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Select Committee on Public Services

Oral evidence: Public services: lessons from coronavirus

Tuesday 8 September 2020

9 am

 

Watch the meeting

Members present:  Baroness Armstrong of Hill Top (The Chair); Lord Bourne of Aberystwyth; Lord Davies of Gower; Lord Filkin; Lord Hunt of Kings Heath; Baroness Pitkeathley; Baroness Tyler of Enfield; Baroness Wyld; Lord Young of Cookham.

Evidence Session No. 17              Virtual Proceeding              Questions 112 - 124

 

Witnesses

I: Audrey Tang, Minister without Portfolio, Government of Taiwan (Republic of China); Todd Krieble, Deputy Chief Executive, New Zealand Institute of Economic Research.

 


 


16

 

Examination of witnesses

Audrey Tang and Todd Krieble.

Q112       The Chair: Good morning, everyone, and a particular greeting to our witnesses this morning. I realise it is not morning for you, but welcome none the less, and thank you very much for giving up the time to be with us. This is our first session after the Summer Recess, and we are really looking at the experience of people in other parts of the world of the whole coronavirus issue and how is has impacted on public services. We are pleased to be able to host this session, so that we think a bit more broadly outside of just what has been going on in this country.

We have an hour for two witnesses. We have Todd Krieble, the Deputy Chief Executive of the New Zealand Institute of Economic Research, and Audrey Tang, who is Minister without Portfolio in Taiwan and has been doing a lot of work on data and the use of data in tackling the virus.

I am very pleased that you are both here, and I want to open the questioning by asking Todd what fundamental strengths and weaknesses Covid-19 has revealed in the New Zealand model of public service delivery and in government culture.

Todd Krieble: Thank you very much for the opportunity to speak this morning.

I will open with a little bit of context. I think we have recognised that good public health is good economics. We have had to rely very much early on on what I would describe as textbook use of traditional public health measuresthe isolation, the social distancing. We honestly have not had a lot of choice, because some of the public health function has been a bit neglected and run down. Initially we probably did not have enough capacity to do some of the contact tracing because the virus was spreading a bit faster than we could track things down. 

It would be fair to say that we were probably not more than a week or two away from being another Italy. We did go hard and fast but only just. I think we also had the opportunity of being an island nation and a fairly small country. We know that the first lockdown in April took about $20 billion off GDP. That is three years of GDP growth wiped off just in that brief period. No one is arguing that it was the wrong thing to do. The Government have set up a very strong monetary response with quantitative easing as well as a very strong fiscal response. The cornerstone of that is some of the wage subsidies.

Some of the strengths of the public service have come to the fore and are particularly important at this time. There are two things I would highlight. One is that we have a really strong culture of co-operation. All the cabinet papers and all the co-ordination was done jointly. It would not be acceptable for any department to go off on its own without having had that proper consultation with the other departments with a major interest. That is just part of the way the culture is. I note from the senior roles I have had in the Ministry of Health, the Prime Minister’s Department and the Ministry for the Environment that that is just the way you do things. There is a social system or a peer system that means that anything less would not be tolerated.

The second fundamental strength is that we have had very high levels of public trust and social licence going into this. In early April, the survey firms were looking at the question: “Thinking about how the New Zealand Government are responding to the coronavirus outbreak, do you think the measures that were put in place are about right?”  The response to that in early April was 60%, and by the end of April it was over 80%. The fact that we had some strong trust and social licence going into that was, if anything, only strengthened during that first lockdown.

There are some weaknesses that have been revealed in the public service model. Notwithstanding that I think we have a very strong culture of co-operation, we also saw that some departments have their own cultures. You will be aware of that. With my health background, for example, I would say that health people can be very caring and very much about patient choice. However, in this case you are flipping that around and the patient is in fact the population and you are seriously thinking about protecting a group of 5 million, which is a slightly different scenario from what I think health people have been used to.

We did see some cases slip out. People were left to go home to self-isolation and if they did not feel well they were meant to let the health authorities know. It is not surprising that the border management is now being led by an air marshal and the number two is from the Department of Corrections. They have had different cultures and maybe perhaps more rules-based approaches to things. It has been a very interesting lesson for us in putting together different cultures—the cultures and services that are most fit for the job have been one thing that has revealed itself.

The other really important thing we have identified is that if you work in health and safety in the workplace you know the terms about how work is imagined and done. For example, the Prime Minister and the Director-General of Health had in their minds the idea that certain things were happening with testing and with PPE, but there is a drift in implementation where things are not yet on the ground, on the front line, exactly where they are quite meant to be.

