The records appear to reveal no other pressure group focused solely on food, tobacco or alcohol that receives funding from Whitehall, although there are several state-funded organisations with a broader ‘public health’ remit which lobby for lifestyle regulation. The UK Health Forum received £216,306 from the Department of Health in 2016/17 in addition to £680,000 from Public Health England and an unrestricted grant of £371,660 from the European Commission. Of a total budget of £1,597,619, state funding amounted to £1,470,626 (92 per cent). It lobbied for a familiar assortment of paternalistic anti-market interventions in lifestyle choices - tax rises, bans, advertising restrictions, minimum pricing, mandatory food reformulation, etc. - before closing down after government funding was withdrawn last year.
Public Health England
Public Health England (PHE) is the new critical dynamic in the politics of the nanny state. Created in 2013, PHE has changed the face of state-funded activism in the field of lifestyle regulation in two ways. Firstly, it has a colossal budget of £4.5 billion, most of which is distributed to local authorities where dozens of Directors of Public Health lobby councillors for policies which restrict personal freedom and disrupt the market, such as outdoor smoking bans and tighter licensing restrictions for bars and off licences. As a semi-autonomous quango with a large pot of money, Public Health England can also grant funds to third parties without ministerial sign-off. For example, when the CEOs of several ‘public health’ organisations decided that they needed to create another umbrella group for their profession, Public Health England handed them £57,200 to create the UK Public Health Network. It has recently started funding ASH, with grants totalling £108,000 in the last quarter of 2018.
Secondly, PHE is itself effectively a pressure group. Through its publications and public pronouncements it has lobbied for such policies as minimum pricing for alcohol, outdoor smoking bans, plain packaging and bans on ‘junk food’ advertising. Every other ‘sock puppet’ group is a minnow by comparison. Public Health England has not made the smaller groups obsolete - the ‘swarm effect’ requires different voices to demand the same policies - but it is now the mothership around which the activist groups orbit. It is also the citadel to which several activists have departed. Martin Dockrell, formerly of ASH, is now the Tobacco Control Programme Lead at PHE, and various prominent anti-alcohol campaigners, including Ian Gilmore of the Alcohol Health Alliance, have been appointed to PHE’s Alcohol Leadership Board.
Public Health England is a more overtly political entity than the public health organisations, such as the Health Education Council, which preceded it. A similar drift towards activism can be seen in other state-funded ‘public health’ groups, up to and including the World Health Organisation. Even organisations that were not set up to preach lifestyle change have got involved, including the Local Government Association, the Food Standards Agency and Food Standards Scotland. Some of the activities of the latter, which received £15.8 million from the Scottish Government in 2017/18, are indistinguishable from those of Obesity Action Scotland as it campaigns for smaller food portions and congratulates the government on its obesity strategy. In 2018, one of its advisors even suggested that the government should put graphic warnings on red meat.
Activist-academics
Other sources of taxpayers’ money are available to activist-academics in the nanny state blob via the National Institute of Health Research (NIHR) and the Economic and Social Research Council (ESRC). Although higher educational institutes are exempt from the anti-sockpuppet rules, the gap between research and advocacy can be narrow to the point of invisibility. The UK Centre for Tobacco and Alcohol Studies (UKCTAS), which has academics from fourteen British universities, says that it is not a ‘lobbying group, but we do have close links with advocacy organisations and will assist them where appropriate.’
Between 2013 and 2017 it attracted £45 million in grant income from public and private sources, including the Scottish Government, Public Health England, the Medical Research Council, NICE, the NHS, the Medicines and Healthcare products Regulatory Agency, the European Commission, NIHR, ESRC, the Department of Health and the EU’s Smoke Free Partnership.
As a result of UKCTAS’s ‘meaningful and sustained collaborative relationships with advocacy organisations’, it is able to list the following political victories:
‘We performed new analyses for the Scottish Government on the comparative effectiveness of Minimum Unit Pricing and alcohol taxation, and this work formed a key part of their successful defence of Minimum Unit Pricing in the Scottish courts'
'Academics from UKCTAS worked with Scottish groups including Alcohol Focus Scotland and Scottish Health Action on Alcohol Problems to advocate for a reduction in the ‘drink-drive limit’ in Scotland'
'Legislation prohibiting smoking in cars carrying children in England and Wales came into force in October 2015. UKCTAS played a leading role in bringing this legislation into place'
'Legislation to introduce standardised packaging for tobacco was passed in the UK parliament in the spring of 2015 and will be fully implemented from May 2017. This covers all parts of the UK. UKCTAS research played a key role in this decision.’
