Softly and suddenly vanish away – Department of Health Responsibility Deal

Remember the Department of Health Responsibility Deal? It emerged in the early days of the Coalition Government, well, I think its gone. I cannot find any official announcements but articles in the Daily Mail and The Grocer around December 2015 signal its demise – although the word used is ‘pause’.

The Responsibility Deal (RD) was Andrew Lansleys attempt to establish a public-private partnership between industry, government, public bodies and voluntary organisations in England. Organisations involved made voluntary ‘pledges’ on various areas, including alcohol, which are designed to improve public health and hence avoid trying to drive health improvement through regulation. Initially it was aimed at traditional targets – principally the alcohol and food industries but it developed to pick up on other areas notably mental health and health in the workplace.

I have documented some of its struggles in earlier blogs:

• Who cares about the Department off Health Responsibility Deal (2012) – this looked at its impact
• A lack of Interest – Mental Health and Responsibility Deal (2013) this explored the lack of traction of the Mental Health element of the Responsibility Deal

Its not our fault guv’

Evidence that the deal is dead is scattered around the web – this includes

• the home page of the Responsibility Deal which now has a very definite start and finish date and a statement that says that “this content was published under the 2012 to 2015 Coalition Government.” In other words its not our fault guv’.
• no mention of the public health Responsibility Deal in the latest government public health strategy produced by its agency Public Health England although the 2013/4 strategy did commit to work on the Mental Health in the Workplace Pledge – clearly not very successfully if you look at the link to on the next bullet point on registrations.
• No new registrations in 2016 and a significant drop off in 2015.

Of course the Government has to say that it was a tremendous success – just look at the evidence based (not!) statement below by Parliamentary Under Secretary of State for Public Health Jane Ellison MP this was given as part of her Responsibility Deal Presentation in March 2015.

Who cares that it is gone?

I would imagine that some of the 776 organisations who have signed up to the pledges might be a tad upset that the Government has walked away from this.

Similarly some special interest groups might also be a bit irritated at the time lost by this diversion from real policy change and activity. In my view this applies particularly to mental health in the workplace – where there is precious little activity taking place anyway.

What can be learnt

We do need to learn from this. Most importantly – and I realise this will fall on deaf ears – the Government needs to learn from this process and share this learning. Here are some thoughts:

• First – there has got to be a realistic view about when regulation is required. The main reasons for key interest groups in the public health world resigning or refusing to engage was because they were concerned that the Responsibility Deal was an inappropriate mechanism for influencing the behaviour of powerful lobby groups in the food and alcohol industries. In a number of cases (smoking, sugar) it turned out that legislation was the only mechanism that would work.
• Second I do think that voluntary processes that seek to  validate the good and motivate the inadequate are a useful driver for change. Local Authorities in particular use this as way to drive improvement. However, the way the RD was set up – its crude infrastructure, vague pledges, cumbersome website, poor communications and failure to share learning meant that it was impossible to understand how meaningful a pledge was, how much traction it had in a sector and whether it was being adhered to or not. It was far too much about spin as Jane Ellison’s presentation shows.
• Finally, it is worth listening a bit more to the professional bodies.  If they say that they cannot be involved because they have don’t have confidence in the model – they are probably worth listening to!

At the end of the day the level of its impact can best be measured by the deathly silence from all the organisations who signed up – that is the sufficient indication of its irrelevance.

What do you think?