The whole monitoring function has revealed itself as being absolutely critical. I can see in your role as parliamentarians that it is the kind of thing you want to ask people on the front line: what is going on? Their reality is a little bit different from what you are hearing from senior public servants, and you have a bit of a dissonance there. That was probably the other thing that revealed itself as a bit of a weakness for us.

Q113       The Chair: That is very interesting.  Do any of my colleagues want to ask a question here? If not, I want to ask about the link between national and local government.

Todd Krieble: Yes, that is an interesting one. We have a lot of local government for a small country. We have 80 district councils and 20 district health boards. There has just been a big review of the health and disability services and it looks as if we will have fewer district health boards soon. I think everyone thinks that we have too much local government. It was an issue, because while the director-general had direct powers under the health Act to make things happen, the staff who had to do things were employees of the district health boards or sitting out in local government. There was more co-ordination than you might think would be needed. That is definitely an issue that has come up quite a bit recently. So there are some issues to do with whether we see consolidation, particularly of some of the public health services.

I know there are some changes happening with Public Health England and elsewhere around the world too; people are having a fresh look at some of those public health functions. I think we are realising here that we probably need a bit more of a centralised approach to some of that, honestly.

The Chair: That is interesting.

Q114       Lord Davies of Gower: My question is for Audrey Tang. Given your extensive experience in digital communication at a clearly strategic level, what can be learned from Taiwan’s experience of Covid-19 about how digital technologies can be used to improve and perhaps democratise public service such as health, education and local government to the benefit of the people?

Audrey Tang: In Taiwan, we have three very easy to remember pillars of what we call our digital socialisation strategy: fast, fair, fun.

The fast, and I think the easiest, part by far to adapt and copy to other jurisdictions is simply setting out a very simple toll-free numberin our case, 1922—which everybody can just call and report their on-the-field experiences to, which Todd was just talking about. The call centre basically listens at scale so that at each and every livestreamed central epidemic command centre press conference they answer all the questions that were proposed to them the previous day while we are still at the pandemic stage, or now every week.

It is a very quick iteration cycle. For example, a call from a boy saying, “I don’t want to go to school, because all I have is pink medical masks”, resulted the very next day in everybody in the medical officers’ livestream who was watching this 1922 report just don pink masks, so the boy become the most hip boy in the class. That is a classic example of a very quick iteration by radically crowdsourcing citizens ideas, essentially.

The fair part pertains, for example, to the rationing of the masks, making sure that people can see in real time where masks are still in stock and where they are not. This has also been deployed in Korea. People queue in line, and if you click on the app and then swipe your national health insurance card, people queuing after you see the number decrease in real time every 30 seconds. Again, this participatory accountability can be enabled with digital technology such as something that is essentially a distribution ledger.

Finally, the fun part is internet memes, which is cute dogs and cats, mostly. There is, for example, a social distancing meme which says that, in outdoor spaces, you have to keep two Shiba Inus away and, indoor, three Shiba Inus away. The Shiba Inu is the spokesdog of our health ministry and is literally a companion animal of our “hashtag officer, the participation officer at the Ministry of Health and Welfare. We say very early on that you wear a mask to protect yourself from your own unwashed hands, which connects mask use and hand sanitation, which is the most important link to get out. You therefore basically give science a higher R value than conspiracy theories. That is something that other jurisdictions can also look into.

Lord Davies of Gower: Could you just expand a bit on that call centre issue and how that operates?

Audrey Tang: The call centre is a toll-free number, a chatbot and a website, so it has many different APIsapplication programming interfaces. Just like the mask availability map where there are more than 140 different applications, the chatbot/toll-free number basically enables anyone to use their preferred way to ask questions to the CECC. If a question has already been freshly answered, the newest answer gets turned into cute dog pictures and circulates around social media. But if it is a new idea, like the pink maskor the use of the traditional rice cooker to disinfect the mask, which is a real thingit becomes the content of the next day’s livestream. So this is both a listening device but also a co-creation ideation device.

Q115       Lord Bourne of Aberystwyth: Thanks to our two witnesses for joining us. My question is specifically for Todd. We have been watching the experience in New Zealand with great interest in the UK. We too are a small island, obviously with a much larger population, but our experience has been very different. Could Todd perhaps expand on lessons that he thinks we could learn in the United Kingdom? Clearly the whole government reform that he has been a central part of, with vast experience, has been part of it, as he touched on. Public trust in this country has gone from a high level to a lower level—the reverse experience, it seems to me, from that of New Zealand. Todd, could you expand on factors that you think have led to the great success, certainly in relative terms, in New Zealand, and what we can learn in the UK?