Similar advocacy-oriented academic organisations have emerged in recent years, including the Tobacco Control Research Group, whose funders include NIHR, ESCR, the NHS, the European Council and the Department of Health. In 2017, the ESCR - which is funded to the tune of £212 million by the Department for Business, Energy and Industrial Strategy - announced the creation of the UK Prevention Research Partnership, a £50 million project aimed at developing ‘robust new knowledge which contributes to demonstrable changes in policy and practice’ by ‘working closely with policy makers’. The same year saw the Department of Health announce that it would be setting up a new Obesity Policy Research Unit with £5 million of taxpayers’ money.
The Obesity Policy Research Unit will be run by Russell Viner, the president of the Royal College of Paediatrics and Child Health, who has been a regular fixture in the newspapers for years making emotive calls for sugar taxes, advertising bans and restrictions on fast food outlets. He accuses fast food chains of ‘enticing young people and their pocket money' and claims that only by banning advertisements for food that is high in fat, salt or sugar ‘can children reclaim their childhood’. It seems unlikely that the £5 million unit will produce any research that challenges these prior beliefs.
Clearly there is no shortage of money available to activist-academics who wish to tax and ban in the name of ‘public health’, but what is most striking is the extent of their activism and the narrowness of the clique to which they belong. Anna Gilmore, for example, was a board member of Action on Smoking and Health before joining UKCTAS and becoming the director of the Tobacco Control Research Group. She also sat on the Steering Committee and Programme Board of Smokefree Southwest until it closed in 2016. During this period, Smokefree Southwest granted £135,000 to Gilmore’s Tobacco Control Research Group and NHS Southwest gave the Tobacco Control Research Group £165,284 for ‘research and evaluation support’ for Smokefree Southwest.
Linda Bauld is the Deputy Director of UKCTAS and is on Public Health England’s tobacco control implementation board. She has also ‘been closely involved in the development of the UKPRP and is a member of the steering group for this new initiative’. Meanwhile, ASH Scotland’s CEO Sheila Duffy is on the Scottish Government's Ministerial Working Group on Tobacco Control and, more surprisingly for an anti-smoking campaigner, also on the steering committee of Obesity Action Scotland.
The EU and local government
Direct sock puppet funding continues to flourish in local authorities and devolved governments, and is endemic at the EU level. EU-funded organisations lobbying for lifestyle regulation include the European Network for Smoking and Tobacco Prevention (€314,039: 52 per cent of income), the Smoke Free Partnership (€400,749: 60 per cent of income), the TackSHS Project (€620,050: 100 per cent of income), EuroHealthNet (€901,000: 80 per cent of income), the World Obesity Federation (€444,672: 33 per cent of income), the European Public Health Alliance (€623,368: 80 per cent of income), Active – Sobriety, Friendship and Peace (€145,188: 63 per cent) and the European Public Health Association (€53,571: 19 per cent). Several likeminded pressure groups, such as the International Order of Good Templars and the Norwegian Policy Network on Alcohol and Drugs, are not EU-funded but are active in EU policy debates thanks to large grants from national governments.
In the regions, a variety of anti-smoking groups funded by local authorities come and go. In the northeast, Fresh continues to be funded through local public health grants, but similar organisations in the northwest and southwest have been wound down since the campaign for plain packaging was won. Smokefree Southwest broadened its remit in 2015 by changing its name to Public Health Action but lost its funding in June 2016 and is now little more than a Twitter account. Smokefree Northwest attempted a similar transformation by becoming Healthier Futures in 2016 but ceased trading in March 2017. Various local ‘Tobacco Control Alliances’ exist in such places as Rotherham, Camden and Durham but are now mainly focused on helping smokers to quit with cessation services and e-cigarettes rather than campaigning for legislative change. A new project called History Makers in Greater Manchester, funded by northwest local authorities, has expressed interest in such policies as banning smoking outdoors, licensing tobacco retailers and banning smoking on TV, but has not yet begun active campaigning.
The lack of overt political activity by these groups since plain packaging was introduced in 2016 probably reflects a dearth of new policies to lobby for and the government’s stated intention not to pass further anti-smoking legislation in this Parliament. The same cannot be said for Balance Northeast, an anti-alcohol group which shares an office with Fresh and, like Fresh, is 100 per cent funded by twelve local authorities. It has been campaigning for minimum unit pricing, warning labels on alcoholic drinks and advertising restrictions for nearly a decade. Its campaign for higher taxes is always more intense before the Budget.
