Minimum unit pricing will not solve NI’s drink problem, but it is a step in the right direction
Scotland and Wales led the way... now it’s time Health Minister Robin Swann followed suit. By Nelson McCausland
In the 18th century there was an epidemic of alcoholism in England, with cheap gin as one of the contributing factors. In some parts of London more than one in 10 of the buildings was a gin shop and, in 1751, the artist William Hogarth depicted the problem with a painting entitled Gin Lane. It showed a gin shop with the slogan “Drunk for a penny, dead drunk for tuppence and clean straw (to lie on) for nothing”. Even then price mattered.
It still matters and minimum unit pricing (MUP) for alcohol has just been introduced in Wales in an effort to reduce the harm caused by excessive alcohol consumption. There is, rightly, a particular focus today on illegal drugs and the misuse of prescription drugs, but alcohol abuse remains a major contributor to illness, both physical and mental, and to premature deaths.
The introduction of minimum unit pricing in Wales is a move which is supported by health professionals and by international evidence of a negative relationship between price, consumption and alcohol-related harms. The World Health Organisation has identified price and controls on promotion and availability as key methods for addressing alcohol-related health harms.
Wales is following the lead of Scotland, where the Scottish Parliament passed the Alcohol (Minimum Pricing) Bill in 2012. At the time it was stated that the intervention was intended to reduce alcohol consumption and related harms. However, the new law faced robust opposition from the alcohol industry, which fought a long-running battle in the courts.
Their case was based on European Union legislation, but in the end they lost and MUP was introduced in Scotland in May 2018 with a minimum of 50p per unit, the same figure being used in Wales.
Subsequently, an early study published in the British Medical Journal confirmed that it had resulted in a reduction in consumption, with the biggest fall being among the heaviest drinkers. The effects were greatest in households who purchased the most alcohol and there was no evidence of a differential negative impact on expenditure on lower-income groups.
There is almost no impact on moderate drinkers or on licensed premises. The impact is on those who consume large volumes of cheap alcohol, usually purchased in off-licences and supermarkets.
Of course, there are ideological libertarians who complain about a “nanny state”. They oppose MUP, just as they opposed compulsory seat-belts for car passengers, plain packaging and health warnings for cigarettes and the smoking ban in cars where there are children in the vehicle. Ultra-libertarians would even want to legalise heroin.
Personal liberty is important, but alcohol-related harm does not merely concern the individual. It affects partners, families, parents, children and wider society.
Around 7,000 babies are born every year in the UK with foetal alcohol spectrum disorder, a condition that can harm the child, physically, mentally and behaviourally.
As regards wider society, around half of all violent crime is alcohol-related and it places an additional burden on the police service and the health service.
There is a growing public awareness of alcohol abuse and Scotland and Wales are not the end of the story for MUP in the British Isles. Last July the UK Government said that while it had no plans to introduce MUP in England, it was watching to see what would happen in Scotland.
Meanwhile, the Irish Republic has already taken a first step and the Public Health Alcohol Act, which became law in 2018, contains a provision for MUP as one of a series of measures. It is being implemented incrementally and already there are restrictions on alcohol advertising on public transport, on children’s clothing and near schools. However, the implementation of MUP has been delayed pending similar legislation in Northern Ireland.
Some years ago a DUP Health Minister supported the move and a lot of the preparatory work was done at that time. However, he was waiting — quite correctly — to see the outcome of the legal challenge in Scotland, a matter that is now settled.
So, with the restoration of devolution it will be interesting to see if new Health Minister Robin Swann takes this forward. It is not the magic solution to alcohol abuse, but it is a step in the right direction and could form part of a strategy to reduce the harm caused by alcohol abuse.