THE SHAPE OF THINGS TO COME

As I write we await the outcome of the House of Lords investigation into the workings of the Licensing Act 2003. One of the things they were considering was whether ‘protecting and promoting public health’ should be added as a fifth licensing objective. I don’t know what their Lordships will conclude on this issue, although rumour has it they will not recommend this, but that hasn’t stopped Public Health England (PHE) from publishing ‘Public Health and Licensing Guidance’, subtitled ‘A simple guide for responding to applications as a responsible authority.’ Directors of public health have been included as Responsible Authorities under the Licensing Act since 2013, so many in the ‘public health’ community may consider this guidance long overdue.

So, we have a guidance document consisting of some 27 sides of A4 which explains to local public health practitioners how to object to a licence application based on one or more of the four existing licensing objectives, notwithstanding that ‘public health’ isn’t one of them! As the document explains on page 7:

“Although the licensing objectives do not include a health objective, there is a health and wellbeing angle to each of them. It is also possible for a Director of Public Health to have an independent and supporting role as a responsible authority. The above provide some examples that do not cover the full range of opportunities for public health involvement, but outline some composite examples of actions that have been taken by responsible authorities that directly draw on the connection of health to the existing objectives.”

The reference in the second sentence of the paragraph quoted to “the above” refers to examples regarding how a director of public health might smuggle in a health objection as an objection based on, say, public nuisance:

“…a representation requesting noise related conditions or objecting to an extension of hours for an application using evidence on the health impacts that sleep deficit can have on the local residents.”

Or evidence from:

“last drinks survey data, A&E and ambulance data indicating a high number of alcohol poisoning cases coming from a particular premises, or from within its near vicinity.”

You can see right here the difficulty in relating general evidence to a particular application for a premises that hasn’t yet opened or had its hours extended. You can also see that the implicit assumption of PHE is that local directors of public health should be looking for reasons to object. In fact, the guidance document proposes a traffic light system based on ‘red’ and ‘green’ applications. A ‘red’ application – one that would need to be looked at with a view to making a representation – would include any application for:

·       Off licences

·       Any application for hours after midnight or before 8 am

·       Anything within a cumulative impact policy

·       Night clubs

·       Premises reviews by other responsible authorities

·       High volume or ‘vertical drinking’ establishments.

Whereas a ‘green’ application – one that would be of low concern to public health – might include applications for:

·       Restaurants before midnight

·       Food venue before midnight 

·       Theatre Bars before midnight 

·       Changes to the Designated Premises Supervisor

·       Temporary Event Notices (TENs) as the Director of Public Health does not have the remit to respond to these.

Clearly these benighted nannies don’t want the citizenry up and drinking after midnight – and even then only in posh eateries or theatre bars – but preferably not at all!

When your starting point is that it’s the availability of alcohol that makes people drink it, and that population levels of consumption drive alcohol harm, then it should come as no surprise that the starting point for directors of public health in relation to any application for a new licence is “how can we stop it?” the purpose of the traffic light system is merely to sift out applications where an objection would stand little chance of success.

I hope that the House of Lords and the government will not introduce a health licensing objective – much less a ‘health and wellbeing’ objective – and if you read the PHE guidance document you will see how often that word is insinuated into the text. The system we have works well as it is, and scarce resources need to be directed at those who really are drinking at unhealthy and damaging levels, not at making mischief through gratuitous objections to individual licence applications based on an objection to beverage alcohol as such, rather than any real local concerns.

Paul Chase

The shape of things to come by Paul Chase

As I write we await the outcome of the House of Lords investigation into the workings of the Licensing Act 2003. One of the things it was considering was whether “protecting and promoting public health” should be added as a fifth licensing objective. I don’t know what their Lordships will conclude on this issue, although rumour has it they will not recommend this. But that hasn’t stopped Public Health England (PHE) from publishing “Public Health and Licensing Guidance”, subtitled “A simple guide for responding to applications as a responsible authority”. Directors of public health have been included as responsible authorities under the Licensing Act since 2013, so many in the “public health” community may consider this guidance long overdue.

So, we have a guidance document consisting of some 27 sides of A4 that explains to local public health practitioners how to object to a licence application based on one or more of the four existing licensing objectives, notwithstanding that “public health” isn’t one of them! As the document explains on page seven: “Although the licensing objectives do not include a health objective, there is a health and well-being angle to each of them. It is also possible for a director of public health to have an independent and supporting role as a responsible authority. The above provide some examples that do not cover the full range of opportunities for public health involvement, but outline some composite examples of actions that have been taken by responsible authorities that directly draw on the connection of health to the existing objectives.”

