Scotch whisky body accused of arrogance over minimum pricing

Health campaigners have accused the Scotch Whisky Association of arrogance after it launched a fresh legal challenge over plans for minimum alcohol pricing in Scotland.

To the dismay of medical experts and ministers in Edinburgh, the SWA said it would appeal to the UK supreme court against a Scottish court ruling last month that plans for a 50p minimum price for alcohol were compatible with EU law.

Alcohol charities said the SWA, which represents global drinks giants such as Diageo and Pernod Ricard alongside smaller family distillers, was borrowing tactics from tobacco companies, putting their commercial interests above public health.

“Twenty-two Scots are dying because of alcohol every single week,” said Alison Douglas, chief executive of Alcohol Focus Scotland. “In taking legal action, SWA members like Diageo and Pernod Ricard continue to put their shareholders’ profits above the public interest. When it comes to the nation’s health, we cannot allow the alcohol industry to call the shots.

“It is totally disingenuous of the SWA to say they are committed to tackling alcohol harm when they consistently block the single most effective measure to achieve that. They are borrowing from the tactics of the tobacco companies in delaying this live-saving measure.”

The Scottish health secretary, Shona Robison, said she was deeply saddened by the SWA’s decision to appeal again against another ruling by Scottish judges. She urged the association to drop its legal action.

“I think the SWA may want to consider that minimum unit pricing was passed with the overwhelming support of the parliament, has been tested in Europe, and has now been approved twice in the Scottish courts,” she said.

“We remain committed to ongoing dialogue with the alcohol industry. Should the SWA drop their appeal, and accept that the time has now come to implement this measure that will save lives, they could expect very strong support from across Scotland.”

A 50p minimum unit price would push the cost of a standard bottle of whisky up to £14. The data analyst Nielsen said earlier this week its research showed 69% of spirits in Scotland would be affected, and 67% of beers. Measured by brand, 76% of Scotland’s most popular spirits would have to increase prices, Nielsen said, with blended scotch prices rising by 20% overall.

The fresh appeal is likely to delay a final ruling well into 2017. The SWA’s legal battle began four years ago and its case has now twice gone through the Scottish courts, with the drinks industry losing each time.

Backed by European drinks associations and nine EU member states including France, it insists that imposing a fixed starting price for all drinks is a breach of EU competition and free trade rules. The SWA argues a blanket approach penalises responsible drinkers unjustifiably, when ordinary taxation could be used to target cheaper types of drink.

The European court of justice (ECJ) ruled last December that this was a clear issue but it referred the case back to the Scottish courts to assess whether that breach of EU competition rules was justified on health grounds. The ECJ added it had to be shown to be more proportionate and effective than using general taxation.

The Treasury already taxes certain alcohol drinks more heavily than others, targeting some on health grounds. However Scottish ministers have no control over drinks taxation but are responsible for health policy, limiting their options.

Last month, Lord Carloway, Scotland’s most senior judge, said minimum pricing was justified as there was a link between alcohol-related deaths and cheap alcohol. “The fact that the legislation would affect moderate drinkers in some way does not detract from the legitimacy of the aim as a measure designed for the general protection of public health and life,” he said.

Julie Hesketh-Laird, the SWA’s acting chief executive, would not explain in detail the legal basis for the further appeal, but said: “This is not a decision we have taken lightly. [But] given our strong view that minimum pricing is incompatible with EU law and likely to be ineffective, we now hope that our appeal can be heard quickly in the UK supreme court.

“Having studied the ruling, we believe the Scottish court has not properly reviewed the legislation’s compatibility with EU law as required by the European court’s judgment.”

The Sheffield Alcohol Research Group at the University of Sheffield argues that minimum unit pricing has been consistently effective and well-targeted when used abroad. It believes a 50p minimum unit price would result in 60 fewer deaths in Scotland, 1,300 fewer hospital admissions and 3,500 fewer crimes due to alcohol within the first year.

