Abstract
The aim of this thesis is to enable a better understanding of how business power influences government policy decisions when there is conflict between business and public health objectives. This is to support more effective public health advocacy. The aim is addressed by a case study looking at the influences shaping government decisions on front-of-pack nutrition labelling (FoPL) during and following the 2009-11 Review of Food Labelling Law and Policy (the Review) in Australia. There is a particular focus on food industry influence.
Multiple sources of evidence and multiple data collection methods were needed given the breadth of issues covered. A mixed methods triangulation design using both quantitative and qualitative data was adopted. Data were obtained from document and literature searches, on-line monitoring of events, requests for official information, content analyses of submissions with both quantitative and qualitative elements, and interviews with key informants.
The Review Panel recommended that an voluntary, interpretive traffic light system (TLS) be introduced. Australian governments rejected a TLS. Instead they announced that a new interpretive system would be developed through a collaborative process involving food industry, public health and consumer representatives. The outcome of this process, the voluntary Health Star Rating (HRS) system, was launched in 2014. While initially opposed to interpretive FoPL, many food manufacturers gradually came to adopt the HSR system, while consistently opposing it becoming mandatory.
Public health and consumer groups had two clear losses. A TLS they had called for in submissions was not implemented, and the HSR system was voluntary. They did, however, have a major gain. An interpretive system was introduced that had the potential to become mandatory if not sufficiently adopted. The food industry was successful in avoiding a TLS, but not in avoiding a government-backed interpretive system.
The author developed a framework of five ‘aspects of power’ through which stakeholders could influence government decisions. The two aspects that emerged as most important FoPL decisions during and after the Review were institutional and ideological power. Institutional power for both the food industry and public health advocates arose from institutional arrangements including the regulatory policy environment (favouring industry) and the predominance of health ministers on the Council/Forum (favouring public health). Pro-market ideology had shaped the regulatory policy environment, while the predominance of left-leaning governments in Australia during the period when crucial decisions were made increased the ability of public health advocates to achieve gains.
In 2014 the New Zealand Government, which had declined to participate in the Review, joined with Australia in supporting implementation of the HSR system.
Eight suggestions for public health advocacy were drawn from the case study. These included seeking change to regulatory policy, trying to change the discourse about regulatory policy, forming policy communities around important public health issues, and (for New Zealand) seeking to change the location of policy advice.