Why localism is key to test and trace

Sometimes you have to keep banging away about something. For some time I have been complaining that the government’s system for providing tests for Covid-19, and then for its approach to contact tracing, suffers from a fundamental flaw of process design. I see this being occasionally mentioned by others, but the idea hasn’t caught on. So I will say it again.

This is relevant because the testing regime seems to be in a state of complete dysfunction. The government is not being transparent about what is going wrong, a an issue which is not unrelated, so I’m having to join some dots, based on a flood of anecdotal evidence from people at different levels in the system that have popped up on the news. The system has been overwhelmed by a surge in demand. Whether or not this should have been foreseen is one question, but taking a step back and looking at the outcome prompts another. This excess demand seems to have caused the whole system to fail, so that while testing capacity is very high (the government claims it is higher than in most other countries), all, or most, of the tests are taking far too long to return results, which completely undermines their usefulness. I have heard experts suggest that if results take longer than 48 hours to be returned, then they are of little practical use. That sounds about right. Results seem to be taking much longer than this in the official system, or at least that which serves most users (I think hospitals are linked to a different one, which might be working a bit better). The problem seems to be at “Lighthouse” labs where samples are analysed. The government suggests that this is just a numbers game: these labs have a capacity and demand is in excess of it, leading to delays – which is perfectly plausible explanation and doubtless at least part of the problem. There are other stories of staffing issues as these labs are losing temporary workers as the university terms start, and finding them hard to replace.

How to manage this? The first response is to stop people taking tests through the booking system, by telling them that they are unavailable, or only available hundreds of miles away. One story is that the only way that people living in the London suburb of Twickenham can get a test locally, rather than one in Aberdeen (in the north east of Scotland), is to say that they are living in Aberdeen. This is causing an immense amount of distress, which is feeding back in complaints to MPs. The government is now trying to impose some form of prioritisation on tests to give this more rationality. But that will be hard going, with goodwill in short supply. There is a least one new Lighthouse lab in the pipeline, and the government doubtless is placing its hopes on this. Alas any relief is unlikely to last for long. The whole thing gets much worse when the need for contact tracing is brought into the picture, where similar problems are emerging, though not, excess demand. The whole damn system is flawed.

What’s gone wrong? The designers of the government system are bewitched by the idea of scale economies. The unit cost of a large scale system operating at full capacity is generally very low. And because covid tests are basically quite standard, at first sight the building of such high volume facilities looks like a sensible way forward. When the government suggested that the system would be “world-beating”, this is doubtless what lay behind it, as many countries have gone for a much more artisanal approach. But that is only one aspect of process design. The problem comes from how you manage the whole process from end to end (i.e. from the moment somebody decides that they need a test to the moment they get the result). The more steps there are in the process, and the more disconnected their management, the less efficient the whole becomes. This can seem quite paradoxical. Each part of the system can seem to be operating well, but the whole can be dysfunctional, and doesn’t seem to be anybody’s fault. The problem is compounded by the the government’s preference for the use of mass-sampling facilities. People are sent to drive-in centres that are able to process large volumes. But these are often idle and simply make the whole process more disconnected. The symptoms of such a disconnected “silo” based process design are very familiar. Bottlenecks, queues, delays, lost files, and all the while managers working frantically hard at their own little section in the knowledge the the problems are all somebody else’s fault. And managers blaming users for making unreasonable demands. There is so much at stake in the overall design that nobody dares point out that it might be better to scrap the whole thing and start again. Instead they work on fixes that ameliorate the worst problems but make the whole process more cumbersome. In this case designing systems to prioritise demand.

