Reducing harm caused by alcohol


Health experts share concerns about complaint made on MUP evaluation

A group of leading health experts have written an open letter to express their concerns about a complaint made by a member of Scottish Parliament regarding the evaluation of minimum unit pricing (MUP) for alcohol in Scotland.

Published today [Saturday 12th August 2023] in the medical journal, The Lancet, the group say that, whether intentionally or not, the complaint made by Dr Sandesh Gulhane MSP, Scottish Conservative Shadow Cabinet Secretary for Health and Social Care, “gives the impression of seeking to undermine the policy”.

Dr Gulhane wrote to the UK Statistics Authority last month and claimed that the findings in the evaluation report carried out by Public Health Scotland “overstate” the impact MUP has had in Scotland.

Health experts are concerned that the move threatens to weaken support for the intervention despite the “high-quality” evidence that shows MUP reduced alcohol-specific deaths in Scotland by 13.4%.

In the letter, authors highlight the five-year legal challenge by parts of the alcohol industry to prevent the introduction of MUP in Scotland as an indication of the commercial and political interests at play in alcohol policy. 

The signatories, which include representatives from the British Medical Association, London School of Hygiene and Tropical Medicine, European Alcohol Policy Alliance, House of Lords and academics, have defended Public Health Scotland’s evaluation methods as “entirely appropriate” and “comprehensive”.

They said, “Comparing trends in Scotland and England, including during the pandemic when alcohol deaths were increasing in many countries, is an entirely appropriate approach. This summary of MUP research is comprehensive, including interviews with individuals who fear the policy will be detrimental to them personally and or financially. The Public Health Scotland approach of emphasising population level findings is the right one for assessing population level interventions like minimum unit price. The alternatives proposed by the Scottish Conservatives are neither feasible or appropriate.”

In response to the letter, Alison Douglas, chief executive of Alcohol Focus Scotland, said, "Calling into question the validity of the Public Health Scotland (PHS) evaluation of minimum unit pricing is a serious charge with potentially damaging consequences. Overseen by multiple advisory groups, including members of the alcohol industry, the evaluation approach that PHS took was peer reviewed and published in 2019, with plenty of opportunities for any concerns to be highlighted ahead of the final report.

"This letter from leading medical and health professionals demonstrates that the approach taken - in particular the comparison of trends in Scotland with England which showed a significant reduction in deaths due to MUP - is robust. We should be in no doubt that without MUP hundreds more people in Scotland would have died due to alcohol over the last six years. If the Scottish Parliament does not vote to continue the policy before May 2024, and to uprate it to make good inflation, the result will be many more families suffering the loss of a loved one in future. MUP is necessary but not sufficient to turn the tide of alcohol harm in Scotland; we also need investment in treatment and recovery support and action on availability and marketing.”    

The letter concludes by outlining that MUP has worked to lessen health inequalities in Scotland, one of the policy’s main aims, and ends with a clear message to policy makers; that they “can be confident that there are several hundred low-income people in Scotland, who would have died from alcohol, who are alive today as a result of minimum unit pricing.”

12 August 2023.