Todd Krieble: Aside from the strong culture of co-operation and coming into this with a high degree of trust, which I mentioned, the other thing that has come through very clearly is the listening to experts. The epidemiologists are now all rock stars in this country, because they really had a lot to say. It has been interesting to see that the academics in particular, including some of the retired academics, have had a lot to say very publicly, and it has clearly come through in the decisions.

This has been an interesting aspect too for the public service, which would have been putting up advice to Ministers. As you know, that is considered free and frank and without fear or favour, but it is done, at least initially, in private. This has been much more of a public discourse.

We have also had the Science Media Centre, where people who have been trained to be spokespeople are go-tos, if you like, for the media. It manages some of the fake news situation that we have worldwide. There was a real flight to authority by the media, I think, so that listening to experts was key.

The other key thing for us, which was touch and go, was that with expert advice we ended up with the idea of an elimination strategy. That is not to say that we would not have Covid outbreaks, but that we would be able to stamp them out pretty quickly. The decision was made based on the expert advice that we could achieve this.

We questioned some of the early WHO advice that you should not have border restrictions. Some of that advice, to us, had not been considered at the scale of smaller island nations. I would say that we are probably a bigger island nation, as you are, but it does seem to allow for a different form of management of the pandemic. Some of that border management and isolation quarantine combined with that broad approach was the right thing.

The other thing for us, importantly, was the communications about the alert levels and the idea of having a bubble. We have had four really clear alert levels so that people understood if we were going up levels or dropping down levels. You could see that things were going to get tighter or there was actually hope that the Prime Minister would signal when we might drop down levels. A lot of this was well telegraphed so that people had a sense of when we might be coming out of some of this.

The concept of bubbles that was introduced was pretty much at levels 3 and 4, and we had to define what a unit was. This also, I think, raises some very interesting issues about society and what constitutes a bubble, because we have, as you would know, blended families, households that might just be students flatting together, or something. That raised some interesting issues, but there was a real concept of what it meant to be in a bubble. That was very important earlier on for making sure that we controlled some of that. That simple communication device was very effective.

The other thing I would point out is that the PM’s press conference each day at 1 o’clock became a must-watch show of the day. In that conference you had what they ended up calling the quint, a group of five key players: John Ombler, the National Controller and a former deputy States Services Commissioner; the now retired police commissioner, Mike Bush; Dr Ashley Bloomfield, the director-general; Sarah Stuart-Black, the controller of civil defence; and another fellow, Peter Crabtree, who provided some of the overall national strategy co-ordination.

You had this visible group of five who all appeared at some time with the Prime Minister, the point being that there were identifiable leads within each of the various departments. In fact, none of them except for one were the chief executives of the department, but they were very senior identifiable people who were the go-tos and the ones providing that tight co-ordination. That was also very clear.

We benefit from having a relatively small public service. People know each other and will be at meetings together from time to time. Having that relationship capital was also very important.

Lord Bourne of Aberystwyth:  Epidemiologists as rock stars will stick with me. That is a really important point, and perhaps we have something to learn on that alone. 

Todd Krieble: Yes, I do not think they would ever have expected it, but there you go.

Q116       Lord Young of Cookham: This is a question for Todd. I want to pick up something you said about the public service model. One of the issues we have come across as our Committee has made progress is the criticism of departments acting as siloes and being reluctant to co-operate with each other. I was very interested in something in the briefing that we got about New Zealand, which says: “It seeks to achieve this by setting up interdepartmental boards to address high-priority issues, bringing together chief executives from relevant government agencies. The boards will have the power and budgets to deal collaboratively with challenges, such as reducing child poverty”. 

How exactly does that work on the budgets? Do they get the budgets directly from the Treasury or do each of the departments that are contributing to this chip in? Do Ministers sit on these boards? What is the method of accountability of these interdepartmental boards and how many are there?

Todd Krieble: That is a great question. Under the new Public Service Act there is the possibility of having these joint ventures and chief executive boards, as you say. It is still very much in its infancy and I was fortunate enough, acting for the director-general, to have been the health representative briefly for the family and sexual violence joint venture, which is the first one. It is essentially leading things out.

