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COVID-19 Committee Contents

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Chapter 3: Resetting the state: Building a resilient nation

23.The central contention of this report is that we need to reset the state to:

• Learn lessons from the pandemic;
• Respond to the changes which the pandemic is creating; and
• Respond to the broader changes of the era, which the pandemic is accelerating and accentuating.

24.This section of the report outlines the nature of that reset, based on our best assessment of the evidence brought before us. There are three elements, as outlined briefly above:

• A new approach to resilience;
• A new emphasis on governing for the long-term; and
• A new focus on wellbeing.

Resilience

25.Traditionally, resilience has focused on securing critical national infrastructure and supply chains, but during the pandemic it is clear that resilience also flows from individual, community and social strength. There is clear evidence across four domains that policy failures which appear to affect only individuals can also trigger system-wide harms. These four domains are:

Inequality—financial and digital exclusion

26.The success of public health measures is critically affected by poverty, inequality, and a lack of financial resilience among many citizens. Many people are unable to afford to isolate, or have been forced by employers to work despite showing symptoms. Overcrowded housing makes it harder to limit the spread of the disease in poorer areas. And our economy will be slower to recover from the recession because of a legacy of debt for many of the poorest families.

27.Digital exclusion is a particular problem when it comes to our resilience. Our education system has been less able to adapt to online learning because of poverty: many families cannot afford equipment for their children. Poorer people are less likely to be able to work remotely, or access digital-first public services.

Poor public health

28.The UK has comparatively high levels of obesity, diabetes and hypertension, alongside high levels of health inequality. The pandemic is clearly demonstrating the extent to which health is determined by socio-economic factors in the UK. Analysis by the ONS shows that disabled people made up 6 in 10 (59.5%) of all deaths involving COVID-19 in England and Wales for the period to 20 November 2020.15 Our poor health and high health inequality makes us more vulnerable to COVID-19, but also makes us more vulnerable to any future pandemic; people with multiple conditions are likely to be affected most seriously by any novel infection.

Unequal social capital

29.The community response to COVID-19 is one of the most reassuring beacons of light during this difficult period. And yet there are huge gaps and disparities in social capital: broadly, there is far less in places of poverty and disadvantage. This contributes to systemic fragility because it increases the demands on the state to support individuals. Strong social capital reduces the burden on the state at a time of crisis.

Information systems

30.Modern means of communication and social media are also creating new systemic risks. The pandemic shows that there is no established playbook for promulgating information from reliable state sources, or countering misinformation. This lack of a coherent information systems strategy has hampered the pandemic response throughout, and continues to affect vaccine hesitancy.

31.A new resilience agenda for the UK must, then, include action to address inequality and digital inclusion; public health; the strengthening of civil society, and the integrity of our information systems. This is essential if we are to be better prepared for future pandemics, or other shocks, than we were for this one. There are likely to be greater catastrophes in the future.

32.Resilience is not, however, simply an agenda for the Government to enact alone. Resilience comes, in large part, from the capacity and capability of non-government actors, from individuals and communities to businesses and charities, to take action and mobilise; the Government’s role is to enable, support and co-ordinate.

33.We welcome plans from the UK Government to reform the process by which the National Security Risk Assessment is developed and commitments to develop a whole of society approach to resilience.16 However, we believe this can, and should, go further. The National Risk Register should be compiled collaboratively with the input of Parliament, civil society, academics and business. We need a national conversation about our stance on managing risk, what price we are willing to pay to mitigate particular risks, and whether that price is consistent across risk domains. This will help contribute to cross-party agreement on appropriate investment.

34.In addition, this Committee recommends:

35.Building on existing work exploring the relationship between health outcomes and socio-economic factors, we want to see the Office for Health Improvement and Disparities working with other Government departments and devolved administrations to assess lessons learned during the pandemic about the socio-economic determinants of health, and within that, racial disparities in treatment, care and outcomes. Co-ordinated Government policy should prioritise narrowing the gap in healthy life expectancy so that no one group is left behind.

36.Renewed efforts to build trusted relationships between the state and all groups within society, including racial and religious groups, young people, disabled people and others. Resilience requires us to recognise the different needs of these communities when it comes to building trust, and investing in building relationships over the long-term. The Department of Levelling Up and Communities should conduct an assessment of the relationship between both the national and local state and communities, and develop a plan for improving trust over time.

37.Major efforts to build social capital through community-level public service innovation. This should start with a new wave of devolution to return power to local government, and beyond to local communities. The Department for Levelling Up and Communities should move to a three-year rolling financial settlement for local authorities, enabling them to plan more effectively and plan for the transformation of services, in partnership with community-level organisations.

38.The Department for Digital, Culture, Media and Sport should make a renewed commitment to digital inclusion, including increasing access to affordable devices and data, and increasing digital skills training. Training and support for excluded people and communities will be best delivered in partnership with community organisations.

