TY - JOUR
T1 - The informal governance of public-private partnerships in UK obesity policy
T2 - Collaborating on calorie reduction or reducing effectiveness?
AU - Ralston, Rob
N1 - Funding Information: Thanks are due to all the interviewees who participated in the research, as well as Katherine Smith, Sarah Hill, Jeff Collin and Richard Freeman who commented on earlier drafts of this paper. Significant thanks are also due to the editors of the journal and two anonymous reviewers, all of whom provided feedback that strengthened the paper. This research was initially funded by an ESRC Doctoral Scholarship (grant number: 1499546).
PY - 2021/11
Y1 - 2021/11
N2 - Collaboration between governments and non-state actors has emerged as the dominant mode of policy making to address a wide range of public and global health issues, particularly via public-private partnerships and multi-stakeholder platforms. Despite its paradigmatic status in contemporary health governance, political claims and promises of partnership approaches as more effective than state regulation have received limited attention. This study addresses this gap by tracing negotiations over a calorie reduction ‘pledge’ within the Public Health Responsibility Deal: a public-private partnership between the UK Department of Health, food industry and civil society organisations focusing on obesity policy. It demonstrates how political claims-making by the Department of Health that a public-private partnership as an effective substitute for legislation, contrasted with protracted and conflictual negotiations with food industry business associations. Employing Erving Goffman's distinction between frontstage and backstage interaction and the concept of informal governance, this study traces a shift to informal back stage governance as a mechanism to cope with acute tensions between economic interests and nutrition policy goals. The study illustrates how this shift to the back stage had substantive public health implications, privileging commercial sector perspectives and marginalising civil society participation. Informalization served to reframe calorie reduction from industry-focused to personal responsibility for lifestyle behaviours, in the process reducing its effectiveness. The results suggest that, while partnership and multi-stakeholder approaches are widely promoted as a legitimate tool in health governance, visible tensions between commercial sector and public health interests challenge political claims about public-private collaboration as consensus-oriented and effective. Informal governance, when used as a coping mechanism to manage tensions public health and commercial sector interests, may be symptomatic of wider dysfunctions and conflicts of interest in partnership approaches. This suggests that there may be limited scope for effective policy innovations where commercial sector actors perceive core interests as threatened.
AB - Collaboration between governments and non-state actors has emerged as the dominant mode of policy making to address a wide range of public and global health issues, particularly via public-private partnerships and multi-stakeholder platforms. Despite its paradigmatic status in contemporary health governance, political claims and promises of partnership approaches as more effective than state regulation have received limited attention. This study addresses this gap by tracing negotiations over a calorie reduction ‘pledge’ within the Public Health Responsibility Deal: a public-private partnership between the UK Department of Health, food industry and civil society organisations focusing on obesity policy. It demonstrates how political claims-making by the Department of Health that a public-private partnership as an effective substitute for legislation, contrasted with protracted and conflictual negotiations with food industry business associations. Employing Erving Goffman's distinction between frontstage and backstage interaction and the concept of informal governance, this study traces a shift to informal back stage governance as a mechanism to cope with acute tensions between economic interests and nutrition policy goals. The study illustrates how this shift to the back stage had substantive public health implications, privileging commercial sector perspectives and marginalising civil society participation. Informalization served to reframe calorie reduction from industry-focused to personal responsibility for lifestyle behaviours, in the process reducing its effectiveness. The results suggest that, while partnership and multi-stakeholder approaches are widely promoted as a legitimate tool in health governance, visible tensions between commercial sector and public health interests challenge political claims about public-private collaboration as consensus-oriented and effective. Informal governance, when used as a coping mechanism to manage tensions public health and commercial sector interests, may be symptomatic of wider dysfunctions and conflicts of interest in partnership approaches. This suggests that there may be limited scope for effective policy innovations where commercial sector actors perceive core interests as threatened.
KW - food industry
KW - nutrition policy
KW - obesity
KW - public health policy
KW - public-private partnership
KW - unhealthy commodities
UR - http://www.scopus.com/inward/record.url?scp=85117355931&partnerID=8YFLogxK
UR - https://www.sciencedirect.com/journal/social-science-and-medicine
U2 - 10.1016/j.socscimed.2021.114451
DO - 10.1016/j.socscimed.2021.114451
M3 - Article
AN - SCOPUS:85117355931
SN - 0277-9536
VL - 289
SP - 1
EP - 8
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 114451
ER -