Just a few years ago the idea of behaviour change as a goal of policy might have seemed vaguely sinister, and to some people it still is. But starting with the 2004 report on changing behaviour from the Prime Minister's Strategy Unit, this concept in its various forms has become a central part of social and public policy debate.
Yet the goal of all policy is at some level to change behaviour, so why has this idea taken on such significance and is it at all useful as a frame for developing and evaluating policy?
The emphasis on behaviour change can be seen to reflect the pursuit of different (in practice, overlapping) objectives. Despite rising public spending in the post-war decades, key social problems persisted and new ones emerged.
Defenders of welfare provision faced a crisis of legitimacy. In particular, welfare recipients were widely portrayed as becoming dependent, and sometimes exploiting their status.
In response to this, modernising progressives sought to re-legitimise welfare, a strategy summed up in Bill Clinton's promise to provide a hand-up, not a hand-out. This theme was taken up by New Labour in the New Deal programme, which made explicit that those rejecting the routes to employment and training offered would see welfare benefits withdrawn. This idea of conditionality is a subset of a wider communitarian commitment to rights and responsibilities going hand in hand.
It is now conventional for any announcement about new or additional provision to the public (especially the disadvantaged) to be accompanied by a strong statement about the conditions attached. Conditionality is not just about legitimacy. It is often argued that those to whom it applies also benefit; the disadvantaged need clear signals and incentives if they are to try to improve their lives.
But as well as applying to a strata of society, behaviour change has extended into a set of behaviours (often but not always legal) deemed too destructive to the individual and society. Thus behaviour change has become a key objective of public health and environmental policy, in areas ranging from obesity to recycling, from sexual health to energy use.
Generally, the idea of behaviour change focuses on strategies of communication and incentive rather than legal compulsion. It is noteworthy that even in relation to smoking, a legal ban on lighting up in public places was justified on the classic liberal grounds of defending the rights of the innocent non-smoker. Supporters of the policy are now pointing to higher smoking cessation rates as evidence of success. It seems it is only when the change has been safely implemented that policy makers are willing to admit paternalistic motives.
As the explicit aim of behaviour change spreads first from the disadvantaged to any of us deemed to be behaving in self-destructive or anti-social ways, so it takes on a more positive connotation.
It has long been commonplace to recognise that the outcomes of public services depend on the ways in which the public use those services. Thus health treatment is more effective if patients pay regard to health advice, schooling is more successful if parents get their children to follow school rules and read and study at home, policing is more powerful if the community is also committed to crime prevention and detection.
This insight challenges the idea of public service 'delivery' with its connotation of service users as passive recipients. The government is placing ever more emphasis on user satisfaction in public service evaluation; it was, for example, an important strand of Lord Darzi's NHS recent review (see box). Building on this, it is likely that future evaluation of public services will contain explicit measures of success in shaping user behaviours.
