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Government reads last rites over alcohol strategy

The formal announcement of the evisceration of the Government’s alcohol strategy for England was made by Home Secretary, Teresa May, though the oral announcement to the House of Commons was made by junior minister Jeremy Brown, a Liberal Democrat. It was explained that MUP would not, after all, be implemented, despite this having been proclaimed as the central plank of the alcohol strategy, and despite Prime Minister, David Cameron, having made a personal pledge to introduce MUP.

In his introduction to the Government’s National Alcohol Strategy for England, published in March 2012, David Cameron said:

“We can’t go on like this. We have to tackle the scourge of violence caused by binge drinking. And we have to do it now.

……. And that means coming down hard on cheap alcohol.  When beer is cheaper than water, it’s just too easy for people to get drunk on cheap alcohol at home before they even set foot in the pub. So we are going to introduce a new minimum unit price. For the first time it will be illegal for shops to sell alcohol for less than this set price per unit. We are consulting on the actual price, but if it is 40p that could mean 50,000 fewer crimes each year and 900 fewer alcohol-related deaths a year by the end of the decade.”  As reported previously in Alert (Spring 2013), Mr Cameron appears to have been the victim of a Cabinet revolt.

Rejected also was another key policy, a ban on heavily discounted multi-buy alcohol promotions in supermarkets, along with the proposal to include the protection of public health as an objective of the Licensing Act. There is thus little left of the original planned strategy and most of the measures that remain are expected by health researchers to have little or no effect on overall levels of alcohol-related harm. (see page 5)

The Scottish Government, however, remains on course to introduce MUP. Scottish Health Minister Alex Neil is reported as saying: “The forthcoming UK decision – whether they decide to proceed or not – has no impact on the Scottish Government’s approach to minimum pricing. Minimum pricing will begin saving lives within months of its introduction. That is why the Scottish Government remains committed to this life-saving policy.”  The Scottish Government has already introduced restrictions on multi-buy promotions, and these are believed to be having the desired effect north of the border. (see page 6)

Next Steps

The Government’s new position is outlined in its response to the public consultation on the alcohol strategy. In her ministerial foreword, Teresa May explains that while the Government is determined to curb excessive drinking, “no one wants to make laws that don’t produce the results they were intended to..(and) the consultation has not provided evidence that conclusively demonstrates that Minimum Unit Pricing will actually do what it is meant to: reduce problem drinking without penalizing all those who drink responsibly.” Mrs May continues: “In the absence of that empirical evidence, we have decided that it would be a mistake to implement MUP at this stage. We are not rejecting MUP – merely delaying it until we have conclusive evidence that it will be effective.”

Mrs May’s assertion that there is a lack of empirical evidence to support MUP is puzzling on several counts, not least that the very evidence described as lacking is actually contained in reports from the University of Sheffield which the Government itself commissioned.  Moreover, the preferred Government alternative to MUP, a ban on ‘below cost’ sales of alcohol, has been assessed by the same research team as having negligible effect on levels of alcohol consumption or harm. (see page 5)

In a Downing Street press conference, David Cameron attempted to salvage some semblance of consistency by insisting that a ‘below cost’ ban is essentially the same as MUP.

“We are introducing …. what is effectively a minimum price.” He said. It will be “illegal” to sell alcohol below the price of duty plus VAT.  He also claimed that the idea of a minimum unit price for alcohol “has merit” but lacked evidence to back it up. He said that if more research showed that it worked he would be happy to reconsider the policy.  He did not refer to the evidence that presumably must exist to back up the ‘below cost’ ban, or explain how the ‘below cost’ ban can have evidence in support while MUP does not if they are essentially the same.

According to the Home Secretary’s response to the alcohol strategy consultation, the new priority of the Government is “to engage the (alcohol) industry…to follow practices that help everyone who likes a drink to consume alcohol responsibly.”  The Government appears to be recommending greater use of voluntary schemes such as Best Bar None to tackle the problems of drunken disorder.

‘Day of shame’

The abandonment of the planned alcohol strategy before it had even begun, combined with the decision to ‘postpone’ the introduction of plain packaging of cigarettes, caused dismay in the public health community and left the Government, and particularly the Prime Minister, looking weak, and vulnerable to the charge that it had succumbed to intense pressure from the alcohol and tobacco lobbies. Conservative backbencher Sarah Wollaston, a former GP and a leading campaigner for both minimum alcohol pricing and plain cigarette packaging, commented that the result of the decisions would be more lives ruined for the sake of political expediency. She tweeted, “R.I.P public health. A day of shame for this government; the only winners big tobacco, big alcohol and big undertakers.”

Responsibility Deal

The Labour Party condemned the Government for its U-turn which, it suggested, had been brought about by lobbyists.

