Civil servants responsible for tobacco
control policy in the Ministry of Health were main targets of
tobacco industry lobbyists. In the 1980s and 1990s, there were only two civil servants dealing with tobacco control, and they had to divide their attention with other issues such as alcohol control and drugs. One government official described the government’s relationship with the industry during these years: “There are frequent meetings between government and tobacco industry because of parallel interests … the government requests the industry to do certain activities (for example, self-regulation of advertising) and the same happens the other way around. The activities of the tobacco industry are important for the success of governmental policy regarding smoking” (Wever, 1988). It was normal practice that ideas for new tobacco legislation were discussed with sparring partners from the industrial sector. This suggests it was very much an insider game. Only when proposals had reached a certain level of incontrovertibility were broader
consultation meetings organised. Symptomatic of the type of relationship was the fact that when two leading civil servants who were responsible for tobacco policy left the Ministry of Health in 1992, industry representatives were present at their farewell reception.Footnote 37
The government continued to allow
self-regulation of
tobacco advertising by the industry well into the 1990s. As government officials needed to have contact with the industry to discuss details of the
advertising code of conduct, this developed into a habit of seeing and meeting each other on a regular basis, which was a great advantage for the industry. At such meetings all aspects of tobacco control could be raised, and it became normal practice that proposals for new tobacco policy made by the Ministry of Health were sent directly, or through the Ministry of Economic Affairs, to the industry for scrutiny and comment, before they were sent to parliament (NVS, VNK, & SSI, 1990). Small steps in regulation and restrictions, especially regarding the many versions of the self-imposed code of conduct regarding tobacco advertising, were discussed endlessly with the industry, which treated these talks as if they were negotiations, while the government regarded them more as consultations. The industry presented their contributions as “concessions” and “giving in” to wishes of the government (Marres & Toet, 1987). In 1992 the code had to be renewed, and the Health Minister,
Hans Simons, wanted it substantially improved, with fewer loopholes for the industry and termination of advertisements promoting positive images of smokers. This involved many meetings with the industry between 1992 and 1994 about the exact content of the new code. The industry’s full support from the trade ministry, gave it a strong position during these talks, evidenced by the fact that they could get away with refusing to end tobacco advertisements. They continued advertising at the important international
Formula 1 races in Zandvoort and at
TT motorcycle events in Assen, a trade-off for the relatively unimportant termination of tobacco promotion through billboards at motorways.Footnote 38
During the 1990s civil servants in the Ministry of Health became increasingly agitated by the arrogant attitude of the industry: “There is very little progress in the talks with the tobacco industry about reducing advertising through self-regulation. We do everything in our power to get concrete results, but the tobacco industry manages to sabotage everything, both regarding the content and regarding the process” (Wever, 1992). Another civil servant complained, “The tobacco advertising dossier has become rather extensive. The lobby by the (inter)national businesses (worldwide tobacco manufacturers, VNO–NCW, European employers, advertising agencies, publishers, media exploiters etc.) is immense” (Engelsman, 1992).
When
Hans Simons was state secretary for health in the Lubbers III cabinet (1989–1994) the relationship with industry representatives began to stiffen, because Simons wished to intensify tobacco control. In 1994 he sent a summary of the outcomes of negotiations with the industry about the new
advertising code to parliament, and received a prompt letter from SSI. The industry was outraged by what they saw as false representation of their intentions: “The industry is seriously disappointed and feels unjustly treated during the contacts with your department. This is all the more troublesome since this has happened already several times in the recent past” (Toet, 1994).
Industry Contacts During the Ministership of Els Borst
One year after Health Minister Borst (D66)
began preparations to revise the Tobacco Act in 1994, she received an unambiguous signal from
Alexander Rinnooy Kan, chairman of employee organisation
VNO–NCW, that she was on a collision course with VNO–NCW (Rinnooy-Kan, 1995a, 1995b), and she was warned not to proceed with her intended plans. He wrote that
VNO–NCW would not take it lightly if she dismissed
self-regulation (“an agreement is an agreement”) or if the
advertising code was not continued for the full period of five years: “It must be clear to you that we do not accept a more paternalistic government.”
The industry was intensely involved in the process of drafting the ministry’s tobacco control policy document, which contained detailed proposals for a revised Tobacco Act, and industry spokesmen even made concrete suggestions for text changes (Van de Mortel, 1996)—the health sector was not consulted. Only after the text had been leaked to the press was STIVORO able to join in (Boudewijn De Blij, 1996a). In a letter to parliament, STIVORO’s director
Boudewijn de Blij noted, “It strikes me that the industry has been involved in every phase of the realisation. I expect STIVORO to be involved in such important decision making processes as well” (Boudewijn De Blij, 1996b). Parliamentarian
Rob Oudkerk (PvdA) responded, “The tobacco industry relies on excellent lobbyists. They have accomplished a lot during 14 meetings with the cabinet, without any involvement from parliament. Cabinet and parliament have only debated about [the bill] twice” (Bruinsma, 1996).
