June 11, 2012; Source: The Guardian
British blogger David Walker recently responded to a proposal by Geoff Mulgan, the director of the U.K.’s National Endowment for Science, Technology and the Arts (NESTA). Mulgan thinks that the evidence-based work of the national Institute for Health and Clinical Excellence (NICE), in which pharmaceutical and other treatment protocols are subjected to rigorous testing and approval, can be replicated more broadly in all of social policy.
Mulgan’s proposal seems like it is a bit carried away with the compelling message of the evidence-based acolytes. Walker suggests that the Mulgan/NICE proposal doesn’t fit with many proposed social policies (he calls the government’s proposals to reform health care “the institutionalization of anarchy,” for example). Making NICE work in the U.S. seems just as preposterous, particularly when the policymaking body to be convinced is the gridlocked Congress.
Walker makes clear why the drug testing of NICE might not have the same effect when applied to social programs: “Drugs have effects: they prevent infection, they control conditions. Social policies are usually much less specific.” Walker adds, “Much social policy is about reshaping institutions and changing governance, and these phenomena are much harder to capture let alone measure than testing a cancer drug or even a discrete intervention such as a smoking cessation programme.”
Walker is basically calling the evidence-basers naïve about real life politics and government decision-making. He reminds his readers, “Ideology cuts a swath across public management. And partisanship more often wants confirmation than challenge. To believe policy can be more evidence based, you need a strong dash of piety and naivety.”
That doesn’t matter to the movement’s true believers. The longshoreman philosopher Eric Hoffer devised the concept of the “true believer,” someone who holds a “fanatical faith” in an idea, someone “without wonder or hesitation.” Despite the obvious impracticalities of Mulgan’s NICE-like proposal for social policy, Britain’s New Philanthropy Capital quickly convened an invitation-only discussion of the idea. An NPC report on the gathering noted, “There was palpable enthusiasm in the room for the idea, with the debate focusing less on whether there should be one and more on what its role would be and to what extent the context was different from that of healthcare.”
Expect the true believers to try something similar here. Is this where the evidence-based Moonies are heading? We’re not talking about those who know how to use outcome measures in a rational way—that is, without devoting ever more money to the search for evidence and less and less to the real work of creating that evidence. We’re talking about the acolytes who have turned the search for the holy grail of evidence into a cult. —Rick Cohen