Scotch whisky body accused of arrogance over minimum pricing

Scottish court rejects appeal against minimum alcohol pricing

Scottish judges have rejected an appeal against the Holyrood government’s plans to introduce minimum pricing for alcohol.

The ruling by the court of session in Edinburgh is the latest in a long-running legal battle led by the Scotch Whisky Association after the Scottish parliament voted in favour of minimum pricing in 2012.

Ministers set the minimum price at 50p per unit of alcohol, a measure that would mean whisky could be no cheaper than £14 a bottle.

Last year the European court of justice ruled that the policy was in breach of EU free-trade laws. The European court of justice said the policy could be justified on health grounds under EU law only if it was more proportionate and effective than using general taxation.

However, in a written judgement issued at the court of session on Friday, the three judges ruled that the government’s policy was not illegal. In the judgement, Scotland’s most senior judge, the Lord President Lord Carloway, wrote that the policies didn’t contravene laws set by the ECJ.

Quoting from the judgement issued by the judge who earlier considered the matter, Lord Doherty, Carloway wrote that drinking was important to Scots.

“For many, the consumption of alcohol is a great social lubricant. It’s use in a responsible manner is an important and positive feature in Scottish culture. The general intent, as the Lord Ordinary noted (Opinion para 54) is to ‘get people to build a healthy and sensible relationship with alcohol’; not to stop them drinking altogether or even to drink moderately at all times.”

More details soon …

Scottish court rejects appeal against minimum alcohol pricing

Avoiding Healthcare Cost With Pricing Transparency Hype

No less than two reports have been published final week which fall loosely underneath the banner of healthcare pricing transparency.

The 1st was Medscape’s Physician Compensation Report for 2014 (right here). The annual Medscape report is based mostly on a survey of in excess of 24,000 physicians in 25 specialties around a broad range of compensation troubles – including satisfaction.

Medscape’s findings (with data from 2013) is marginally far more insightful than the Medicare Information dump from 2 weeks in the past (here). 1 of glaring inadequacies of the Medicare data (for 2012) is the simple reality that income isn’t compensation. Seeing an annual summary of what Medicare paid to individual suppliers has practically no patient use.

In accordance to the Medscape report (slides right here) there weren’t many big swings in compensation (there seldom are), but there’s usually a few noteworthy shifts. No significantly less than 19 of the 25 various practice regions noticed an improve in compensation from the prior year, 1 was neutral and five saw a decrease. Of the decreases, only 1 (nephrology) saw an 8% decline in compensation. Three of the remaining four saw a 2% decline.

All round satisfaction was close to or over 50% for most of the specialties across 4 categories (Total, Income, Career and Specialty). The two noteworthy exceptions have been Loved ones &amp Internal Medication with 32% and 27% (respectively for decision of specialty) even even though they appeared to be comparatively content (50% &amp 46%) with their income. Other findings as quoted from the slide notes:

• Those who carry out procedures have the highest incomes compared with individuals who manage chronic illnesses. Earnings are for total-time function only. They include salary, bonus, and profit-sharing contributions. They do not consist of non-patient-connected earnings.


• In this year’s Medscape report, the perception of being relatively compensated does not correlate to real compensation for several doctors. Orthopedists had been the most hugely paid physicians, but they fell under the middle of this record, with only 45% believing that they are fairly compensated. And despite the fact that plastic surgeons were seventh between the leading earners, at 37% they have been the least most likely of all physicians to think that they are fairly paid.


• When evaluating newer payment versions with survey results from 2011, there has been a dramatic rise in doctors choosing ACOs, with 24% of all doctors now employed in these organizations vs only 3% in 2011. Moreover, ten% are planning on joining this yr. In spite of considerable publicity, income-only and concierge practices are nonetheless not significant payment designs.


• 5% of employed and 15% of self-employed doctors explained that they will not get new Medicare or Medicaid patients.