The reference in the second sentence of the paragraph quoted to “the above” refers to examples regarding how a director of public health might smuggle in a health objection as an objection based on, say, public nuisance: “…a representation requesting noise-related conditions or objecting to an extension of hours for an application using evidence on the health impacts that sleep deficit can have on the local residents.” Or evidence from: “...last drinks survey data, A&E and ambulance data indicating a high number of alcohol poisoning cases coming from a particular premises, or from within its near vicinity.”

You can see right here the difficulty in relating general evidence to a particular application for a premises that hasn’t yet opened or had its hours extended. You can also see the implicit assumption of PHE is local directors of public health should be looking for reasons to object. In fact, the guidance document proposes a traffic light system based on “red” and “green” applications. A “red” application – one that would need to be looked at with a view to making a representation – would include any application for off-licences, any application for hours after midnight or before 8am, anything within a cumulative impact policy, nightclubs, premises reviews by other responsible authorities and high volume or “vertical drinking” establishments.

Whereas a “green” application – one that would be of low concern to public health – might include applications for restaurants before midnight, food venues before midnight, theatre bars before midnight, changes to the designated premises supervisor and Temporary Event Notices as the director of public health does not have the remit to respond to these.

Clearly these benighted nannies don’t want the citizenry up and drinking after midnight – and even then only in posh eateries or theatre bars – but preferably not at all! When your starting point is it’s the availability of alcohol that makes people drink it, and that population levels of consumption drive alcohol harm, then it should come as no surprise the starting point for directors of public health in relation to any application for a new licence is “how can we stop it”? The purpose of the traffic light system is merely to sift out applications where an objection would stand little chance of success.

I hope the House of Lords and the government will not introduce a health licensing objective – much less a “health and well-being” objective – and if you read the PHE guidance document you will see how often that word is insinuated into the text. The system we have works well as it is, and scarce resources need to be directed at those who really are drinking at unhealthy and damaging levels, not at making mischief through gratuitous objections to individual licence applications based on an objection to beverage alcohol as such, rather than any real local concerns.

The hydra-headed monster by Paul Chase

I thought I would return to the fray with a new twist on an old theme – minimum unit pricing (MUP). Readers of my articles may recall the legality of a minimum unit price for alcohol is an issue that has been batted back and forth between the Scottish government and the Scotch Whisky Association (SWA) since 2012. The Scottish courts had their say (legal); it was referred to the European Court of Justice (not legal). But the ECJ left the final decision to the Scottish courts, which needed to be convinced there was no other, less trade-restrictive way of achieving the Scottish government’s health objectives in respect of alcohol if they were to conclude it was, after all, “legal” to impose a minimum price on a unit of alcohol.

They promptly did so when the Scottish government provided them with the latest research findings from the boys and girls at Sheffield University, whose modelling forms the basis of all the claims made for this measure. So, game, set and match? Well, not quite. The SWA has appealed the Scottish court’s decision to the Supreme Court in London. They have been rather busy of late considering whether the UK government has to get parliamentary approval before triggering Article 50 of the EU treaty to take us out of the European Union. But the little matter of MUP is likely to be ruled on around June this year.

Meanwhile, the authors of the Sheffield model haven’t been sitting around twiddling their thumbs. Oh no! They’ve been modelling the effect of an MUP of 50p on alcohol-related hospital admissions and deaths in Northern Ireland. A charity called Northern Ireland Chest Heart and Stroke said raising the minimum price paid for booze would save lives, lower hospital admissions and cut the costs of crime by £20m a year. Neil Johnston from the charity said: “Alcohol sold for less than 50p a unit makes up the majority of alcohol purchased by high-risk drinkers. Work by Sheffield University shows that pushing up the price of very cheap alcohol will reduce consumption of it by high-risk drinkers and bring considerable benefits. Introducing a minimum unit price of 50p is estimated to save 63 lives a year and result in almost 2,500 fewer hospital admissions.” Very impressive, but do the figures stack up? It is informative to compare Sheffield University’s predictions for Northern Ireland with its predictions for Scotland:

• How can it be that a 50p MUP saves three fewer lives each year in Scotland than in Northern Ireland, despite the fact Scotland has 3.6 million more people than Northern Ireland? And, in terms of alcohol-related hospital admissions, nearly twice as many of these are saved in Northern Ireland despite the fact Northern Ireland’s population is only a third of Scotland’s!

• It is interesting to note that MUP as a policy has been enthusiastically and uncritically supported by Scotland, Wales and Northern Ireland, whereas in England the UK government’s view has been much more sceptical. The “healthiest” agenda tends to receive much more support by governments that are relatively new, struggling for legitimacy or relevance, and for whom embracing policies that claim to improve the “health of the nation” gives them an opportunity to promote themselves as standing up for the interests of “the people” and against those of big business – in this case Big Alcohol.

