Alcohol Policy UK

New public health White Paper outlines future alcohol health policy

The Department of Health has published the new White Paper Healthy lives, healthy people: our strategy for public health in England. It sets out the framework in which a new public health service, named Public Health England, will manage a ring-fenced budget of around £4 billion. The paper proposes Public Health England will take on full responsibilities from 2012 with the ring-fenced funding allocated to local government from April 2013 as Primary Care Trusts are removed. 

The White Paper states it will "end central control and give local government the freedom, responsibility and funding" to address public health locally. In the foreword, the Health Secretary Andrew Lansley says it aims to avoid "nannying" but "empowers individuals to make healthy choices". The paper confirms the controversial Responsibility Deals - industry led groups tasked with promoting healthier lifestyles on areas such as alcohol and obesity.

Limited detail is given in respect of alcohol specific treatment and interventions, though states it will "align funding streams on drug and alcohol treatment services across the community and in criminal justice settings" and will "incentivise recovery outcomes". Further details will be outlined in the forthcoming Home Office drugs strategy. A consultation page for the White Paper is available here. The proposals will need to be approved by Parliament as part of the Health and Social Care Bill.

See reports on the White Paper from the Guardian, BBC and the Telegraph. See statements and comments from Drugscope, the King's Fund and the Faculty of Public Health.

Beer duty to be adjusted according to strength as part of plans to tackle 'problem drinking'

The HM Treasury today announced plans to change beer duty for certain strengths as part of Government plans 'to review alcohol taxation to tackle problem drinking without unfairly penalising responsible drinkers, pubs and important local industries.'

The Treasury announced its plans to introduce a new additional duty on beers over 7.5% abv in strength and a reduced rate of duty on beers at a strength of 2.8% abv or below. The changes are intended to 'encourage the production and consumption of lower strength beers' whilst 'addressing the consumption of cheap, super-strength lagers'. They are expected in the next budget in March 2011.

See the HM Treasury Review of alcohol taxation November 2010 [pdf].

Trade associations such as the British Beer and Pub Association (BBPA) welcomed the break for lower strength beers. However the Association of Licensed Multiple Retailers (ALMR) said the review was a “missed opportunity” to make a real difference to the “pocket money prices” being charged by supermarkets. See full quotes from trade bodies in reports from the Morning Advertiser and Publican. See press coverage from the Telegraph and Guardian.

Commenting on the proposals on tax and plans to ban below cost sales, Alcohol Concern's Don Shenker said:

“A much more effective approach would be for cider duty to be bought in line with beer; and for there to be low, medium and high strength duty bands on all products including wine. In addition, to effectively stop retailers from loss leading, duty rises must be accompanied by a minimum unit price of 40p or more. There is nothing in these proposals which would stop 2 litres of high strength cider from being available for under a £1."

Earlier this year the IFS made recommendations on alcohol taxation, whilst Dr Sheron suggested rises should be offset by reduced VAT for pubs. The definition of ciders was recently changed to prevent industrial white ciders enjoying the tax privileges of traditional cider.

'Below cost' ban expected in bid to address binge drinking

Legislation to introduce a 'below cost ban' on alcohol may be announced in the week ahead as part of Government plans to tackle binge drinking. 'Below cost' is now expected to be defined as duty + VAT, but health campaigners say it will fall short of the impact a 50p per unit minimum price policy would have on reducing alcohol-related harm.

The Sunday Telegraph reported the cost thresholds will be £10.50 for a litre bottle of spirits, at least £8.50 for a 20-pack of beer, and at least £2 for a bottle of normal-strength wine. The prices equate roughly to a minimum unit price level of between 18-26 pence, suggesting few drinks or promotions would actually be affected.

The possible definition of 'below cost' has been subject to debate since the Coalition announced it were to implement the ban. Critics have argued it would be unenforceable and suggested that supermarkets can beat a below cost ban based on a duty + VAT definition. Retailers expressed support for the definition and ASDA have already voluntarily introduced it, but Mark Hastings of the BBPA had said "you cannot ignore production and distribution costs and margins".

Don Shenker, chief executive of Alcohol Concern, said: “While we would welcome the government’s acknowledgement that they need to tackle this issue, we would not be convinced that anything other than a minimum price on alcohol, which has a solid evidence base behind it, will be at all effective."

The measure is expected to be announced alongside changes to the Licensing Act as part of the Police and Social Responsibility Bill. The HM Treasury is also reviewing alcohol taxation and intends to 'change alcohol pricing to ensure that it tackles binge drinking'. See here for a channel 4 news report.

Alcohol pricing: why a 'below cost ban' is not 'minimum pricing'

As the media has frequently referred to the 'ban on below cost' sales as 'minimum pricing', below we attempt to clarify the key distinctions between the two pricing approaches.

