Is the Green paper a missed opportunity?

THE  UK Government has recently published a green paper on improving public health and preventing disease. A green paper is a consultation document produced by the Government. It proposes policy ideas and targets for public health that people both inside and outside of the Government can feed back on. The paper was released quietly, without a press release and for many people it could have been easy been missed...  So this is what it was all about, in short...

► What is public health and prevention?

Public health is the science of preventing disease and helping the population to live as well as possible. Public health specialists work to understand diseases and act to help prevent them. In some places this may be working to prevent infectious diseases like Ebola. In other places, like the UK, the emphasis may be on other conditions such as cancer or diabetes. Examples of public health interventions are vaccinations and taxes on sugary drinks.

This green paper comes at a time where public health budgets have been cut over several years and there has been a change in prime minister, possibly leading to a change in priorities. Increases in life expectancy have slowed to a standstill in some groups and inequalities in health are growing.

► What is in the green paper?

The Government have used the green paper to lay out some targets for public health over the next 10 years. These include the aims to make Britain a smoking free country by 2030 and to go further in reducing childhood obesity. There are also targets surrounding gene science. The Government wants to screen more people for more conditions and use genetic testing to make this personalised.

► Is the green paper a missed opportunity?

But many argue that the green paper is a missed opportunity and does not go far enough. The paper reports that 50% of the impact on people's health comes from the social and economic conditions that they live in. This requires an approach that goes beyond the NHS and public health. Austerity, changes to the benefit system and cuts to social care have impacted peoples physical and mental health. These problems cannot be solved with simple solutions. The proposals in the green paper are not likely to be effective without broader changes across Government departments known as:- "health in all policies." The paper does acknowledge this and talks about changes to housing and transport. But it does not go into detail or discuss cuts to local Government funds and public health services.

► What does this mean for pancreatic cancer?

Pancreatic cancer sometimes occurs out of the blue and cannot always be prevented. If the Government carries out measures to analyse the genomes of up to 5 million people, it could mean that more people are screened for the disease. This may help to increase early diagnosis.

Other areas of the plan could also affect pancreatic cancer. There are some factors that increase your chances of getting the disease and smoking is 1 of the most important. If the Government could bring smoking rates down to zero by 2030 it could eliminate around a quarter of cases of pancreatic cancer that are thought to be caused by it.

Measures to reduce obesity may also impact pancreatic cancer. It is thought that slightly over 10% of cases are down to excess body fat. Measures to stop advertising to children and increase the accessibility of healthy foods could lead to a reduction in cases.

It is, however, unlikely that these measures will be effective without addressing the wider causes of ill health. These have led to the poorest people living shorter lives in worse health than the rich. In terms of pancreatic cancer, some groups are diagnosed later than others. This means that their cancer is more likely to have spread and affects their treatment options. Prevention needs to reduce this inequality for patients and give everyone the best possible chance of survival.

Gulf between UK fracking industry and public opinion laid bare as less than 1 in 10 people say regulation of shale gas extraction is too strict

A major new public attitudes survey on fracking highlights the gulf between public opinion and those in the UK energy industry and Government hoping to persuade communities to support shale gas as a viable alternative energy source. People have low trust in the energy companies involved and want decisions taken at a local level.

The 'UK National Survey of Public Attitudes Towards Shale Gas' (Research Briefing attached) conducted by academics, at 5 Universities, and jointly funded by the Natural Environment Research Council and Economic and Social Research Council, shows very little public support for relaxing the rules and regulations around fracking;  a key demand of major shale gas extraction companies like Cuadrilla and Ineos.

The independent survey shows only 8% of people in the UK think that the:- 'Traffic Light System' currently used to monitor and regulate seismic activity during fracking is too stringent and just 22% support the UK Government regulator changing the threshold of seismic activity at which hydraulic fracturing must cease from 0.5 to 1.5 magnitude.

These will be challenging results for those calling on the industry regulator, the Oil and Gas Authority, to relax the rules and regulations around fracking. At the start of July 2019, energy firm Cuadrilla announced that fracking will resume at its Lancashire site, with an expressed aim to support a technical review to raise the seismic operating limit. The drilling at the Lancashire site has been halted on several occasions due to underground tremors. Currently any tremor measuring 0.5 magnitude or above means fracking must be temporarily stopped while tests are carried out.

Francis Egan, Cuadrilla Chief Executive is just 1 industry leader calling for the tolerance on earth tremors to be lifted and pointing to limits of between 2.5 and 4 magnitude elsewhere in the world. In April, Natascha Engel, quit as commissioner for shale gas after only 6months, claiming that a:- "perfectly viable industry is being wasted" and policy was being driven by:- "environmental lobbying rather than science." Ms Engel said the industry was being damaged in the UK by the refusal to review the limit for earth tremors caused by fracking.

