The UK Government’s Alcohol Strategy (GAS), published in March 2012, unexpectedly included a commitment to introduce minimum unit pricing (MUP) for alcohol in England, following the adoption of similar measures by the Scottish Government. Yet just 16 months later, the introduction of MUP was placed on hold indefinitely. Our recent article published in Policy and Politics seeks to explain how and why MUP came so unexpectedly onto the policy agenda in England, before disappearing just as suddenly, and what this tells us about the evolving political dynamics of post-devolution and post-Brexit Britain.
In Scotland, MUP passed into law at the second attempt in 2012 and came into force in 2018 following a six-year legal battle with the Scotch Whisky Association and other industry actors. The emergence of MUP as a viable policy option was, however, a ‘cross-border’ process with developments in Scotland inextricably linked to those ‘down South’, particularly the support for, and background work on, alcohol pricing within the Department of Health. Following its adoption in Scotland, a ’policy window’ opening in which MUP came onto the policy agenda in England also. However, this proved to be short lived. Our article argues that the success of MUP in Scotland and its failure in England can largely be explained in terms of the differing levels of political commitment to the policy in each context.
It was Nicola Sturgeon, initially as health minister, who was a key figure in the introduction of MUP in Scotland. It was widely believed that the decision to include MUP in the GAS was the personal decision of the then Prime Minister, David Cameron. However, here the similarities between the two leaders end. While Sturgeon demonstrated robust and ongoing political commitment to the policy in the face of significant industry opposition, Cameron’s commitment was only ever lukewarm and easily sacrificed for political contingencies. Interviewees reported that Cameron’s decision was taken at short notice and without the necessary preparatory work inside or outside . This had the knock-on effect that policy makers and advocates were unprepared for the announcement and unable to provide support for the policy with additional support in the media and policy circles as Scottish NGOs had done.
While the Scottish government adopted a clear and unified position on MUP, there was a complete lack of buy-in amongst key cabinet ministers in England. This included Health Secretary Andrew Lansley and Home Secretary Theresa May whose departments were responsible for alcohol policy. MUP in England also emerged in the context of the Public Health Responsibility (PHRD), an industry partnership that did not extend to Scotland, which was Lansley’s key policy initiative. Without high-level political support, MUP was vulnerable to policy drift.
In this vacuum, industry actors mounted a rearguard campaign, using a public consultation on MUP to challenge its introduction. Industry submissions went far beyond the remit of the consultation (on whether the price per unit of alcohol should be set at 45p or higher) to question the entire rationale behind the policy, as part of a wider strategy to oppose its introduction. This coincided with an apparent shift within government towards the introduction of a far less effective ban on below-cost selling of alcohol as an alternative to MUP. In July 2013, the Government went a step further, announcing to Parliament that it would not bring forward plans to implement MUP, citing the need for greater supporting evidence of its effectiveness and the Scottish legal challenge, while calling on the alcohol industry actors to self-regulate. Despite the resolution of the court case in 2018 and the mounting evidence of alcohol harms and the effectiveness of MUP, no efforts have subsequently been made to bring MUP into effect.
The case of MUP in England thus offers interesting insights into the policy dynamics within the post-devolution UK and the centre of gravity on health policy interventions in different policy contexts. Firstly, it demonstrates the capacity for policy collaboration between health actors across the UK to develop viable and effective policy solutions. Secondly, it highlights the possibility of policy transfer from one policy context to another. In part, this explains why industry actors demonstrated such determination to oppose MUP in Scotland, since they feared it would lead to its adoption in bigger, more lucrative markets. Thirdly, it demonstrates the importance of sustained, high-level political commitment for policy change. While the personal intervention of David Cameron brought the policy into the strategy, it failed to gain sufficient high-level political buy-in across cabinet to see it through. This contrasts starkly with the consistent support of Nicola Sturgeon and colleagues in Edinburgh. Policy windows often open unexpectedly, sometimes as the result of individual policy entrepreneurship. That they can also close equally quickly shows the importance of decisive political action to push measures over the line when the opportunity presents itself.
Fourthly, and perhaps most interestingly for the future of the UK, this study underlines the very different approach to public health in England and Scotland – and the willingness of policy-makers to legislate to protect this – which has emerged since devolution. This health policy divergence has accelerated under the Scottish National Party’s administrations since 2007 keen to promote a Scottish policy agenda on issues of health inequalities that Westminster had failed to address. MUP signals a shift in policy approach towards ‘whole population’ measures, with implications for the functioning of ‘free markets,’ which are vehemently opposed by the alcohol industry. In this way, it requires governments to choose sides in the battle between health protection versus health harming industries. On the issue of MUP, Scotland chose decisively in terms of the former, while England failed to follow its lead. As the consequences of Brexit begin to emerge, the desire of the UK government to pursue a pro-corporate agenda – perhaps as a pre-requisite for a trade agreement with the USA – may find itself increasingly at odds with policy makers and the wider population in Scotland committed to health protection and sceptical about the economic direction of the UK. Given the majority vote to remain in the EU in Scotland in the 2016 referendum, health policy divergence may become a touchstone for, and perhaps even an engine of, more significant political and constitutional divergence.
You can read the original research in Policy & Politics:
Hawkins, Benjamin and McCambridge, Jim (2020) ‘Policy windows and multiple streams: an analysis of alcohol pricing policy in England’ [Open Access], Policy & Politics, DOI: https://doi.org/10.1332/030557319X15724461566370
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