Minimum alcohol pricing gets backing of UK government’s health advisers

Policy rejected by Westminster but backed by SNP in Scotland seen as vital to tackling medical and economic toll of drinking

Source: The Guardian

Denis Campbell Health policy editor

1 December 2016

New evidence commissioned by the government from its own health advisers has concluded that ministers should introduce minimum unit pricing of alcohol to tackle the grim medical, economic and social toll of drink-related harm.

The in-depth study has found that drink is now the biggest killer of people aged between 15 and 49 in England. It accounts for 167,000 years of lost productivity every year and is a factor in more than 200 different illnesses.

It leads to such huge harm that the lost economic activity it produces, through early death and disability among workers, is more than that for the 10 most common cancers combined, the review found.

Its publication, by Public Health England (PHE), is an embarrassment for ministers because it says they should embrace a policy that they have rejected due to an alleged lack of evidence.

The coalition government pledged in March 2012 to bring in the policy, but it made a spectacular U-turn in July 2013, earning condemnation from medical organisations and arousing strong suspicions that it had caved in to intense lobbying by the alcohol industry.

PHE, the government’s advisory agency on public health issues including obesity and smoking, is due to jointly publish what it calls “a comprehensive review of the evidence on alcohol harm and its impact in England” with the Lancet medical journal on Friday.

But details of its findings, obtained by the Guardian, show that PHE has come very close to endorsing a policy that the government opposes. Sources say senior PHE officials feel its remit prevents it from explicitly backing minimum pricing, though ministerial opposition may also be a factor.

The new analysis has examined all the available evidence globally on alcohol harm and the steps effective in reducing it.

Prof Kevin Fenton, PHE’s national director of health and wellbeing, is expected to urge greater action to minimise alcohol’s damaging effects and say: “This evidence review will help local and national government and public services like the police and NHS to develop policies designed to reduce the harmful effects of alcohol.”

PHE will make clear that the pricing of drink and way that it is marketed – issues of concern to medical groups – need to be urgently re-examined. “The review provides national and local policy makers with the latest evidence to identify those policies which will best prevent and reduce alcohol-related harm,” PHE will say. “It details policies that impact directly on the environment in which alcohol is sold and marketed, including its price, availability and advertising, along with policies directed at people most at risk”.

The review, undertaken by PHE and researchers from Sheffield University, has found that the economic burden of health, social and economic alcohol-related harm is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP.

 “Alcohol-related deaths affect predominantly young and middle-aged people. As a result, alcohol is a leading cause of years of working life lost in England,” it says.

The authors’ conclusions will pose difficulties for the Department of Health, which asked PHE to undertake the assessment of the latest research. It will now face questions about why the government is not pushing ahead with introducing the policy, given that the evidence suggests that it would be effective.

In 2013, the government justified abandoning its plans because, it said, public consultation had “not provided evidence that conclusively demonstrates that minimum unit pricing will actually do what it is meant to: reduce problem drinking without penalising all those who drink responsibly”.

It is unclear how Jeremy Hunt, the health secretary, will respond to the results of a review which his own department asked PHE to instigate.

Medical groups want ministers to take tougher action on alcohol. Although total alcohol consumption has fallen since 2008, that has not been accompanied by a drop in alcohol-related harm.

Nicola Sturgeon’s Scottish National party government in Edinburgh is pressing ahead with the introduction of minimum unit pricing there, after recently success in seeing off a legal challenge to the policy brought by the Scotch Whisky Association. It plans to set a minimum price of 50p a unit, the level backed by many doctors. The scrapped Westminster plan was to set the level at 45p a unit.

Medical and public health groups are likely to welcome the new findings but alcohol firms are expected to dismiss them. Manufacturers often argue that a minimum unit price would penalise responsible drinkers who stick to the amounts of alcohol recommended by the chief medical officers of the four home nations. That guidance was revised in January to set a weekly consumption limit of 14 units for men as well as women, down from the 21 units previously advised for males.

However, previous evidence has concluded that the move would save thousands of lives because the heaviest drinkers are most likely to consume less as a result of the hike in price.