What’s the alternative? It is to create local facilities that do the whole job end to end, or as much as possible. Best of all is if the testing function can be integrated with a similarly localised system of contact tracing, all accountable to a local director of public health, part of local government. Where possible staff should be able to cover multiple jobs, rather than specialising in just small parts of it. This is more or less how it works in Germany, among other places. Such a system cannot solve all problems. It may not be able to overcome shortages in critical supplies (reagents for tests, and so on), though managers are more empowered to find work-arounds. How would it cope with excess demand, as is happening at the moment? It is superior in several ways. Firstly because managers are likely to have a better overview of the whole system, problems are more likely to be foreseen. Secondly bottlenecks are more easily fixed. It is easier to recruit two or three extra staff in a local centre than a couple of hundred in a centralised facility. And where there are problems, they will not bring the entire country to a halt. And finally communication with the end user is likely to be far superior, as they are much closer to a knowledgeable, human interface.

These principles have been well-understood since the 1990s (when I used them to reorganise processing operations that I was managing). Alas the government, and those it appoints as advisers, are far too wedded to the imperial silo-based model and seem incapable of understanding that they are dealing with poor systems design rather than a few teething difficulties. Doubtless the silo approach works well in some contexts. But not here. But quite why the lessons of the 1990s are so widely forgotten in 2020 remains something of a mystery to me – my guess is that managers and politicians have been distracted and beguiled by new technology.

The Lib Dems search for a new strategy

To be a Liberal Democrat in Britain is to experience long spells in the political wilderness, interspersed with short intervals of relevance. After passing through most of 2019 in one of those intervals of relevance, the party is well and truly in the wilderness now. What should it do?

It is worth asking what is the party for. It provides a political home for those who want a party which has liberal values at its core, rather than a peripheral part of a wider coalition (as is the case for Conservatives and Labour, and indeed Scottish Nationalists or Greens). It then seeks to advance those values, either by winning elections and taking political office, or by forcing other parties to compete for liberal votes, and so making them more liberal in their exercise of power. What are those liberal values? It is about individuals taking control of their lives as far as possible, regardless ethnic or national origin, or sex or sexual orientation. That’s how liberals are classically defined, and it matters in the current world because many prefer a political narrative that elevates the nation-state into something close to sacred, rather than a mere means to an end, and there is a widespread belief that multiculturalism has failed. But modern liberals have attached other beliefs to this classical core. One is a strong belief on the need to intervene to protect the environment, and another is the need for the state to play a very active part in the management of the economy, through the welfare state, public services, redistribution of wealth and regulation of private business. There is a further belief that political power should be distributed amongst international bodies, national government and local government. That makes them in favour of such bodies as the United Nations and the European Union, as well as much stronger regional and local government. Liberals (or at least those that the Lib Dems seek to represent) think that too much power is concentrated in Westminster, where often it is captive to an out of touch elite, even if that elite is often liberal in its instincts.

But there are people who believe in all of this who are members of the Conservative and Labour parties. The problem is that in these parties liberal ideas have to compete with others. Among the Tories the nationalist narrative plays very strongly; they overlook the unbalanced distribution of wealth and power; and they are reluctant to take on corporate vested interests for environmental protection, amongst other things. Labour is less concerned with individual empowerment and have a tendency to see the answer to all problems as being concentrating more power in national government. This was taken to extreme lengths under the leadership of Jeremy Corbyn. But it is perhaps a measure of success for the Lib Dems that both major parties are making a pitch for the liberal vote, and that many voters struggle to see the need for another political party. Answering that question lis at the heart of any Lib Dem strategy.

Which is why it matters so much to Lib Dem strategy what the other parties are doing. There are some in the party who think that the party should ignore the other parties to go full on with the promotion of liberal values, and so build a loyal core vote. Alas this can only be one strand in a larger strategy, and not the most important. For now Lib Dems are much happier defining themselves against the Conservatives than Labour. The Tories are controlled by radical ideologues, more interested in wrecking things that they dislike than in governing competently.

Labour is the conundrum. Its new leader, Sir Keir Starmer, has resisted defining a clear ideological path, concentrating his fire on government incompetence. The ideological legacy of his predecessor, Jeremy Corbyn, is slowly being pushed into the background. This creates a blank canvass onto which voters, including liberal ones, can project their hopes. This is not unlike Sir Keir’s most successful predecessor, Tony Blair. How do the Lib Dems compete?

