The blind ideology of public health

I wrote last month about the demonstrable failure of minimum pricing to lower the death rate from alcohol in Wales. Anyone who reads the official evaluation will see that it has misfired and backfired in predictable ways. And although the report barely mentions it, the rise in the number of alcohol-specific deaths, alcohol-related hospital admissions and even drink driving fatalities strongly suggests that putting a 50p floor price under a unit of alcohol is a mug’s game. 

But no bullets can keep this zombie policy down for long. Last week, a study was published in the journal Public Health by three proponents of minimum pricing who claim that it has “successfully reduced alcohol purchases and consumption of high-strength alcohol, in a way that is consistent with what we would expect, with the biggest impacts on products such as cider that are bought disproportionately by heavier drinkers.” 

You may ask how such an outcome is consistent with alcohol-specific deaths going through the roof. Minimum pricing in Wales took effect in 2020 and is approaching its fifth anniversary. According to a computer model conducted by the Sheffield Alcohol Research Group, whose members include one of the authors of the Public Health study, a 50p minimum price was supposed to reduce the number of alcohol-related deaths by 22 in the first year and to have saved a total of 504 lives by the end of the fifth year. 

This has clearly not happened. As of 2023, there have been nearly 500 extra deaths and so the authors have moved the goalposts. In the abstract of their study, they say that minimum pricing has “changed purchasing behaviour, which should lead to public health benefits in the longer term.” Jam tomorrow.

It did not help that Wales introduced the policy a few days into the first lockdown when a large number of us turned to drink. But, as I showed in my previous article, Wales did not even do relatively better compared to England. This was underlined again yesterday when the Office for National Statistics belatedly published the alcohol mortality data for 2023. If anything, the situation in Wales is getting worse. Between 2019 and 2023, Wales saw the alcohol-specific death rate rise by 5.8 per 100,000 people compared with 4.2 per 100,000 people in England, 4.1 per 100,000 people in Scotland and 0.2 per 100,000 people in Northern Ireland. Scotland, which has had minimum pricing since 2018, is still the worst performer by far, but under minimum pricing Wales is catching up.

Almost incredibly, the Guardian reported the new ONS figures as follows:

Alcohol-related deaths in UK hit record high of 10,473, ONS data shows

Health experts urge ministers to do more to tackle drinking-related harm by bringing in minimum unit pricing

The newspaper quotes Katherine Severi of the Institute of Alcohol Studies (the successor to the UK Temperance Alliance) who has this to say: 

For the government’s growth and health missions to succeed, we need measures that are proven effective at reducing alcohol harm. Minimum unit pricing for alcohol has reduced alcohol-specific deaths by 13% in Scotland, with the greatest benefits seen among the most disadvantaged communities.

Among the new policies needed, “MUP for England is the top priority, as it would save the most lives the quickest”, Severi said.

Do you see a 13 per cent reduction in deaths in Scotland in the graph above? Can you see lives being saved quickly in Wales? Would you buy a used car from the Institute of Alcohol Studies? 

If you said yes to any of those questions, you are deep in the “public health” rabbit hole where a rise is a fall and it is more important to suppress the sale of products that are “bought disproportionately by heavier drinkers” than it is to tackle the causes of heavy drinking and prevent people dying. 

If “public health” were a truth-seeking enterprise, there would be some curiosity about why the number of deaths from alcohol rose in Wales while the sale of cheap drink declined. There would be some interest in why the pandemic led to a surge in alcohol-related harm despite booze being less available and less widely advertised. A thoughtful “public health professional” would look at the graph above and ask why the alcohol-specific mortality rate in Scotland dropped so sharply between 2006 and 2012 despite no notable anti-alcohol policies being introduced.

There is none of this. There is only blind ideology and a pig-headed refusal to admit that they got it wrong. At this point, faith in minimum pricing is essentially religious. It requires no proof and no evidence can test it.