Almost everyone I know in Britain has been surprised—for once, pleasantly so—by the success of the country’s vaccination program against Covid-19. We are so accustomed to the abject failure of our public administration in almost everything, from its political dithering, followed by self-evidently wrong (and costly) decisions, to its bureaucratic incompetence and moral corruption, that when something goes right, we stand amazed. What, indeed, can explain why something should at last have gone right?
The vaccination campaign has been effectively—even brilliantly—organized and coordinated. The government deserves credit for having invested money in research and taken the chance of buying vaccines before proof existed that they worked. This was a serious political risk: if the vaccines had not worked, which opponents of the government must almost have hoped, it would have fashioned a heavy stick with which to beat it. In Britain, we are accustomed to government “investing” billions of pounds in schemes that fail for everyone except the individuals and corporations that manage to extract many millions, or tens of millions, from them.
The government decided that everyone should be immunized according to risk—first the oldest people and health workers, then the slightly less old and those with compromised immunity, and then the still less old, and so forth, until all adults will have been covered. By spring, more than half the population had received a first (and most important) dose of a vaccine. Almost no opposition to, or even criticism of, this manner of proceeding has arisen— unlike with almost everything else the government has done in its response to the pandemic—and the uptake of the vaccination offer has been high, except among some ethnic minority groups.
The government website to make a vaccination appointment could hardly have been better designed. It gave a large choice of locations, based on their distance from one’s home; we could select time and place. My wife and I chose the following day at noon at Ludlow Racecourse, where a large vaccination center was operating. We could have had our vaccination at my local doctors’ office, 300 hundred yards away from where we lived, but in a time of lockdown, we wanted a day out: so reduced have been our horizons of late that a drive of 20 miles or so seemed almost exciting.
Everything was well indicated at the racecourse, the spaces and temporary buildings designed perfectly for their purpose. The staff (many volunteers), from the car-park attendants to the nurses giving the vaccine, were cheerful and polite. Their morale was evidently high. The pamphlets given to the vaccinated were clear and well written. Even a professional fault-finder such as I could find nothing to complain of, and much to praise.
But then a question arose in my mind. How was it possible that so large a campaign should be so excellently organized in a country increasingly infamous for its maladministration, from its police forces to its educational system?
The 20-mile drive in Shropshire, from my town, Bridgnorth, to Ludlow (said by John Betjeman to be England’s loveliest town), through the most pleasing rolling countryside, past wonderful country houses and pretty villages, gave abundant evidence of the degradation of British public administration. Alas, it was by no means unique in this, but typical.
First, the condition of the road itself was appalling. Of course, I am judging by the standards of England a few years ago, not by those of, say, rural Guatemala. But much of the road surface was breaking up, with potholes that would jolt the cars of the unwary. This was not the consequence of an increased heaviness of traffic, or of bad weather; over the last pandemic-affected year, the traffic doubtless has been lighter than usual, and the weather has been normal.
Some desultory efforts recently were made to patch up the road surface. A few months earlier, I had traveled the road and part of it was closed for repairs, necessitating a diversion. This time, the notices saying, “Road Closed Ahead” remained visible, but the road was no longer closed; someone had neglected to remove the signs after the road had reopened. No one apparently had thought, even with the road closed, to indicate exactly where it was impassable and whether an alternative route existed. The public clearly was not important enough to be entrusted with such valuable information.
Some temporary signs had tipped over and lay strewn about like upturned beetles. They were rusting away. The sandbags that had previously held them down were also strewn about, no one having thought to remove them. Many of the permanent signposts, as well as the bollards on curves in the road, were now at an angle to the vertical, to which no one had returned them. They were all dirty. Orange-and-white plastic cones, once used to mark roadworks, lay scattered, uncollected.
Along the entire route, garbage—which no one had tried to clear—disfigured the roadside. Mostly, the litter was the wrapping of refreshments or cans of soda that drivers or their passengers had consumed along the 20 miles. The beauty of the countryside gave them no pause before they disembarrassed themselves. The garbage glittered in the sunlight; discarded plastic bags hung from hedgerows or fluttered in the breeze from trees, like prayer flags in Buddhist countries.
The garbage should not have been thrown out of the cars in the first place: something was wrong with a population that behaved this way. But it was also evident that no government council at any level had any interest in cleaning the mess up. If the roadside had become a pigsty, officials apparently did not care, or did not think it very important.
Local taxes are higher than at any time before and destined soon to rise higher still. Of course, with ever more retired council workers with unfunded pensions to support, councils cannot afford to waste their money on providing public services. The county council is adept at two things: losing money and spending even more to make up for it. In 2018, it bought three shopping centers in the county town, Shrewsbury, for £51 million. Two years later, even before the Covid-19 epidemic, the shopping centers were revalued at £17.5 million. The loss represented more than half the council’s financial reserves; it has since blocked attempts by opposition councillors to investigate how the purchases were made. I haven’t met anyone in Shropshire who believes that corruption was not involved, though this suspicion is not in itself evidence. Such an explanation, however, is by far the most charitable possible, in that it suggests that at least a few councillors had their wits about them.