As was discussed previously in Chap. 2 of this book, in 1996 routine meetings between the industry and the government to discuss tobacco policy were abandoned and the Ministry of Economic Affairs stepped back in favour of a more dominant role from the Ministry of Health, so the industry sought new ways to improve and strengthen communication with the tobacco policy officers at the Ministry of Health. They were not very successful. The relationship between industry representatives and the Ministry of Health at the time could best be characterised as distant and reserved, certainly not warm and welcoming.
In 1997 the ministry agreed to have “broad regular meetings” to which “other interested parties would also be invited, so that all aspects of comprehensive tobacco control policy could be discussed” (Van Hoogstraten, 1997a). This implied that not only would the tobacco industry be invited, as had been previous practice, but also representatives from the health sector. After the cabinet made its tobacco control policy intentions public, the Ministry of Health organised a broad
consultation session in September 1997 (Van Hoogstraten, 1997b). The health sector including STIVORO, the Heart Foundation, Cancer Society, Medical Alliance Against Smoking, Clean Air Netherlands (CAN) and the Gemeentelijke Gezondheidsdienst (Association of Community Health Services) (GGD) was to be heard in the morning. Representations from civil society such as VNO–NCW, labour unions, NOC-NSF (the national sports federation), consumer organisations, the advertising sector, and the hospitality sector could present their arguments in the afternoon, followed by the tobacco industry sector, represented by lobbyists from LBT, SSI, VNK, NVS, and NSO. Soon afterwards Health Minister Borst received a letter from SSI, complaining that the Ministry of Health did not seem to take industry arguments seriously: “During these talks we brought a great number of concerns to the table. It is now clear that in no way whatsoever did you include any of our concerns in your policy” (Roelofs, 1998). VNO–NCW sent a critical letter to Borst demanding that “the wish list of this cabinet can be and must become considerably shorter” (Blankert, 1997). From these and other letters at the end of the 1990s it is clear that the industry had completely lost its inside grip on tobacco control policy and fell back on intimidation and external pressure.
For many years the tobacco team at the
Ministry of Health was understaffed. Until 2000, only two public servants dealt with tobacco. They were not full-time dedicated staff, since they also had to deal with alcohol. In 1998, Minister Borst was asked in parliament why it took her so long to implement the tobacco control initiatives that she had presented two years earlier. She explained that the new tobacco control policy “contains in total more than 50 initiatives, intentions, projects and actions. … All this work, in addition to the complete alcohol control policy, has to be done by just a few workers at my department.”Footnote 39 Her predecessor, State Secretary Hans Simons, had also complained that he was so understaffed that negotiations with the industry about the advertising code of conduct were difficult and took too much time.Footnote 40 Sometime around 2000 the tobacco team was reinforced with three dedicated civil servants and a liaison officer from STIVORO to help adopt and implement the new Tobacco Act. Inspired and protected by Minister Borst, these officials were dedicated tobacco control advocates. The team worked closely with health organisations and kept contact with tobacco industry spokespersons to a minimum, but this did not mean that contact was rare. Officials and industry representatives continued to meet frequently to discuss technical aspects of regulation (such as specific allowances regarding advertising at points of sale), and industry representatives were given the opportunity to present their concerns and problems to the civil servants and sometimes to the director-general. A tobacco control officer said,
You just wanted to allow all concerned parties to have their say. Did we write the correct text, are there any other ideas? Yes, you cannot write a product regulation proposal without ever having talked about it with the industry. … It was common practice. … I believe it is appropriate that we do it like that. This is sort of the consensus model that we have in the Netherlands:
polderen and deliberating until we have a good outcome.Footnote 41
VNO–NCW
continued, unsuccessfully, to lobby for periodic regular meetings with the Ministry of Health (Schraven, 2001b).