That joint venture has chief executives of the departments that you would imagine are relevant to those issues. I would say that it is still finding its way somewhat, but the idea is that everyone commits to a unified plan for that joint venture. You do not have your own departmental workstreams on that; you bring everything there and the decisions are made collectively so that there really is a unified effort on those cross-departmental issues.

It is also in large part stopping departmental budget bidding wars, so that all the budget bids to the Treasury go through that joint venture. You could not have an outside budget bid; it is agreed to by the joint venture. By the time it gets to the Treasury, it is understood to be the best offering from that collective for that joint venture.

A slight aside hereintended—is that it will stop employment bidding between departments for civil servants, because you will potentially be on the same pay grade and there will be more interchangeability and interoperability. So if you are a senior policy adviser, it means the same thing across the public service. I see it having some benefits not just for whole of government but for the whole issue of the public finances and how we deploy our human resources in the public services.

It is still very much in its infancy, but I think it is promising at this point in time. The Covid groups have existed for a while. I would not say that they are technically set up as joint venture or chief executive boards, but they are de facto.

Lord Young of Cookham: I do not want to press this, but I wonder if it is possible to have a memorandum on exactly this issue from Todd or his department, giving us the background and the modus operandi of these interdepartmental boards. It is a really interesting concept that might have some relevance here.

Todd Krieble: Yes, we can do that.

The Chair:  Thank you.

Q117       Lord Filkin: Thank you, Todd and Audrey. This question looks forward. Mostly we have rightly been on crisis response at this point in time, but I would be interested in the thinking in both New Zealand and Taiwan about the big public policy questions that you now think, in the light of the crisis, require change. Without loading the question too much, one for us is certainly health prevention. Our system focuses on treating ill health much more seriously than on trying to keep people healthy. I would welcome your thoughts on the public policy issues and priorities in the light of the crisis going forward and, if you wish to, your comments on the relevance of improving health resilience individually and societally.

Todd, would you like to start?

Todd Krieble: Thank you, Lord Filkin. The one big project I would want to mention is that at the institute here we have just joined in partnership with the Helen Clark Foundation—Helen Clark is a former Prime Minister—to look at inclusive growth for the next generation. It is very interesting to think about the distributional impact of Covid and who the winners and the losers are. We see it as an opportunity not to be wasted, and we want to use it to think about how we might think about things like pre-distribution rather than redistribution. It is an opportunity to come up with different and new ideas about how we might close some of the equity gaps for young people.

We definitely have issues, and Covid has revealed this for Maori and Pacific populations. The disadvantage has just been revealed by Covid. We see, for example, that mortality rates in Maori are about 50% higher than in the general population. The opportunity to deal with some of those equity and disadvantage issues is really coming to the fore now. That would be the number one issue.

Lord Filkin: It would be very interesting, again, if there is an existing note on that, because it has obviously thrown a light here in exactly the same way. Certain groups, certain individuals, certain societies have been much more at risk than others and it has thrown a spotlight on those weaknesses. We would love to know more about your response to that. Thank you.

Audrey, any comments from Taiwan on that?

Audrey Tang: Definitely. I would like to echo what Todd said, and interestingly we also have our quintuple in the daily CECC press conference, as epidemiologists are rock stars. In Taiwan, we benefit from the idea of broadband as a human right, which we have deployed since last year, right in time for the pandemic. Anywhere in Taiwan, if you do not have 10 megabits per second and unlimited data at just $15 per month, it is personally my fault. Because of that, our chief epidemiologist has a crash course on coronavirus, which is an open, very well-attended massive online course. Our top epidemiologist happens at this time to be our Vice-President, so when he wants to convince the President he just knocks on the door next door.

The idea is that we see that people learn and meet much more closely online, because while we never had a lockdown we put restrictions on large gatherings for a couple of months. So we see a lot more satellite learning, which also benefits the more indigenous people, the rural, the remote islands and so on, so that they can basically engage in a co-presence, co-education infrastructure.

That infrastructure now benefits from our 5G auction, because for the extra money which the 5G telecoms put into the 5G bid, we make them start the 5G deployment in the under-resourced places, the most rural places and so on. Using this very cheap 5G virtual reality headset for classrooms and things like that has basically transformed our healthcare and education. This is a great opportunity, because the senior decision-makers are basically forced to encounter the latest in video conferencing technology and discover that it is nothing like what they remember 20 years ago. It is pretty good nowadays.

Lord Filkin: Thank you very much indeed.

