Academia, policy and politics

In October 2003, I started a secondment from the London School of Economics (LSE), where I hold the Richard Titmuss Chair of Social Policy, to No 10 Downing Street, where I worked as a senior policy adviser to the Prime Minister, Tony Blair. I began working initially on a specific project: developing policies on extending user choice in public services, with particular reference to health care and education. Then I was asked to be the Prime Minister’s health policy adviser, a role I agreed to take on up to the general election that took place in May 2005. In the event I stayed on a few weeks after the election until August of that year, when I returned to LSE. So I worked for nearly two years in Downing Street. Mine was an unusual appointment. Most of my Downing Street colleagues were much younger than me; unlike me, all had had experience of working as political or policy advisers in government, despite their relative youth; and none were academics. Although interchange between government and academia is not uncommon in the United States, it is rare in the UK and other countries. So the editors of this journal felt that readers might be interested in my reflections on the experience, especially the differences between being an academic in a university and an academic in government: the squarish peg of academia in the round hole of politics and policy. Of course, the most obvious difference was in working style. As a senior academic at a good university, your time is broadly your own to allocate as you will – apart from the occasional lecture or seminar series, and even those you can usually re-arrange if necessary. But in government, as Harold Macmillan so famously noted, you are at the mercy of events. So often I would wake up in the morning, switch on the radio, hear about the latest outbreak of MRSA in a National Health Service (NHS) hospital or the mile-long queue of people waiting to register for a new NHS dentist, and know that the reflective paper the Prime Minister wanted on the pros and cons of more patient choice was going to have to be put off yet again. Rarely did days work out as planned; indeed, rarely did minutes work out as planned