About you
What is your name?
Name
(Required)
Nicola Merrin
Are you responding as an individual or on behalf of an organisation?
Name of organisation
Alcohol Focus Scotland
Information about your organisation
Alcohol Focus Scotland (AFS) is the national charity working to prevent and reduce alcohol harm. We want to see fewer people have their health damaged or lives cut short due to alcohol, fewer children and families suffering as a result of other people’s drinking, and communities free from alcohol-related crime and violence. AFS welcomes the opportunity to respond to the Constitution, Europe, External Affairs and Culture Committee’s call for views on the UK internal market.
ASH Scotland is the national charity working on reducing the use of and harm from tobacco and related products (including recreational nicotine products like e-cigarettes). ASH Scotland endorses and supports AFS’s submission to the Committee and the concerns raised here. We have parallel concerns and would be happy to provide additional information.
Obesity Action Scotland is the national advocacy organisation on prevention of overweight and obesity in Scotland. We work to see improvements in the food environment to ensure that we can improve the diet of the Scottish population. OAS endorses and supports AFS’s submission to the Committee and the concerns raised here. We have parallel concerns and would be happy to provide additional information.
ASH Scotland is the national charity working on reducing the use of and harm from tobacco and related products (including recreational nicotine products like e-cigarettes). ASH Scotland endorses and supports AFS’s submission to the Committee and the concerns raised here. We have parallel concerns and would be happy to provide additional information.
Obesity Action Scotland is the national advocacy organisation on prevention of overweight and obesity in Scotland. We work to see improvements in the food environment to ensure that we can improve the diet of the Scottish population. OAS endorses and supports AFS’s submission to the Committee and the concerns raised here. We have parallel concerns and would be happy to provide additional information.
The UK Internal Market
How devolution is being impacted by the new constitutional arrangements arising from the UK internal market.
Please provide your response in the box provided.
It is our view that the UK internal market substantially undermines devolved regulatory autonomy and limits the ability of devolved governments to implement measures to improve public health.
We have serious concerns that the effect of the mutual recognition principle for goods will be to significantly reduce the benefits of introducing new devolved measures to protect public health. Such requirements will be inapplicable to trade from outside Scotland, and as such they will place local Scottish trade at a disadvantage. The net effect is likely to be to stifle policy innovation and to curb the ability to make different public health policy choices at the devolved level. Improvements to pre-existing requirements are also likely to be disincentivised, as any substantive update to such requirements may bring them within the scope of the legislation.
Mutual recognition will allow any English good that meets English regulatory requirements to be sold in Scotland without having to adhere to Scottish regulatory requirements. The Act provides no general public health protection exclusions to the application of this principle; mutual recognition can be denied only to prevent the spread of pests, diseases or unsafe foodstuffs, under strictly controlled conditions.
The non-discrimination principle for goods could also impede the ability of devolved administrations to legislate for public health. The public health grounds for justification for measures deemed discriminatory seem a very challenging bar. Measures that directly discriminate can only be justified as a response to a public health emergency. Such a definition is far too narrow to enable measures to be taken on public health protection grounds. In order to be justified, measures that indirectly discriminate would have to be ‘considered a necessary means of achieving a legitimate aim’ and deemed necessary to protect life or health, or public safety or security, with no alternate means of achieving the aims. This risks a situation where the Scottish Government is unable to legislate to protect the health of citizens or faces costly and excessive delays due to legal challenge. The Act’s placement of economic interests above those of the public is likely to undermine devolved regulatory autonomy.
Section 8 (7) of the Act gives the Secretary of State powers to make substantial changes to the legislation, including - for example – removing the public health exemption from the non-discrimination principle. Amendments have tempered these powers, requiring the Secretary of State to seek consent from the devolved administrations before making regulations. However, the Secretary of State may make the regulations without consent if it has not been secured within one month. They must publish a statement explaining their decision to do so. We are concerned that this limits the capacity of the Scottish Parliament to protect the public health exemption.
Example: Alcohol Labelling
AFS has long called for statutory regulation on alcohol labelling given the alcohol industry’s ongoing failure to provide basic health information on a voluntary basis (1).
The Scottish Government has made clear its preference for mandatory labelling across the UK but has supported the UK Government’s attempts to encourage voluntary approaches by the industry. The Scottish Government’s Alcohol Framework, however, reserved the right to legislate: “if insufficient progress is made by the time of the UK Government’s deadline of September 2019, the Scottish Government will be prepared to consider pursuing a mandatory approach in Scotland" (2).