Q118       Lord Hunt of Kings Heath: I was very interested in Lord Filkin’s question about the future. I want to ask about vaccines and the extent to which both Todd and Audrey have given thought to fake news, which you both mentioned. Have you given thought to strategies that will be necessary to persuade your people to take up the vaccine?

Audrey Tang: In Taiwan, we already had a habit of wearing masks, which we refer to as the physical vaccine, because the numeric model shows that if more than three-quarters of people put on a mask and keep up hand sanitation, the R value will be consistently under one, which is as good as having a vaccine. We are not in that much of a rush to get everybody vaccinated, I have to say.

Beyond that, we look forward to working with our “humour over rumour” counter-disinformation strategy. This is a consistent strategy whereby whenever there is an anti-vax rumour, or an election-interfering rumour before an election—there were countless disinformation campaigns about the Hong Kong protest and things like that—we bring out a “humour over rumour” book.

We put out a public notice, meaning that instead of an administrative takedown we work with the social media companies so that there is a very clear public notice whenever a rumour is debunked by the international fact checking network, including Taiwanese members of the Taiwan FactCheck Center. Then, whenever you share one of those pieces of disinformation on the social media, it will say, for example, “This is a Reuters photo and it has been modified and recaptioned by people who work on disinformation”, or, “This came from a certain web book account”, and things like that, so that people learn the whole story, the whole narrative, and basically become amateur fact checkers in their spare time to contribute to the media.

We do not have media literacy; we call it media competence. It is also part of our K-12 education. Basically, it enlists citizen’s creativity, again in making the humour spread faster than rumour.

Todd Krieble: The idea of a physical vaccine is interesting. I will use that. We have had issues with vaccine hesitancy for some time, so that is not a new thing for us. I think we would rely on what we have been doing with this—I mentioned the Science Media Centreand there is enough comment in the media that perhaps we could manage that, but I know that when you are looking at herd immunity you have to make sure that you get your vaccine levels up high enough.

The folk I have been talking to, the specialists, are saying that there have been no Covid vaccines. If you look at the history of vaccines, they take up to a decade or more to produce. This one may end up more like a flu vaccine, and we have to have it seasonally. While there is a lot of talk about vaccines here and a lot of hope, and even an expectation that some very small universities will produce them, I worry about false hope on that front. So a little bit of a reality check is needed on that, and we might need to talk more about the physical vaccine for a while.

There might be therapeutics coming well that could help, but we have relied very strongly on the advice coming to the Prime Minister. She listens to her chief science adviser, and we have seen that throughout. I think we would just back what we have seen. The quality of the dialogue and the media chasing the right sort of scientific advice will probably see us through. I would hope so, anyway.

Q119       Lord Hunt of Kings Heath:  This question is to Audrey. I was fascinated by your description of fast, fair and fun in your strategy. The impression I got—and, again, from what you have said about the use of masks—is that the Taiwanese population has been largely receptive to the messages that have come from the Government. First, can you confirm that? To what extent do you think some of the techniques you have used in digital technologies, which you have used to improve and democratise public services, are transferable to, say, the UK, which obviously has a different political culture?

Audrey Tang: Thank you for that question. In answer to your first question, which is really about why people are receptive of the science, clarifications and memes, or course it is not just the cute dogs but because we make sure that we amplify the best ideas from civil society and the social sector: that is to say, these are not our ideas. When people show that the mask availability map display is better than a tabulated PDF or whatever, we take that.

For a few years now, so before the pandemic, we have had a culture, the idea, of a presidential hackathon. Every year, the top social innovators—more than 200 this year—propose their ideas on how to use data to form data collaboratives, for example to reduce plastic use, measure air quality and water quality, and so on. The top five teams receive a trophy shaped liked Taiwan and with a micro projector from our President each year. If you turn on the micro projector, it shows you Dr Tsai Ing-Wen handing you that trophy. It is a self-describing trophy. In that small film you will hear Dr Tsai Ing-Wen say, “Whatever you did in the past three months, we commit to making it public policy, national policy, in the 12 months afterwards”. Basically this is presidential power as a hackathon prize.

This kind of co-creative culture naturally then incentivises the social sector to bring their best ideas forward, and our work is mostly just to innovate those ideas. If you asked a random person on the street back in March, “Why are you wearing a mask?”, they would not say, “Oh, t’s because the spokesdog tells us to”. They would say, “You know, this is a great idea that we hear from Professor Li Chen or whoever that talks about traditional rice cookers and so on, and we put on a mask when the CECC tells us to and when the CECC tells us there is no need to”.  Because for 48 hours or so we wrongly said that in well-ventilated places such as metro stations you did not have to put on a mask. People ignored that, so we changed our message very quickly, just two days afterwards.

