The following section is set out according to the broad, yet distinct categories in Kingdon’s Multiple Streams framework: problems; policies; and politics. The article focuses on events and decisions taking part in each of these ‘streams’ before considering how these factors have converged to make a ‘policy window’ for increased support and investment in walking promotion in England.
The problem stream
Walking levels in England have been in decline since the mid-1970s and this reduction in walking has been accompanied by an increase in car use . The consequences of this shift include reduced overall physical activity levels, increased traffic congestion, and higher levels of carbon emissions. The problems associated with low levels of walking have been recognised by several well established interest groups/organisations, which formed a key focus of the empirical research. These types of interest groups play an important role in nearly every aspect of health policy, from bringing issues to the attention of government, proposing new policy options, and building pressure for action .
It is imperative that issues are defined in a way which will attract political interest. According to Weiss , issue definition is concerned with the organisation of a set of facts, beliefs, and perceptions, or ‘how people think about circumstances’. The way in which an issue is ‘packaged’ determines how it is perceived by both policymakers and the public and thus can impact upon the agenda-building process . ‘Symbols’, which can be described as “objects to which people attach political significance”, are used to attract attention to an issue, to define an issue in a specific way, and to mobilise support for specific policy options over others . The issue of walking promotion has been defined or ‘packaged’ in three primary ways: as a health issue; a transport issue; and as an environment issue; and this has impacted on how responsibility for walking promotion has been dealt with by the government. A senior staff member from the Ramblers stated, for example:
“I think it has been spread between transport and health and environment… and it’s kind of shifted and moved around depending on whether you’re talking about the countryside or whether you’re talking about urban walking, or obesity or issues like that” (London, May 2012).
Sometimes recognition that a problem exists is sufficient for the problem to make it onto the political agenda; however there are usually many problems competing for recognition, meaning that only a fraction of them make it into the formal process of political deliberations. Which problems receive government attention is often influenced by ‘policy entrepreneurs’ [23, 31]. These entrepreneurs are highly motivated individuals who seek to raise the profile of an issue among both government officials and the general public. Policy entrepreneurs typically hold positions of leadership within relevant interest groups and are usually well connected politically. The main roles of an entrepreneur are to define and reframe problems, advocate new ideas, specify policy alternatives, broker ideas among policy actors, mobilise public opinion, and help set the decision-making agenda .
There have been several long standing advocates for walking promotion, who have been instrumental in bringing the issue to the attention of government and for encouraging political action. These include Dr William Bird, a general practitioner who was instrumental in the establishment of the national led walk program Walking for Health, and Sir Muir Gray, who has held several senior positions in preventive health and has been described as a “a ceaseless champion of walking as a means of tackling obesity and inactivity” . A former employee at DH reflected on the powerful influence of these types of policy entrepreneurs:
“They can walk the talk. They brought good examples of what was happening elsewhere… you talk about people being influential and stuff like that. It's a fact of life that certain people will like other people and listen to what they say. And it happens more than you could ever believe in terms of someone having the ear of a Minister” (London, July 2012).
The lobbying efforts of these policy entrepreneurs have been facilitated by several factors including growing research evidence on the health benefits of walking [9, 10] and prevalence data on rising levels of inactivity, for example from the ‘Allied Dunbar Fitness Survey’ , and more recently the Health Survey for England [5, 35]. One of the biggest challenges for these policy entrepreneurs, however, has been to convince policymakers that walking promotion legitimately falls within the government’s remit. There is a long history of policy in England which emphasises the importance of individuals taking responsibility for their own health behaviours. For example, Saving Lives: Our Healthier Nation , identified behavioural risk factors such as smoking and physical activity as an individual responsibility and beyond the remit of the government. Even some of the more recent policy documents, including Healthy Lives, Healthy People—A Call to Action on Obesity in England , emphasise the need for individuals to take responsibility for their own health by making healthier lifestyle choices. Therefore the challenge has not only been to convince the government of the magnitude and consequences of the problem of low walking levels but also to convince them that dealing with the problem is a government responsibility.
An additional barrier to walking promotion, which was expressed by representatives from both DH and DfT, is the perception that walking is such a simple behaviour that the general public will not view walking promotion as sufficiently complex or necessitating high level expertise, to warrant political attention, and thus this will not be considered an appropriate use of scarce government resource. This sentiment is captured by the following quote from a senior government official:
“Governments can feel a little foolish promoting walking in a sense that it's a Daily Mail headline—Government tells people to walk!—Government gives people lessons on walking! Suddenly you can be ridiculed because it’s such a natural thing to do” (London, April 2012).
The policy stream
The linking of solutions to policy problems is thought to increase the chances of gaining political attention and support for an issue. Having pre-formulated policy solutions can increase the government’s confidence that there are appropriate solutions to the identified problem and thus that the problem can be dealt with in a timely fashion without the need for drawn-out political deliberations on appropriate policies. Therefore once one or more problems are identified, ‘policy communities’, consisting of experts in the area, try to affix solutions to the problem, usually driven by their own values and interests .
Each of the key walking organisations has conceptualised different policy solutions, including led walk schemes, infrastructure changes to improve the environment for walking, and resources such as websites and maps. Multiple Streams theory holds that the survival of ideas and solutions in the policy stream is determined by three factors.
First, the degree of technical feasibility, which relates to how easily a theoretically sound idea can actually be translated into practice. Ideas that can make the transition from theory to practice with the least difficulty are thought to stand a better chance of survival.