The Act limits the capacity of the Scottish Parliament to regulate on alcohol labelling without the agreement of UK government. Labelling will be subject to common frameworks, a mechanism through which the UK Government and devolved administrations can work together on policy areas where powers returned from the EU intersect with devolved competence. The Food Compositional Standards and Labelling provisional common framework was presented to parliament in March 2021, however progress on this has stalled due to the pandemic. This has led Food Standards Scotland to comment that “the resultant legislative landscape is therefore messy and challenging to navigate” (3).
Although common frameworks have a dispute resolution process, if agreement isn’t reached then the UK Government would not have to pass the regulations necessary to allow for divergence. Alcohol Focus Scotland has concerns that this will both deter the Scottish Government from bringing forward proposals to improve alcohol labelling and constrain the ability of the Scottish Parliament to ensure that people have access to the information they require to make informed decisions about their drinking.
Example – Minimum Unit Pricing for Alcohol (MUP)
The UK Government amended the bill during its passage to ensure ‘manner of sale’ requirements - such as MUP - would fall under non-discrimination instead of mutual recognition. This was welcome; however, the question remains whether the ‘adverse market effect’ condition can be met (section 8 (1) (c) and 8 (3)). The Act’s definition of this term is unclear, although it is our interpretation that the requirement would have to disadvantage incoming goods in a way that it does not do for local goods, to cause significant adverse effect on competition in the market. Although we do not see how MUP would have a differentiated impact on Scottish and English alcohol, we are concerned that the uncertainty in the legislation could open the way for a challenge to the policy by the alcohol industry. The risk of such litigation, or the threat of it, may arise if and when the policy is modified.
The Scottish Government had committed to reviewing the minimum unit price after two years of implementation (i.e. from May 2020) (4), but this has been delayed due the pandemic. The Scottish Government’s Legislative Consent Memorandum on the Internal Market bill noted that an adjustment to pricing in line with inflation may put MUP within scope of the market access principles (5) (NB. the LCM was drafted at an earlier stage of the bill so states an adjustment may put MUP in scope of mutual recognition, in fact as noted above it would be under non-discrimination).
Minimum unit pricing has been successful in reducing off-sales consumption by 3.5% (6) and there are early signs that it is reducing harm with a reduction in alcohol deaths of 10% in the first full year of implementation (7). However, it is generally accepted that the effects of MUP will have been eroded by inflation since the policy was first approved by the Scottish Parliament in 2012. Alcohol Focus Scotland believes it is essential that the minimum unit price is uprated to ensure that it delivers full benefits and that initial gains from the policy are not lost. We believe the MUP should be increase to at least 65p per unit to take account of inflation over the last nine years since the Parliament approved MUP, as well as increasing the impact of the policy, saving more lives.
However, as public health advocates, we know only too well that the threat of litigation can create regulatory chill among decision-makers. Given the recent experience of the MUP legal challenge launched by the Scotch Whisky Association against the Scottish Government, which took almost five years to conclude, those considering regulation are likely to think long and hard about not only the likelihood of winning a case but the opportunity costs of the process.
If it is deemed that raising MUP would create an adverse market effect, then reliance would be on being able to justify the measure on the basis that it is ‘considered a necessary means of achieving a legitimate aim’ (Section 8 (1) (d)). This is a high threshold. Given the Internal Market Act prioritises economic considerations, there is concern that the outcome reached on MUP in the European and UK Courts (where the economic impact was put aside in favour of the positive public health implications), may not be the same when re-assessed, without the underpinning EU Law.
Example – Alcohol Marketing
The Scottish Government will consult shortly on measures to restrict alcohol marketing to protect children and young people from its effects (8). If the Scottish Parliament legislated to impose new advertising restrictions on alcoholic drinks in a way that disadvantaged English imports and adversely affected competition on the relevant UK market, Scotland would need to justify the application of those rules to English goods on public health grounds. This necessity test is strict and difficult to fulfil because it requires that there is no other less restrictive way of achieving the aim.