Download pdf version

Some further reports on pricing measures include:

• The University of Sheffield's modelling of minimum pricing
• The IFS pricing report calling for increased taxation
• NICE guidance calling for minimum pricing
• A SABMiller commissioned report by the CEBR outlining arguments against minimum pricing
• SNP pages on minimum pricing and the Scottish Alcohol Bill.
• An interim report on Manchester's proposed local minimum pricing
• BMJ report urging a VAT reduction for the on-trade 
• Aberdeen University research arguing minum pricing does not target lower income groups

NHS Drinking to be replaced by NHS Choices & Change4Life resources

The NHS Drinking website and 'Alcohol Effects' campaign are to be de-commissioned, but NHS Choices alcohol pages will continue to offer a range of tools, information and advice. Organisations can also use NHS Choices website content for free by registering as a syndicate partner. Change4Life also has alcohol pages as part of the healthy lifestyles campaign.

The NHS Choices alcohol pages (www.nhs.uk/LiveWell/Alcohol) include a number of tools including an online self-assessment tool (based on the AUDIT), a desktop
alcohol tracker, and an iphone drinks tracker app.  

The industry funded www.drinkaware.co.uk also provides a range of alcohol-related  information, including free unit wheels and fact sheets available to order. Drinkline, a 24 hour alcohol information and support line will provide advice and local service information on 0800 917 8282.

The Alcohol Learning Centre is a comprehensive resource of alcohol-related guidance, e-learning, research and resources.

FASE: Preventing alcohol-related harm in drinking environments

The FASE (Focus on Alcohol Safe Environments) project is co-funded by the European Commission to develop a better understanding of what works to reduce alcohol-related harm in drinking environments. The project is collecting research from across the world and focuses on interventions that can be implemented at local level, covering five key areas:

1. Responsible server/staff training interventions
2. Interventions to reduce underage access to alcohol
3. Policing and enforcement approaches
4. Interventions delivered in drinking establishments
5. Multi-component community interventions

An outline paper Preventing alcohol-related harm in drinking environments is available as is a presentation by UK partners the Liverpool John Moores University (JMU). The paper says:

'The best evidence of effectiveness available is for multi-component community interventions – schemes that bring together local agencies in a partnership to plan and deliver a combination of strategies to prevent irresponsible alcohol sales, address risky drinking and enforce licensing legislation at a community level.

Despite programmes such as designated driver schemes and educational campaigns frequently being used in Europe, the study found little evidence to support their effectiveness. It also found that staff training programmes and test purchasing operations often have little effects when implemented as standalone measures. However these measures can be important components within broader multi-component community interventions.'

The study reports further research is needed, particularly within the UK context. A study by Dr Simon Moore of Cardiff University will shortly be published in the Addiction journal; 'Interventions for disorder and severe intoxication in and around licensed premises' - see draft proof version.

News and updates Nov 2010: Manchester minimum pricing interim report; Minister backs partnership alcohol schemes

AGMA, the association of 10 local authorities in Manchester considering a local minimum price, have released an interim report assessing the potential move. Councillor Cliff Morris, Chair of the Greater Manchester Health Commission, said:"The interim report recognises that there are a number of complex issues which require more investigation including the legal, economic, health and social implications of such an approach before any steps to create a bylaw are considered." See press release and reports in the Publican and Daily Mail.

Speaking at the Responsible Drinks Retailing Awards 2010 conference, Home Office Minister James Brokenshire praised the work of pubwatches and responsible retailing schemes. See his speech here, in which he also emphasised the importance of Community Alcohol Partnerships and age verification schemes. However on-trade concerns over the licensing reforms were re-iterated in this Morning Advertiser feature following the speech. A piece on the Publican has also recently asked 'Will the government ever stand up to the supermarkets?'

Street marshals have been funded by local businesses in Leeds to help reduce alcohol-related crime and disorder - Daily Mail. The Safer Leicester Partnership are trying alcohol awareness courses as an alternative to on the spot fines as part of a pilot scheme.

Cut VAT on alcohol in pubs suggests leading doctor

Varying the rate of VAT between the on and off-trade could help to reduce the negative impact of cheap alcohol without punishing pubs, argues Dr Nick Sheron of Southampton University. Sheron explores the idea in a BMJ article: Vary VAT on alcohol: a more palatable way to achieve minimum pricing?

Sheron says that although minimum pricing would be effective in addressing cheap off-sales without punishing pubs, he recognises that 'the UK government is not keen on the concept'. As an alternative, variable increases in duty to deliver an effective minimum price of 40-50 pence per unit could be offset in pubs by reducing the level of VAT. Varied VAT levies exist for other food and drink, for instance more VAT is charged to drink coffee on a premises than to take away. Sheron suggests the reverse of this could be applied for alcohol, for instance reducing the VAT for on-sales from 20% to 12%.

