Public Health Responsibility Deal

This article is part of the Spinwatch public health oriented Alcohol Portal project.

Healthy lives, Healthy People: Our Strategy for Public Health in England, published on 30 November 2010 sets out the coalition government’s vision for public health. Health Secretary Andrew Lansley and his team have developed what they describe as a “new mechanism to take forward some aspects of public health outcomes.” This in practice involves the establishment of five networks designed to work to address public health challenges set by the government. Despite Lansley's claims that this is a 'new' approach, the networks are a continuation of the Labour government's partnership approach to public health, where government and public health professionals work in partnership with industrial sectors that produce products that contribute towards the UK's growing consumption-related health problems. Certain issues are ruled outside the remit of the networks, such as pricing, tax and any issues that conflicts with competition law. A Public Health Responsibility Deal Plenary Group oversees the work and commitments made by the networks.

This article is part of the Health Portal project of Spinwatch.

Andrew Lansley's push for self regulation

Andrew Lansley and his colleagues argue that the business community can play a positive role in the development and implementation of public health policies. In 2008 when Lansley was shadow Health Minister he established a Public Health Commission that aimed to develop public health policy for the Conservative Party. The chair of Unilever, Dave Lewis, headed the commission, which found the way forward for public health was to allow more involvement from industrial sectors. The commission's recommendations have been carried forward and Lansley has assured the business community that the Conservative Party's approach will not involve regulation from government but is centred on self regulation and social responsibility. Lansley's strategy is a clear continuation of the previous government's Change4Life campaign ethos and reflects his view that government should "nudge wherever possible and nanny only where necessary".

This article is part of the Foodspin project of Spinwatch.

Criticisms

This allows industry objectives and not evidence based public health strategies to dominate the agenda. Most of the pledges are minor and will cause little improvement in public health and little inconvenience for corporate partners. Furthermore, many of the pledges have already been made elsewhere. On alcohol labelling, for example, the network deal pledges are the same as commitments given and not fulfilled by the alcohol industry in 1998 and 2007. The pledge to eliminate trans fats was already made in 2007 and most large companies had done this by the end of 2007, yet it hasn't prevented them from signing up to this pledge again in 2011. There is no sanction or penalty if companies do not sign up to the pledges and as long as they are committed to the network they can still use their membership as part of their marketing and CSR portfolios.

Sustain's research estimates that between 2000 and 2010, £54 million pounds has been spent on voluntary initiatives between government and industry that have failed to materialise.

The House of Lords Select Committee on Science and Technology took evidence from the government and a range of professionals on their plans to use interventions designed to change behaviour and the role of the new Behavioural Insights Team. The government gave three main arguments to support this approach; "a preference for non-regulatory policy tools, engagement with a range of organisations through partnership working, and a greater role for local authorities." Some of the evidence given to the committee referred to lessons that could be drawn from the experience of establishing the Public Health Responsibility Deal. Overall the committee was supportive of government efforts to work with outside organisations although they stressed:

"We have major doubts about the effectiveness of voluntary agreements with commercial organisations, in particular where there are potential conflicts of interest. Where voluntary agreements are made, we recommend that the following principles should be applied in order to ensure that they achieve their purpose:

• The Government should specify clearly what they want businesses to do based on the evidence about how to change behaviour, and what steps :they will take to achieve the same result if voluntary agreements are not forthcoming, or prove ineffective.
• Voluntary agreements should be rigorously and independently evaluated against measurable and time-limited outcomes.

Given that these principles do not appear to have been applied consistently to the Public Health Responsibility Deal Network, we urge Department of Health (DoH), in particular, to ensure that these principles are followed when negotiating further voluntary agreements. In relation to the current agreements, we recommend that DoH should state for each pledge what outcomes are expected and when, and provide details of what steps they will take if the agreements are not effective at the end of the stated period. (Emphasis Added)

Pledges

This strategy relies on partners committing to pledges to act on specific targets and together these pledges form the basis of the governments public health strategy. There are two types of pledges involved, individual pledges where individual corporations and organisations make a specific commitment for action and collective pledges where a group of stakeholders agree on a particular course of action. Partners in the network must sign up to the core commitments of the network, these core commitments are extremely broad and allow partners to work towards these commitments at their own pace and in their own way to develop deliverables that work towards the core commitments. The core commitments are:

• We recognise that we have a vital role to play in improving people’s health.
• We will promote and enable people to adopt a healthier diet.
• We will foster a culture of responsible drinking, which will help people to drink sensibly within recommended limits
• We will encourage and assist people to become more physically active
• We will actively support our workforce to lead healthier lives

Corporate Involvement in Public Health

This article is part of the Foodspin project of Spinwatch.

The extent of corporate involvement in the government's public health network was made public after a question in the Commons from shadow health minister Sharon Hodgson. Her question forced Anne Milton to admit:

Other than multi-stakeholder meetings, since May 2010, departmental Ministers have held meetings with Unilever, McDonalds and Unacom, while the Department's Special Advisers held meetings with Diageo and Kellogg's. During the same period, departmental officials have held meetings with Diageo, Unilever, Nestle, McDonalds, the Advertising Association, 23Red, Freud Communications, M&C Saatchi, VCCP Health (a Bell Pottinger Communications & Chime Communications company) MCBD and Fast Track Agency.

Responsibility Deal Networks

• Public Health Responsibility Deal Plenary Group
• Responsibility Deal Food Network
• Responsibility Deal Alcohol Network
• Responsibility Deal Health at Work
• Responsibility Deal Physical Activity
• Responsibility Deal Behaviour Change