Human Rights
The Act undermines the ability of devolved administrations to legislate to protect and improve public health. The World Health Organization (WHO), in its Global Strategy to reduce non-communicable diseases, emphasises the importance of creating “health-promoting environments” which reduce consumption of tobacco, alcohol and unhealthy food (9). However, the Act is very likely to limit future regulatory action on unhealthy commodities across the UK and may encourage a default to the lowest common denominator. This would impede implementation of the WHO’s most cost-effective policy recommendations for reducing alcohol harm (10), such as action on marketing, price, availability and labelling.
The Act could also prevent fulfilment of the Scottish Government’s legal obligations to put health before profit. The right to health finds legal expression in a number of key international instruments to which the UK is signatory, including the International Covenant on Economic, Social and Cultural Rights (ICESCR). In ratifying this Covenant, the UK has made a commitment, binding in international law, to abide by the terms of the Covenant. This requires government, Parliament and the courts to make efforts to ensure the fullest possible compliance with the terms of the ICESCR. The Scottish Government has committed to incorporate the ICESCR, alongside three other United Nations treaties, into Scots Law (11).
General Comment 14 of the ICESCR lends specific support to an understanding that the right to health includes an obligation to regulate unhealthy products. It outlines the state’s duty to protect people from an infringement of their right to health by third parties, including corporations. If products are being consumed in a manner hazardous to health, an obligation is placed on the state to intervene to protect the right to health e.g. by developing a policy response to reduce the detrimental effects of alcohol to health by altering the market or consumption patterns.
In addition, General Comment 14 also supports the argument that states have an obligation to regulate unhealthy products in order to fulfil the right to health. Fulfilment of the right to health requires states to take positive measures ‘that enable and assist individuals and communities to enjoy their right to health’ (12). This could be interpreted as including the obligation to create an enabling environment for healthier lifestyle choices.
(1) Alcohol Health Alliance UK (2020). Drinking in the dark: How alcohol labelling fails consumers. London: AHA UK. https://ahauk.org/wp-content/uploads/2020/09/DRINKING-IN-THE-DARK.pdf
(2) Action 15 - The Scottish Government (2020). Alcohol Framework 2018: Preventing Harm. Next steps on changing our relationship with alcohol. Edinburgh: The Scottish Government https://www.gov.scot/publications/alcohol-framework-2018-preventing-harm-next-steps-changing-relationship-alcohol/
(3) Food Standards Scotland Board paper on EU Exit 8 months on for meeting on 21 September 2021, https://www.foodstandards.gov.scot/downloads/06_-_EU_Exit_8_months_on_-_Board_Meeting_-_21_September_15.pdf
(4) Action 3 - The Scottish Government (2020). Alcohol Framework 2018: Preventing Harm. Next steps on changing our relationship with alcohol. Edinburgh: The Scottish Government https://www.gov.scot/publications/alcohol-framework-2018-preventing-harm-next-steps-changing-relationship-alcohol/
(5) https://www.parliament.scot/S5_Finance/General Documents/SPLCM-S05-47.pdf
(6) Giles, L., Richardson, E. & Beeston, C. (2021). Using alcohol retail sales data to estimate population alcohol consumption in Scotland: an update of previously published estimates. Edinburgh: Public Health Scotland. https://publichealthscotland.scot/media/2994/using-alcohol-retail-sales-data-to-estimate-population-alcohol-consumption-in-scotland-an-update-of-previously-published-estimates.pdf
(7) National Records of Scotland (2020). Alcohol-specific deaths: main points. Edinburgh: National Records of Scotland. https://www.nrscotland.gov.uk/files//statistics/alcohol-deaths/2019/alcohol-specific-deaths-19-main-points.pdf
(8) Scottish Government (2021). A fairer, Greener Scotland. Programme for Government 2021-22. Edinburgh: Scottish Government. https://www.gov.scot/publications/fairer-greener-scotland-programme-government-2021-22/documents/
(9) World Health Organization (2017). ‘Best Buys’ and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases: Updated (2017) Appendix 3 of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020: https://www.who.int/ncds/management/WHO_Appendix_BestBuys_LS.pdf
(10) World Health Organization (2017). ‘Best Buys’ and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases: Updated (2017) Appendix 3 of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020: https://www.who.int/ncds/management/WHO_Appendix_BestBuys_LS.pdf
(11) Scottish Government (12 March 2021). New Human Rights Law. Scottish Government. Accessed 28/10/21 from https://www.gov.scot/news/new-human-rights-bill/
(12) CESCR General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12), Adopted at the Twenty-second Session of the Committee on Economic, Social and Cultural Rights, on 11 August 2000
We have serious concerns that the effect of the mutual recognition principle for goods will be to significantly reduce the benefits of introducing new devolved measures to protect public health. Such requirements will be inapplicable to trade from outside Scotland, and as such they will place local Scottish trade at a disadvantage. The net effect is likely to be to stifle policy innovation and to curb the ability to make different public health policy choices at the devolved level. Improvements to pre-existing requirements are also likely to be disincentivised, as any substantive update to such requirements may bring them within the scope of the legislation.