Minister Borst Turns Her Back on the Tobacco Industry
In May 2000 the relationship between the industry and the Ministry of Health reached a dramatic low. Borst, in an interview with morning newspaper De Telegraaf, announced “rigorous measures” against tobacco and declared there was no future for tobacco in the Netherlands. The industry reacted furiously. Immediately the next day they sent an angry letter to her, with carbon copies to the ministers for social, economic, and financial affairs, and to parliament (Roelofs, 2000a), and a separate letter to prime minister Kok (Roelofs, 2000b). They blamed
Borst for not talking with the industry: “This is not the first time that you have unilaterally launched proposals and ideas in public without first engaging in a constructive dialogue with us. … Your approach to repeatedly confront the tobacco industry through the media with new measures and unfounded accusations is unacceptable to us.” They demanded that the prime minister call Borst to account for “the way she chooses to deal with the tobacco and related sectors … letters are not replied to, appointments are not kept and requests for executive meetings are ignored. … We assume that you are willing to call upon your colleague from the Ministry of Health to normalise relationships with our sector.”
A few weeks later, a meeting was indeed organised between
VNO–NCW and
Borst, accompanied by her top-level civil servants (Schraven, 2001a). They reached a compromise: there would be a dialogue between the Ministry of Health and the industry under independent chairmanship. Since this did not happen,
VNO–NCW brought the matter up again a year later and proposed the possibility of an executive-level meeting once or twice per year between the industry and the ministers for health and for economic affairs (Schraven, 2001a). In addition they proposed regular tobacco policy expert meetings, open to both industry experts and experts from all involved societal organisations, ranging from STIVORO to smokers’ right groups. However,
Borst, who wanted to finalise her
revision of the Tobacco Act before the end of her time in office, continued to hold off contact with the industry sector, despite many letters from the industry complaining that they were not heard. She allowed her civil servants to push the bill forward with limited opportunities for the industry to be consulted about the timing of its implementation (Horeca Nederland, 2002; Kalis, 2002).
Health Ministers Keep the Industry at a Distance
The SSI approached Borst’s successor,
Eduard Bomhoff, soon after he started work as the new minister for health. Bomhoff, a university professor in economics, had been a member of the Labour Party for many years, but was asked by the populist Lijst Pim Fortuyn (Pim Fortuyn List) (LPF) to take up the position of health minister in the first Balkenende Cabinet. SSI wrote him a long letter complaining about the “unacceptable way the Ministry of Health currently does not give meaning to a decent dialogue with the concerned industry sectors,” demanding a resumption of “constructive dialogue” and requesting that the implementation of the Tobacco Act be put on hold (Monkhorst, 2002; SSI, 2002). Bomhoff replied in unmistakable terms that he wanted no personal contact with the industry, and was not willing to consider a respite in the implementation process (Bonhoff, 2002).
Bomhoff was minister for a very short period in 2002. Because of a fight between him and the Minister for Economic Affairs Herman Heinsbroek (LPF), the cabinet resigned. When his tasks were temporarily taken over by State Secretary
Clémence Ross-van Dorp (CDA),
VNO–NCW recognised an opportunity to bring the idea of regular executive meetings to her attention (Schraven, 2003a). Instead of granting the request, the ministry sent a short questionnaire to a large number of societal and business organisations with a stake in tobacco policy, asking them whether they were interested in being part of regular broad meetings about tobacco control policy (Kalis, 2003). When it became clear that these had also been sent to health organisations, the industry stepped down, not liking the prospect of having meetings with the ministry in the presence of tobacco control advocates. The ministry received replies from 26 of 67 organisations, insufficient for regular meetings (Hoogervorst, 2003b), and instead decided to continue the habit of granting meetings with individual stakeholders as circumstances required.
In the meantime, the industry and civil servants at the Ministry of Health had various meetings to discuss the ramifications of the transposition of the
EU Tobacco Product Directive (TPD-1).
The most difficult issue was the requirement that manufacturers submit lists of all additives used in the manufacture of their products, specifically at the level of each brand. The industry was not prepared to do this without a fight, claiming that the requirement infringed on company secrets. They tried to offer alternative formats that would entail a far smaller level of detail.
State secretary Clémence Ross did not give in to their pressure, and after numerous letters and fruitless meetings between industry and government officials she published the regulation in the Bulletin of Acts and Decrees in April 2003.
Not only ministers Borst and Bomhoff but also their successor
Hans Hoogervorst (health minister from 2003 to 2007) resented
industry lobbyists. Hoogervorst made it clear that he had no intention of reinstalling the executive meetings (Hoogervorst, 2003b) and was not prepared to discuss the decision to make public the ingredients of cigarette brands (Hoogervorst, 2003a). A few weeks later the industry summoned the Dutch state to argue the ingredients matter in court.