Local authorities also fund pressure groups involved in food and soft drink regulation. Sustain for Life received £45,000 from the Greater London Authority and Royal Borough of Greenwich in 2016/17 in addition to lottery funding of £85,068 and £146,647 from the European Commission. This organisation funds the Children’s Food Campaign and runs SugarSmart, both of which were heavily involved in the campaign for the sugar tax and now lobby for a ban on ‘junk food marketing’. Sustain also set up and funded the Children’s Health Fund (with the help of Jamie Oliver) in 2015 to lobby for the sugar tax but this group was wound down once the tax was introduced in April 2018, with the group announcing that it was ‘passing the baton on to Government’.
The Birmingham Food Council, created in 2014 and funded by grants from Birmingham City Council, claims that sugar and high-fructose corn syrup are ‘psychoactive substances’ and that even sparkling water causes ‘dental decay and contributes to other health problems’. These dubious scientific claims accompanied a briefing paper urging Birmingham City Council to reject partnerships with Coca-Cola and to ‘avoid future commercial relationships with food and drinks companies whose products carry standard rate VAT’. This came in the wake of Coca-Cola giving £20 million to three local authorities to fund free activities in public parks, such as karate, Zumba and yoga. The Birmingham Food Council describes Coca-Cola as a ‘“food drug” corporation’ and calls for the sugar tax to be extended to all fizzy drinks even if they do not contain sugar. Its pronouncements on social media include ‘Shame we can’t ban sugar in public places’.
Scotland and Wales
The Scottish Government continues to be the primary funder of Alcohol Focus Scotland, with an unrestricted grant of £472,000 in 2017/18. Scottish Health Action on Alcohol Problems which, like Alcohol Focus Scotland, campaigns to limit the marketing, availability and affordability of alcohol, depended on government funding for 100 per cent of its €200,000 budget in 2015/16, according to the EU Transparency Register. Both organisations lobbied heavily for one of the Scottish National Party’s flagship policies - minimum unit pricing for alcohol - which was introduced in May 2018. When Alcohol Focus Scotland co-hosted the Global Alcohol Policy Conference in Edinburgh in 2015 - an event sponsored by the Scottish Government and NHS Scotland - SNP leader Nicola Sturgeon gave the opening speech and the organisers paid tribute to her ‘political courage’.
A similar arrangement developed in the Republic of Ireland where Alcohol Action Ireland, which relied on the state for 97.5 per cent of its income in 2015, not only lobbied for minimum pricing but set up another group, the Alcohol Health Alliance, specifically ‘to support the Public Health (Alcohol) Bill’ of which minimum pricing was the cornerstone. In addition to writing submissions to government as ‘an independent voice for advocacy and policy change’ and promoting the legislation in the media, Alcohol Action Ireland set up a webpage which enabled its supporters to lobby their parliamentary representative with a standardised e-mail (‘I urge you to please support the implementation of the Public Health (Alcohol) Bill, in full’ etc.). In 2016, Ireland’s Department of Health gave Alcohol Action Ireland an additional €75,000 ‘to engage with the EU to build support for the Public Health (Alcohol) Bill’ (Tighe 2016). The law was passed in October 2018.
State-funded lobbying does not get much more blatant than this, although the similarly named Obesity Action Scotland comes close. Founded in 2015 and wholly funded by a grant from the Scottish Government, it campaigns for a 9pm watershed on advertising for food that is high in fat, salt or sugar (HFSS), bans on price promotions such as buy-one-get-one-free and ‘regulations to control portion size’. It says that all this - plus food reformulation and the sugar tax - ‘will only be the start’ of restrictions on the free market in the name of obesity prevention. All of these policies were included in a consultation document put forward by the Scottish Government in October 2017. Obesity Action Scotland publicly welcomed the proposals and drafted an encouraging consultation response (its only complaint was that some of the measures did not go far enough). In July 2018, Scotland’s Diet and Healthy Weight Delivery Plan was published with all of Obesity Action Scotland’s demands met.
This kind of activity is relatively new in the area of food, but has long been practised in the field of tobacco. Today, both the Scottish and Welsh governments fund their branches of Action on Smoking and Health (ASH) more heavily than Whitehall funds the English branch. ASH Scotland received £604,798 directly from the Scottish Government in 2016/17 (77 per cent of its total income) while receiving just £3,126 in voluntary donations. ASH Wales received £207,872 from the Welsh Government in 2016/17 in addition to £136,247 from the EU’s Erasmus+ project. In total, ASH Wales depended on government grants for 69 per cent of its income, with just £3,570 coming from individual donations and legacies.
Taken from Still Hand in Glove? A re-examination of state-funded activism.
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