Mutual recognition will allow any English good that meets English regulatory requirements to be sold in Scotland without having to adhere to Scottish regulatory requirements. The Act provides no general public health protection exclusions to the application of this principle; mutual recognition can be denied only to prevent the spread of pests, diseases or unsafe foodstuffs, under strictly controlled conditions.
The non-discrimination principle for goods could also impede the ability of devolved administrations to legislate for public health. The public health grounds for justification for measures deemed discriminatory seem a very challenging bar. Measures that directly discriminate can only be justified as a response to a public health emergency. Such a definition is far too narrow to enable measures to be taken on public health protection grounds. In order to be justified, measures that indirectly discriminate would have to be ‘considered a necessary means of achieving a legitimate aim’ and deemed necessary to protect life or health, or public safety or security, with no alternate means of achieving the aims. This risks a situation where the Scottish Government is unable to legislate to protect the health of citizens or faces costly and excessive delays due to legal challenge. The Act’s placement of economic interests above those of the public is likely to undermine devolved regulatory autonomy.
Section 8 (7) of the Act gives the Secretary of State powers to make substantial changes to the legislation, including - for example – removing the public health exemption from the non-discrimination principle. Amendments have tempered these powers, requiring the Secretary of State to seek consent from the devolved administrations before making regulations. However, the Secretary of State may make the regulations without consent if it has not been secured within one month. They must publish a statement explaining their decision to do so. We are concerned that this limits the capacity of the Scottish Parliament to protect the public health exemption.
Example: Alcohol Labelling
AFS has long called for statutory regulation on alcohol labelling given the alcohol industry’s ongoing failure to provide basic health information on a voluntary basis (1).
The Scottish Government has made clear its preference for mandatory labelling across the UK but has supported the UK Government’s attempts to encourage voluntary approaches by the industry. The Scottish Government’s Alcohol Framework, however, reserved the right to legislate: “if insufficient progress is made by the time of the UK Government’s deadline of September 2019, the Scottish Government will be prepared to consider pursuing a mandatory approach in Scotland" (2).
The Act limits the capacity of the Scottish Parliament to regulate on alcohol labelling without the agreement of UK government. Labelling will be subject to common frameworks, a mechanism through which the UK Government and devolved administrations can work together on policy areas where powers returned from the EU intersect with devolved competence. The Food Compositional Standards and Labelling provisional common framework was presented to parliament in March 2021, however progress on this has stalled due to the pandemic. This has led Food Standards Scotland to comment that “the resultant legislative landscape is therefore messy and challenging to navigate” (3).
Although common frameworks have a dispute resolution process, if agreement isn’t reached then the UK Government would not have to pass the regulations necessary to allow for divergence. Alcohol Focus Scotland has concerns that this will both deter the Scottish Government from bringing forward proposals to improve alcohol labelling and constrain the ability of the Scottish Parliament to ensure that people have access to the information they require to make informed decisions about their drinking.
Example – Minimum Unit Pricing for Alcohol (MUP)
The UK Government amended the bill during its passage to ensure ‘manner of sale’ requirements - such as MUP - would fall under non-discrimination instead of mutual recognition. This was welcome; however, the question remains whether the ‘adverse market effect’ condition can be met (section 8 (1) (c) and 8 (3)). The Act’s definition of this term is unclear, although it is our interpretation that the requirement would have to disadvantage incoming goods in a way that it does not do for local goods, to cause significant adverse effect on competition in the market. Although we do not see how MUP would have a differentiated impact on Scottish and English alcohol, we are concerned that the uncertainty in the legislation could open the way for a challenge to the policy by the alcohol industry. The risk of such litigation, or the threat of it, may arise if and when the policy is modified.
