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Co-Published Books
11 June 2026
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20 January 2026
https://iea.org.uk/wp-content/uploads/Inside-the-sausage-factory_Online.pdf
“Laws are like sausages. It is better not to see them being made.”
– Attributed to Otto von Bismarck
In the classic model of evidence-based policymaking, the government identifies a problem, canvasses a range of potential policies to address it, and commissions high-quality evidence from impartial academics to find the most cost-effective solution. After implementation, the government commissions independent research to evaluate whether the policy has achieved its clearly stated goal.
It is widely acknowledged that real world policymaking rarely, if ever, follows this idealised model of a rational, linear process. In democracies, politicians do not necessarily get to decide which issues take priority. Problems and their purported solutions can be thrust upon them by emergencies, media pressure, the parliamentary opposition and lobbyists from business and civil society. Nevertheless, the United Kingdom has a system of public consultations, impact assessments and post-implementation reviews which, alongside the checks and balances of academic publishing, is designed to put evidence at the heart of policymaking.
The aim of this book is to examine the role of evidence in public health policymaking in the United Kingdom. It examines four case studies between 2008 and 2018: plain packaging for tobacco, the Soft Drinks Industry Levy, minimum pricing for alcohol, and the stake reduction for fixed odds betting terminals (FOBTs). With the exception of minimum pricing, which was introduced in Scotland but not England, the campaigns for all four policies succeeded and were said to be evidence-based.
To assess which pieces of evidence were most influential in each policy debate, a quantitative analysis was conducted to examine the documents cited by government departments and agencies, politicians and the media during the course of each campaign, using the online archives of five major media outlets and the transcripts of fourteen debates in the House of Commons. In each case (although more weakly in the FOBT debate) there were ‘superstar’ studies which dominated political and media attention. All of them supported the policy proposal and they combined to produce ‘packages of evidence’ which appeared to show (1) how the policy would work in theory, (2) how a similar policy had recently worked in another country, and (3) that experts believed the policy would succeed.
Following a qualitative analysis of the packages of evidence and a retrospective evaluation of the policies, I identify a series of significant deviations from the classic model of evidence-based policymaking which suggest that the decision to proceed with the policy (or abandon it) was, in every case, not primarily, or even largely, dictated by a dispassionate review of high-quality research evidence.
Further analysis indicates that, in contrast to many case studies in the political science literature, the policymaking process was dominated by small, paternalistic interest groups who achieved their policy aims in a relatively short period of time without having to make any major compromises. None of the policies were formulated within government and none of them had been priorities for the government or the electorate at the outset of the campaigns.
Using insights from public choice theory, I conclude that the behaviour of virtually all the policy actors, including politicians, the general public and professional lobby groups on both sides, can be explained by the pursuit of
‘thick-rational’ self-interest. Ambivalent policymakers responded to political pressure from concentrated interest groups who used research evidence as one of several devices to generate publicity for their campaigns. Consumers who would be adversely affected by the policies had insufficient incentive to mobilise in their collective interest and non-consumers had no obvious reason to oppose policies that offered the possibility of a marginal benefit. Seeing little public opposition, the government considered the reputational risks of inaction to be greater than the risks of proceeding with policies that were broadly revenue-neutral or, in the case of the sugar tax, revenue-raising.
– Attributed to Otto von Bismarck
SUMMARY
In the classic model of evidence-based policymaking, the government identifies a problem, canvasses a range of potential policies to address it, and commissions high-quality evidence from impartial academics to find the most cost-effective solution. After implementation, the government commissions independent research to evaluate whether the policy has achieved its clearly stated goal.
It is widely acknowledged that real world policymaking rarely, if ever, follows this idealised model of a rational, linear process. In democracies, politicians do not necessarily get to decide which issues take priority. Problems and their purported solutions can be thrust upon them by emergencies, media pressure, the parliamentary opposition and lobbyists from business and civil society. Nevertheless, the United Kingdom has a system of public consultations, impact assessments and post-implementation reviews which, alongside the checks and balances of academic publishing, is designed to put evidence at the heart of policymaking.
The aim of this book is to examine the role of evidence in public health policymaking in the United Kingdom. It examines four case studies between 2008 and 2018: plain packaging for tobacco, the Soft Drinks Industry Levy, minimum pricing for alcohol, and the stake reduction for fixed odds betting terminals (FOBTs). With the exception of minimum pricing, which was introduced in Scotland but not England, the campaigns for all four policies succeeded and were said to be evidence-based.
To assess which pieces of evidence were most influential in each policy debate, a quantitative analysis was conducted to examine the documents cited by government departments and agencies, politicians and the media during the course of each campaign, using the online archives of five major media outlets and the transcripts of fourteen debates in the House of Commons. In each case (although more weakly in the FOBT debate) there were ‘superstar’ studies which dominated political and media attention. All of them supported the policy proposal and they combined to produce ‘packages of evidence’ which appeared to show (1) how the policy would work in theory, (2) how a similar policy had recently worked in another country, and (3) that experts believed the policy would succeed.
Following a qualitative analysis of the packages of evidence and a retrospective evaluation of the policies, I identify a series of significant deviations from the classic model of evidence-based policymaking which suggest that the decision to proceed with the policy (or abandon it) was, in every case, not primarily, or even largely, dictated by a dispassionate review of high-quality research evidence.
Further analysis indicates that, in contrast to many case studies in the political science literature, the policymaking process was dominated by small, paternalistic interest groups who achieved their policy aims in a relatively short period of time without having to make any major compromises. None of the policies were formulated within government and none of them had been priorities for the government or the electorate at the outset of the campaigns.
Using insights from public choice theory, I conclude that the behaviour of virtually all the policy actors, including politicians, the general public and professional lobby groups on both sides, can be explained by the pursuit of
‘thick-rational’ self-interest. Ambivalent policymakers responded to political pressure from concentrated interest groups who used research evidence as one of several devices to generate publicity for their campaigns. Consumers who would be adversely affected by the policies had insufficient incentive to mobilise in their collective interest and non-consumers had no obvious reason to oppose policies that offered the possibility of a marginal benefit. Seeing little public opposition, the government considered the reputational risks of inaction to be greater than the risks of proceeding with policies that were broadly revenue-neutral or, in the case of the sugar tax, revenue-raising.
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