The UK government’s Public Health Responsibility Deal was greeted sceptically by many campaigners when it was first unveiled last year. The announcement of the pledges themselves and the decision by the British Heart Foundation and Diabetes UK not to endorse the Deal, Ben Cooper writes, have done little to dispel the air of cynicism that surrounds the policy.

The refusal of two health charities to sign up to the Government’s Public Health Responsibility Deal on food may not be quite the blow to the voluntary, ‘big-tent’ health initiative that corresponding decisions by six other charities was to the deal on alcohol, but it still leaves both the Government and the food industry with something to think about.

From the start, the primary challenge for the Government has been to avoid the Responsibility Deal being viewed as a sop to industry.

In theory, the Deal aims to tackle public health issues through partnership between government, business and the voluntary sector. After discussion within the five multi-stakeholder ‘networks’, which cover food, alcohol, physical activity, health at work and behaviour change, voluntary commitments, or ‘pledges’, would be agreed on actions geared to improve public health.

On one level, this could be seen as mature, inclusive policymaking, embodying the practical benefits of voluntary action – such as speed of implementation, cost and positive corporate engagement – that advocates of self-regulation so readily espouse.

But when it was first announced, critics said it gave companies too much influence and a voluntary approach would be unlikely to bring about the changes in commercial practices and product formulation required to make a real impact in areas of public health concern. Others suggested the Deal was no more than a ‘thank you’ note to big business for its support of The Conservative Party in the run-up to last year’s election.

The devil was therefore always likely to be in the detail. Substantial, game-changing undertakings would have to force the sceptics to think again. By the same token, a lack of endorsement by NGOs would only affirm the views of the doubters.

In that regard, the alcohol deal has been severely undermined, following the decisions by groups such as the British Medical Association, the Royal College of Physicians and in particular Alcohol Concern not to sign up. The food deal may not be holed below the waterline but it is certainly listing.

The food deal comprises three industry pledges: to provide calorie information for food and non-alcoholic drink in out-of-home settings from 1 September 2011 in accordance with the principles for calorie labelling agreed by the Responsibility Deal; to commit to the salt targets for the end of 2012 agreed by the Responsibility Deal, which collectively will deliver a further 15% reduction on 2010 targets; and to remove artificial trans-fats from products by the end of 2011.

While the Food and Drink Federation said it looked forward to working in partnership with the Government to deliver “a significant contribution to improving public health”, the British Heart Foundation (BHF) and Diabetes UK were less enthusiastic.

The BHF, which had been working on all of the networks apart from alcohol, said it was not satisfied with the measures in place for monitoring the pledges and asked for more clarity on the timetable for reviewing progress and possible regulatory action that might be taken if results were not achieved.

Meanwhile, Diabetes UK, which was working on the food, health at work and behaviour change networks, also said it would not be signing up to the Deal. Diabetes UK chief executive Barbara Young said the charity was disappointed that the Deal had not been “more ambitious in its vision”, suggesting that many of the pledges “replicate existing standards”. Diabetes UK also questioned whether the monitoring and evaluation framework was sufficiently robust or independent, and said it would not sign the deal until it had been strengthened.

An important facet of these criticisms is that they are not damning of the idea behind the deal itself. Some of the scepticism around the Responsibility Deal has come from people and organisations that are highly suspicious of any corporate involvement in public health issues.

However, both Diabetes UK and the BHF were at pains to point out that they were not opposed to the involvement of industry.

Speaking to just-food, Diabetes UK spokesperson Huw Beale, said: “We agree that government, industry and the voluntary sector all have a part to play but playing our part in this means we’ve got to be critical if we don’t think it’s strong enough.”

Indeed, these groups were already engaged in the process through the networks, and have said they are both willing to remain involved in discussions.

BHF chief executive Peter Hollins said his organisation would “continue to be supportive of the Government’s strong focus on public health and engage constructively to strengthen the Responsibility Deal in any way we can”.

Beale stressed that Diabetes UK had not prejudged the idea of the Responsibility Deal when it was first announced last year, and that there was nothing intrinsically wrong with the idea of voluntary industry commitments. “We waited to see what [the pledges] were and this is our response. Anything that brings everyone together and moves this forward is to be welcomed. The actual idea of us all coming together is fine but the detail in this we don’t think is strong enough.”

It is important to note that discussion around the Responsibility Deal is rather different from the standard tit-for-tat exchanges between industry and NGOs over possible regulation. Typically in those exchanges industry backs one course of action, NGOs another and government decides. In this instance, the credibility of the central policy idea – the Responsibility Deal itself – rests on the pledges being backed by consensus.

If the Responsibility Deal is only about industry making pledges which the other stakeholders deem to be insufficient, then the danger of the Deal simply being viewed as a victory for corporate lobbying is clear.

All this leaves the food industry to ponder whether it has offered enough, and Andrew Lansley, Secretary of State for Health, whether he should have pushed industry a little further.

It is rather telling that on the page of the Department of Health website set aside for “Views on the Responsibility Deal”, there is only one comment from a non-industry stakeholder and it is the only one expressing criticism. This alone should provide the Government with a hint that the search for consensus must continue.