It remains to be seen whether the UK Supreme Court will risk being labelled “enemies of the people” by yet again standing up for rationality and finding against MUP. In this “fake fact” world, where an appeal to prejudice is seemingly all that is needed to identify a large constituency of support that will rise up vociferously, it seems to me we need some unelected judges who aren’t afraid to tell us the truth.

ALCOHOL CONCERN R.I.P.

It may have escaped your attention, but Alcohol Concern (AC) and Alcohol Research UK (ARUK), the UK’s two leading anti-alcohol sock puppet charities, are to merge. This merger has consequences for the way in which anti-alcohol advocacy will be conducted going forward, but first, a little bit of history:

Alcohol Concern and the International Order of Good Templars

The International Order of Good Templars, or ‘IOGT International’ as they now refer to themselves, was the most zealous of the clutch of anti-alcohol groups that sprang up in the 1850s. Despite the repeal of Prohibition in America in 1933, it remained in existence as a hard-line anti-alcohol sect until the 1970s, when its leader Derek Rutherford, recognising that campaigning for the outright prohibition of alcohol was a lost cause, moved IOGT to an apparently softer line of campaigning to reduce alcohol-related harms. Initially, in the UK, IOGT worked with the National Council on Alcoholism, which later evolved into the anti-alcohol advocacy group Alcohol Concern (AC).

The two groups parted company in 1982 after a row with the new chairman who said he had no time for “a bunch of Methodist teetotallers.” IOGT walked out and Rutherford, along with Andrew McNeill set up the Institute of Alcohol studies as an alcohol research organisation. So, whilst the National Council on Alcoholism and IOGT parted company, the legacy organisations they spawned have their roots deeply embedded in historical temperance.

Alcohol Research UK (ARUK)

ARUK is another organisation with its roots in historical temperance. Indeed, today 70% of its income is derived from returns on an investment fund that arose out of the Licensing Act 1904! The government of Conservative Prime Minister Arthur Balfour established the ‘Licensing Compensation Scheme’ to compensate licensees who lost their licences through no fault of their own, but as a result of action by local Justices to close down premises in areas where they deemed there was overprovision. The scheme was funded by a levy on all licensed property, from £1 on small beer houses to £150 on large hotels. The scheme was not popular with either side in the alcohol/society debate, with temperance campaigners dubbing it the “Brewers Endowment Fund” and brewers calling it the “Mutual Burial Fund”.

The scheme didn’t last for long, but the money collected was not returned to the trade from whose pockets it had been picked. The fund was left in abeyance, and it wasn’t until the 1981 Act that half of the residual funds were transferred via a liquidator to establish the Alcohol Education and Research Council (AERC). In 2011 the AERC was wound up and the investment fund was transferred to a new charity, Alcohol Research UK.

The merger

On the 7^th December 2016 there was a joint press release announcing that AC and ARUK are to “merge” by April 2017. Why has this happened? If you look at the published accounts of both organisations this gives you a clue. AC has struggled to fund itself since it lost core funding from the UK government in 2012. It still receives taxpayers’ money from the Welsh Assembly government totalling £185,108 in 2016, with its second biggest funder being the Big Lottery – Pembrokeshire which contributed £62,459 in the same year. In the recent past AC has received money from the pharmaceutical industry for its support for a treatment for ‘mild alcoholism’ that was marketed as ‘Selincro’. However, in 2016 its expenditure exceeded its income by some £72,330 and it is apparent that AC struggles to make ends meet, and if the UK government isn’t going to finance its sock puppet activities using public funds to lobby for public policy change, then its long-term future looked uncertain at best.

ARUK, on the other hand, is losing even more money, with its expenditure exceeding its income in 2015 by £317,701. Whilst this is a much bigger budget deficit than Alcohol Concern’s, ARUK does have a dependable source of income from its historical investment fund of £15.7 million, which delivered £548,855 in 2015, with just £51,972 from voluntary donations and an income of just £17,864 from “charitable activities”.

So, when is a merger not really a merger? Well, the CEO of the newly-merged organisation will be Dave Roberts, who currently heads up ARUK. AC’s current CEO Joanna Simons was appointed with the specific remit of looking at options for its future strategy and she will leave in April 2017, when the merger is accomplished. Emily Robinson, AC’s deputy CEO has already left. So, it appears that ARUK will gain AC’s income of around £950K a year, lose the cost of the two biggest earners from its payroll, and, presumably merge the two offices and save even more cost. All very sensible.

But what will really remain of AC’s campaigning efforts in the future? ‘Dry January’ will presumably still go ahead in January 2017, but after that will it be retained, rather like Fidel Castro’s cigar, as the signature symbol of a dead icon, or will it be dispensed with? I guess that will depend on whether AC’s funders are prepared to fund the AC part of the merged charity.