• Although Medicare is known to have lowered fees, private insurers are also paying less, especially to modest practices without having any strong influence. Robert Morrow, MD, a family members physician in the Bronx and a Medscape advisor, mentioned he now receives $ 82 from Medicare for an office visit but only about $ 45 from commercial insurers.


• About 72% of respondents to this survey routinely or sometimes go over the expense of treatment method with individuals. This has gone up from 68% in 2012.


• 35% of employed doctors devote at least ten hrs a week on paperwork compared with 26% of the self-employed.

The second report – Price Transparency in Overall health Care (PDF right here) – was from the Healthcare Financial Management Association (HFMA). For people unfamiliar with HFMA, their site (right here) describes the organization this way:

HFMA is the nation’s top membership organization for healthcare monetary management executives and leaders. More than forty,000 members-ranging from CFOs to controllers to accountants-consider HFMA a respected believed leader on best trends and troubles dealing with the healthcare industry. 

In fairness, they exclusively indicate that the “primary audience for this report is sector stakeholders in provider, payer, and purchaser settings that this report calls upon to take distinct actions to improve the transparency of healthcare prices” (ie: not customers or sufferers).

The conclusion from HFMA’s 20-page report is just this:

The lack of price transparency in well being care threatens to erode public believe in in our healthcare system, but this erosion can be stopped. Sufferers are assuming greater financial accountability for their healthcare needs and in turn need the data that will permit them to make informed healthcare selections. Price is not the only details needed to make these selections as this report has mentioned, cost must be presented in the context of other relevant data on the quality of care. But it is an important element. The time for price transparency in well being care is now.

I have grave doubts about stopping the erosion of public trust. Two of the seven headings are “Guiding Ideas for Value Transparency” and “Recommendations for Price tag Transparency Frameworks.” In impact, it’s generally another market “call to action.”

Sadly, the worth of any of this “transparency” is truly marginal – either in terms of our own actions – or in terms of the influence on our Nationwide Healthcare Expenditure (NHE). The Centers for Medicare and Medicaid (CMS) forecasts our NHE to be $ 3.1 trillion this 12 months. In reality, our NHE as forecasted by CMS (Table one web page five right here) seems to be like this through 2022 (the two with and without Obamacare).

All of which tends to make this type of transparency comparable to rubbernecking a freeway accident. There’s a short minute of anxiousness and tension and then everyone speeds on their way. Assuming data accuracy, releasing any healthcare pricing is a hollow objective because there is virtually nothing at all any person can do with it. We merely have no way to influence it – either individually or collectively – and absent quality (or clinical outcomes), there is no way to equate any worth. We may possibly as properly use random amount generators.

The 1 point it constantly does, nonetheless, is to highlight how significantly our healthcare program is optimized all around income and earnings. Possibly someday this will translate into a debate about real healthcare reform – the one we continually keep away from (cough – SGR / “doc fix” – cough). That debate is not called transparent anything. Its known as healthcare cost.

Avoiding Healthcare Cost With Pricing Transparency Hype

Minimum alcohol pricing could lessen well being inequalities | Suzi Gage

It is frequently argued by libertarian consider tanks that introducing minimum pricing for alcohol would disproportionately harm reasonable drinkers, particularly individuals from low socioeconomic status backgrounds. Indeed, this was cited as a explanation for the government dropping the policy it had previously endorsed.

A new paper in the Lancet suggests this may not be the case. Not only that, but hazardous drinkers from low socioeconomic backgrounds might really benefit the most from such a policy modify, reaping above 80% of the predicted wellness rewards of minimizing their harmful drinking. The research authors suggest that introducing a minimum alcohol price tag could assist to decrease health inequalities, which would be of enormous advantage to society.

The study utilized financial and epidemiological models to predict the impact on spending, consumption and health of introducing a minimum alcohol value of 45p per unit. All round the model predicted the policy would consequence in the equivalent of twelve units significantly less drank per yr per drinker. But they found that the policy would impact diverse sorts of drinkers, and men and women of diverse economic backgrounds, differently.