We learn from this failure culture. That is the most important thing: to keep amplifying the best ideas from the front-line public service and from the social innovators. That, I think, is transferable, because Taiwan also had a culture of anonymous civil servants. But when we really give credit to the front-line public servants who come up with the good ideas, we basically make them heroes. As Ministers, we absorb the risk that changes the matrix of reward. That will then make the social sector innovate more with the front-line public sector people. That part is transferable.

Lord Hunt of Kings Heath:  You mentioned the impact of some of your experts. Clearly in the UK we also have experts, but they do not always agree with each other. We have had what one would call a healthy debate right from the start of this crisis. There have been legitimate disagreements between scientists and public health doctors about the approach, and that continues. Have you also experienced conflicts between the experts, and how have you moderated that? 

Audrey Tang: In Taiwan, we benefited from the societal inoculation against the 2003 SARS. Nowadays I should call it the SARS 1.0 incident, in which we had to lock down an entire hospital unannounced and with no fixed termination date for that lockdown.

It was very traumatic. Everybody above 30 years-old remembers that incident, which is why we are so averse to lockdowns and why we never had a lockdown in the first place. So basically the baseline consensus of the scientific communitythere are of course differences in opinion and legitimate debate on SARS 2.0, novel coronavirusis that we do whatever we do assuming that this is the same as SARS 1.0. That forms a baseline consensus.

On top of that, the asymptomatic aspect is of course the main difference between SARS 1.0 and 2.0, but the message, Wear a mask to protect yourself from your own unwashed hands, has brought agreement. It is a rough consensus. We push that out first and then we deliberate whether, for asymptomatics, wearing a mask is useful or not in scientific debates. So first we push out the message for which there is rough consensus, with the spokesdogs and so on.

Q120       Baroness Wyld: I very much agreed with regard to Lord Hunts question. Taking that on, the point about doctors as rock stars is great, but how did you manage the potential political tension as your political leaders have to make decisions assessing risk that might not be able to be completely in line with a purely medical view of simply containing the virus?

Audrey Tang: I think that is more of a Todd question, because in Taiwan, as I said, the author of the textbook on epidemiology was literally the Vice-President.

Todd Krieble: That has been an interesting one here, too. There was a point where the Prime Minister was almost beginning to get criticised for listening too much to the science, and she gets paid the big bucks to make the difficult political decision on things. But we were so successful, and we have been so successful to date, that that has just worn away.

There was some discussion about we how we should be taking a bit more of a Swedish approach to things, but the proof of the pudding is in the eating, and we have managed to get through this and ended up with very little opposition to it. Even with the election coming in a few months, the opposition parties were, if anything, giving the Government a hard time for not doing the policy as rigorously and as firmly as was set out. So there really is no objection on fundamentals there.

The Chair: If there is no one else on that issue, I will bring in Baroness Pitkeathley. I just warn the witnesses that you will not see her, because the camera on the computer she is using is not working this morning. We apologise for that.

Q121       Baroness Pitkeathley: My apologies to the witnesses as well. I am so sorry about that.

It has been fascinating to hear what you have had to say. Having worked with healthcare services in New Zealand in the past, I very much appreciated the way in which people seem to know each other and work across boundaries. Many of your show and tell accessories, Audrey, we will remember for a very long time.

I would like you to comment on the UK and how we have done, because you will have heard a lot about what has happened with us. Obviously this will come from your experience: what do you think is the most important lesson that the UK should learn when we try to redesign public service in the light of what has happened in this pandemic?

Audrey Tang: Thank you for the question. When I first became Digital Minister in 2016, I modelled my office after a certain UK unit called the Policy Lab, which I visited. The Policy Lab, which was part of the UK Cabinet Office, is at the perimeter of the Government, if I understand it correctly. It was basically like a Lagrange point between the social sector on one side, using ethnography or just hanging out with the stakeholders, and on the other side, of course, the Cabinet Office, with all its departments, siloes and so on. It has always fascinated me how we can apply the insights from design thinking to policy-making.

I was also fortunate that one alumnus from the Policy Lab, Feng Jiao, who is Taiwanese, returned to Taiwan to bring the Policy Lab working methodologies with us, and now we work with other designers from the IDO, the RCA and so on on this design aspect.