Having learned the hard way—hard, that is, on Shropshire taxpayers, who lost more than £100 of public assets per head—that shopping centers were not exactly the wave of the future (something evident well before the council bought them), the council then decided to refurbish one of the centers for its own offices, at a projected cost of £12 million, a figure that one can probably safely double or triple, given the almost invariable law of British public expenditure that all estimates for the costs of public-sector activities are underestimated by a factor of two, three, or more.
But at least the £12 million estimate was only half the £24 million estimate to refurbish its existing offices, a modernist building designed by the county architect. Opened in 1968, it is of unredeemable hideousness and sited only a few hundred yards from another of the most beautiful town centers in England. Medieval, Elizabethan, Jacobean, Georgian, and Victorian buildings, all very different stylistically, last for centuries and can be adapted to different uses epochs after they were built. It fell to the second half of the twentieth century to invent a dysfunctional style improvable only by demolition—as the council’s present offices will now be, at the inevitable cost to taxpayers. Needless to say, the uglification of the town took place with the full cooperation of the council’s planning department, which must give permission before anything is built.
In short, the council seems like some mad scheme of demand management, as if governed by a Keynes stoned on cannabis.
What is true of Shropshire is true of almost all of England. Despite exceptions, the country seems increasingly maladministered. Sloppiness, indifference to appearances, and inefficiency are everywhere, combined with grotesque administrative bloating.
It is not a simple question of regulation and laissez-faire. Regulation can result in an excellent service, better than what an unregulated service might have provided. London’s licensed taxi drivers are, in my experience, the best in the world, for example, and this is due to proper regulation. To obtain a license to operate, they have to master the Knowledge: learn the street plan of London—as higgledy-piggledy as that of any city in the world—not only in theory, as an abstract mental image, but in actual practice. This usually takes them three years, spent driving around the city, day in, day out. When finally they think that they have mastered it, they are examined—often by a retired policeman—and have to be able to say how they would get from A to B, or from C to D, not only by the shortest but also by the quickest route. Only then (and provided they have no police record) are they granted a license.
Obtaining the Knowledge is a formidable intellectual feat: indeed, neuroscientists have used it to demonstrate by brain scans differences between London taxi drivers and others in the possession of spatial knowledge and powers of orientation. And the result of the regulation requiring the Knowledge is that London taxi drivers, besides being small businessmen working largely on their own account and therefore committed to their profession, are generally intelligent, capable men. No doubt the advent of GPS will reduce the need for much of this effort, at least among unlicensed drivers, who were never required to have it anyway. The license was, and is, a guarantee of quality; and the point remains that regulation is not sometimes without benefit to the public.
What do the regulation of London taxi drivers and the success of the vaccination program have in common? I think that it is in the clarity, but also in the modesty, of their goals. The object of the regulation of taxi drivers, for example, is to produce a large cadre of drivers who provide an excellent public service—and the means to achieve this object are unmistakably and obviously connected to that goal. Any group comprising tens of thousands of human beings will contain some who fall below, even much below, the standard desired, but I know of no profession whose members more approximate its ideal. The drivers are justly proud of what they are. There have been no efforts to make saints, or even good people, of them; all that is required is that no ill be known of them and that they have the requisite knowledge. In 50 years of taking London taxis, I’ve never had a bad experience and have had innumerable good ones.
As for the vaccination campaign, the goal was also clear and self-evident: to immunize as many people against Covid-19 as quickly as possible, so as to put an end to the locust year, or years, of the epidemic. Practically no one contests the goal, except for those few at the margin of insanity (among whom, most prominently, is Piers Corbyn, brother of the former leader of Britain’s Labour Party, who believes that the vaccination campaign is a plot by Bill Gates and George Soros to reduce the fecundity of the world population). The relationship between the effort needed and the ultimate goal was so clear-cut, the goal so undeniably beneficial for the entire population and so devoid of possibilities for the ideological posturing by political entrepreneurs that obstructs and distorts almost all other governmental activities, that the resources of human intelligence were used constructively rather than for endless squabbling and point-scoring. Nor, as far as I know, has anyone come up with that perennial (and most obstructive) of arguments when any expenditure of time, effort, and money is proposed—that they could all be better expended on something else. No involved and potentially disputable cost-benefit analysis was necessary; not even Scrooge could have found anything to say against the mass vaccination.
As the Delta variant reminds us, it is too early to declare victory over the virus; there may yet be unpleasant surprises. A neighbor, overweight and over 80, has refused vaccination on the grounds that, having isolated himself, he sees no one who might infect him with the virus, that his diet is healthy, that the vaccine might not be effective against new variants (whose emergence, he believes, it might encourage), and that the long-term effects of the vaccines are unknown. No one, he says, can be certain how long the immunity that the vaccines induce lasts. And there will be other viruses, apart from the Covid variants.
