24 hours at the Public Policy Hospital

by Dennis Grube

Hold on to your paradigms, my friends. 2017 is here and it’s taking no prisoners.

For governments, 2017 will be the year that finally confirms that public policy is no esoteric science. It’s a dirty, hands-on, fly-by-the-seat-of-your-pants type of business that is inextricably bound together with the wider forces of politics. Where politics leads, policy will follow. In the process, some of the cherished beliefs of public policy from the past few decades will find themselves under extraordinary attack. To paraphrase Bette Davis - paradigm change is no place for sissies.

I decided to take an ethnographic approach to the new year by visiting the public policy hospital and having a stroll around the wards. Below are excerpts from my field notes:


I enter an unremarkable room, where evidence-based policy (EBP) is lying on its deathbed. Nobody is coming to visit because EBP has always lacked the capacity to actually connect at a human level. Data is a cold companion. Evidence never buys a round of drinks. The lessons from Trump and Brexit are that persuasion matters. Data doesn’t speak. Evidence doesn’t dance. They are merely the raw materials that policymakers must use to actually persuade people about the need for change.

EBP looks up at me plaintively and whispers quietly: ‘I forgot I needed a narrative.’ I nod in quiet agreement. The year 2016 showed us that if you forget to tell the story, the democratic populace may stop being interested in the data and evidence altogether. You can’t just wave numbers at people and expect them to meekly fall into line. Doomsday predictions have lost their capacity to frighten. The extraordinary irony of the age of ubiquitous information is that people no longer trust it. Instead of relying on the cold embrace of data, people are trusting in the authenticity of those who tell them not to worry about the evidence and offer them a hug instead.

EBP is pressing the button to ring for the nurse, but no-one is on duty because the statistics said it wasn’t necessary.


The era of ‘small government’ is in intensive-care. It looks pretty shaken up. This three-decade old paradigm has a mottled appearance, like a used car that’s been left out in the elements. The engine still runs, but there’s no sign of any get-up-and-go. It’s been here on life support for eight years now. It had a head-on smash with the Global Financial Crisis and despite some ongoing repairs, it just doesn’t look like a people-mover anymore. It’s a Soviet-era Trabant in a world that needs Cadillacs. Government suddenly has to be big enough to keep us safe against unseen terrors, to patrol our borders against ‘unwanted’ immigrants, and to create enough jobs to scoop up the millions who have seen their quality of life melt slowly away. As I walk by, small government is complaining to a doctor that its life support machine needs an injection of fluids, forgetting that the fluid budget was cut and outsourced last year and there’s a 28-day wait for the extra supplies.


Meritocracy has the flu. It’s stuck out in a general ward, sharing a crowded room with holiday pay and the housing bubble. It might get better, but in a world of increasing anti-microbial resistance, it might never fully recover. Meritocracy was always a fiction, but a noble one that grew out of a desire to combat the evils of patronage. But governments around the world are looking for new ideas - for innovators, disrupters, and change-makers. Such people rarely fall off the meritocratic production lines marked by the predictable processes of administrative advancement.

The fact is that merit has always been in the eye of the beholder. Meritocracy is a comfortable fable that lends a veneer of objectivity to the strange science of advancement. I offer to sit and read to it, but Meritocracy waves me away because I don’t have my level 5 bedside reading certificate.


I come to a large door marked ‘Experts Ward’. There is a warning sign ‘under sedation – enter at own risk.’ I peer through the glass in the door. I see a long line of people, literally banging their heads against a brick wall at the side of the room. A doctor walks up beside me and presses her face to the glass. ‘It’s sad isn’t it’, she says, ‘the government keeps trying to connect with them but they say they don’t know how – so they just keep banging their heads against that wall.’ I suggest that maybe we could find a common language to share ideas through? The doctor laughs at my naivety and moves away.


I have time for one more visit and decide to check on my old friend the Westminster system. He’s been around here so long he has a wing all to himself, but nobody quite knows for sure what he looks like. Some say he looks like a parliament with two houses; others say his ministerial responsibility has gone septic. A surgeon is coming through the doors towards me and bars my way. ‘I’m here to check on the Westminster system’ I say hopefully. ‘I’m sorry Sir, but he’s been pronounced dead’ replies the surgeon, her face grave. But then she smiles unexpectedly: ‘But don’t worry, he’s been pronounced dead more times than I can remember and he always bounces back.’

About the author

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Dennis Grube is a Lecturer in Public Policy at the University of Cambridge. He has written extensively on prime ministers and administrative leadership in Westminster democracies.
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