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Blocking minimum alcohol pricing in defiance of the evidence: a peculiarly British oddity

As a foreigner living in the UK for more than a decade I am still in awe of its quirky little ways. Like any other country Britain has its particularities that are possibly not that obvious to the British person as they are to expatriates.

My native Germany has no speed limit on the Autobahn, which is obviously idiotic. The US are obsessed with the right to carry guns and shooting people, which is also rather strange. Compared to this, the British are unique as even their idiosyncrasies are rather measured - my favourites are quirky ways of speaking.

The latest phrase I have come to love is ‘shelving’ projects - the term which has been used to describe a change of heart by the Government over introducing minimum unit pricing (MUP) in England.

Only one year ago, David Cameron was clear that he supported MUP, famously stating that: ‘The responsibility of being in Government isn’t always about doing the popular thing. It’s about doing the right thing.’

To be fair, judgements and opinions change with time, but this is different. The modelling and research is strongly in favour of introducing MUP.1 It is supported by everybody who has any interest in public health or alcohol treatment. British Columbia in Canada introduced it in 2002 and the results are overwhelmingly in favour.2

A predictable failure

So why the change of heart? No politician wants to be seen as weak or a push-over. We can only speculate what has happened, but make no mistake, ‘shelving’ means ‘gone for now’ as much as ‘a brave suggestion’ means ‘you are completely mad’.

In my view there are only two plausible answers as to why this happened. David Cameron might have thought that it would be too unpopular with the public - keep in mind that directors of public health are not necessarily a significant swing vote, and are not the most popular healthcare professionals.

The other explanation is more concerning: that politicians inside the cabinet were influenced by lobbyists by the drinks and/or retail industry. Have supermarket brands and lobbyists got more influence over what happens here than Public Health England does?

Resurrecting MUP

But it is pointless and simply a rhetorical exercise to voice our discontent. Though I would love to send a strongly-worded letter – the British version of going around and beating someone up – it will not make any difference.

Experience tells me that we will get MUP eventually. Luckily the British are rational people with a strong belief in common sense. It will come back, but using slightly different words that mean the same in a couple of years’ time. The evidence in its favour will become stronger. I am sure that once it is introduced we will look back and wonder what all the fuss was about. Think of the smoking ban – is it not marvellous that we can now get drunk in a pub without stinking of cigarette smoke?

In the meantime we have to wait for our scientists to do more research, and can keep ourselves busy by inventing an alternative name for MUP. That could be a nice little workshop to make the time pass quicker.

It is a shame that until then people will come to harm and die because of the delay. Hopefully it won’t take too long.

Dr Carsten Grimm is the clinical lead for the RCGP’s alcohol misuse certificate, clinical lead for the alcohol misuse treatment service in Kirklees, and a GP in West Yorkshire.


1 Purshouse R, Meier P, Brennan A, Taylor K, Rafia R (2010). 
Alcohol pricing policies: Estimated impact on health and health economic outcomes. Lancet 375, 9723, 1355-64

2 Zhao, J., Stockwell, T., Martin, G., Macdonald, S., Vallance, K., Treno, A., Ponicki, W. R., Tu, A. and Buxton, J. (2013), The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002–09. Addiction, 108: 1059–1069. doi: 10.1111/add.12139


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