To my ears, his arguments sound like rationalizations for a visceral hostility to immunization as such. (There has been such hostility since immunization was first practiced scientifically—more than to any other medical procedure.) Not all of what he says is false; by definition, we cannot know long-term effects with certainty. This is true of any human action, though, let alone of any widespread policy, such that everything we do partakes of an element of faith, that the past is, to an extent, a guide to the future, that the harmfulness of what we do will be limited, and so forth. But not all faiths are based just on wild surmises or are completely without reason, and the faith in mass vaccination is as reasonable as any that one can imagine. The alternative, after all, is to let Covid-19 peter out by itself. Fortunately, if the numbers of contrarians such as my neighbor are sufficiently small, the effectiveness of mass immunization on public health will not be vitiated.
The success of the vaccination program (as of the regulation of London taxi drivers) has depended largely on the absence of questions of so-called social justice in its implementation. It is true that to vaccinate people largely by order of age group is to use a net with a wide mesh; according to epidemiological statistics, some people will be more at risk than those vaccinated before them. But the population seems to have accepted that to use a finer mesh would introduce administrative confusions that would impede speed and efficiency.
True, also, there have been mutterings about the differential in uptake of immunization, free and universal, between rich and poor, and between white and ethnic minority (never further disaggregated). Typically, the percentage uptake of ethnic minority workers in the health- and social-care system has been about 60 percent of that of white workers, in whom it has been very high. The difference exists, even though the ethnic minorities, roughly speaking, have had a higher mortality from Covid-19 than whites.
Naturally, the blame for both the higher mortality from the disease and the lower vaccination uptake by the very people who, statistically, have most to gain from it is laid by all right-thinking people at the door of “structural racism.” This is despite the tacit admission that two of the reasons for the lower rate of uptake are cognitive, or a matter of irrational belief: first, among Muslims that the vaccines are not halal—that is to say, they contain pig products; and second, among blacks that they are designed to reduce fertility. More sophisticated Muslims try to persuade their coreligionists otherwise, and indeed mosques have been used as vaccination centers; but the fear persists. As for blacks, it seems to me likely that the constant public emphasis on their immemorial ill-treatment, as well as on current abuses, must induce a paranoid frame of mind that suggests that nothing has changed, and that only abuse and injustice are real. An item in the British Medical Journal attempting to explain the relatively low uptake among ethnic minorities (though more than 50 percent of the eligible have accepted vaccination) referred to the Tuskegee experiment. It is not, of course, that the experiment should be forgotten or fail to serve as a warning to future generations; but in the current climate, the iteration in a completely different context is more likely to reinforce suspicion than to lay it to rest, and thereby maintain or even widen the differential uptake. It is as if Jews refused the Pfizer- BioNTech vaccine because it was partly developed in Germany by Muslim researchers.
As to the suggestion that immunization should be compulsory for all hospital and social-care workers, it has been widely called discriminatory (whether or not a good idea from the point of view of preventing death and disease), for it would undoubtedly affect more ethnic minority than white workers, who have been immunized anyway. Thus, everything is grist to the structural racism mill—differential death rates from the disease, differential uptake of vaccination, and equal requirement to be vaccinated.
So far, though, this carping has not affected the vaccination campaign much and probably will not do so in the near future. But such complaints affect almost everything else that the government or public agencies do, to such an extent that the purposes of all such activities become muddy. Lack of clarity of goals is a recipe both for inefficiency and an opportunity for bureaucratic overgrowth. Practically nothing goes uncontested; all is confusion. The police are unsure whether their job is to keep public order, prevent and detect crime, or engage in social engineering, by, say, eliminating expressions of hatred or joining in local carnivals by dancing in them. Are teachers supposed to impart certain basic skills and knowledge to children, or turn them into right-thinking mental clones, incapable of bad thoughts? Absurdities proliferate, generating heat but no light. A primary school in Birmingham, for example, pitted teachers, who insisted on teaching children aged five to 11 about transgenderism, against parents, more than nine out of ten of whom were Muslim and opposed to such indoctrination.
In a world of such conflicts, something like the vaccination campaign comes as a relief. At last, an unequivocal public good to aim at! Thousands of well-intentioned citizens have volunteered to help without pay. Unexpectedly, bureaucrats have shown a capacity to arrange things well. The secret of success, it seems, is an intellectually modest, but very clear, goal in the national interest. In such circumstances, organizational complexity can be managed. It is ideological confusion of purpose that conduces to incompetence.
Photo: A Covid-19 vaccination site in Westminster Abbey (STEFAN ROUSSEAU/ZUMAPRESS/NEWSCOM)