The Scottish Government had committed to reviewing the minimum unit price after two years of implementation (i.e. from May 2020) (4), but this has been delayed due the pandemic. The Scottish Government’s Legislative Consent Memorandum on the Internal Market bill noted that an adjustment to pricing in line with inflation may put MUP within scope of the market access principles (5) (NB. the LCM was drafted at an earlier stage of the bill so states an adjustment may put MUP in scope of mutual recognition, in fact as noted above it would be under non-discrimination).
Minimum unit pricing has been successful in reducing off-sales consumption by 3.5% (6) and there are early signs that it is reducing harm with a reduction in alcohol deaths of 10% in the first full year of implementation (7). However, it is generally accepted that the effects of MUP will have been eroded by inflation since the policy was first approved by the Scottish Parliament in 2012. Alcohol Focus Scotland believes it is essential that the minimum unit price is uprated to ensure that it delivers full benefits and that initial gains from the policy are not lost. We believe the MUP should be increase to at least 65p per unit to take account of inflation over the last nine years since the Parliament approved MUP, as well as increasing the impact of the policy, saving more lives.
However, as public health advocates, we know only too well that the threat of litigation can create regulatory chill among decision-makers. Given the recent experience of the MUP legal challenge launched by the Scotch Whisky Association against the Scottish Government, which took almost five years to conclude, those considering regulation are likely to think long and hard about not only the likelihood of winning a case but the opportunity costs of the process.
If it is deemed that raising MUP would create an adverse market effect, then reliance would be on being able to justify the measure on the basis that it is ‘considered a necessary means of achieving a legitimate aim’ (Section 8 (1) (d)). This is a high threshold. Given the Internal Market Act prioritises economic considerations, there is concern that the outcome reached on MUP in the European and UK Courts (where the economic impact was put aside in favour of the positive public health implications), may not be the same when re-assessed, without the underpinning EU Law.
Example – Alcohol Marketing
The Scottish Government will consult shortly on measures to restrict alcohol marketing to protect children and young people from its effects (8). If the Scottish Parliament legislated to impose new advertising restrictions on alcoholic drinks in a way that disadvantaged English imports and adversely affected competition on the relevant UK market, Scotland would need to justify the application of those rules to English goods on public health grounds. This necessity test is strict and difficult to fulfil because it requires that there is no other less restrictive way of achieving the aim.
Human Rights
The Act undermines the ability of devolved administrations to legislate to protect and improve public health. The World Health Organization (WHO), in its Global Strategy to reduce non-communicable diseases, emphasises the importance of creating “health-promoting environments” which reduce consumption of tobacco, alcohol and unhealthy food (9). However, the Act is very likely to limit future regulatory action on unhealthy commodities across the UK and may encourage a default to the lowest common denominator. This would impede implementation of the WHO’s most cost-effective policy recommendations for reducing alcohol harm (10), such as action on marketing, price, availability and labelling.
The Act could also prevent fulfilment of the Scottish Government’s legal obligations to put health before profit. The right to health finds legal expression in a number of key international instruments to which the UK is signatory, including the International Covenant on Economic, Social and Cultural Rights (ICESCR). In ratifying this Covenant, the UK has made a commitment, binding in international law, to abide by the terms of the Covenant. This requires government, Parliament and the courts to make efforts to ensure the fullest possible compliance with the terms of the ICESCR. The Scottish Government has committed to incorporate the ICESCR, alongside three other United Nations treaties, into Scots Law (11).
General Comment 14 of the ICESCR lends specific support to an understanding that the right to health includes an obligation to regulate unhealthy products. It outlines the state’s duty to protect people from an infringement of their right to health by third parties, including corporations. If products are being consumed in a manner hazardous to health, an obligation is placed on the state to intervene to protect the right to health e.g. by developing a policy response to reduce the detrimental effects of alcohol to health by altering the market or consumption patterns.
In addition, General Comment 14 also supports the argument that states have an obligation to regulate unhealthy products in order to fulfil the right to health. Fulfilment of the right to health requires states to take positive measures ‘that enable and assist individuals and communities to enjoy their right to health’ (12). This could be interpreted as including the obligation to create an enabling environment for healthier lifestyle choices.
