Why the government needs to ditch fears of nanny statism when it comes to matters of public health - Amy Gandon

New research from the Institute for Public Policy Research and Public First reveals a very different story. Far from fearing a public backlash, political leaders have an opportunity – indeed, a mandate – to take bold action on the nation’s health. Voters don’t want the government to take control of their lives, but they do want it to level the playing field – to take on junk food giants, rogue landlords and exploitative employers; to challenge the systems stacked against people and give everyone a fair shot at living well.

The report, The health mandate, draws on polling of 2,000 UK adults and focus groups in key battleground constituencies. It shows that the voters likely to swing the next election - people who moved from Conservative to Labour in 2024, and Labour voters now considering Reform – support health-focused policies even more than the average voter.

Take regulation of junk food advertising: a policy long seen as a lightning rod for ‘nanny state’ accusations, especially when the 9pm watershed was announced in 2021. Two-thirds of the public support it. Among swing voters, support is higher still. The same goes for extending smoking bans, raising housing standards and investing in early years services like Sure Start. In fact, those who voted Labour at the last election but are now open to voting for Reform UK were more likely than any other group to call for the government to act.

This should be a wake-up call for politicians. For too long, public health has been framed as a paternalistic project, at odds with public opinion. But the evidence shows that it’s the public, not the politicians, who want the government to do more. They understand that health isn’t just about willpower and individual choice, but is shaped by the world around them: the jobs they do, the homes they live in, the food they can afford, and the time they have left for anything else. Add the rising cost of living, constant work pressures, and a digital world filled with targeted advertising, and it’s no wonder staying well feels like an uphill battle. People aren’t asking for handholding – they’re asking for a fair chance.

The irony is that while political commentators obsess over backlash, what really frustrates voters is inaction. Across the focus groups, there was deep frustration that successive governments had failed to make changes that actually cut through on health. People pointed to bold interventions, like the sugar tax or plain packaging on cigarettes, as rare examples of the government doing something that made a visible difference. In polling, the public’s biggest concern about new health initiatives wasn’t their impact on personal freedoms, but whether they would work at all. In short, people don’t see the government as overbearing – they see it as absent.

This is the space where the government can act – credibly and confidently. Of course, people believe in personal responsibility: 78 per cent say individuals have a great deal of responsibility for their own health. But they also recognise the broader picture. A majority said that government, businesses and the NHS also play a major role when it comes to health. Strikingly, 84 per cent of people told us that the food and drink industry had a ‘great’ or fair’ amount of responsibility for improving the nation’s health – that’s larger than the 79 per cent of people who said the same about the NHS.

In the focus groups, people expressed a strong desire to live more healthily, but also a sense that the odds were stacked against them. Long hours and low pay left little time or energy for self-care. Healthier food was more expensive and harder to access. Renters spoke of cold, damp homes that made neighbours ill, but with no power to challenge landlords. These weren’t marginal grievances, they were part of daily life. And they point to a space where the government can intervene – with public backing – to address the conditions that make healthy choices harder than they should be.

We see this reflected in the policies that drew the strongest support: tougher standards for private landlords (80 per cent), restrictions on junk food advertising (65 per cent), investment in early years services like Sure Start (70 per cent), and higher standards for workplace health (71 per cent). These are not areas where individual effort alone can deliver change. They are structural issues – where the government not only holds the tools, but is expected to use them.

So, let’s retire the tired clichés about nanny statism. If politicians are willing to reframe action on public health not as a constraint on freedom, but as the foundation for it – to create the conditions for people to make good choices, support their families, and enjoy their lives – they’ll find the public not just receptive, but ready to reward them at the ballot box.

Amy Gandon is associate fellow at IPPR and author of The health mandate: the voters' verdict on government intervention.