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Politicians need to take bold action to improve public health


3 min read

Earlier this month I interviewed Wes Streeting, the shadow health secretary, at The King’s Fund Annual Conference.

One of the topics was the recent decision by the government to delay the ban on buy-one-get-one-free offers, which the Labour Party support. It’s a move that has dismayed many because of the strength of evidence on the need to tackle obesity. Streeting’s argument was that politicians care about what the public think, and if the public don’t want the ban, it’s right to delay.

This got me thinking about politicians, public opinion and the so-called nanny state, bringing to mind a quote from the United States political drama, The West Wing: “There go my people. I must find out where they are going to so I can lead them.”

There is space for politicians to bring the public with them on specific and targeted actions

Streeting is the latest – but by no means the first and certainly not the last – politician to say that the reason to not act is because the public don’t want action. However, this is just not true. The public regularly say they want the government to do more, particularly on issues such as obesity and public health.

For example, in 2020, 62 per cent of people supported restrictions on promotional offers on unhealthy foods in supermarkets. So a majority support taking action. Although government claimed that the delay was also due to the cost of living crisis, their own impact assessment showed that people spend more with promotional offers.

This reluctance to act isn’t a new phenomenon. To take just one other example, in the 00’s politicians were similarly slow to see the direction of public opinion around the smoking ban in public places. It is now heralded as the most important public health intervention of the 21 century and such a normal part of our everyday lives. It’s easy from the perspective of 2022 to assume there was an inevitable path to its introduction. But that was not the case. It was only very late in the process that politicians finally felt brave enough to remove wide exemptions from the legislation.

Research by the Health Foundation shows that government action on the leading health risk factors are not viewed favourably. Fewer than one in five people believe the government is working effectively to improve physical activity, diets as well as reduce alcohol-related harm and obesity. Given this public recognition of failure to lead on these issues, why are politicians reluctant to act?

Politicians think the public dislike the so-called nanny state, but there is an important difference between mistrust of the general concept of government’s intervention in people’s lives and broader public support for specific policies and interventions, such as the sugar tax. There is space for politicians to bring the public with them on specific and targeted actions and do more. 

Over decades, countless politicians have shown that they simply aren’t prepared to take the lead on public health measures. They can even be relatively slow followers of public opinion.

Politicians say they want to improve health, but don’t use the levers available to them. As The King’s Fund’s recent work on cardiovascular disease shows, the benefits to health could be huge if politicians used all the levers available. Politicians need to be braver and quicker to act boldly on how to help us all improve our health. Far from the public being resistant to that, they are often keener for the government to act than politicians themselves realise.

Imagine if politicians decided to lead and shape public opinion even further, rather than being reluctant and slow followers on measures to support us all to be healthier. 


Sally Warren, director of policy at The King’s Fund.

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