(1) Alcohol Health Alliance UK (2020). Drinking in the dark: How alcohol labelling fails consumers. London: AHA UK. https://ahauk.org/wp-content/uploads/2020/09/DRINKING-IN-THE-DARK.pdf
(2) Action 15 - The Scottish Government (2020). Alcohol Framework 2018: Preventing Harm. Next steps on changing our relationship with alcohol. Edinburgh: The Scottish Government https://www.gov.scot/publications/alcohol-framework-2018-preventing-harm-next-steps-changing-relationship-alcohol/
(3) Food Standards Scotland Board paper on EU Exit 8 months on for meeting on 21 September 2021, https://www.foodstandards.gov.scot/downloads/06_-_EU_Exit_8_months_on_-_Board_Meeting_-_21_September_15.pdf
(4) Action 3 - The Scottish Government (2020). Alcohol Framework 2018: Preventing Harm. Next steps on changing our relationship with alcohol. Edinburgh: The Scottish Government https://www.gov.scot/publications/alcohol-framework-2018-preventing-harm-next-steps-changing-relationship-alcohol/
(5) https://www.parliament.scot/S5_Finance/General Documents/SPLCM-S05-47.pdf
(6) Giles, L., Richardson, E. & Beeston, C. (2021). Using alcohol retail sales data to estimate population alcohol consumption in Scotland: an update of previously published estimates. Edinburgh: Public Health Scotland. https://publichealthscotland.scot/media/2994/using-alcohol-retail-sales-data-to-estimate-population-alcohol-consumption-in-scotland-an-update-of-previously-published-estimates.pdf
(7) National Records of Scotland (2020). Alcohol-specific deaths: main points. Edinburgh: National Records of Scotland. https://www.nrscotland.gov.uk/files//statistics/alcohol-deaths/2019/alcohol-specific-deaths-19-main-points.pdf
(8) Scottish Government (2021). A fairer, Greener Scotland. Programme for Government 2021-22. Edinburgh: Scottish Government. https://www.gov.scot/publications/fairer-greener-scotland-programme-government-2021-22/documents/
(9) World Health Organization (2017). ‘Best Buys’ and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases: Updated (2017) Appendix 3 of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020: https://www.who.int/ncds/management/WHO_Appendix_BestBuys_LS.pdf
(10) World Health Organization (2017). ‘Best Buys’ and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases: Updated (2017) Appendix 3 of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020: https://www.who.int/ncds/management/WHO_Appendix_BestBuys_LS.pdf
(11) Scottish Government (12 March 2021). New Human Rights Law. Scottish Government. Accessed 28/10/21 from https://www.gov.scot/news/new-human-rights-bill/
(12) CESCR General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12), Adopted at the Twenty-second Session of the Committee on Economic, Social and Cultural Rights, on 11 August 2000
The challenges and opportunities in domestic policy divergence including the risks/rewards of policy divergence between the four parts of the UK and the EU.
Please provide your response in the box provided.
The nature and extent of public health problems can vary across UK jurisdictions and devolution enables each to innovate in how it responds. This, in turn, can help to drive UK-wide public health improvements. For example, the rate of alcohol-specific mortality in Scotland remains significantly higher than that in England (13). The existing devolution settlement has allowed the Scottish Government to develop and implement the internationally path-breaking policy of minimum unit pricing for alcohol (MUP), which is estimated to have reduced net off-sales purchases in Scotland, compared to England and Wales, by 3.5% in the first year of implementation (14). Furthermore, Scotland saw a reduction in alcohol-specific deaths of 10% in the first full year of operation of MUP (15).
MUP has now also been implemented by the Welsh Assembly Government, and the Northern Ireland Health Minister has announced his government’s intention to consult on the policy by September 2022 (16). Similarly, the Scottish Parliament legislated to ban smoking in public places in 2006, an approach which was subsequently adopted by other administrations, and which has saved and improved tens of thousands of lives across the UK (17).
The opportunity for different administrations across the UK to innovate in public health policy can be of mutual benefit as the evidence obtained from implementing such policies in one country can help inform decision-makers in others. The UK government has previously noted that, while it has no plans to introduce MUP in England, “it will continue to monitor the progress of MUP in Scotland and will consider available evidence of its impact” (18).
(13) In 2019, alcohol-specific death rates were 68% higher for men and 78% higher for women in Scotland compared with England & Wales. Richardson. E. & Giles, L. (2021). Monitoring and Evaluating Scotland’s Alcohol Strategy: Monitoring Report 2021. Edinburgh: Public Health Scotland.