The answer I most often hear is to this is locally. To win the next election Labour must climb a huge mountain. That journey would be slightly easier if they decided to ignore the Lib Dems in a few critical geographical areas and let them challenge the Conservatives there. And if Labour thought that the Lib Dems were picking off Tory votes that they would be unable to reach, then this semi-cooperative strategy looks more attractive. But at the same time Labour does not want to leak votes to the Lib Dems, and would prefer the party not to exist. There are something like 30 seats where Lib Dems are first or second placed and able to mount a credible challenge (they are second-placed in about 60 more – but so far behind that this hardly matters). In their current state the Lib Dems would happily settle for that.

That is all very well, but the party needs a degree of national strength and purpose if it is to present a convincing local challenge anywhere. To do so it needs to champion causes that the Conservatives and Labour are ignoring, but which are both popular and highlight the party’s values. Two lines of advance are often advocated. The first is to continue the party’s strident pro-Europe stance by proposing to rejoin the EU as soon as practical. Labour are anxious to win back Brexit-supporting voters, and so are making their Brexit challenge about competence and not principle. The trouble is that most people are thoroughly fed up with the politics of Brexit, and accept that the Brexit side won. Meanwhile the Conservatives are anxious to promote a narrative that the country is being undermined by Remainers who have not accepted the democratic verdict of the people. So a pro-EU strategy risks either flopping because it is too out of touch with the national mood, or, if it gets traction, of supporting the Tory narrative and distracting attention from government incompetence.

The second possible line of attack is to attract leftists disillusioned by Sir Keir’s prevarications. The party is already adopting a mild version of this strategy, through adopting a robust environmental agenda and talking up such ideas as universal basic income. And yet the party’s most promising constituency is soft Tory voters who find left-wing radicalism suspect.

So the party is not doing much of anything. That will do for now. Tory-inclined liberals are throughly disgusted with Boris Johnson’s government. Many voters are thoroughly suspicious of Labour. Sir Keir will have to break cover on economic and environmental issues; when he does so opportunities will open up for the Lib Dems.

The key is to find issues that show how liberal values favour ordinary people. To discover what these might be the party needs to listen more, as its new leader Ed Davey is doing. There are some straws in the wind. The Black Lives matter movement has shown how disappointed and frustrated people from ethnic minorities are that so much prejudice remains. The government’s struggles with covid testing and tracing are showing how nationally centralised systems are often ineffective, and that local centres should be given more scope to find their own ways and mobilise local resources. Grand government schemes to soften the blow of lockdowns are all very well, but far too many people, especially self-employed, are falling through the cracks. Can a narrative of diverse local communities working together to overcome local challenges be developed, to compete with the Conservative and Labour ones focused on winning national power?

The wilderness period will continue for a while yet for the Lib Dems, but there is always hope.

The world in August 2020: the dance of the Great Powers

I haven’t posted at all in August. This is mainly because my wife and I finally completed our house move to a village in East Sussex. We have been reunited with the bulk of our possessions after nearly four months of storage, and we have been unpacking figuring out what to do with them. Then came choosing and ordering all sorts of new things to fit our new house and lifestyle; getting to know the neighbours has been constrained by social distancing, but there has been some of that too. It just hasn’t felt appropriate to take time out to do some blogging. Besides I quite like to take extended periods off for reflection. I’m sill not sure what direction to take the blog. I’ve had two main ideas. One is to try to dig a bit deeper to develop some ideas in series of essays. The second is the opposite: to fire off quick opinions on the issues of the day. Of course I can do both. I’m going to try the second idea first, by reflecting on the month that has just passed.

The pandemic gets messy

The biggest issue of the day remains the Covid-19 pandemic. In the developed world the good news is that death rates have plummeted (outside the USA). But infections remain persistent, which makes loosening restrictions much harder. The exponential nature of infectious diseases means that things can quickly get out of control. Not enough people have caught it to confer herd immunity, and it looks likely that immunity isn’t conferred for long periods after illness anyway. Meanwhile the impact on jobs and normal life has been heavy, and could get worse as measures to head off the worst, such as paying people to do nothing, run out of steam. Difficult decisions pile up on governments and members of the public, and everybody, across the world, is struggling. Apart from trying to head off another wave of nasty, slow deaths, the biggest worry seems to be the effect this is all having on children’s education, closely followed by how to rebuild economies as people realise (or not) that the we can’t go back to how things were before.