Second, survival is determined by whether solutions are widely supported by a range of specialists within the policy community. The more wide-spread support there is for a policy solution, the greater the likelihood that the solution will be adopted.
The third factor relates to budgetary implications, with less costly solutions often receiving a greater level of support from policymakers .
In recent years two walking programmes have received substantial government resource; Natural England’s Walking for Health programme and Walk England’s Walk4Life Miles project, which received £3 million and £1.4 million respectively from DH in 2008. Natural England’s Walking for Health programme is a led walk initiative, established in 2000. Walking for Health had already expanded into a national programme and in 2010 the programme consisted of over 600 local schemes, all of which were delivered by a network of over 11,000 trained volunteers . This programme, in many ways, met Kingdon’s proposed criteria for survival within the policy stream. Walking for Health had a proven track record of feasibility, the programme had widespread support from various stakeholders (and particularly Dr William Bird), and it could be delivered at relatively low cost due to the engagement of a large network of (existing) volunteers.
Walk England’s Walk4Life Miles project was a new initiative which would involve setting up 2012 one mile sign-posted walking routes across the country. It was envisaged that the one-mile routes would be safe, attractive, and connected to where people live, and that people would be able to use the miles to test their fitness, using the principles of the Rockport One-Mile Walk Test . The aim of the project was to get 30,000 people to improve their fitness and sustain an increase in physical activity . The simplicity of this intervention would facilitate judgements of feasibility and cost and, although there was not wide spread support for the initiative from the walking sector as a whole, it was lobbied for fiercely by Walk England, as illustrated by the following quote:
“I found out that Walk England had snaffled a million quid… the reason that happened was that [they] never got off the phone from [the Department of Health]. They badgered, badgered, badgered, badgered and badgered. And just badgered [the Department of Health] so badly that in the end that’s what happened” (London, May 2012).
Although the ‘evidence-based policy movement’ has sought to promote the rigorous analysis of policy options in order to improve decision-making [42, 43], the findings of this research lend support to Head’s suggestion that policy development is often based more on politics and professional judgement, rather than on research evidence alone , and highlights the influence that key ‘policy entrepreneurs’ can have in the decision making process.
The politics stream
The politics stream relates to the political ‘mood’ and openness to change based on the current political climate [22, 23]. Clearly a range of factors such as impending elections, a change in government, and interest group activity can lead to the inclusion or exclusion of different topics on the political agenda, as well as influencing how these problems are perceived by the electorate and policymakers, and how potential solutions are evaluated.
In July 2005 it was announced that London would host the 2012 Olympic and Paralympic Games. Subsequently DCMS released Before, During and After: Making the Most of the London 2012 Games , which outlined the Government’s intention to make the UK a world-leading sporting nation. However a key feature of both the bid and the subsequent policy was the promise of delivering a ‘physical activity legacy’ which would inspire population increases in sport and physical activity, or, as one interviewee summarised it, political interest in physical activity and walking promotion was bolstered by the world’s largest sports mega-event: “The driver, I would say, was the Olympics, because funding was allocated to help meet that target” (London, July 2012).
Specifically this policy identified the target of getting two million more people ‘active’ by 2012, and committed to investing £7 million into walking promotion as a key approach to achieving this target. Interestingly, the basis of this legacy is the belief that elite sport success can act as a catalyst for increased physical activity and sport participation among the masses; a belief that has little evidence from previous sports mega-events [44–47].
The ‘policy window’
At key points in time the three streams outlined above are joined together: a problem is recognised, an appropriate solution is identified, and the political ‘mood’ is right for the government to embrace and drive forward policy change. This confluence of the three streams is referred to by Kingdon as a ‘policy window’.
The success of London in securing the 2012 Olympic and Paralympic Games was the primary trigger in the creation of a policy window for walking promotion in recent years. The profile of hosting this mega-event meant that political interest was high, and the subsequent promise of delivering a physical activity legacy provided a ‘problem’ in that the government were now required to provoke large scale increases in physical activity [21, 48]. Time and resources were allocated to delivering this target and thus the government were seeking appropriate policy solutions in which to invest. A former employee at DH recollected on this situation:
“We had a target to meet and we had to get two million people active so we had to find programmes that would do that and it was very clear that the biggest potential was in walking. I think what possibly wasn’t clear was what the right interventions were” (London, July 2012).
Therefore, the role of interest groups and policy entrepreneurs was to identify appropriate policy solutions and to convince the government of their value. Two organisations were successful in this endeavour, Natural England and Walk England.
A key feature of the policy window however, is that as quickly as it opens, it may close, due to other competing agendas or simply a change in the political ‘climate’. In May 2010 there was a general election and a change in government. When the new government came into power, the UK (and the rest of the world) was in the midst of an economic recession. In an attempt to address the economic crisis the coalition government undertook a review of non-departmental public bodies, including Natural England. The review concluded that Walking for Health was peripheral to Natural England’s core objectives and was not something that it should be delivering. A competitive tendering process ensued and in March 2012, the Ramblers took over the coordination of the Walking for Health programme .
In addition, there was a Treasury review of the public spending commitments made by the previous government between 1st January 2010 and the General Election . This review examined £34 billion of spending that was approved during the previous government’s final few months in office. The aim of the review was to assess whether these commitments were affordable, whether they would deliver value for money, and whether they were considered a priority for the new government. In total 12 projects were cancelled because they were deemed unaffordable and not a government priority, one of which was Walk England’s Walk4Life Miles project. This is an example of the ‘window of opportunity’ closing due to a change in politics.