‘Public Health Policies and interventions to reduce harmful gambling’ study is heavily criticised

Categories: News

On 1 October 2021, Public Health England (‘PHE’) published an evidence review of gambling-related harms in England which – it claimed – “reveals harms associated with gambling estimated to cost society at least £1.27 billion a year”. Subsequently, this report became widely regarded as flawed, as is explained in an iGaming Business article entitled ‘The flaw in the Public Health evidence base’, published in July 2022.

On 18 June 2022, we reported on a number of wide-ranging recommendations made by UK public health leaders for protecting the public from being harmed or exploited by gambling and the gambling industry. Those recommendations included:

  • the prevention of clustering of gambling outlets in vulnerable communities,
  • the banning of high-risk gambling products 
  • setting the primary objective of the regulator and the local authority licensing teams as ‘aim to protect the public’ instead of ‘aim to permit gambling’ and
  • building public health considerations into local regulatory processes.

More recently (on 1 August 2022), a Delphi study sponsored by the Department for Health and Social Care (‘DHSC’) entitled ‘Public Health Policies and interventions to reduce harmful gambling: an international Delphi consensus and implementation rating study’ (together with a Supplementary Index), intended to ‘guide future policy’ on gambling, was published in The Lancet. 

This study received immediate criticism, including notably within a Racing Post article entitled ‘Prohibitionist charter the latest warning sign for betting and racing‘, written by Dan Waugh of Regulus Partners. Describing this study as “a follow-up to the fatally flawed Public Health England review of gambling harms and conducted by the same research team” that “reads like a prohibitionist charter”, he characterised the authors as “a clandestine group of 34 public health researchers and practitioners …. who probably didn’t like betting very much” who “were asked their opinions on how the market should be controlled”.

The research team rated a list of 81 proposals for each of four ‘PASE’ (i.e. practicability, affordability, side-effects, and equity) dimensions. The 40 following measures were regarded by the research team as achieving “a consensus for effectiveness rated for likelihood of implementation success” although, as Dan Waugh points out, “the researchers did not provide any justifications for these measures (or any suggestion that they considered justification necessary) and resisted the idea that it might be sensible to conduct small-scale trials before implementation”:

Measures with a consensus for effectiveness rated for likelihood of implementation success

Price and taxation domain

Operators’ duties to rise each year above the rate of inflation*

55·0%

Gambling research, education, and treatment funded from general tax revenue* 

55·0%

Ban operators’ tax deductions on advertising, marketing, and sponsorship*

51·3%

Availability domain

Maximum limit on customers gambling on an operator’s website at once†

70·0%

UK banks and other operators to block payments to unregulated operators*

66·3%

Ban the display of scratch cards and lotto at points of sale*

63·8%

Loot-boxes and related content in video games to be defined as gambling*

62·5%

Ban in-play betting on sports events*

61·3%

Ban spread betting on sports events†

61·3%

UK internet service providers to block access to unregulated websites*

60·0%

Local authorities to restrict new operating licences by cumulative effect*

58·8%

Maximum limit (h per day per week) that EGMs operate in land-based premises†

58·8%

Maximum limit on number of all categories of EGMs in land-based venues†

57·5%

Accessibility domain

Individuals must be aged at least 18 years to participate in all forms of gambling*

71·3%

Ban all gambling in venues where young or vulnerable people are present*

71·3%

The Gambling Act (2005) to include an explicit focus on preventing and

reducing harm*

61·3%

Establish a public health licensing objective to reduce gambling harm*

53·8%

Mandatory age verification on all gambling websites before entry*

53·8%

Marketing, advertising, promotions, and sponsorship domain

Ban all price and discount promotions on gambling products and services*

68·8%

Ban bet-to-view commercial arrangements*

65·0%

Ban strategies that incentivise gambling or create a sense of urgency to bet*

60·0%

Ban gambling advertising during television programmes aimed aat children

and during age-rated films*

57·5%

Universal ban on all gambling marketing, advertising, and promotions*

57·5%

Ban advertising and marketing on radio, television, social media, and streaming*

53·8%

Environment and technology domain

Standardised minimum speed of play on EGMs and online gambling products*

62·5%

Ban maximum bet or credit buttons on EGMs†

58·8%

Video games with any gambling content to have a minimum age restriction of 18

years*

57·5%

Operators to provide data on gambling to an independent data bank*

56·3%

Mandate banks to provide customer data to an independent data bank*

52·5%

Mandate EGM display of cash amounts rather than credits*

52·5%

Online operators to provide a single customer view*

52·5%

All operators to make customer winnings available immediately*

51·3%

Information and education domain

Feedback of real-time information to customers on time spent and money lost*   

55·0%

Display of health messaging on all gambling products and websites†

53·8%

Operators to disseminate official information on gambling-related harms†

51·3%

Treatment and support domain

Establish a single multi-operator customer self-exclusion scheme*

58·8%

Provide online and mobile application-based psychosocial interventions†.             

55·0%

Facilitate access to mutual aid and peer-support resources*

53·8%

Ban automatic or default opt-in options following self-exclusion*

52·5%

Offer free psychosocial interventions for harms associated with gambling*

51·3%
  • EGM = electronic gaming machine
  • * Online Delphi consensus for highly effective.
  • † Online Delphi consensus for moderately effective.

As was the case with last year’s ‘flawed’ PHE evidence review, this new heavily criticised study will no doubt be relied upon by the DHSC and others calling for radical change in the regulation of gambling. Before it too places reliance on the study, it is to be hoped that due note is taken by the Government of the shortcomings very clearly identified by Dan Waugh in his article.

UPDATE: The following Parliamentary question was subsequently posed by Andrew Bridgen MP to the Secretary of State for Digital, Culture, Media and Sport: “On what date the Gambling Commission advised her Department of its opinion that Public Health England’s cost estimates associated with harmful gambling were unreliable?”. On 3 October 2022, Gambling Minister, Damian Collins, answered that question as follows:

DCMS officials have regular discussions with the Gambling Commission on a range of issues relating to gambling regulation and the evidence on gambling. The Commission has given the Department no formal advice or notification relating to the cost estimates in Public Health England’s evidence review on gambling related harm. Protecting people from gambling harms remains a priority for the government and the Gambling Commission, and we will be led by the best evidence to ensure the right protections are in place.