Public health demands commencement of minimum unit pricing must proceed.
Public health alcohol policy, framed by the Public Health Alcohol Act, enacted minimum pricing for alcohol products as a proven measure to reduce alcohol use especially amongst the most hazardous of drinkers. This establishes a floor price for all alcohol products beneath which they cannot be legally sold. However, after near 700 days it still remains to be implemented. This would ensure that the cheapest, strongest alcohol, carefully selected by drinkers in search of the greatest high for the lowest price– the €11 bottle of Irish Whiskey, the €12 bottle of Gin or the 2-litre dynamite flagon of Irish cider, so evident throughout the retail landscape – will become a thing of the past.
Despite all the pubs being closed from the end of March through to early July, and only half opened since then, indications are that Ireland’s alcohol use has only declined by 4%. Meantime, trade data consistently show that Off-Trade sales are booming, as more and more drinkers shift their alcohol use into their homes having unearthed the exceptional affordability of alcohol in the retail market.
Price is central to demand and Off-trade price surveys consistently highlight how affordable alcohol is, with men’s low risk drinking weekly guideline – 17 standard drinks -within reach for as little as €7.65 and a woman – 11 standard drinks – for less than a fiver at €4.95.
The 2020 Programme for Government renewed a ‘longstanding’ commitment to implement MUP but ‘in consultation’ with the Northern Ireland Executive. Back in 2015 the then Executive announced it would proceed with an alcohol minimum unit pricing policy having commissioned research that suggested that such a policy would lead to a reduction in alcohol use by 5.7% and could reduce alcohol related deaths in Northern Ireland.
The recent announcement by the Northern Ireland’s Minister for Health to consult on the possible introduction of such a measure however suggests further interminable delay.
The rate per hundred thousand of alcohol related deaths in Northern Ireland stands at 15.09 per 100,000 (NISRA 2018); Ireland’s rate currently stands at 21.2, according to the Health Research Board’s 2013 alcohol-related deaths. The Global Burden of Diseases (2016) estimate of attributable deaths suggests Ireland’s current rate could be as high as 56 per 100,000.
In this context, the government can no longer ignore the public health objectives for the measure, determined by Cabinet some seven years ago and democratically approved by the Oireachtas two years ago.
While ideological objections and spurious considerations of cross border trade have stalled implementation, we cannot allow permutations, contemplated solely through a biased economic lens, to block and delay public health measures that can contribute to reducing alcohol harm and improving public health.
Only one of the five alcohol products priced in Northern Ireland and which feature in the Department of Finance’s Tax Strategy Group 2019 paper: ‘Analysis of off-trade cross border price differences’ is lower than a floor price to be established by the Public Health (Alcohol Act).
Most significantly, in terms of any common purpose, the UK Government’s recent White Paper on the UK Internal Market, and the Bill now before the UK parliament, may further hinder the capacity of a Northern Ireland’s Executive to pursue innovative public health policy that embraced a devolved measure such as minimum pricing for alcohol products. The Bill described by the Scottish Constitution Secretary, Mike Russell, ‘undermines devolution’ and will ‘endanger key public health policies such as minimum unit pricing’.
It must be recognised that there are multiple factors contributing to the decision-making to travel and purchasing goods in Northern Ireland.
Currency fluctuations, VAT differential and the relative price differential remain the principal factors in such considerations. These monetary and fiscal factors, added to consumer choices, ultimately determine the purchase point of alcohol for communities both sides of the Irish/UK border.
Distance and proximity to the border are very important considerations. Over 60% of the estimated value (€458m; CSO:2018) of current Ireland to Northern Ireland cross-border shopping is transacted by those who live closest to the Border. The daily weaving of living between each jurisdiction is part of everyday life; commercial transaction in one or other is determined by the immediate value of the currency and the relative price differential.
‘The AA’ (Automobile Association) seasonal consumer cross-border survey demonstrates that fashion items and cosmetics feature higher than any other products in motivating such cross-border shopping. Approximately a third of those who shop cross border ‘intend on picking up alcohol’ where there is also a 13% difference between the VAT rate on alcohol products in the UK (20%) than in Ireland (23%).
Ensuring that cheap, strong alcohol cannot be sold in Ireland beneath a certain price is unlikely to contribute any further impetus to an already well-established practice and trade.
Since 2013, when the government decision to introduce MUP was agreed, there have been 875 deaths from direct alcohol poisoning alone, likely induced by acute alcohol episodes. The Global Burden of Diseases would estimate that 19,530 deaths related to alcohol use have occurred in this period.
In a judgement, from the UK Supreme Court (2017) rejecting a legal challenge by the Scotch Whisky Association et al to the proposed introduction of minimum pricing in Scotland, Lord Mance, delivering an unanimous decision, and reflecting on the incomparable values of health or economic impact on producers, stated ‘the courts should not second-guess the value which a domestic legislator puts on health’.
So, Ireland can no longer wait. It must lead. Implementation must proceed and pandering to the spurious doubts of vested interests can no longer be a rational government position to delay the commencement of a democratically approved public health measure.
An edited summary of this piece was published as an Opinion Piece on The Journal on 26th September 2020