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Scotland's Minimum Pricing Policy Falls Short of Expectations

Public Health Scotland's claims challenged as evaluation reveals underwhelming outcomes and conflicting findings

Friday, February 23, 2024
7 mins

by Annemarie Ward

Scotland embarked on the implementation of minimum pricing for alcohol in 2018 with high hopes. However, the subsequent evaluation conducted by Public Health Scotland revealed that the intended outcomes were not achieved. 

It is evident that the effectiveness of the grand plan fell short of expectations. Multiple agencies have endorsed this initiative, but regrettably, a significant portion of the public and independent observers perceive it as a well-orchestrated public relations campaign. Although the perception of governmental autonomy may be disheartening, it has become increasingly commonplace. The prevailing narrative and its ability to obfuscate seem to take precedence over substantive outcomes.

One would anticipate that the introduction of such a policy would result in a reduction in alcohol-related crime. Yet, the evaluation findings challenge this assumption.

The evaluation found no significant changes in alcohol-related crime and disorder, except for that one local authority where things actually got worse. Bravo!

And what about reducing alcohol-related A&E visits? Nope, didn't happen either. In fact, it seems like there were even more emergency department visits related to alcohol after minimum pricing came into play. Way to go!

Also more research found no impact on alcohol-related ambulance call-outs.

Furthermore, it is crucial to consider the impact of the policy on the heaviest drinkers, the primary target demographic for this initiative. However, it appears that the intended message did not effectively reach this group.There was no clear evidence that they cut down on their alcohol consumption. Instead, some of them even drank more! Impressive strategy, don't you think?

But wait, there's more! Researchers found all sorts of unintended consequences.

People started spending less on healthy fruits and vegetables and more on crisps and snacks. And guess what? Switching from cider to spirits seemed to result in increased intoxication. Who saw that coming? (Eh, US at @FAVORUK & most other people from working class backgrounds with common sense)

And let's not overlook the fact that Scotland experienced its highest rate of alcohol-specific deaths in over a decade. But hey, the rest of the UK is not far behind, so at least we are in good company, right?

However, it is worth noting that Public Health Scotland has presented a contrasting perspective by portraying the policy as a success. They contend that minimum pricing positively impacted health outcomes, referencing a study that compares Scottish data to a counterfactual based on trends observed in England. While this approach may seem incongruous, it is important to approach scientific analysis with caution.

Nevertheless, it is prudent to critically evaluate the study's claims of causation based solely on correlation. Disregarding the random decrease in alcohol-related deaths that occurred in Scotland prior to the policy implementation further raises questions about the study's findings.

Similarly, the purported decline in hospital admissions lacks statistical significance and relies on estimates derived from hypothetical scenarios. Moreover, the data indicates that alcohol-related hospital admissions did not exhibit a reduction in 2018 or 2019. These observations warrant careful consideration when assessing the efficacy of the minimum pricing approach.

But wait, there's even more conflicting evidence. Public Health Scotland conveniently ignores a study that found women reduced their alcohol consumption more than men, contrary to their claims. In addition, it is important to acknowledge the presence of conflicting evidence in the discourse. Public Health Scotland, in their assertions, appears to overlook a study that reveals a contrasting trend. This particular study indicates that women demonstrated a greater reduction in alcohol consumption compared to men, contrary to the claims made by Public Health Scotland. Moreover, the study found that heavy drinking men actually increased their alcohol consumption following the implementation of the policy. These unexpected findings challenge preconceived notions and underscore the complexities of the issue at hand.

In the end, it all comes down to one study that claims to support the success of minimum pricing. But let's not dwell on the fact that it's an outlier, lacks solid proof of causation, and heavily relies on the assumptions of its authors. Let's just pretend it's the golden ticket to success!

So, Scotland, congratulations on your flagship policy that didn't quite live up to expectations. It's been a wild ride of selective interpretation and ignoring inconvenient evidence. But hey, at least you can say you gave it a shot, right? The Welsh tried too and it didn’t work there either.

To calculate the percentage rise in alcohol-specific deaths in Scotland from 2018 when MUP was introduced to the latest figures we have up till 2021, we can follow these steps:

Determine the difference between the number of deaths in 2021 and 2018: 1245 deaths in 2021 - 1136 deaths in 2018 = 109 additional deaths

Calculate the percentage increase: (109 additional deaths / 1136 deaths in 2018) * 100

Using these calculations, we find that the percentage increase in alcohol-specific deaths in Scotland from 2018 to 2021 is approximately 9.60%.

In the realm of distorted public health narratives, it seems that a 9.6% increase can somehow be portrayed as a 13% decrease. Astonishingly, despite the fact that the number of alcohol-related deaths reached a 15-year high, Public Health Scotland engaged in some questionable "modelling" and magically asserted that the figures would have been 13% higher otherwise. Subsequently, government-funded organisations and their associates began fervently spreading this gospel-like proclamation. As it appears, I am once again considered a heretic and await the inevitable stake-burning.

Scotland's attempt at implementing minimum pricing for alcohol in 2018 fell short of expectations. Despite Public Health Scotland's efforts to present it as a success, the evaluation revealed underwhelming results. Alcohol-related crime and disorder showed no significant changes, and in some areas, the situation even worsened. The policy also failed to reduce alcohol-related A&E visits and ambulance call-outs. Most concerning was the highest rate of alcohol-specific deaths in over a decade.

Public Health Scotland's claims of positive health outcomes were based on a study that compared Scottish data to a questionable counterfactual. The evidence presented was conflicting and often disregarded inconvenient findings. The flagship policy suffered from selective interpretation and the dismissal of contradictory evidence.

However, amidst this disappointment, there is hope for a better future. It is essential for the addiction sector and related agencies to transcend their self-interests and partisan politics. Embracing the forthcoming Right to Recovery Bill can revolutionise funding systems and promote collaboration rather than competition. By setting aside personal egos and embracing the power. If only we could shift our thinking away from either/or scenarios and embrace the power of ("and with”) true progress might be achievable & genuine developments  achieved.

Regrettably, when it pertains to Scottish Government policies, there is a lack of trust in Public Health Scotland's transparency. Their "communication framework" effectively restricts them from voicing criticism of government policies or presenting data that might reflect negatively on government ministers.

https://gov.scot/binaries/content/documents/govscot/publications/foi-eir-release/2021/07/foi-202100213128/documents/foi---202100213128---information-released/foi---202100213128---information-released/govscot%3Adocument/FOI%2B-%2B%2B202100213128%2B-%2B%2BInformation%2Breleased.pdf…

https://thetimes.co.uk/article/watchdogs-remit-is-to-shield-snp-ministers-0wgpxsn5d

Political forces may seek through many agencies to muddy the waters, diverting attention to unrelated debates and narratives. But if we can shift our thinking away from divisive dichotomies and focus on the transformative potential of the Right to Recovery Bill, a brighter future is within reach. 

Despite skepticism, there remains optimism for a change in mindset and a united effort to support recovery and well-being.

Let us hold onto hope and work towards a transformative shift in addiction policies and practices. Here's to a future where collaboration, recovery, and progress prevail. Here's to a future where people can have access and choice of treatment brought to them courtesy of & enforced by the law. 

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