It is a well-known proverb that ‘the road to hell is paved with good intentions,’ or, alternatively, ‘hell is full of good meanings, but heaven is full of good works.’
The formulation of public policy is a similar minefield, with innumerable policies enacted with wholly good intentions cast aside on account of the fact they didn’t work out entirely as planned. Gordon Brown’s 2008 abolition of the 10p tax rate to cut the basic rate of income tax from 22 to 20p is one classic example; Universal Credit is quickly shaping up to be another.
Which brings us to last Wednesday’s Supreme Court ruling which upheld the Scottish Government’s right to introduce a minimum price per unit of alcohol, which could be set to 50p as early as April.
The court described it as a ‘proportionate means of achieving a legitimate aim,’ that legitimate aim of course being the improvement of public health.
Campaigners quickly shifted their attention south of the border, arguing that England should follow suit. 2014 research by the University of Sheffield found that such a policy would, over ten years, result in 860 fewer alcohol-related deaths per year, and 29,990 fewer hospital admissions per year.
The populist refrain came, rather ironically, from the Thatcherite think tank the Institute for Economic Affairs, who claimed: ‘Minimum alcohol pricing is a policy that clobbers the poor and exempts the rich. Most of the beer, cider and spirits sold in the off trade will become more expensive under a 50p minimum price, but doctors and politicians can relax. The champagne at their Christmas parties will not be affected.’
Now, if this is giving you a sense of déjà vu, I don’t blame you. A very similar row over a very similar policy erupted in 2015 over the prospect of a 20% tax on sugary drinks to improve public health, and the first thought that crossed my mind upon hearing Wednesday’s news was how similar it all sounded.
For example, the Taxpayers’ Alliance’s chief executive, Jonathan Isaby, in May 2016 said it was ‘deeply concerning’ that the government was ‘pushing ahead with this regressive tax which will hit the poorest families hardest.’
This phenomenon is something we could probably refer to as ‘regressive progressivism,’ where a seemingly laudable move, in this case to address ‘problem drinking’ or obesity, hits the hard-pressed hardest.
After all, in Britain it is the poorest who are the most likely to be obese in the first place. A quarter of the most disadvantaged children in England are obese by the time they leave primary school, double the rate of the most advantaged. Treating diabetes accounts for 10% of the entire budget of the NHS, and obesity costs the health service £5.1b a year. Income inequality is reflected in the health inequality between rich and poor.
But policies designed to try and rectify that inequality, such as a sugar tax, or the setting of a minimum price per unit of alcohol, raise cries against the dreaded ‘nanny state,’ or that politicians are patronising real people, by assuming they cannot look after themselves and must have central government diktats about what they should consume imposed upon them.
Moreover, there is of course the paradox that these policies do raise the prices of products disproportionately consumed by the poorer in society, because those products are inherently unhealthy. Regressive progressivism in a nutshell.
However, interestingly enough, the University of Sheffield report found no evidence to support the claims that a minimum pricing of alcohol would disproportionately affect poorer moderate drinkers.
Moreover, as Dr Sarah Wollaston MP argued in 2015: ‘A levy on these products need not hit the pockets of low-income families as there would always be an alternative, untaxed and cheaper equivalent. One of the main purposes of a sugary drinks tax would be to encourage healthier choices, and that has clearly been the effect in countries such as Mexico.’
It seems that the answer to such cries is for politicians to have the courage of their convictions. It is no surprise that David Cameron, the ultimate style over substance politician, abandoned his initial 2012 promise to introduce a 40p per unit price under pressure from the drinks industry, and vetoed the idea of a sugar tax.
The fact of the matter is this; in the area of public health, our politicians have a duty to us to tackle these issues, whether that is obesity or alcohol consumption. It should not be seen as the government patronising ordinary people by raising the prices of something provably bad for you. To do otherwise would run counter to the whole point of an elected government, that it is supposed to legislate to improve our lives, and they should not necessarily shirk from such measures because they are accused of particular buzzwords.
Of course, there is no silver bullet for either of these problems, nor have campaigners claimed that raising prices or increasing taxes would be such a thing, and it is comforting to see politicians such as George Osborne, when he was Chancellor, advocate ‘whole systems’ approaches, whereby money raised would be reinvested into schools, gyms and communities.
But to return to the point with which we began, it is worth applauding the Scottish Government on having the guts to spend five years fighting on behalf of a potentially unpopular policy. To echo the Supreme Court’s words, a ‘proportionate means of achieving a legitimate aim.’ Good intentions indeed.