A Losing Bet? Alcohol and Gambling: Investigating Parallels and Shared Solutions, a report by Alcohol Concern and the Royal College of Psychiatrists
There is a great deal in common in the nature of alcohol and gambling problems and in the ways they can be prevented and treated. This report, out this week, from two eminent and influential organisations, breaks new ground by considering alcohol and gambling and the harms each can cause side-by-side. The field of gambling studies has a great deal to learn from its alcohol counterpart, which is much longer and better established. Gambling Watch UK welcomes this report and fully endorses its recommendations.
The first recommendation is that the availability of gambling should not be allowed to increase and that special care should be taken with new technologies. This is particularly true in the case of gambling: no new form of gambling or significant development of an existing form should be allowed to become legal or to be made more available without a proper social and health impact assessment. If that had been done in the case of fixed odds betting terminals (FOBTs or B2 gambling machines), the problems associated with them which are now causing so much concern might have been avoided.
The second recommendation is that children should be properly protected. It may be recalled that the Gambling Review Body (the Budd committee), which preceded the 2005 Gambling Act, expressed great concern about Category D gambling machines which children are allowed to play in Britain, unlike almost anywhere else. Their report said that, were we starting from scratch, that would not be legal, and that this issue should be kept under review. All the attention which has been given since to casinos, internet gambling, and FOBTs, has pushed that issue into the background, but it should not be allowed to slip off the agenda.
The third recommendation is that there should be good access to advice and treatment. Although some progress has been made on that score – for example the first NHS Problem Gambling Clinic set up in London, and the GamCare counselling and helpline services – the availability of treatment and advice for gambling problems is still unacceptably thin and patchy considering that adult prevalence in Britain is very similar to the prevalence of problems relating to illicit drug consumption (in the region of 6 to 9 per 1000 of the population).
The fourth recommendation is also well taken: we agree that there should be improved screening for gambling problems in all substance misuse services. We would add that there should be similar screening in all mental health services and in services serving other vulnerable groups such as offenders and the homeless and those with continuing debt problems. But the majority of people who get into trouble with gambling are not in those particularly high risk groups, and progress on identification of gambling problems will only be made when frontline and primary care professionals are much more aware of such problems they are now, which is the report’s fifth recommendation.
With recommendations six and seven we heartily concur. A national database about gambling problem gambling is essential for planning treatment and prevention. Britain was in the lead internationally in having carried out three national gambling prevalence surveys in the first decade of the 20th century and the intention was that these should be repeated regularly from now on. The 2012 report of the Department for Culture, Media and Sport Select Committee on the workings of the 2005 Gambling Act was rightly critical of the Government’s decision to withdraw funding from the Gambling Commission for these important surveys.
The final recommendation may be one of the most important. A general conclusion to be drawn from the Alcohol Concern/Royal College of Psychiatrists report is that gambling and the harm associated with it should be viewed as a public health issue. It follows that there should be a major role in Government for the Department of Health (DoH), and in service delivery for Public Health England. Lead Government responsibility, which used to be with the Home Office, was transferred under New Labour to the Department for Culture, Media and Sport. The latter department, as well as having an increasing burden of other major issues to contend with, is not in our experience competent to consider the health aspects of gambling and problem gambling. DoH must be asked to play a part.
Finally, there is the interesting question of whether alcohol and gambling mix. The evidence, hardly surprisingly, suggests that they do not: decisions taken in a state of intoxication are generally riskier and poorer. This was recognised by the Budd committee which made it one of its principles that the two should be separated as far as possible. Thought might be given to following Norway in the way this is dealt with: we understand that in that country a licence to serve alcoholic beverages may be withdrawn if gambling is also on offer. There might be a lot of support in Britain for removing gambling machines from our pubs!