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In 2007, the English Department of Health (DH) issued advice stating 'pregnant woman' and 'those trying to conceive' should abstain from drinking alcohol. As others have noted, this advice was issued despite their being no new evidence about the deleterious effects of low levels of alcohol consumption. In this paper, we argue this development is significant for the social construction of 'risk', since in advocating abstinence without an evidence base for this advice, policy makers formalise a connection between uncertainty and danger. We suggest this development has important implications, most obviously for pregnant women, certainly impacting on the nature of the advice they will now receive and likely more generally on their experience of the transition to motherhood. We suggest it has wider implications for individuals' experience also, as policy makers appear to be advocating the same approach to risk to non-pregnant people. Further, it suggests a noteworthy formalisation of a new definition of risk, which should be debated far more extensively, as it matters for the future development of health policy. [ABSTRACT FROM AUTHOR]

A new Labour government was elected in the UK in May 1997 with a strongly stated commitment to improving public health and tackling inequalities. This focus on public health was part of a concerted attempt to tackle poverty and social exclusion through 'joined up thinking' across central government. Thus health inequalities were to be tackled 'upstream' through wider government initiatives. Fundamental to the government's policy has been the development of public health capacity, including a more multi-disciplinary public health workforce and greater partnership working at local level. Improving public health is a long-term project, however, and politicians' decisions are often driven by short-term election cycles. Midway into its first term, the government published The NHS Plan which re-focused policy attention on the problems of the health care system. As the 2001 election approached, the government launched Shifting the Balance of Power, a major re-organization of the English NHS with the intention of improving the 'delivery' of health care, but which also had profound implications for the public health function. This paper argues that UK government policy towards public health has been characterized by continuing and fundamental tensions. Far from empowering public health practitioners, these tensions in central policy have contributed to practitioners' uncertainty about their roles, and how they can meet the centre's increasing demands for demonstrable 'delivery'. The implications are considered for building capacity in the UK and for a wider systems understanding of capacity issues. [ABSTRACT FROM AUTHOR]

While there are important differences between the public health policies of Conservative governments of the 1980s and 90s and the current British Labour government a significant element of continuity is the emphasis on government facilitating informed choice by consumers as a key public health objective. The article considers such approaches to disclosure of health risks with respect to policy on the regulation of smoking. It argues that regulation, in this area, under the Conservatives has not served to ‘empower’ consumers and that such regulatory weaknesses appear to be replicated under its successor. Defects in regulation are traced with respect to disclosure of information on tar and nicotine ‘yields’; and cigarette design with respect to tip ventilation and the use of additives to increase nicotine delivery. It is argued that lack of disclosure and insufficient controls on the industry have led to consumers being misled concerning the relative risks of different types of cigarette. Equally, it is also likely that such deficiencies have enabled manufacturers to represent some cigarette types as ‘safe’. The paper concludes by arguing that, while the weaknesses of the current regulatory regime suggest the need for measures of increased disclosure and control of product design, there is also an unresolved tension as to whether ‘empowerment’ is an intrinsic goal of policy or a means to the achievement of public health targets. [ABSTRACT FROM AUTHOR]