The subject of policy, lobbying and politics was recently back in the spotlight following an investigation by Greenpeace's Unearthed. The issue may be of particular significance as the Government plans a new national alcohol strategy for England which will be expected to set out its stance on contested issues including minimum pricing, taxation, treatment funding, advertising and labelling.
Is policy determination 'fair'?
The high profile think tank the Institute of Economic Affairs (IEA) was recently in the news after its director Mark Littlewood told was filmed telling an undercover reporter for Unearthed that it facilitates an “off the record” forum for corporate donors to discuss their interests with ministers and senior politicians. During Unearthed's undercover video, Littlewood referenced alcohol policy:
“To give you an example, we would take money from alcohol companies. We would go to alcohol companies and say we want to write about the cost of living being too high and actually alcohol consumption is not costing the National Health Service as much money as they often complain.”
The IEA has previously been criticised for its lack of transparency over its funding sources and the appropriateness of its status as an educational charity. Those in the alcohol field may know of the IEA primarily through Christopher Snowdon, who has frequently criticised the 'alcohol health lobby' on his own blog and written reports for the IEA on alcohol policy and pricing.
In response to the investigation, the IEA said they "do not act in donors’ interests, except to the extent that they have an interest in pursuing free trade and free markets". As such the IEA maintain that they have acted within the parameters of the law, but health groups often express dissatisfaction with the level of access industry bodies or representatives have to senior policy makers; a recent parliamentary answer identified 14 meetings in 2017 and 2018 in which health and social care alcohol policy lead officials met representatives of the alcohol industry.
Earlier this year a systematic review on alcohol industry involvement in policy making concluded that alcohol industry were 'highly strategic, rhetorically sophisticated and well organised in influencing national policy‐making'. More recent research states that 77% of all alcohol is drunk by those drinking above the guidelines, and as such argue the alcohol industry at large has a fundamental conflict of interest and cannot be trusted to genuinely support responsible drinking.
The Parliament Arms: should MPs drink on duty?
Meanwhile a piece in the journal Drug Science, Policy and Law has called for legal reforms in Westminster to address a drinking culture which it claims has significant implications for political decision making and the country. It says up to £1.3 million of subsidised drinks are sold in the House of Commons bars every year and that 'one of the world’s largest alcohol consortiums, Diageo, with revenues of over £10 billion last year, holds regular parties within Parliament itself, not to mention countless sponsoring of Parliamentary events.'
The article calls for politicians to be held to the same standards as Doctors with regards to their decision making, proposing that breathalysers should be used before voting given that 'surely the making of a decision to go to war should be treated as seriously as that of driving a car?'. It also calls for an end to freebies from tobacco companies to parliamentary assistants and to move towards a drug and alcohol-free workplace.
Policy options for the new strategy
With minimum pricing implemented earlier this year in Scotland and Wales following suit, Westminster politicians appear to have been under increasing pressure to decide on England's future stance. Other key policy areas including taxation, treatment funding, advertising and labelling are also issues where alcohol groups feel policy is largely weak. Health groups therefore argue the determination of alcohol policy has for too long prioritised business or other interests at the cost of population health. Of course, voices claiming the opposite - that public health wishes are pandered to by a 'nanny state' - have degrees of support from some of the public, albeit that attitudes towards alcohol policies aimed at reducing alcohol harms vary by policy and demographics.
Whilst news items on how big business and associated groups access and influence policy are by no means new, those who wish to see decision making move towards control policies may continue to ask what strategies exist to effect change. Academic perspectives on why policymakers 'ignore' evidence may also be an ongoing subject. A recent DPH blog argues that on the issue of public health budgets, where the oft stated false economy of cuts have resulted in a crisis in drug and alcohol services, there is an acute need for 'better arguments, not better evidence'. Pointing out the limitations of pushing evidence alone, the blog argues that public health could focus more on strategies such as 'calling out rubbish arguments’, ‘understanding other’s points of view’, ‘clarify what we're asking for', and even, 'nicking some tricks'.
In the context of the broader political climate, alcohol policy decision making may of course be subject to far wider forces. Health groups may at least hold optimism for minimum pricing given positive expectations from Scotland's forthcoming evaluation. Plans for other areas, including budgets for treatment services or issues of regulation such as advertising, may be less certain, though advocates of various directions of policy will continue to seek out the best available means for achieving their objectives.
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