Just after Hoogervorst took office, the Framework Convention on Tobacco Control (FCTC) treaty was signed by the Netherlands. This meant that the government was expected to refrain from interactions with the tobacco industry unless it was “strictly necessary to enable them to effectively regulate tobacco industry and tobacco products.”Footnote 42 While Hoogervorst was minister,
VNO–NCW was frustrated that regular meetings were not reinstated (Schraven, 2003b). Hoogervorst’s policy regarding interaction with the industry was in line with the FCTC requirement: he only allowed contact about technical issues of implementation of tobacco regulation, of which he gave this example: “The government does not talk with the industry about whether there must be graphic health warnings on tobacco packages, but the government can initiate contact with the industry about practical matters such as the transition period that is necessary to adjust the packs.”Footnote 43 Throughout his term in office Hoogervorst refused cooperation or meetings with the industry about general policy, explicitly referring to the FCTC (Dortland, 2005; Hoogervorst, 2006a, 2006b). However, the Ministry of Health allowed industry representatives to have bilateral contact with civil servants to discuss “concrete policy matters” (VWS, 2003). It is clear from the email correspondence published in the Truth Tobacco Industry Documents databaseFootnote 44 that the bureaucrats from the ministry did this reluctantly until around 2008, often using the formal “u” to address the recipient in emails, keeping the language aloof and business-like, while the industry used the informal “je” and was more direct and, at times, intrusive and pushy.
The Ministry of Health Resumes Contact with the Industry
In contrast to the three previous ministers, health ministers Ab
Klink (2007–2010) and Edith
Schippers (2010–2012) did not regard contact with the industry as inherently problematic. At first the ministry told the industry that the policy of the previous ministers, that there could be no collaboration between government and the tobacco sector regarding policy, would be continued (De Goeij, 2006), but this changed when Klink, after four months in office, granted a personal meeting with industry CEOs (Smid, 2007), followed by an “exceptionally constructive” (in SSI/VNK’s words) meeting with SSI and VNK (SSI & VNK, 2007). Further meetings were planned to discuss industry ideas about such things as youth smoking prevention and new safer cigarettes (Klink, 2007). Minister Klink set the example and the norm for how government officials should communicate with the industry, and the number of contacts increased and emails between officials and industry representatives had a friendlier tone. Civil Servants fell back on the familiar habit of involving and
consulting the sector. Symptomatic of the desire not to step on industrial toes was a reassuring response from one of Klink’s tobacco control officers to a letter in which SSI expressed its concerns about the drafting of the guidelines to WHO
Article 5.3, which could lead to full exclusion of the industry from the policymaking process: “First of all, I want to stress that it concerns non-binding guidelines. … Secondly, it is certainly not a matter of excluding the industry” (De Jager, 2008).
In March 2009, halfway through Klink’s ministership, Director-General
Hans de Goeij, who had a solid track record in tobacco control, was replaced by an economist who had less affinity with public health. The new Director-General for Health
Paul Huijts, a former employee of the Ministry of Economic Affairs, set out to restore the dialogue with the industry that had gone astray under previous ministers. On 24 August 2009, after a meeting with the industry, Huijts looked back on “a useful and positive meeting, in which mutual interests and differences were well covered. … Future meetings … will have to contribute to mutual information exchange and the building up of mutual trust” (Huijts, 2009). Soon afterwards, the industry confirmed that it shared with the ministry the wish to come to a better understanding and was grateful that the ministry was again “open to any contacts, interventions, signals or questions” (NVK, NVS, SSI, & Philip Morris Benelux, 2010).
In 2009 Ministry of Health officials accepted an invitation from VNK to attend a “company day” (VNK & Ministry of Health, 2009). In the past, the industry had organised yearly small conferences around a specific theme, sometimes combined with a visit to a company or factory, for small groups of government officials. These meetings had been abandoned during the previous cabinets, but were reinstated under Huijts’ leadership. The meeting took place in September 2009 and was attended by officials from three ministries (finance, economic affairs, and health) (VNK & Ministry of Health, 2009). In 2011 officials from the ministries of health, finance, and economic affairs visited a tobacco factory (VNK, 2011).
The responsive attitude towards the tobacco industry continued when
Edith Schippers (VVD) became minister for health in October 2010. In reply to a congratulatory letter, Schippers confirmed to SSI and VNK, “I appreciate the intention to invest more in the coming time in an open and constructive exchange of thoughts about different international topics” (Schippers, 2010). The government’s “generous” interpretation of the FCTC commitments, and in particular
Article 5.3, lasted until 2016, when it felt obliged by a court case initiated by the
Youth Smoking Prevention Foundation to rethink its policy regarding Article 5.3 and to settle for an implementation more in line with the spirit of the FCTC (discussed in Chap. 6).