The US election: is Trump catching up?

The month started with US President Donald Trump trailing his Democratic challenger Joe Biden for November’s presidential election. It ended with all sorts of experts from both sides saying that Mr Trump is closing the gap with his relentless focus on law and order, following riots in various US cities over police racism. The betting now has the two contenders nearly even. The hard evidence for this catching up is rather thin so far, so we await polling based on the month end, after the republican convention. Doubtless both sides have their reasons for talking up the President’s chances, but I remain sceptical. Compared to four years ago, many more people have already made up their minds. Those that have plumped for Trump will be cheering him on, and remain on fire. But Trump sceptics will have seen nothing in his transparent politicking and outright lies to persuade them to change their minds. Mr Biden seems to be holding his nerve, and appears to be well-advised. Mr Trump, on the other hand, remains his own worst enemy. Still the polls don’t have to narrow by very much for the election to become quite close, such is the built-in Republican advantage. But this is no rerun of 2016.

Belarus: spheres of influence

The big idea of the moment on the political right (taking in some on the left too) is national sovereignty and the primacy of the nation-state, with a reaction against supranational structures and treaties. Alas, just as it did in the 19th Century this soon morphs into an international system based on a small number of “Great Powers”, surrounded by minor powers, satellites and colonies who are not fully independent in any practical sense. Each Great Power demands its sphere of influence, where other Great Powers must keep their noses out. This is evident in Belarus, where there is a popular uprising against a rigged election and a dictatorial regime that has been in power for too long. But Belarus is, more clearly than any other country, within Russia’s sphere of influence. The rest of the world seems to accept this, and are keeping out of it. This is bad news for the people taking part in the uprising. President Lukashenko’s support in his security forces looks strong, and the Russian government do not want the uprising to succeed. They only want to weaken Mr Lukashenko’s regime so that they are less able to resist Russian influence, which doubtless involves making the Russian oligarchy richer. Belarus’s claim to be an independent nation is probably the weakest in Europe, after all; it only won independence from Russia by accident.

China: victim culture

Another Great Power seeking to undermine the independence of others to further its interests is China. Like Russia (which feels it was shafted when its communist regime collapsed in the 1990s) and the USA (where Trump supporters are convinced that their country has been taken advantage of by all and sundry), this assertiveness is driven by a strong sense of historical victimisation. In China’s case this is based on abuse by colonial powers in the 19th Century (it did not achieve Great Power status and was treated as fair game, by the values of the time) and then subjected to a decade of attack by Japan from the 1930s, in which it was devastated. China’s sense of victimhood has more historical validity than Russia’s or Donald Trump’s. But victim mentality is hard to turn into mature, constructive engagement and long-term success. The country is demonstrating its contempt for Western liberalism by crushing dissent in Hong Kong (where nobody questions its sphere of influence). Its subordination of all to its national interest, and its willingness to bully and bend rules, including its tolerance of cyber attacks from within its borders (or worse) have raised security fears for equipment supplied by businesses based their, and any data they might get their hands on. This is causing costly commercial disengagement with the West, not helped by Mr trump’s paranoia. It has now also deeply antagonised the other Asian giant, India. It is hard to know where all this is going. Personally I’m not as convinced as most commentators by the country’s unique combination of central party control with rampant commercialism, with the former increasingly taking priority. There are distinct financial instabilities which even China’s highly competent management may be unable to control, and the rest of the world is slowly ganging up against it.