39.The Online Safety Bill is a welcome effort to bring greater regulation to the online information economy, and reduce the harmful impact of disinformation and misinformation. There will, no doubt, be pressure to dilute the impact of these proposals and the Government must stand firm in resisting such pressure. Alongside this, the Department for Digital, Culture, Media and Sport should work with platforms, media organisations and civil society to publish the lessons learned about our information systems from the pandemic, and build a public shared plan for industry, civic and Government approach in any future crisis.

Governing for the long-term

40.The pandemic reminds us that the cycle of politics does not deal kindly with long-term problems, or managing the risk of relatively infrequent events. This is a wake-up call. As we look forward, we can see a huge number of long-term problems facing the country, from our changing demographics and ageing population through to our shifting role in global politics; from regulating technological change to dealing with climate risk. Political leaders and policy makers should begin to think about ways to deal with long-term issues, where the problems and possible solutions will extend beyond the life of one Parliament or one electoral cycle. We also want to see politicians learning from the scenario-planning and other work undertaken by previous governments, regardless of the political colours of those predecessors.

41.We need urgently to improve our systems of government: the balance of power between Westminster and the devolved nations, between national and local governments, between state and non-state organisations. Our ability to plan and to co-ordinate has been shown to be wanting; now is the opportunity for us to reset the state and build it back to be more adaptable, more resilience, more devolved, and more collaborative.

42.In particular, this Committee recommends:

43.A new settlement between the devolved nations and the UK Government to better clarify roles and responsibilities, and build enduring agreements on issues that affect all the nations of the United Kingdom.

44.The Cabinet Office should pull together an interdisciplinary team to co-ordinate the development of long-term policy planning, and implementation.

45.A longer-term approach to funding public services and local government. In particular, we recommend in our Towns and Cities report17 that local government should move as swiftly as possible to a rolling three-year funding settlement.

46.A new approach to efficiency, recognising the importance of some redundancy of provision in public services. In effect, the pandemic reminds us that surge capacity is an essential component of resilience, even if it looks expensive during normal times. This will require a major shift in our approach to workforce planning, in particular, which will need to continue to leverage volunteer and community capacity in a systematic way, alongside formal provision. In effect, we need to move away from a “just in time” model of provision to a “just in case” model for many services.

Wellbeing

47.A major theme in the early contributions to the Committee’s work was mental health and wellbeing. The Centre for Mental Health estimates that 10 million people (8.5 million adults and 1.5 million children and young people) in England will need support for their mental health as a direct result of the pandemic over the next three to five years.18 Its study identifies key groups of people who are particularly at risk, including: “people who have survived severe COVID-19 illness (especially those treated in intensive care), those working in health and care services during the pandemic, people economically impacted by the pandemic, and those who have been bereaved.”19 Alarmingly, the report argues that predicted levels of demand are “two to three times that of current NHS mental health capacity within a 3–5 year window.”20

48.The scale of the issue cannot be dismissed; such a demand for treatment will be almost impossible to meet without a radically different approach. We received evidence making the case that the Government should shift its priorities towards the prevention of mental health problems, and make the wellbeing of the population the primary goal of all Government activity.21

49.In making its policy decisions during the pandemic, the Government has had to balance the competing claims of keeping people alive and well, supporting the economy, educating our children, and maintaining the mental health of the community and more. It is becoming increasingly clear that to make these decisions well, competing claims like these must be evaluated against some overall criterion. This Committee’s view is that the best criterion, going forward, is the wellbeing of the people.

50.The science of wellbeing has now reached a point where much is known in quantitative terms about how different life experiences influence people’s wellbeing. This makes it operationally possible to use wellbeing as the criterion for choosing between policy options. This shift is at the core of what we mean when we propose moving to a Wellbeing State.

51.The purpose of the Wellbeing State would be to secure the wellbeing of all its citizens, and tackle those inequalities that hold back specific groups and communities. The Wellbeing State would move Government away from a focus on economic growth as a goal in and of itself, to a focus on sustainable economic growth as an important contributing factor to individual and societal wellbeing.

52.It is important to note that pursuing aggregate or average wellbeing will be insufficient. A society cannot truly be considered a Wellbeing State if there are substantial barriers to wellbeing for particular groups within that society as a result of their age, gender, disability status, sexual orientation, race, religion or class. Our definition of a Wellbeing State is one in which these characteristics no longer determine anyone’s chance of life satisfaction, recognising that different people and communities will have different aspirations, and different needs. Decisions should not be taken about the needs of particular communities unless those communities have been consulted and asked their views: as the saying goes, ‘No decision about me, without me.’

53.We welcome the inclusion of life satisfaction, and disparities in life satisfaction across the UK, as an economic indicator in the recent budget and spending review. We recommend that the Treasury use wellbeing as the main indicator of societal and economic progress.

54.We believe that developing wellbeing as a measure of successful Government activity, alongside the development of a Wellbeing State, would benefit from detailed exploration by a Parliamentary Select Committee.

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