The model contains data collected across the Uk on existing alcohol rates, current drinking patterns among United kingdom grownups of a variety of ages and backgrounds, and current investing on alcohol by various groups. All these elements had been measured at numerous occasions, so could be tracked towards preceding fluctuations in alcohol pricing. Health outcomes had been assessed using information from the Workplace for National Statistics’ Hospital Episode statistics.

Study has proven that moderate drinkers really don’t purchase a lot alcohol at beneath 45p per unit. Alcohol that is this low-cost is generally sturdy, and normally purchased by heavy drinkers, and youthful drinkers searching to get quite drunk as cheaply as feasible. This implies moderate drinkers wouldn’t be overly impacted by the introduction of minimal pricing. This is real even for reasonable drinkers from lower-income backgrounds. The study discovered that less than 20% of the alcohol these reasonable drinkers from reduced socio-financial backgrounds drink costs significantly less than 45p per unit. The research divided socioeconomic status into 3 classes: regimen or guide households, intermediate households, and managerial or professional households.

The drinkers who currently acquire the most alcohol priced beneath 45p per unit are those classified as damaging drinkers by a measure referred to as the GLF (Basic Lifestyle Survey). This instrument divides folks into reasonable, hazardous or harmful drinkers, with harmful drinkers currently being defined as men who drink much more than 50 units a week, and females who drink much more than 35 units. Hazardous drinkers buy a lot more inexpensive alcohol, across all socioeconomic backgrounds, but this is even a lot more pronounced in those of reduced socioeconomic standing, for whom roughly forty% of their alcohol purchases are currently below 45p per unit.

The model predicts that a minimal alcohol pricing policy would lead to reductions in drinking in heavy reduced-revenue drinkers, and some critics of the policy believe that a reduction in drinking is a negative policy outcome. But the research discovered that most reduced-cash flow drinkers do not fall into the hazardous drinking group dangerous consuming is truly most frequent in these of larger socioeconomic status.

Nevertheless, the damaging health outcomes of harmful drinking at present disproportionately affect individuals of lower socioeconomic status. A wealthy particular person with a drinking dilemma is less likely to endure serious overall health troubles or die from alcohol-related conditions than a comparable drinker who is much less well-off.

That the well being advantages would boost so significantly more for individuals damaging drinkers of low socioeconomic standing is a genuinely intriguing obtaining. If this model is appropriate, and the introduction of minimum alcohol pricing would in fact go some way to decreasing wellness inequalities in the Uk, then this is of huge relevance.

It is also interesting to note that the model predicts that the amount individuals commit on alcohol will not modify tremendously, overall. It predicts folks will move brands or sort of beverage, for example, to steer clear of paying out much more for their alcohol.

Of course, this is only a model, so might not accurately signify what will occur in the actual world if the policy is launched. The model has been utilised ahead of, to predict the influence of introducing minimal alcohol pricing in Canada. Findings from that study slightly underestimated the impact of the introduction of minimum pricing.

Canada also provides us with concrete evidence of what takes place after minimum alcohol pricing is launched. And it is excellent news for health, as study showed a drop in alcohol-related harm after the policy was launched.

If the Uk government genuinely needs to shield high-threat drinkers from bad wellness and untimely death, this research suggests minimum pricing of alcohol could be an efficient and productive way of carrying out this, without penalising individuals who drink much more moderately.

Some effects of introducing such a policy can not be predicted. There is the possible that alcohol organizations will put up costs further than they want to, and “blame” the total increase on the policy, as the tobacco market has carried out in the past when taxation has enhanced. Actions such as these are tougher to build into this kind of a model, and of program there will usually be limitations in predicting long term behaviours from past actions.

