Key health organisations do not sign responsibility deal

Six health organisations previously involved in the government’s Responsibility Deal Alcohol Network (RDAN) have decided not to sign up to the overall Public Health Responsibility Deal because of serious reservations about the proposed alcohol pledges.

The Responsibility Deal is a partnership between the Department of Health, industry and the health community covering alcohol, food, physical activity, and health at work. Organisations were asked to sign up as partners to the Deal by Monday 7 March.

The six organisations – Alcohol Concern, British Association for the Study of the Liver, British Liver Trust, British Medical Association, Institute of Alcohol Studies, and the Royal College of Physicians, have written to the Department of Health to say that they are unable to support the Deal as a whole, and have signed up to the following joint statement explaining their position.

Collective statement

This is a collective statement from the health organisations listed above on the Public Health Responsibility Deal Alcohol Network (RDAN). The listed organisations have participated in RDA discussions with Government and the drinks industry, representing the health community and providing expert advice. We have now been invited by Government to sign up to the final Responsibility Deal drafted by the Department of Health. The RDA sets out a series of voluntary pledges for the drinks industry. We are unable to support the RDA for the following reasons:

  • The overall RDA policy objective to ‘foster a culture of responsible drinking’ does not adequately address the need to reduce alcohol-related mortality and morbidity.
  • The RDA drinks industry pledges are not specific or measurable and do not state what would be evidence of success.
  • The RDA process has prioritised industry views and not considered alternative pledges put forward by the health community. These have included proposed pledges: to not advertise alcohol based on price; to not advertise in cinemas for under-18 films: and to include health warnings on all drinks products.
  • The scope of the RDA is currently too limited. It does not tackle issues such as, availability or promotion of alcohol, and focuses on voluntary interventions with no evidence of effectiveness.
  • We have not yet seen evidence that Government is working towards a comprehensive, cross-departmental strategy to reduce alcohol harm, based on evidence of what works, with rigorous evaluation metrics.
  • There has been no commitment made on what alternative actions Government will take if  the RDA pledges do not significantly reduce levels of alcohol-related harm.

The health organisations listed above call on Government to provide the following:

  • A clear and firm commitment on how it intends – via evidence based policy – to tackle affordability, availability and promotion of alcohol as part of a cross-government strategy, with rigorous evaluation metrics.
  • A clear presentation of the steps that will be taken if the current RDA objectives are not met in 12 months time.
  • A firm commitment to consider change - including through regulation - if voluntary commitments from business are not met after an agreed time period.

The alcohol health community remains completely open to dialogue with the government and is prepared to continue to engage in discussions about how industry can act as responsible producers, distributors and promoters of alcohol. However, we do call upon government to follow recommendations from the World Health Organization and two parliamentary select committees; that alcohol policy should be guided by public health interests and the best available evidence, not influenced by competing commercial interests.

We believe that the government’s stated intention to develop a new alcohol strategy gives an opportunity for us to help develop an evidence-based policy to reduce the currently unacceptable levels of morbidity and mortality from alcohol in England. We would welcome the opportunity to put the case for evidence based alcohol policy measures to a grouping that include representatives from all the relevant Government departments including the Treasury, and we would have no objection to the drinks industry being allowed to debate their counter proposals. Such a process should be transparent, fully open to the media and with representation from civil society. The health community would be happy to host such a process.

Individual comment from the organisations

Don Shenker, CEO of Alcohol Concern said:

This is the worst possible deal for everyone who wants to see alcohol harm reduced. There are no firm targets or any sanctions if the drinks industry fails to fulfil its pledges. It's all carrot and no stick for the drinks industry and supermarkets.

The deal on alcohol is clearly the result of determined drinks industry lobbying coupled with a coalition government in thrall to business.

By allowing the drinks industry to propose such half-hearted pledges on alcohol with no teeth, this government has clearly shown that when it comes to public health its first priority is to side with big business and protect private profit.

The problem with this ‘name and praise’ approach is that it assumes one retailer’s positive action will lead to others following. If the government are going to mistakenly rely on self-regulation to reduce problem drinking, they must clearly state what they intend to do if it fails.

All the evidence so far is that the alcohol industry has no interest in reducing alcohol consumption, and we will continue to call for laws to compel drinks companies and retailers to sell alcohol responsibly, with mandatory labelling, health warnings and reduced marketing.

