a paper on social problems facing young people, which Prime Minister John Key requested after the death from alcohol poisoning of King’s College student James Webster in May last year.

Si Peter’s report is here.

I’d make the initial point that the tragic death of James Webster would not have been affected by a change in the alcohol purchase age. That is very clear.

Secondly I’d concede that raising the drinking age and increasing the price of alcohol is likely to reduce harm from alcohol. If you made the purchase age 25 and made the cost of a glass of beer $20, then there would be far less harm from alcohol.

Likewise if you really wanted to lower the road toll, you’d engineer all cars so they can not go faster than say 40 kms/hr.

So why don’t we do these things? Because while it reduces harm for some people, it also imposes costs and removes choice from other people.

The 318 report from Sir Peter is a very useful piece of work. You need good science to tell you what may and may not work. But the science is only an input.

Science could tell you that if we banned fast food outlets from New Zealand, we might be a healthier country. If we passed a law making it mandatory for people who weigh over 95 kgs to go to the gym twice a week, then we might also be a healthier country.

But most people don’t want to live in a country like that. They want a country where responsible people are not punished for the decisions of irresponsible people.

Dissent on making pseudoephedrine prescription only

October 9th, 2009 at 6:24 am by David Farrar

The very sensible MacDoctor disagrees with the decision. He blogs:

Unfortunately Mr. Key is being poorly advised on this matter by his science advisor, Peter Gluckman – who has no medical qualifications, BTW

The strike through is after a commenter pointed out Sir Peter actually graduated medical school, and spent two years as a doctor before going into research. He is also a former Dean of the Faculty of Medicine and Health Sciences at the University of Auckland.

Once again, I link to a real scientific study on phenylephrine and pseudoephedrine so the Sir Peter can actually read something useful on the subject. There are dozens of others, but this one is freely available to be read in full. All the scientific evidence (as opposed to the anecdotal ones) shows that phenylephrine is essentially useless as a nasal decongestant. If you want relief from your cold, you are going to have to use pseudoephedrine. All that making this a prescription item will do is make the treatment of a cold more expensive for people. It will also move the monitoring of drug seekers from the pharmacy to the GP, who is even less likely to spot the serial script seeker. “Shoppers” for pseudoephedrine will just move from doctor to doctor, gathering scripts.

Stuff also reports dissent:

The Pharmaceutical Society’s chief pharmacist adviser, Euan Galloway, said the proposed replacement, phenylephrine – which Mr Key said was a “safe and effective alternative” – was not as good.

“Ask any community pharmacist and they’ll tell you they may make one sale [of a phenylephrine medicine], but never again,” Mr Galloway said.

Phenylephrine had a very high “first past metabolism effect”, which meant most of the drug was metabolised or rendered inactive before it reached the parts of the body where it was needed.

The plan against P

October 8th, 2009 at 1:08 pm by David Farrar

John Key has announced a wide range of measures, as part of a plan to reduce the supply of, demand for, and harm caused by P. The main measures are:

  • Making pseudoephedrine a Class B2 controlled drug, making it prescription-only. (I have attached the report from Sir Peter Gluckman recommending this)
  • Use proceeds of crime legislation to fund additional Police and Customs activities to fight gangs and organised crime plus an expansion of drug treatment services.
  • Investing in additional $22 million in clinical services to fund treatment for P addiction to more than 3,000 additional patients over the next three years.
  • Assigning 40 additional Customs officers to special dedicated drug-taskforce duties to help break the supply chain. Key also announced in just two weeks Customs has managed to make 26 seizures of ingredients with a street value of $13 million if they had been used to produce P.
  • A new Police Methamphetamine Control Strategy which aims to use intelligence in new ways to target gangs, investigate drug syndicates which import P precursors illegally, target P ‘cooks’ and seize funds and assets gained through P-related activity.
  • Reviewing the outdated Alcoholism and Drug Addiction Act 1966, to provide a more effective legal means to get P-addicts into compulsory assessment and treatment.
  • Making chief executives of Government agencies accountable for delivering on our plans, as measured against a range of targets that will be clearly set out in the actual Action Plan to be released next week.

The status quo has obviously failed. It is good to see that the plan does not just try to target one aspect, but is a balance of measures that aim to reduce supply, reduce the demand for P, and reduce the harm caused by those addicted to it – which is far far wider than self harm.

The Gluckman report is here – Pseudoephedrine report.

A recent story on how destructive the addiction to P is, was a great story in the HoS by Carolyne Meng-Yee on Lynne Carter:

One of Auckland’s poshest hotels has turfed out a high-profile socialite, saying her erratic behaviour has scared guests and staff and claiming she has left her $600-a-night suite uninhabitable. …

The eviction of Carter, who is facing methamphetamine and fraud charges in the Auckland District Court, is the latest twist in a sad fall from grace for the businesswoman who once boasted a $6 million waterfront mansion, a Ferrari and a booming property development business.

She was set for life.

“She smokes and we don’t allow smoking, and her dog pisses everywhere,” Bourke said. “We have chucked her out many times but she keeps coming back in the middle of the night.” …

“She was smoking all the time and the dog was in the room. It was peeing everywhere.

“She would get up in the middle of the night … She was out like till 3am, running up and down the hallways calling out ‘Louis, Louis’ and we had complaints from guests saying ‘who is the woman running up and down the hallway screaming?’

“Or we would have functions on… It was horrible, it really was.”

On another occasion, Bourke said Carter sat in the Herne Bay hotel’s library, staring vacantly at the ceiling.

And if not bad enough:

Bourke said that, in her opinion, Carter had “gone from someone who was well-dressed and well-spoken… and she has turned into a country bumpkin who walks around with no shoes and dirty hair”.

Bourke said Mollies could not hire out her suite because of the stench of dog urine and stale cigarette smoke. “We have to air it a little bit longer to get rid of the smell.”

And that is just a case of self-harm, and is nothing compared to the cases of William Bell, Antonie Dixon, and others where innocent Kiwis get butchered in P fuelled rages.

Treasury on emissions target

August 18th, 2009 at 8:23 pm by David Farrar

A few people have tried to portray the Government’s target of a 10% to 20% reduction over 1990 levels as some sort of half hearted wimp out. In fact it is right at the top of what is achievable without lunacies such as shooting cows.

Matthew Hooton pointed out in NBR how massive this target is:

The 10-20% target announced by John Key, Nick Smith and Tim Groser this week is far more radical than it sounds.  By 2020, under business as usual, New Zealand’s net emissions are forecast to be up 40% over 1990 levels.

This means the Greens’ 40% target cut over the 1990 baseline is in fact a 57% cut over the base case.  National’s 20% target would require a 43% cut.

In other words, National has offered up a proposed cut that is three-quarters of what the most swivel-eyed neo-Marxists in the Green movement have been demanding.

This is why Labour does not dare say what their target would have been.

Now NZPA report what Treasury says the target should be:

But Treasury recommended a target range with an unconditional target of 8 percent reduction on a base year of 2005.

This was equivalent to emissions 15 percent above the 1990 level because New Zealand’s total greenhouse gas emissions increased 24.7 percent between 1990 and 2005.

So the Government has gone for a target of 10% to 20% below 1990 levels, when their official advice was aim for 15% above 1990 levels. So again, if an eco marxist tries to claim this target is some sort of wimpy sell out, go drop a cow on them. If anything the Government could be criticised for too ambitious a target.

Incidentally I would recommend people read Professor Sir Peter Gluckman’s summary of the issues on climate change.