This is a somewhat edited model of a post I wrote for the Psychological Elf, a site and app delivering data on psychological wellness investigation, policy and guidance

Minimum alcohol pricing could lessen well being inequalities | Suzi Gage

Minimum alcohol pricing would conserve 860 lives a 12 months, research finds

An off-licence in Chesterfield. Photograph: Christopher Thomond for the Guardian

Introducing minimal pricing for alcohol would lead to 860 fewer deaths a year and 29,900 fewer hospital admissions among hefty-drinkers although getting only a slight effect on moderate drinkers, in accordance to research into the policy’s effect.

The research, from Sheffield University, predicts that creating stronger drinks much more expensive, through a price of 45p per unit of alcohol, would effect people who drink most heavily and are on lower incomes. They would reduce their consuming and reap a wellness advantage, with fewer alcohol-associated deaths and illness.

In March 2012, David Cameron announced that the government would bring in minimal unit pricing, saying he thought it was “a massive element of the response” to binge drinking and alcohol harm. But final July, the government carried out a U-flip and ditched the programs. Final week, it moved to ban “deep discounting” rather. This will avoid supermarkets slashing the charges of alcohol to below value cost, which has often made alcohol cheaper than bottled water.

Campaigners say that attacks on deep discounting will have tiny effect on the nation’s heavy consuming problems. The Alcohol Health Alliance, an umbrella organisation which includes charities and doctors’ organisations, explained the influence would be negligible, affecting just 1% of income in shops and supermarkets and undertaking nothing to minimize the appeal of robust drinks targeted at the young.

The new modelling examine, published in the Lancet health care journal, shows that hefty drinkers at large chance of accidents and deteriorating health would be most impacted by a 45p minimum price tag. They acquire big quantities of minimal-expense alcohol, although reasonable drinkers will acquire significantly less of the low-cost booze and much more with a increased price tag.

The result would be greatest among the five% of the population classified as dangerous drinkers – guys who put back much more than 50 units a week and women who drink much more than 35 units. This can be every day consuming or binge consuming.

The model predicts that 75% of the resultant fall in consuming from a minimal unit price of 45p would be among these damaging drinkers, which would reduce the number of deaths by 860 a yr and hospital admissions by 29,900.

Dangerous drinkers on lower incomes would be squeezed most of all. They spend on common just under £2,700 a year on alcohol, forty% of which at the minute costs them less than 45p a unit. The model predicts that they would lower down by virtually 300 units a year.

The effect on the moderate drinker would be slight by comparison, the review demonstrates. Moderate drinkers on minimal incomes do not acquire significantly cheap alcohol – less than one unit a week under 45p. They would not lower down by considerably – only the equivalent of about two pints of beer a 12 months, say the researchers, and spend just 4p much more.

Moderate drinkers as a total -– across all income groups – are predicted to forgo the equivalent of one particular pint of beer a yr and invest 78p much more.

In accordance to the study’s lead author, Dr John Holmes: “General, the effect of a minimal unit price tag policy on reasonable drinkers would be extremely small, irrespective of revenue. The policy would primarily affect hazardous drinkers, and it is the minimal earnings harmful drinkers – who purchase far more alcohol beneath the minimum unit price tag threshold than any other group – who would be most impacted. Policymakers need to have to stability more substantial reductions in consumption by dangerous drinkers on a minimal revenue against the huge wellness gains that could be seasoned in this group from reductions in alcohol-associated sickness and death.”

Professor Petra Meier, director of the Sheffield Alcohol Research Group, and a co-author of the examine, extra: “Our research finds no evidence to assistance the concerns highlighted by government and the alcohol industry that minimum unit pricing would penalise accountable drinkers on low incomes. As an alternative, minimal unit pricing is a policy that is targeted at those who consume large quantities of low-cost alcohol. By substantially lowering costs of sick health and premature deaths in this group, it is very likely to contribute to the reduction of well being inequalities.”