And what will be the position of those key figures in ARUK who insist that theirs is an objective, independent research organisation, now that they are about to acquire an organisation dedicated to advocacy and campaigning? ARUK states that its aim is to “reduce levels of alcohol-related harm by ensuring that policy and practice can always be developed on the basis of research-based evidence”; whereas AC states that they “work throughout England and Wales towards our vision of a world where alcohol does no harm”.

There is a big difference between reducing levels of harm, and creating a world where alcohol does no harm – which, given the mantra of “there is no safe level of alcohol consumption” - can only mean a world without alcohol. Whose vision will prevail? Given the tendency of anti-alcohol groups to undergo Trotskyite-like splits, will this marriage of financial convenience last, or might the Institute of Alcohol Studies and IOGT win-out in the neo-temperance merger stakes? We’ll have to wait and see.

Paul Chase

LOOKING FORWARD TO 2017

In terms of the ongoing culture war in relation to alcohol, there have been three signal developments over the past 12 months that I think will reverberate over the course of 2017. They are: the development, and publication in January this year, of the UK CMOs’ new, ‘low risk’ drinking guidelines; the establishment of the House of Lords all-party committee inquiring into the Licensing Act 2003; and the decision by the Scottish Inner Court of Sessions that minimum unit pricing (MUP) is, after all, lawful – a decision which the Scotch whisky association (SWA) has now announced it will appeal to the Supreme Court in London.

Let’s take a look at each of these in turn, and what the likely developments mean for the trade in beverage alcohol:

The ‘low-risk’ guidelines

The real significance of the new alcohol drinking guidelines is not that they set a new, low-risk level of 14 units a week alcohol consumption for both men and women, but the assertion that there is “no safe level of consumption”. Any pretence that official advice on alcohol consumption was about influencing drinking behaviour, and encouraging moderate consumption, was destroyed when the new ‘low-risk’ guideline was set at a level that was widely derided by the drinking public and the industry alike as having no basis in the reality of peoples’ drinking habits. Since “public health” has no belief in the efficacy of education as a driver of social change, because they believe it’s a soft option embraced by Big Alcohol as a means of warding-off real change, the only purpose of the new guidelines was to influence public policy. Specifically, alcohol policy.

Fundamental to this latest attempt to demonise alcohol is a determined effort at science-denial. Denial that there are any health benefits to moderate alcohol consumption despite decades of science showing that regular, moderate drinking results in lower all-cause mortality and greater longevity than that associated with abstinence. Coupled with this is the attempt to link low and moderate consumption of alcohol with a range of cancers on the basis of, largely, very weak epidemiological associations.

By establishing the “no safe level of consumption” and the “every time I reach for a glass of wine I think of the cancer risk” mantras, “public health” seeks to establish through propaganda what it can’t establish through science: that alcohol can’t be part of a healthy lifestyle.

The House of Lords committee on the Licensing Act 2003

The positive aspect of this review of the effectiveness of the Licensing Act 2003 is that, by all accounts, their Lordships really do “get it” – they are very much aware of the issues and the differences of opinion and are seeking evidence. My concern at the outset of this inquiry is that it was just a cover for seeking the introduction of a fifth licensing objective – ‘Promoting and Protecting Public Health’, or even ‘Promoting and Protecting Health and Welfare’.

If we were to see the introduction of a ‘health’ licensing objective, then this would open the door to all the career alcophobes of so-called “public health” like James Nicholls from Alcohol Research UK, and Jon Foster from the Institute of Alcohol Studies, to encourage local PCTs to oppose applications for new licences. It’s probably not a practical possibility for them to do this for every application, but if your fundamental belief is that it’s the availability of alcohol that drives consumption and harm, then under what circumstances wouldn’t you object?

Minimum unit pricing

The Scottish Parliament legislated to introduce this in 2012. Since then it has been subject to legal challenge by the Scotch Whisky Association (SWA) and others in respect of whether its implementation was contrary to European Union competition law.  In Scotland the Outer Court of Sessions ruled it was legal, but then the Inner Court of Sessions quashed that decision and sent it off to the European Court of Justice (ECJ) to be determined. The ECJ pretty much gave it the thumbs down, but returned it to the Scottish courts to determine. They gave it the thumbs up!

The position now is that the SWA wants to appeal this to the Supreme Court in London and have lodged an application with the Scottish Court for leave to appeal. The SWA’s decision to appeal has, of course, been subject to expressions of faux outrage by the cranks at Alcohol Focus Scotland who have characterised the decision to appeal as an affront to democracy! Comments like “it beggars belief” etc., etc.

I am opposed to MUP because I think it is a bad policy; if it also turns out, eventually, to be unlawful, then I think that would be enormously helpful. But, then we’re supposed to be leaving the EU aren’t we? So whether we continue to be subject to ECJ rulings will depend on whether we want access to the single market.

All three of these issues will continue to make waves in the coming year. Watch this space!