UK Health, Climate Policy Ambitions Hampered by Weak Policies and Political Ideologies

Efforts to tackle major issues facing the UK, including the nation's health and climate change, are being hampered because politicians often ignore the existing evidence when setting policies, according to Dame Theresa Marteau, a public health expert at the University of Cambridge.

Writing in the journal Science and Public Policy, Professor Marteau argues that this 'evidence-neglect' is a result of incentive structures that encourage politicians to set ambitious policy goals while simultaneously disincentivising them from implementing the policies needed to achieve them, and of political ideologies and interests that conflict with effective policies.

Two changes could mitigate these factors, she writes: engaging citizens more in policy-making so their interests dominate; and increasing the accountability of politicians through legally binding systems for all stages of policy-making.

Recent UK governments have set ambitious goals to improve the nation's health and tackle climate change. These include halving childhood obesity by 2030, eradicating smoking by 2030, narrowing the gap in healthy life expectancy by 2030, and achieving net zero carbon emissions by 2050.

But, says Professor Marteau, Director of the Behaviour and Health Research Unit at Cambridge, "None of these ambitions is on course. Of course, scientific evidence is just one of many sources of information for policymakers to consider, but neglecting evidence is a sure-fire route to unsuccessful policymaking."

According to predictions, childhood obesity is on track to double, not halve, by 2030. Smoking eradication is on track sometime after 2050, not by 2030. By 2030, the gap in healthy life expectancy between local areas where it is highest and lowest will have narrowed, but by 2035 is set to rise by five years. And the UK Sixth Carbon Budget – a key target towards achieving net zero carbon emissions – is likely to be missed by "a huge margin".

Achieving each of these ambitions requires sustained changes in several sets of behaviour across all socio-economic groups including what we eat, drink, whether we smoke, and how we travel. A wealth of research demonstrates that achieving such change is difficult, requiring many interventions that change the environments or systems that too readily cue, reinforce and maintain unhealthier and unsustainable behaviours.

"There are many possible reasons why these policy ambitions are so far off-track, but chief among them is the neglect of evidence, particularly around achieving sustained changes in behaviour across populations," said Professor Marteau.

"Put simply, these failures are baked-in, given the policies designed to achieve these ambitions are based on interventions that cannot achieve the change required."

Part of the problem, she says, lies in the incentive structures for politicians, which favour setting ambitious policy goals whether as part of achieving election promises, attracting positive publicity or both. But they also discourage the policies needed to achieve them.

"Fear of electoral damage plays a role here. Take taxes on tobacco, alcohol, junk food and carbon emissions: these are among the most effective interventions for improving health and the climate, but they are unpopular with the public and so politicians are unwilling to adopt them."

Such policies may not just be unpopular with the public – they may also run counter to political interests and ideologies. Neoliberalism, for example, emphasises a small role for governments in the economy and public policy more generally, and a larger role for individuals to be personally responsible for behaving in ways to achieve health, wealth and happiness. Such ideologies often portray attempts by the government to intervene as 'Nanny Statism'.

Certain industries, too, focus on personal responsibility to discourage politicians from adopting effective policies that conflict with their industries' interests, such as those aimed at reducing consumption of fossil fuels, tobacco, alcohol, meat and junk food. These industries may cast doubt on the effectiveness of policies that would reduce their sales, as well as lobbying governments to persuade them of the business case for the status quo.

Professor Marteau added: "There are no quick or single fixes to overcoming these problems, but there are two changes which could help: engaging citizens more in priority setting and policy design, and increasing the accountability of politicians through introducing legally-binding systems for reporting progress on policy ambitions."

There are a number of options available to policymakers when it comes to engaging citizens, including: surveys, focus groups, town hall meetings and citizen assemblies, as well as working with civil society organisations. This approach has the potential to reduce the political costs of unpopular policies by exposing citizens to evidence for the effectiveness of policies, which – across many studies – has been shown to increase policy support. Policies designed with citizen engagement also attract more public support, such policies being seen as fairer and more successful as a result.

Introducing legally binding systems for reporting policies and progress on policy ambitions, with plans to get back on track if progress is off course, could be a powerful way to decrease the neglect of evidence which is central to policy success.

An example of this is the UK government's recent Levelling Up strategy paper, which included plans to introduce a statutory obligation for government to report annually on progress towards meeting the Levelling Up missions. Alongside these plans, it published a set of metrics against which to measure progress against the missions and evaluate the success of the strategy.

"Although these requirements are by no means perfect, the legislation as drafted will at least allow parliament significantly more scrutiny of progress towards a government ambition than is often the case."

According to Professor Marteau, failure to consider the evidence risks undermining the government's attempts to take action.

"Laudable policy ambitions to improve a nation's health and protect life on the planet will remain unfulfilled ambitions unless and until evidence is given a more central role in the policy-making process."


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