The one thing that those excellent interaction designers and service designers taught me is that when you are doing design thinking, a lot of the costs of the policy that we think stops things actually causes more problems of externalities because of the inherent solutionism that is embedded within that bureaucratic culture: that we have to do something and do it quickly and solve a problem. But in double-diamond design thinking, basically before delivering or developing anything it is important to question the common value and then, out of those very different positions, decide whether this is something that people can live with.

It is delusional to think that something is perfect or near perfect for a particular issue, but rough consensus is something that people can roughly live with and resonates. For example, we use assisted intelligenceAIto ask people to rate and rank acceptable measures of using digital technologies to counter the coronavirus, in collaboration with the de facto US embassy, the AIT, and the coronavirus hackathon. Every time we see large debates on the devices part, we promptly ignore those and act only on the one that has broad consensus, no matter which ideological side the people are on.

The crowdsourcing agendastepping back a little bit to define common valuesis one part that has worked really well in countering coronavirus, as well as any other large, broad structural issues facing society when we are designing policy.

Baroness Pitkeathley: Thank you very much. Todd, I think many of us would have been particularly interested in what is said about joint budgets with departments. Could you include that in your answer, please?

Todd Krieble: Sorry, do you mean in the use of technologies?

Baroness Pitkeathley: No, I was thinking about the way you talked about having agreed joint budgets in teams working across departments.

Todd Krieble: The joint ventures will have direct appropriation for whichever particular area of focus they have. That is a much tidier way of making sure that resources are being corralled and channelled appropriately, having the best project, the best offering, from different departments and trying to bring those together and co-ordinate those after the fact. It will be much tidier if we can get that working effectively.

As I say, it is really just the family and sexual violence joint venture at the moment. There will be others on the way soon, and I can give you some more information on that.

Baroness Pitkeathley: Has that kind of approach been particularly important in your work with coronavirus?

Todd Krieble: It has all happened so quickly. As I said earlier, it is just in the culture of the way we do things. The new legislation, the Public Service Act, will give a bit more structure to that, particularly some of the budget things and lines of reporting and accountability. It should only get better from here, I think. The coronavirus thing has been a great example of that, even though it was not done officially and formally.

Q122       Baroness Pitkeathley: In terms of your advice to us, you mentioned siloes. We have had a lot of problems with siloes, as some of my colleagues have mentioned. Is that one of the things that we should tackle most urgently when we are thinking about public service reform?

Todd Krieble: I would say that you would have to, because all the interesting and difficult public policy issues are on the interface. They are not solely within the health silo, a primary industry silo or the environment silo. They are the ones that cross.

We talked earlier about some of the prevention things. You will not deal with some of the issues to do with disadvantage and improving health status unless you deal with basic security of tenure of housing, security of income, stable family or household units. These things are coming from wider social determinates that need to be factored in.

We have a child poverty unit within the Prime Ministers unit at the moment. We need to do much better on that. We did not score very well on the latest UNICEF report. That is the kind of thing that, unless you work collectively across it, individually everyone just ends up pointing their fingers at each other and you will never get there.

Baroness Pitkeathley: Thank you both very much for reminding us of the breadth of our agenda.

Q123       Baroness Tyler of Enfield: This question follows on from the point that Baroness Pitkeathley was just making and which Lord Young raised earlier about this new approach, particularly in New Zealand, of cross-government working and looking at the difficult issues with different sorts of accountability structures, budgets, ways that civil servants work and so on. All countries have faced very difficult trade-off issues in the balance between health outcomes, keeping the public safe, and the impact on the economy. I was interested to know whether you felt that this new way of looking at issues on a cross-government basis had made some of those decisions easier to make and were also gaining greater acceptability with the public.

Todd Krieble: The way I look at these joint ventures is that they are really trying to unify around not just one but multiple policy objectives in play. It means that there might be health objectives but there also might be policing objectives or other child well-being objectives. The joint ventures can grapple with those more, because they take responsibility for each others objectives and it is not just simply a question of looking after only your own single, siloed set of objectives. That, I think, is really where that value and that accountability come through. They are accountable collectively for multiple policy objectives. They are not left to their own departments and their own budgets only.

Baroness Tyler of Enfield: Was there a joint board looking at how to balance the competing objectives of public health safety and keeping the economy going?

Todd Krieble: I mentioned the ‘Quint, whose role it was very much to co-ordinate that. I do not think it was officially set up as a chief executive board or a joint venture, but if you would allow me, I will come back with something on that.

