Analysing public debates, to support productive engagement with politicians and stakeholders

ISSUE: UK public health debates have become highly politicised. Sean Sinclair (SCS) conducted 37 semi-structured interviews with public health professionals to understand how this affects their engagement with stakeholders. Interviewees said it has become more difficult to gain stakeholder support for public health policies. They hypothesised that politicians didn’t listen to evidence regarding health outcomes. SCS counter-hypothesised that debates are not always about facts, but sometimes about values. If a politician's main concern is, say, economic growth or personal responsibility, then evidence of health outcomes will not address their concerns. SOLUTION: To understand people's values, SCS analysed UK public debates about four contentious issues: vaccine passports; lockdown; healthy living advice; and Prep (the HIV prophylactic). SCS used the techniques of argument analysis used in analytic philosophy, ensuring the structure of arguments was transparent, and so amenable to assessment. RESULTS: From the analysis, SCS developed a conceptual toolkit to allow public health professionals to analyse what motivates politicians from different points on the political spectrum. They can then tailor their evidence to show how a policy will deliver on a politician's concerns, or tweak the policy to mitigate the features that trigger scepticism. To assess the material, SCS presented it to public health professionals in qualitative discussion groups. Feedback indicated that it will help them engage more effectively with stakeholders, eg: ‘Makes me think about what argument might be most impactful, rather than my instinctive response.’ LESSONS: In any country that is politically divided over public health policy, this method can reveal new ways of arguing for policies, eg by appealing to a politician's own values. SCS has developed the expertise to help develop similar analyses in other countries. KEY MESSAGES: • In any country that is politically divided over public health policy, it can be difficult to gain stakeholder support for policies. Analysing public debates builds understanding of people's concerns. • This method can reveal new ways of arguing for policies. Public health professionals can tailor the evidence they present to show how a policy will deliver on each politician's concerns.