Dr Nick Sheron, British Association for the Study of the Liver, said:

The priority for the drinks industry is to deliver shareholder value - this basic conflict of interest should preclude them from an influence on alcohol policy. An effective UK alcohol policy must include measures which reduce overall alcohol consumption in the UK at a population level, and the drinks industry has always opposed such initiatives.

There are however a number of actions that the industry could take to reduce alcohol related harm which have either no impact, or at best a limited impact of their profitability. These actions include meaningful reductions in the average %ABV of certain alcoholic drinks, coupled with the marketing initiatives necessary to drive purchases. The industry could agree to stop lobbying against effective health policy initiatives such as the introduction of a minimum price. They could agree to stop lobbying against the current initiative on labelling in the EU, where intense pressure from the drinks industry has resulted in an exemption where drinks will now be exempted from labelling legislation if they contain alcohol. They could take a leaf from the French retailers where substantial reductions in alcohol consumption, and in alcohol related deaths have been achieved alongside increases in the turnover of the drinks industry by building quality and not quantity into their marketing strategies.

Unfortunately the RDAN agenda has been set entirely by the drinks industry, and an opportunity has been squandered so far. Were a better and more equitable structure to be established, then BASL would consider again whether this was something where our expertise would be of use.

Alison Rogers, Chief Executive of the British Liver Trust, said:

At the heart of our decision not to join the initiative is the inherent conflict of interest in the alcohol industry’s involvement in developing alcohol policy, especially when the key policy impacting health – an overall reduction in consumption – is so directly contrary to the alcohol industry’s profit motive.

The alcohol industry has in the past, and still has, too much clout in formulating alcohol policy. The clear outcome – rising liver deaths – is ignored and disregarded. For more than 10 years we have been persuaded to play the long game, sitting and watching the alcohol industry cultivate their relationship with the Government. Now it must stop for the sake of the 100 families losing loved ones each week from alcohol-related liver disease.

Dr Vivienne Nathanson, Director of Professional Activities at the BMA, said:

The BMA has thought long and hard about walking away from the table but ultimately we do not feel we have any option.  The government has talked the talk in respect of wanting to tackle alcohol misuse but when it comes to taking tough action that will achieve results it falls short.  Instead it has chosen to rely on the alcohol industry to develop policies - given the inherent conflict of interest these will do nothing to reduce the harm caused by alcohol misuse.

We are not sure how much evidence the government needs to see before it has the courage to act.  If it really wants to tackle alcohol misuse it must develop a comprehensive strategy that will work across government departments and focus on affordability, availability and promotion. These policies will not be popular with the alcohol industry. But the government must show that it cares more for reducing the number of lives ruined by alcohol misuse than it does for keeping the industry happy.

We hope that as health experts we will have an opportunity to sit down with people from many government departments, including health, transport and treasury, to explore the actions and policies, based on evidence, that are essential to turning the tide against alcohol harm.

Katherine Brown, Head of Research and Communications at the Institute of Alcohol Studies, said:

We have serious reservations about the level of importance placed on the Responsibility Deal as providing a solution to the problem of alcohol in the UK.  The RDA pledges are not based on evidence of what works, and were largely written by Government and industry officials before the health community was invited to join the proceedings.  Furthermore, there are no hard outcomes attached to the pledges, which rely heavily on evaluation by the industry.

We cannot endorse a process in which the alcohol industry is invited to co-create and self-regulate health policy. There is clearly a conflict of interest between industry economic objectives and public health goals of reducing alcohol consumption and associated harms. This has been highlighted by two parliamentary select committees and the WHO.

The most effective means of reducing alcohol related harm is through adjustments in affordability, availability and promotion. These policies are supported by a broad evidence base and have been recommended to Government by a recent cross party House of Commons Health Committee report. The Responsibility Deal fails to address any of these policy areas and we are yet to see any real proof that Government is looking into developing a cross-departmental comprehensive alcohol strategy, based on evidence of what works.

Sir Ian Gilmore, Royal College of Physicians Special Advisor on Alcohol, said:

While it is perfectly appropriate for Government to take into account the economic impact of any public health policy, it is not acceptable for the drinks industry to drive the pace and direction that such public health policy takes. The industry pledges published in various newspapers, do not give practicing doctors, who see the rising tide of health harm from drink in their daily practice, any confidence that they will get to the core of how we reverse this entirely preventable cause of illness and death.