“Do I detect traces of lobbying on the minister’s breath?” Labour Home Office spokeswoman Diana Johnson asked in parliament. “After a two-year Whitehall farce over their alcohol strategy, we’ve ended up exactly where we started.”

However, when in office, Labour had also failed to introduce MUP, and in debates the Labour government repeated its position that ‘it would be unfair if responsible drinkers had to pay significantly more for their alcohol because of a small minority of people who drink irresponsibly’. The Labour government even appeared to pre-empt the recommendation to introduce MUP made by its own Chief Medical Officer. Prior to the publication of the Chief Medical Officer’s report, the Times quoted a “source close to the Prime Minister” (Gordon Brown) as saying ‘I do not think this is where we are going. The majority of sensible drinkers should not have to pay the price for the irresponsible and excessive drinking by a small minority.’

To add to the Government’s woes, the few remaining public health organisations still participating in the Government’s ‘Responsibility Deal’, designed supposedly to encourage commercial operators to contribute to the public health programme, walked out in protest at the abandonment of what they regard as evidence-based policies in favour of mainly industry-preferred charades.

A joint statement was issued by Cancer Research UK, the Faculty of Public Health, the UK Health Forum, and Professor Nick Sheron, Responsibility Deal Alcohol Network Co-Chair, and Head of Clinical Hepatology, University of Southampton:

 

“We are extremely disappointed that despite the wealth of good evidence that it will save lives without penalising moderate drinkers, minimum unit pricing (MUP) is not in the Government’s alcohol strategy.

 

“Talk of ‘punishing the hard worker’ who can afford few other pleasures than a pint of mild is a red herring. There is no such thing as an entirely safe level of alcohol, and a moderate drinker would hardly notice a minimum unit price, particularly if he or she drinks in a pub.  It is our most deprived communities who pay the highest price for cheap alcohol through the consequences of street crime, violence and younger people developing alcohol-related health problems....

 

“...It is perfectly clear that MUP has fallen victim to a concerted and shameful campaign of lobbying by sections of the drinks industry who are putting profits before health and public safety. The actions of those companies and trade organisations undermine the efforts of public interest advocates and NGOs, and are completely at odds with the objectives and purpose of the Responsibility Deal. In light of this, we have withdrawn from the Alcohol Network of the Responsibility Deal.

 

“If we are serious about reducing early deaths from harmful drinking in this country we need leadership from Government, not the drinks industry, to implement legislation where there is good evidence it will work.”

Just for good measure, the Government’s own new authority for public health, Public Health England, also expressed disappointment at the decision.

“Public Health England shares the disappointment of the public health community that the introduction of a minimum unit price (MUP) for alcohol is not being taken forward at this point, although it recognises that this remains under active consideration.

Professor Kevin Fenton, PHE’s Director of Health and Wellbeing, said:

“From a public health perspective the evidence base for MUP is already strong and growing. Alcohol misuse is a major cause of early death and dysfunction for individuals, their families and the community. There is strong evidence that MUP would make cheap and higher-strength alcohol less available, with the greatest impact being in younger and in heavier drinkers. Six countries including Canada have introduced minimum pricing for alcohol and we are beginning to see significant benefits. PHE will take forward a comprehensive and scientific review of all the available evidence to inform the Government’s final decision on implementation of this measure.”

A particular bone of contention with the health NGOs was the pledge made by 32 alcohol industry participants, signed up to the Responsibility Deal, to reduce the total number of units of alcohol consumed by reducing the strength of some beverages and promoting the sale of lower strength brands.  The pledge was “we will remove 1 billion units of alcohol sold annually from the market by December 2015 principally through improving consumer choice of lower alcohol products”. The job of overseeing progress towards achieving the pledge was given to the alcohol industry’s Portman Group. However, public health organisations are understood to be very unhappy that the evaluation is being conducted in a far from transparent manner, with a marked lack of clarity about how the calculations are being made.

Commenting on the whole debacle, IAS’s Katherine Brown said:

“Today we saw the final nails hammered into the Alcohol Strategy’s coffin. No minimum pricing, no public health licensing objective, no ban on multi-buy promotions. The Government has instead identified its “immediate priority is to engage with the industry” and outlined a series of deregulatory measures that will ultimately make it easier for alcohol to be available. It goes without saying that today’s winners were Big Business and the losers public health.

“To add insult to injury, Teresa May cited that the consultation had not produced enough evidence to show minimum pricing would work, despite a Government commissioned report published by the Sheffield Alcohol Research Group showing that it would have a 40 to 50 times larger effect than a ban on below cost sales. What we have is a Government that is willing to ignore evidence about saving lives in order to appease the global alcohol producers.

Government response, Next steps following the consultation on delivering the Government’s Alcohol Strategy can be accessed here:

http://tinyurl.com/pmgec4j