Politics of partnership in UK and Scotland: understanding governance in obesity policy

Abstract

Background Partnerships are now established as a dominant governance tool in global and public health. In the UK, successive governments have viewed partnership with the food industry as a legitimate and effective tool in obesity policy. This model of governance appeals to the notion of decision making between public and private actors as interactive and collaborative. However, while this governance approach is framed as a more open and accommodative form of policy making to state-centric authority, empirical research of partnerships with unhealthy commodity industries is surprisingly limited in both political science and public health literatures. Taking this gap in the theoretical and empirical literature as the starting point, this thesis set out to explore the ‘black box’ of partnerships tasked with encouraging food industry self-regulation to address obesity policy concerns in England and Scotland between 2010 – 2015. Methods The thesis is based on an analysis of documents released under the Freedom of Information Act, partnership documents (e.g. steering group minutes), relevant policy statements, and 50 qualitative interviews with individuals involved in public health debates. Interviews include UK and Scottish policy makers that had experience of partnerships in food policy, in addition to individuals involved in advocacy, food industry representatives, and academic researchers. It adopts a practice-based interpretive framework that understands governance as sets of rules and procedures, using the analytical frameworks of public accountability, multi-level and network governance to explore decision making in partnership. Results The thesis is divided into four empirical chapters that explore governance using various combinations of this analytical framework. Chapters 1, 2, 3 develop this approach in England, and Chapter 4 considers partnerships in Scotland. Chapter 1 examines the operationalization of partnership at the UK level, making the case that policy statements framed this mode of governance as increasing the problem-solving capacity of government. Chapter 2 draws on an empirical case study of accountability practices, and considers how a lack of formal mechanisms of accountability seemed to create opportunities for commercial sector actors to circumvent being held to account within partnership arrangements. Chapter 3 extends the focus to decision-making processes in partnership, illustrating the tension between collaborative modes of governance and the political strategies of food industry actors. Chapter 4 then explores partnership arrangements in Scotland, combining an analytical focus on accountability, multi-level and network governance to consider how policy divergence from partnership arrangements at the UK level was constrained through limits to collaboration between the Scottish government and food industry actors. Conclusion The findings problematise the suggestion that partnership arrangements improve the governance and policy effectiveness of interventions to address diet-related ill health. This research draws upon contemporary theories of governance, in combination with a wide range of empirical data, to highlight how commercial sector actors exercise policy influence in partnership arrangements. In contrast with a tendency within public health studies to assume a conflict between the interests of commercial sector actors and public health aims, this research makes a distinctive contribution in exploring the micro-political decisions that constitute such tensions.