Strategy – why bother when you get crises coming along?
Having suggested what a health and wellbeing strategy should look like, the current Covid crisis raises the question: ‘if something like this comes along and throws everything into the air, why bother with a strategy?’
Generally, I think, it’s still worth having a strategy, though there might be a few extreme cases where it’s not.
It all depends what you expect the future to bring. That invites the response that the whole point is that unexpected events are, well, unexpected. However, that’s not quite right. Notwithstanding various philosophical issues, for practical purposes, we can predict and forecast (albeit imperfectly).
Even when we cannot predict exactly what will happen, we generally have a good idea what the range of possibilities are. We may not be able to predict the weather very well beyond the near future, but we know in principle what to expect and can prepare for it. The same goes for the economy and much social activity.
So, in general, we have enough idea about the future to make it worth planning for it. And the fact that we may be wrong doesn’t provide any guidance for alternative action: all we can do is our best. We didn’t know we would be hit by a coronavirus pandemic this year, but a pandemic of some sort was expected at some point. Equally, things like antimicrobial resistance, climate change and even asteroid strikes are on risk registers somewhere.
The next question is how predictable we think the future is, including stability, uncertainty and range of events. So, how many unexpected (or unusual) events do we think there will be? What is their likelihood? What sort of events might they be? For instance, if your country sits on a geographical fault line in a certain part of the world, it might expect fairly frequent earthquakes, volcanic eruptions, violent storms etc. Others might expect a pandemic but have little certainty of when it will happen or the severity. And the range of events may vary in terms of their type, severity and impact (from droughts to, say, an asteroid impact). Strategic planning may need to be adjusted to take account of each of these variables.
So, the events themselves should be prepared for, as best as possible, based on their likelihood and nature and this does indeed happen to a greater or lesser extent. The issue here, though, is how might events affect the strategy and do they invalidate it?
There are (at least) four ways in which the unexpected event may affect the strategy. It may delay all, or aspects of, the strategy. It may mean some aims have to be achieved in different ways. It may accelerate some aspects. Or, more unusually, it may render some aims redundant.
Firstly, delays to the strategy could happen, as in the current crisis, because resources are diverted from, say, preventive activity to dealing with the present emergency. Some rules and regulations might be relaxed to allow a focus on the crisis, which could set back progress in some areas.
Secondly, some aims may have to be achieved in different ways such as befriending schemes to address loneliness or exercise classes having to be delivered online.
Thirdly, there may be opportunities to accelerate aspects of the strategy. This could include: the rapid increase in remote and online consultations; encouraging people who want to get out of their homes to do more physical exercise; or taking the opportunity of reduced traffic to improve cycleways.
So while all those things affect the implementation of the strategy, and may alter the targets and ways of achieving them, they do not make the strategy worthless.
The fourth possibility is that it is conceivable that events may make some whole strand of a strategy irrelevant. To take an extreme example, if a whole sector of the population, (say very old and frail people) were wiped out, then the policies and strategy relating to them could become irrelevant. Similarly, it’s conceivable that you might spend decades trying to change some behaviour (such as stopping smoking or sexually transmitted diseases or reducing obesity) and then something happens that changes things overnight (e.g. the risks of smoking become dramatically even more dangerous so most people just quit; sexually transmitted infections die out because of isolation; or war time rationing means everyone eats less and loses weight). To be fair, I don’t have any hard evidence of how likely this fourth set of possibilities are, but my judgement is that they’re pretty rare.
So, is it worth having a strategy despite unexpected, extreme events? These arguments suggest it usually is. There might be circumstances where so much turmoil is expected, such as a world war on the horizon or climate change about to hit a tipping point, that there is just no point in spending time on a health and wellbeing strategy ‘for normal times’. But generally, even with a pandemic that dramatically affects almost all the world, it’s still worth having a strategy.