The premise still relies on raising the overall cost of cheap alcohol to deter retailers selling alcohol below a certain unit threshold - which largely applies to off-trade sales. Modelling by the University of Sheffield exploring the link between price and harm estimated minimum unit pricing could save thousands of lives and reduce other health and social costs. The IFS recently urged the Government to increase tax on alcohol to achieve pricing increases, as minimum pricing would transfer an estimated extra £700m revenue to retailers and producers. Not surprising that Tesco have supported minimum pricing, Sheron suggests.

Sheron also questions the proposed below cost ban, which has been subject to debate over a definition and whether any real impact would be seen on cheap sales; "No form of 'below cost' ban can deliver a price of 40 pence a unit without swingeing increases in duty on alcohol."

Currently an HM Treasury review into alcohol and taxation is taking place. However Sheron indicated that when the idea was recently suggested, the Treasury "were not immediately keen on the concept of changing VAT but produced no concrete reason why it could not work." The Home Office plan states "Pricing options must be enforceable, compatible with EU trade law and easily implemented by business."

See reports in the Guardian, Telegraph, and a Publican story quoting support from pub industry bodies the BBPA and CAMRA.

MP speaks out on supermarket's "unholy price war"

An MP has spoken out on an "unholy price war" as supermarket's alcohol discounts and offers are rolled out in the run up to Christmas. Lib Dem MP Greg Mulholland, Chair of the cross-party Save the Pub group, said in a commons debate:

"As we approach the festive season of Christmas, an unholy price war has broken out in the supermarkets over the sale of alcohol. Tesco are now offering two 70 centilitre bottles of top spirit brands for just £20, Asda selling one litre bottles of spirits for just £15 and Sainsbury's and Morrisons selling Baileys at half price."

Mr Mulholland also asked for a statement on when the below cost ban will happen, and "whether it will cover irresponsible promotions that do nothing to encourage responsible drinking, and damage the pub industry?". The question follows the recent publication of the Home Office business plan which indicates below cost legislation will be introduced in May 2012 but only "if necessary".

The answering MP George Young said licensing changes will be introduced shortly "to address the pressures caused by excessive late-night drinking". He finished by stating "It is also our policy to ban the sale of alcohol at below cost in supermarkets". See reports from The Publican and the Press Association.

A Tesco spokesman said: "We are coming up to Christmas, purse strings are tight and people are looking to save money. We are not just doing special offers on alcohol either, but things like Pringles and Sprite." A Sainsbury’s spokesman commented: "It is important to remember that the overwhelming majority of our customers buy alcohol as part of their weekly shop and drink responsibly in their own home."

Lansley's public health 'responsibility deal' under question

The Government's move to empower the food and drinks industry with a key role in public health policy could face a commons review. The shadow public health Minister Dianne Abbott has demanded an inquiry by the health select committee to review the 'Responsibility Deal' that gives industry a key role in deciding Government action on alcohol misuse and obesity.

The Health Secretary Andrew Lansley set up the Public Health Commission in 2008 to 'outline a practical and achievable Responsibility Deal between business and Government' to improve public health. The group is chaired by the Chief Executive of Unilever and membership includes representatives of Diageo and the Wine and Spirit Trade Association (WTSA). The group also includes non-industry members, though the Guardian reported that Professor Simon Capewell had described health interests as always in a minority and under pressure to support the party line.

The Guardian has asked Who is the government's health deal with big business really good for? whilst the Daily Mail reported McDonald's, KFC and Pepsi to help write government policy on obesity and diet-related disease.

Lansley was quick to outline a non-regulatory public health approach of 'social responsibility, not state regulation' earlier this year. Abbott spoke out when calling for the review, saying the Government had 'sold out the interests of the nation to the interests of big business'. She warned it was naïve to think companies would put business interests behind them in favour of making people healthier. The Faculty of Public Health (FPH) recently released a report stating whilst greater individual responsibility was important, Government intervention was also necessary and had public backing.

The Responsibility Deal sets out a key objective 'to enable and encourage people to drink sensibly and responsibly'. It outlines plans to 'contribute to a social marketing emphasis on creating positive peer pressure towards responsible drinking' and to back the roll out of Community Alcohol Partnerships. It also sets out to 'work with the drinks industry to improve labelling so that people are more aware of units of alcohol, the guideline limits, the units as a percentage of the guideline limit.'

The new public health white paper is due next month. It will detail a new 'Public Health Service' that will see local authorities take charge of a ring-fenced budget for local provision including substance misuse.

A recent BBC Panorama episode 'tax the fat' explored whether tax should be increased on food high in sugar and fat. It asked whether Britain, which now has the highest obesity rate in Europe, should tax junk food and use the revenue to promote and subsidise healthier foods. Interviewed on the programme, Lansley said "tax is not a nudge, it's a shove".