Conclusiones

The government documents, published by successive administrations, overtly acknowledged evidence, which shows that responsibility for healthy diets lies beyond individuals’ choices, and that ‘choice’ is determined by economic, environmental and cultural factors. Indeed, the overarching rhetoric is one of

collective responsibility because of environmental factors that can override individuals’ agency over food choice. Yet, as earlier sections in this chapter have described, such rhetoric is ignored in practice, where public health

interventions emphasise that individuals are expected to make healthy choices because they are given more information, and wider ranges from which to make choices (see sections 4.3.3 and 4.4.2). This ignores the governments’

persistent recognition of the robustness of Foresight, which states:

the evidence presented in this report provides a powerful challenge to the commonly held assumption that an individual’s weight is a matter solely of personal responsibility or indeed individual choice (F p122).

So there was recognition of the challenges that individuals face, and of collective responsibility, involving national and local government, civil society and business as well as individuals. Yet strategies fail to show a commitment to changing the “modern world” of appealing, ubiquitous, cheap food (HLA p19).

Rather the government’s aim was: “to determine the least intrusive approach possible” (HLHP p23) in relation to choice, using methods as low down the so-called ‘ladder of interventions’ (Figure 4.5) as possible (HLHP p29), thereby reinforcing the discourse of individual responsibility to make healthy choices.

Figure 4.5: Nuffield ‘ladder of interventions’

Graphic source: Healthy lives, healthy people (2010) p30 Based on original source: Nuffield (2007) p42

The ladder was designed by the Nuffield Council on Bioethics as an illustration of what it called its ‘stewardship model’ of public health. Nuffield does not suggest that interventions should, by default, start at the bottom of the ladder.

Yet HLHP’s “least intrusive approach”, on the low rungs, permeated the PHRD, exemplifying an ideology that equates “the freedoms of individuals and organisations” (HLHP p28); and disguising the prioritisation of commercial freedom over the freedom of individuals from commercial power. It also reinforced the discourses of individual responsibility and minimum industry regulation, disregarding commitments to actions based on evidence, and acknowledgments that diet is best improved by environmental, collective measures. Additionally, the “ladder” is a very particular, linear approach to interventions, which does not account for the complexity of the food environment.

This chapter section has illustrated the often-subtle discourse of the hegemony of market freedom in the analysed reports, underpinned by the neoliberal ideology that drives government rhetoric: industry remains free from policies that could meaningfully help individuals eat more healthily. Simultaneously, government hails individuals’ “freedom” of choice, while underlining their responsibility for reigning in that freedom within a food environment that

“makes it harder for us to make healthy choices” (HLA p18). Additionally, the dissociation between listed determinants of poor diets and the proposed remedies is clear on close scrutiny of the documents. As such, the subject position of government is superficially one of a responsible leader, proposing solutions to diet-related public health problems. Yet, the dominant discourse that repeatedly comes back to individual responsibility in effect casts

government in the role of a non-interventionist guide, prioritising the corporate sector, rather than an enforcer of measures that are more likely to benefit the public’s health. This discursive contradiction illuminates inconsistencies of this subject position. Such inconsistencies are the rhetorical gaps through which

‘responsibility’ dissipates in the overarching narrative of market-situated individual choice.

4.6 Summary

Scrutiny of the documents confirmed that the discourse of responsibility is centred upon the actions and interactions of three main, discursively

constructed groups of actors: ‘government’, ‘corporations’ and ‘individuals’. As shown in the literature review, the terms ‘individuals’ and ‘members of the public’ are often used interchangeably – the discursive significance of this will be explored in section 5.1. By far the most encumbered with responsibility of the three groups were ‘individuals’, who were presented as the public-at-large, as a set of autonomous, rational consumers who must navigate the ‘complex’

food system via their food choices. Corporations were presented as a largely undifferentiated group of food producers, retailers and marketers who have their part to play in providing ‘healthy’ foods, but who must also give their customers, ‘individuals’, what they want and provide a range of ‘choices’. The documents presented the food industry as a willing “partner” in public health measures, ostensibly committed to responsible practices that help individuals make healthy dietary choices. Government was consistently referred to as the various state agencies whose job it is to promote public health and to thereby regulate the market system within which corporations and the public interact. It was depicted as responsible for diet-related public health by guiding business practices and “empowering” individuals to eat well. On closer scrutiny a subtler distribution of responsibility emerged.