A revitalised European Union

The EU hit a low point early in the year, as the advance of Covid-19 made it look irrelevant, and Britain’s exit diminished it. But the institution advances in times of crisis, and release from the Brexit saga seems to have invigorated it, as well as fresh leadership within the Commission. Its scheme to deliver collective relief for the Covid crisis broke new ground, especially with the issue of collective debt. The usual Anglo-Saxon sneerers (like the New Statesman columnist John Gray) predict the EU’s imminent demise, but, not for the first time, the institution lives on. The flaws of the nation-state system may not be evident to these critics, but it surely is to the EU’s member states. But it is sobering for British Europhiles like me to realise that the EU’s step forward has been made much easier by the UK’s departure. shared debt would have been a very hard sell in Britain’s political climate, even if Brexit had been headed off.

Brexit endgame

But Brexit isn’t done yet. What will happen once Britain ends its transition period from leaving the European Union on 1 January 2021? Negotiations seem deadlocked, with both sides blaming the other for intransigence. They may well both be right. Britain’s light-headed government as a strong belief in cobbling things together at the last minute, and does not want to end up as appearing to be an EU satellite. It hankers after status somewhere in between being a Great Power, where it develops spheres of influence, while not being in a minor power, where it would be in somebody else’s sphere of influence. There is no sign that this has been properly thought through, and so what it is prepared to compromise on. But the EU is behaving decidedly in the manner of Great Power which doesn’t mind denting a neighbour’s sovereignty for its own convenience. But a no-deal would be very costly to both sides, so the betting is that a way will be found of saving face.

Britain’s essay-crisis government

Britain’s Conservative government’s approach to Brexit, leaving everything difficult to the last minute and trying to bodge through, is reflected in everything it does, and the results aren’t pretty. The most egregious example in August was the collapse of its attempt to replace A-level and GCSE exam results with a moderated system of teacher assessments putting the overall results in line with previous years. Instead there has been massive grade inflation, and doubtless injustice as some teachers were more generous with their assessments than others (though, of course, this may be the case with exam marking too). The government had plenty of time to prepare, and yet walked straight into the elephant trap, relying on moderation by algorithm rather than human intervention. This partly reflects the managerial approach of the Prime Minister, Boris Johnson, who celebrates his light touch, but abhors competence and dissent amongst his ministers. But it goes deeper. Britain’s political class has for a couple of generations become political specialists, with little experience of serious organisation and management beyond election campaigns. The civil service is little better, drawing a critical distinction between “policy” and “implementation”. Civil servants take pride in specialising in the the first, and assuming that the second can be dealt with by separate implementation specialists. In the real world policy and implementation need to be in a close feedback loop which separation makes impossible. And when the government (in both political and civil service guises) asks for help from practical people, it usually asks the wrong ones: people from big business or the major consultancies that support them. Big business succeeds by making things simple and employing economies of scale; public services are in the public sector largely because the have to deal with human complexity, for which this approach is ineffective (otherwise the private sector would already be handling them). The government’s sub-standard Covid testing and tracing regime arises from the false application of big business wisdom.

Ed Davey: the new Lib Dem leader

The British Liberal Democrats chose a new leader, Ed Davey, who comfortably beat his rival, Layla Moran. I know them both quite well. The party went for the experienced Ed, who was a coalition minister. Many of Layla’s supporters had hoped to put those coalition years, with their student tuition fees and benefits cuts, behind them. But many members had joined precisely because they thought the coalition was a worthy project. On being chosen, Ed said that the party had to “wake up and smell the coffee”. A rather tired cliché, but he is right that the party needs to broaden its appeal beyond an opposition to Brexit that tipped into taking sides in a culture war. Like the Labour leader, Keir Starmer, he seems to want to make competence centre stage, as the Conservatives seek to distract the public from their failures with cultures wars. But will the party be crushed by Labour? Or will Labour seek to operate in a sort of partnership depending on relative local strength? The answer to that depends on the party’s local strengths, and relatively little on the leadership. Meanwhile there is a lot of quotidian work to be done to make the party’s national infrastructure more effective, after years of crisis management have created dysfunction . The same can be said of Labour, but, as a smaller party the job is much easier for the Lib Dems. The party’s President, Mark Pack, and Chief Executive, Mike Dixon, recent appointments both, are up for this patient work – the signs are that Ed is too.