Policy process and practice

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Policy process and practice

• Professor Roger BrownswordDirector of TELOS,
  Kings College London

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Factors in public health policy

1. Evidence
2. Risk
3. Precaution and proportionality

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1) Evidence

• Evidence about causes of ill health and the
  efficacy of interventions
• Should be based on peer-reviewed research
• Usually incomplete and contested

Conclusion accuracy and fairness in presenting
evidence is of crucial importance
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2) Risk

• Assessing risk
• Statistical view considers probability and
  severity
• Social construct view considers value judgements

Conclusion the assessment of risk in the
development of policy should be based on the
statistical view
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3) Precaution and proportionality

• Prefer the term precautionary approach
• Application involves weighing costs and benefits
  on case-by-case basis, and judgement
• The seriousness and urgency of the problem should
  also be considered
• Any intervention should be proportionate and the
  least intrusive

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The intervention ladder

• Eliminate choice
• Restrict choice
• Guide choice by disincentives
• Guide choice by incentives
• Guide choice by changing the default policy
• Enable choice
• Provide information
• Do nothing

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Reducing health inequalities

• Targeting strategies
• Targeting disadvantaged or at-risk groups
• Concerns e.g. stigmatisation
• Universal strategies
• Relies on people taking up opportunities
• Favours better educated people

Conclusion monitoring of strategies of crucial
importance