As I say, it was part of the culture, the way we just do things. Even if it was not formally set up quickly enough, there is the expectation, and that is exactly the kind of thing we will see with more chief executive boards and joint ventures coming.

Baroness Tyler of Enfield: Thank you. Audrey, would you like to add anything on how those trade-offs were dealt with in Taiwan? 

Audrey Tang: Yes, definitely. We will probably record GDP growth this year, so we will not have to make that much of a trade-off. Key was the fact that our quint shared very early on that if we achieved eliminationas defined by four weeks with zero locally transmitted or confirmed caseswe could safely move on to the stimulus part, the revitalisation part. Of course, we kept our word.

So right after that comes the stimulus part; we have triple stimulus vouchers that you can spend only outdoors and not on e-commerce. If you spend £100 outdoors, you can withdraw two-thirds of that back from your nearby friendly automated teller machine, and things like that. It is a way to stimulate the economy.

I will give an example of one reason why this trade-off is not seen as a trade-off. I am the Digital Minister, but my full title is the Minister without the portfolio in charge of the public digital innovation space. PDIS is not a ministry; it is literally just a space, and it looks like this. It is a really fun park in the central part of Taipei city, with public art by people with Downs Syndrome, people with differences that are very creative.

People from 12 different ministries are stationed here, from section chief level all the way to director-general level, and they still work with their own ministries and departments. The only thing I ask them to do is to work out loud and share whatever they have learned with other people who may be in that place. I hold public official office hours there and tour Taiwan, too.

All this is to make sure that everyone knows what everybody else is working on. This is not a joint budget programme but a joint horizontal communication programme.

The Chair: That was fascinating and has demonstrated just how much we have to learn from around the world. It has been a very interesting and useful session.

Can I just check that I am not preventing anyone who would like to ask a question from asking one? No, I think we have explored with both Taiwan and New Zealand.

Q124       Lord Filkin: This has been a fascinating session. I would love to get more detail on the innovation process as described by Audrey Tang and, as a subset of that, the insights from design thinking. I think we have a lot to learn on that.

A very quick question to both of you. You are both talking about more open and porous forms of policy-making and implementation. We still feel, in the light of this crisis, that it has been a centrally dominated process that is run largelyI am caricaturingbehind traditional civil service boundaries and mechanisms. How has the central local nexus worked, and has there been a participative relationship between central policy-making and delivery and local policy-making and delivery?

Audrey Tang: Taiwan is officially a transcultural republic of citizens. It is a country with 23 million people, but it is actually a quite small place. Taking the high-speed rail from Taipei to the southmost municipality of Kaohsiung takes just an hour and a half, so it feels like just a slightly larger municipality when you look at it geography-wise. So it has enabled a central epidemic command centre essentially to tour Taiwan very quickly and to look at how things really are and share with the local municipalities, which play a supportive role.

This is what we learned from SARS, because when SARS 1.0 came the Taipei municipality issued reverse directions from the health bureau. VP Chien-jen was the director of the health ministry at the time, and I think he learned the lessons. Then the constitutional courts charged the legislature to design a central command system, so that if anyone, be it a local level or a central level, put on the jackets that our quint put on they automatically become part of the CECC command chain, the infrastructure. It has a very clear line of report. The municipalities are definitely in an implementing role instead of possibly issuing countering policies. That was a big problem back in 2003 and we have legal, design and regulatory remedies for that.

Todd Krieble: From my end, I would say that we can do better between central and local government co-ordination. The one issue that has really come to the fore is in Auckland, which is the main entry point where most of the managed isolation facilities are. The council itself has definitely had a big business downturn, so its revenue is down, yet most of those cases are being managed out of Auckland, and it is a port of entry. Central and local government had to come together quite strongly.

Again, being a relatively small county, the mayor is a former Labour Minister, so he is well known at the centre, which I am sure has helped. That for us has been the main thing.

For example, in the South Island they are saying things like, “Well, we’ve had very little Covid, if any, so why can’t we move down to level zero and be completely free to move around?. So there are also differences between islands that we are just working our way through.

The Chair: Thank you. As I hope both witnesses recognise, we really appreciated your contribution this morning. Thank you for coming at different and unusual times for you. We do appreciate it and it will be very helpful to us in our future deliberations.

The Committee overall will be meeting again tomorrow, so we will pursue the work of the Committee tomorrow in our more normal slot.

Thank you very much indeed.

Todd Krieble: Thank you, Baroness.

Audrey Tang: Thank you. Have a good time. Live long and prosper.