The energy companies and advocates for shale gas though are not convincing the wider public. While 48% of people oppose changing the threshold of seismic activity at which hydraulic fracturing must cease, 31% said they didn't know and the same number said they didn't know if the:- 'Traffic Light System' was too stringently or loosely regulated.

The main sources for information about shale gas extraction are from environmental non-Governmental organisations such as:- Friends of the Earth, Greenpeace, the National Trust, and Campaign for the Protection of Rural England with 48% using this source 'sometimes' or 'often.'

Only 12% of people said they trusted shale gas industry groups or firms to provide information about fracking and only 11% said they want the UK Government to make the decisions about shale gas extraction sites. 41% of participants want decisions for planning consent to be taken at the local level (eg Council planning).

The most trusted sources of information are the British Geological Survey (61%) and University scientists (59%), supporting the need for further independent research into the environmental impact of shale gas extraction.

Professor Patrick Devine-Wright from the University of Exeter and the Principal Investigator on the dynamics of public attitudes to shale gas project says:- "It is clear from the public attitudes survey that people lack trust in the shale gas industry. While some people have already made up their minds, many others are unsure about specific details or policies. This indicates a need to provide better quality information and scientific evidence that people can trust. The UK energy industry and Government must address these public concerns and lack of trust about shale gas extraction. Community engagement and support is vital to tackle the environment and climate emergency and we will not make progress unless people feel they can trust the information provided or have a voice in decision-making."

The survey shows that overall opposition to shale gas extraction currently stands at 56% with 32% in support and 12% said don't know. Shale gas as an energy option for the UK is currently only slightly more supported (31%) than Russian pipeline imports (24%) compared to 70% for UK offshore gas fields, 59% for UK onshore drilling without hydraulic fracturing and 50% for European imports.

Dr Darrick Evensen at the University of Edinburgh who led on the survey says:- "This is the most comprehensive and rigorous study of public attitudes on shale gas extraction in the UK to date. Due to this being a longitudinal survey, we will be able to track how public support changes over time at national, Regional and local levels, and the relationship between support and key issues, such as trust and perceptions of regulations that govern the fracking industry. We will conduct a further survey in 2020 to investigate opinion change over time amongst the same participants. We also intend to investigate how social media affects public attitudes to shale gas and conduct local case study research in communities directly impacted by proposals for exploratory drilling."

The Government's own public attitudes survey on energy shows opposition to shale gas extraction at its highest levels since 2014 due to concerns about destruction of the natural environment, risk of earthquakes and safety. (Department for Business, Energy and Industrial Strategy Public Attitudes Tracker, March 2019 - Wave 29)

In the UK National Survey of Public Attitudes 2019, the Government's Sovereign Wealth Fund is shown to have little impact on public support for fracking. The fund was designed to ensure revenues generated by shale gas extraction would benefit communities in the north of England where the main sites for fracking have been identified. In the public attitudes survey, 65% of respondents did not change their opinion of shale gas extraction following presentation of information about the Treasury's Sovereign Wealth Fund, whilst 15% became more supportive. 20% of participants actually became less supportive of shale gas extraction following the presentation of information, suggesting that the SWF may be perceived to be a bribe by these people.

Patrick Devine-Wright says:- "The UK Government has put more emphasis on a policy that offers direct financial benefits to shale gas communities to secure their support, rather than giving them a strong say in the decision making process about whether shale gas drilling should go ahead. Our findings show, for the 1st time, that only a small number of people (15%) are swayed by this incentive, and some people actually become more opposed to shale gas extraction. These findings provide much for both the shale gas industry and Government to reflect on, in particular why there is so little public trust in industry and how we can build a sustainable energy strategy that has the support of society as a whole."

The UK National Survey of Public Attitudes 2019 is part of part of the Unconventional Hydrocarbons in the UK Energy System Programme to improve the understanding of unconventional hydrocarbon development in the UK. The overarching objective of the research programme, jointly funded by the Natural Environment Research Council and Economic and Social Research Council, is to significantly improve the scientific evidence base on shale gas as a potential energy resource for the UK as well as develop our understanding of the governance, public and political support and impact on wider society.

The ASSIST (Attitudes to Shale gaS In Space and Time) project aims to shed light on how public attitudes and community responses to shale gas unfold over time at national, Regional and local levels. It is led by academics at Exeter, Stirling, Edinburgh, Heriot Watt and Cardiff Universities. The survey was led by Dr Darrick Evensen (University of Edinburgh) with contributions from the project team, and carried out by YouGov using an online panel with 2,777 participants broadly representing the population of England, Wales, Scotland and Northern Ireland.

More information is available online at:- UKUH.Org.

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