In examining the portrayal of measures that constitute governmental and corporate responsibility, many of them transpired to implicitly shift responsibility to individuals; and to reinforce and perpetuate the subject position of ‘individuals’ when describing the general public. An analysis of the discourse and the content of the documents revealed that depictions of

responsibility for a ‘healthy’ diet were somewhat obscured by a diverse range of rhetorical devices around the concept of responsibility. Complexity featured as a notable theme within this, partly as a descriptive term for the nature of the food system but also as a characteristic of the task to improve the population’s

diet. It also served to spin a web of apparent confusion and inertia around the clear understanding of determinants and solutions to diet-related illness.

Additionally, “complexity” obscured a discourse of individual responsibility by deflecting from the absence of any truly systemic changes and by diluting government or corporate responsibilities in the complex food system. Indeed, inconsistencies emerged between the acknowledged complexity of the issue and the incommensurately simplistic solutions such as package labelling.

The discourse of responsibility and the actors and interactions that inhabit it were described in the context of neoliberal market relations, albeit mostly implicitly. These were presented as buyers (the public) and sellers

(corporations) of food, leaving the role of government somewhat incongruously on the sidelines. Not only was this in line with neoliberal governance,

prioritising individualism and market growth (Schrecker & Bambra 2015), but also biopolitical ideology whereby individuals are expected to be actors who

“conform to the idealized figure of the healthy and responsible citizen”

(Greenhough 2014). As a consequence of this market-orientated, neoliberal framing, the public, as a consumers, was constructed as all-powerful and autonomous, while the corporations were positioned as reactive providers of choice, bound by the market system within which they operate. However, this framing is shown to be at odds with the power these corporations exercise over government; and it serves to obscure their role as architects of the food system, and as determinants of ‘choice’.

The analysis also revealed that many of the government proposals to improve public health had ideological, neoliberal foundations such as a focus on individualism, minimal state involvement, and a reluctance to regulate the practices of the food industry related to health beyond existing safety

standards. This was couched in the discourse of “freedom” both for members of the public (of choice) and corporations (from regulation), yet this seemingly appealing concept masked a tension between such freedom and the

responsibility it appears to carry. Neoliberal values were evident not only in the

rhetoric but also in the inconsistencies between the purported determinants of poor diets and the proposed solutions. As such, many proposals ultimately left responsibility with the general public rather than subjects in a position of power in the food system, even if only implicitly.

This approach revealed an ideology that permeated the responsibility discourse:

while government and the food industry literature represented their respective roles as those of responsible actors in the food system, there was a reluctance to take measures that could restrict principles of free market economics. The discourse of individual responsibility throughout the documents “influences how ideas are put into practice and used to regulate the conduct of others”

(Hall 2001a, p.72). Its persistence therefore serves to discursively form a

“regime of truth” whereby the “truth” that individuals are responsible for their diets, whatever the condition of the food environment “is produced only by virtue of multiple forms of constraint. And it induces regular effects of power”

(Foucault 1984, pp.72–73). Thus – in a collaboration of corporate and political biopower – rather than government effectively governing market practices with public health in mind, responsibility falls on individuals to pursue the

“imperative of health” by navigating a food environment that optimises commercial goals.

The subtlety and pervasiveness with which the discourse of individuals’

responsibility for their diets in the public health-food system axis was reiterated throughout the documents had “strongly coercive elements in that [they] set out to shape and normalize human behaviours in certain ways” (Lupton 1995, p.10). So, finally, even references to corporate and government responsibility, persistently deflected ultimate responsibility for healthy eating back to

individuals.

Chapter 5