(14) Giles, L., Richardson, E. & Beeston, C. (2021). Using alcohol retail sales data to estimate population alcohol consumption in Scotland: an update of previously published estimates. Edinburgh: Public Health Scotland. https://publichealthscotland.scot/media/2994/using-alcohol-retail-sales-data-to-estimate-population-alcohol-consumption-in-scotland-an-update-of-previously-published-estimates.pdf
(15) National Records of Scotland (2020). Alcohol-specific deaths: main points. Edinburgh: National Records of Scotland. https://www.nrscotland.gov.uk/files//statistics/alcohol-deaths/2019/alcohol-specific-deaths-19-main-points.pdf
(16) Northern Ireland Department of Health (September 2021), Preventing Harm, Empowering Recovery A Strategic Framework to Tackle the Harm from Substance Use (2021-31). https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-substanceuse-strategy-2021-31.pdf
(17) For example, Sims, M., Maxwell, R., Bauld, L., & Gilmore, A. (2010). Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction. BMJ, 340, c2161 https://doi.org/10.1136/bmj.c2161; Frazer, K., Callinan, J. E., McHugh, J., van Baarsel, S., Clarke, A., Doherty, K., & Kelleher, C. (2016). Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database of Systematic Reviews, (2) https://doi.org/10.1002/14651858.CD005992.pub3.
(18) Lord Bethell, Parliamentary Under-Secretary (Department of Health and Social Care) response to written question HL1749, Alcoholic Drinks: Minimum Prices, on 6 March 2020, https://www.parliament.uk/written-questions-answers-statements/written-question/lords/2020-02-24/HL1749
MUP has now also been implemented by the Welsh Assembly Government, and the Northern Ireland Health Minister has announced his government’s intention to consult on the policy by September 2022 (16). Similarly, the Scottish Parliament legislated to ban smoking in public places in 2006, an approach which was subsequently adopted by other administrations, and which has saved and improved tens of thousands of lives across the UK (17).
The opportunity for different administrations across the UK to innovate in public health policy can be of mutual benefit as the evidence obtained from implementing such policies in one country can help inform decision-makers in others. The UK government has previously noted that, while it has no plans to introduce MUP in England, “it will continue to monitor the progress of MUP in Scotland and will consider available evidence of its impact” (18).
(13) In 2019, alcohol-specific death rates were 68% higher for men and 78% higher for women in Scotland compared with England & Wales. Richardson. E. & Giles, L. (2021). Monitoring and Evaluating Scotland’s Alcohol Strategy: Monitoring Report 2021. Edinburgh: Public Health Scotland.
(14) Giles, L., Richardson, E. & Beeston, C. (2021). Using alcohol retail sales data to estimate population alcohol consumption in Scotland: an update of previously published estimates. Edinburgh: Public Health Scotland. https://publichealthscotland.scot/media/2994/using-alcohol-retail-sales-data-to-estimate-population-alcohol-consumption-in-scotland-an-update-of-previously-published-estimates.pdf
(15) National Records of Scotland (2020). Alcohol-specific deaths: main points. Edinburgh: National Records of Scotland. https://www.nrscotland.gov.uk/files//statistics/alcohol-deaths/2019/alcohol-specific-deaths-19-main-points.pdf
(16) Northern Ireland Department of Health (September 2021), Preventing Harm, Empowering Recovery A Strategic Framework to Tackle the Harm from Substance Use (2021-31). https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-substanceuse-strategy-2021-31.pdf
(17) For example, Sims, M., Maxwell, R., Bauld, L., & Gilmore, A. (2010). Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction. BMJ, 340, c2161 https://doi.org/10.1136/bmj.c2161; Frazer, K., Callinan, J. E., McHugh, J., van Baarsel, S., Clarke, A., Doherty, K., & Kelleher, C. (2016). Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database of Systematic Reviews, (2) https://doi.org/10.1002/14651858.CD005992.pub3.
(18) Lord Bethell, Parliamentary Under-Secretary (Department of Health and Social Care) response to written question HL1749, Alcoholic Drinks: Minimum Prices, on 6 March 2020, https://www.parliament.uk/written-questions-answers-statements/written-question/lords/2020-02-24/HL1749