Minimum Pricing will survive 2024 review with a higher unit price

By Jack Cummins

(This article was written before the publication of Public Health Scotland’s report on the effectiveness of Minimum Unit Pricing. You can view the report here)

MINIMUM pricing (MUP) is set to hit the headlines yet again this summer when Public Health Scotland (PHS) publishes its final, overarching evaluation on the effectiveness or otherwise of the hugely controversial legislation. 

This will be a landmark moment: MUP came into force on May 1, 2018 and, in terms of the legislation, it will be switched off six years after that date unless Scottish ministers make a continuation order approved by the Parliament. 

On the face of it, the PHS evaluation is – or ought to be – the key factor deciding MUP’s future. 

It must in particular contain information about the effect MUP has had on the 2005 Act’s licensing objectives. “Such categories of persons as the Scottish ministers consider appropriate”, licensed businesses and producers of alcohol.

Over the past five years or so, highly-polarised arguments as to the effectiveness of MUP have raged on and on. Critics have labelled the measure a shambles, doomed to fail from the start. 

Supporters have claimed impressive success. Let’s look at very recent examples of this divergence. 

A study published last month in The Lancet found that MUP was associated with a 13.4 per cent reduction in deaths wholly attributable to alcohol consumption. Hospitalisations linked to alcohol consumption fell by 4.1 per cent. 

That report attracted considerable publicity – but other research published last month in Science Direct and commissioned by PHS appears to have been largely ignored. 

This presents a less encouraging picture and it’s worth setting out two key passages (with my emphasis in italics):

“The results [of the research data] suggest the introduction of MUP in Scotland did not lead to a decline in the proportion of adult drinkers consuming alcohol at harmful levels. It also did not lead to any change in the types of alcoholic beverage consumed by this group, their drinking patterns, and the extent to which they consumed alcohol while on their own or the prevalence of harmful drinking in key subgroups… The decline in the prevalence of hazardous drinking in our findings is consistent with the decline in alcohol consumption found in previous evaluations of MUP in Scotland. However, the lack of evidence for a decline in the prevalence of harmful drinking arising from MUP is contrary to model-based evidence that informed the introduction of the policy.”

Is that negative analysis enough to sink MUP? In my view, absolutely not. As I’ve said before on this page, the blame for any shortcomings is likely to be found in the minimum unit price… and this report confirms my prediction. 

It suggests that the current 50p per unit, set 12 years ago, is too low to generate detectable impacts, while conceding that those drinking harmfully still faced significant price increases. 

As one commentator put it, this is an old routine: the medicine isn’t working so let’s prescribe more. The plain truth is that those whom MUP is supposed to address aren’t sensitive to price and likely find a way to access alcohol no matter the cost, sacrificing spend on food and other essentials. In so doing they find themselves in an even worse mess.

To be fair, the researchers also suggest that there was a 3.5 per cent reduction in consumption among people drinking at ‘hazardous’ levels, defined as 14 to 35 units a week for women and 14 to 50 units for men. (Whether 14 units is an appropriate starting point is, of course, very much a matter for debate.) 

That’s a positive that will be seized upon when MUP’s fate is ultimately decided, along with a small – but essentially trivial – reduction in consumption across the whole population. 

In short, MUP is set to survive and it’s likely that we’ll see an increase in the unit price as the anti-alcohol campaigners are already seeking. 

But we won’t see much more effective steps taken to address the misery caused by alcohol misuse; and I say again that much, much more must be done in funding robust support for those whose lives are being wrecked by addiction.