Sir Ian Gilmore, the Royal College of Physicians’s unique adviser on alcohol, and chair of the Alcohol Wellness Alliance explained: “It is superb to have this important confirmation of what we have been telling Uk government – a minimum unit price for alcohol would NOT damage the pockets of reasonable drinkers whatever their cash flow and is an evidence-primarily based policy that is exquisitely targeted at those, and these around them, who are at the moment suffering harm. It is time for government to stop listening to the vested interests of the drinks business and act.”

Minimum alcohol pricing would conserve 860 lives a 12 months, research finds

The alcohol pricing U-turn exhibits the power of the organization lobby | Anne Perkins

‘Investigators have established there have been 130 meetings between the drinks market and coalition ministers, such as two that took spot right after consultation on the proposed minimal pricing legislation had ended.’ Photograph: David Levene for the Guardian

A minimal value for alcohol is a single of those policies that seems so wise – the only mystery is that it hasn’t currently been launched. (I speak as one who surreptitiously visits alcohol concern web sites to verify exactly where on the functioning alcoholic spectrum they fit). There are various ways of undertaking it, but in 2012 there was general enthusiasm when the coalition confirmed it would fulfil its pledge to carry in minimal pricing by alcoholic unit. The only question was at what level.

It looked like a carried out deal. Yet within months there were indications that the policy was falling out of favour. In July it was announced – to some shock – that the consultation had produced a clear majority towards and the policy was abandoned.

The charity Alcohol Policy Uk has presently pointed out that while the consultation on the legislation had asked for views on the suitable pricing level per unit of alcohol, the health secretary presented it as if all these who desired a higher level than the 45p proposed had been the same as people who did not want any minimum at all. The “no” vote was added to the “not at this level” vote. Not so significantly massaging the figures as dislocating them.

The most current problem of the BMJ supplies a persuasive explanation for why the government killed off its very own initiative, even although the Canadian encounter is exhibiting what professionals contact “dramatic” benefits to public overall health. Their investigators have established that there have been 130 meetings amongst the drinks industry and coalition ministers, such as two that took place after consultation on the proposed minimal pricing legislation had ended. Probably they have been arranging for the Tory party conference in October, the place drinks giant Diageo was sponsoring a cocktail lounge.

Today, in an astonishingly temperate intervention, Professor Sir Ian Gilmore, the Royal University of Physicians’ alcohol adviser, along with 21 other authorities in public well being and liver illness, have written a letter in the Every day Telegraph suggesting with masterly understatement that big organization may be trumping public well being issues.

It seems to be obtaining trickier and trickier to keep funds and politics apart. Here’s a listing of curious developments in the planet the place the two collide. Plain packaging for cigarettes, yet another instance of David Cameron’s worthy claim of getting in politics to do the correct point, not the popular factor: it went into the wonderful political ashtray final July too. There are recommendations it might come back soon after the election, depending on the proof. Australians seem to be fairly convinced presently. As their former prime minister, Julia Gillard, argued in a blog final month, this is a global campaign towards a single of the world’s biggest industries, and they aren’t going to give up simply. And, while Cameron insists it’s very irrelevant, it need to be comforting for the market that their guy Lynton Crosby is 1 of the prime minister’s closest advisers.

The evidence is that British politics and certainly the great vast majority of British politicians are decent and well-meaning. But the impression is that the hand of big organization is found as well shut, also usually, to huge choices. From finance to housing to healthcare, there are repeated signs of something far more than the shared goals that a rightwing government and personal business could be presumed to take pleasure in. The stupendously misnamed transparency of lobbying bill, now virtually on the statute book, was trailed as the solution. Its weedy, misjudged restrictions on third-celebration action and its partisan assault on the unions will do precisely practically nothing to adjust that impression.

It truly is damagingly straightforward to spot conspiracy the place it isn’t going to exist, all the a lot more so in which voters have become so sceptical about the political approach. Putting it right is going to get a prolonged time. But it would be a start off if the political class would recognise just what they do to public believe in every time they weasel out of undertaking something their backers do not like.

The alcohol pricing U-turn exhibits the power of the organization lobby | Anne Perkins