Minimum pricing for alcohol in Wales

On 2 March 2020 legislation for a Minimum Price for Alcohol (MPA) came into force in Wales. This means that all alcohol in Wales can only be sold at a price above 50 pence per unit. Making alcohol less affordable is one of a number of policies aimed at reducing alcohol consumption and the harm associated with it.

There is plenty of evidence that excessive alcohol can lead to physical, psychological and social harms. This is often within certain groups (dependent drinkers, perpetrators of domestic abuse, people who are homeless, and people with mental health issues), many of whom are in regular contact with social care and social work agencies. These groups might be particularly adversely affected by the introduction of the MPA policy. Social work and social care staff are in the frontline of responding to the needs of these groups, as well as the wider consequences of sustained alcohol use. Understanding the MPA legislation, the research behind it, and its impact is therefore essential for Welsh social care practice.

MPA measures are considered one of the most effective policies for alcohol reduction, and has been introduced in a number of countries and states in the world in different forms, notably Scotland, Kazakhstan and Russia; and is due to be rolled out in others, for example, Ireland. While based on robust modelling, the research evidence of its actual effectiveness and impact is only just beginning to emerge. Scottish and Welsh introduction and evaluations are likely to play a significant role in the world’s understanding of the success of MPA.

What do we mean by minimum pricing for alcohol?

Units are a form of measuring the volume of alcohol. They are calculated by multiplying size of drink and its alcohol content. It is then possible to say how many units are in any given can or bottle and determine a minimum price for sale at price per unit. This became law in Wales on 2 March 2020 and has been in law since May 2018 in Scotland.

We do not tend to think of ourselves as buying or drinking alcohol in units, therefore some of the key information includes the most basic question of how to calculate units of alcohol. This example is the one most people would have seen the Welsh Government providing via retail outlets.

Perhaps the most detailed news report including quite a lot of price change examples was that written for Wales Online by Mark Smith.

Following the enforcement of MPA in Wales, material has been made available to the public to convey the basic principles and implications. These focus on helping people to understand why minimum pricing is being used and what is likely effects will be.

The British Association of Social Workers has a Special Interest Group for alcohol and other drugs. They have produced a range of introductory pocket guides on the impact of and how to work with alcohol and other drug issues, specially written for social workers and other social care staff. These include a general guide, and those focusing on children and families, domestic abuse, mental health and older people. These guides are easy to use, but based on underlying research.

There is a sense that while MPA is a ‘whole population measure’ designed to affect all drinks and all drinkers, it will impact on some individuals and agencies that support them more than others. This includes social care. Welsh Government has issued a range of more detailed advice for those who might be working more closely within this policy area.

Two of these of note are:

• wider social care stakeholders
• while this is aimed at retailers it provides really useful information for those wanting to get a better understanding and/or challenge myths and misunderstanding.

Understanding how alcohol use and in particular MPA fits into overall alcohol and drug use in Wales can be seen in the 2019 annual Welsh Government report.

Most of the research compares data from before and after the implementation of MPA, and with countries where MPA has yet to be introduced. For example, MPA is not in place in England and researchers are using it for comparison. Many studies are longitudinal, where researchers repeat observations over time, and are only now beginning to become available.

Of particular concern for social care staff are the concerns raised in the early stages of drafting legislation in Wales about the possibility of drinkers switching to other (cheaper) drugs. Welsh Government commissioned research on what might happen once the legislation was in place. The findings suggest that alternative drug use is unlikely except for those who already have an experience of illegal and illicit drug use. Instead drinkers might switch between different alcohol types and brands. An important finding was that people might redirect funds away from buying food and paying household bills to maintain levels of alcohol consumption. This is reflected by some early findings from Scotland where strong cider drinkers switched to spirits or wine, and drinker cut back other essential spending. See the ‘switching’ study.

All the research reports from Scotland’s 19 different studies will be published on the Health Scotland’s - Measuring and Evaluating Scotland’s Alcohol Strategy (MESAS) Alcohol website. Those published so far can be found Public Health Scotland's website.

Minimum pricing is only one policy measure for reducing the harms associated with alcohol use. The purpose of increased pricing is to reduce consumption by making alcohol less affordable. Most international and government strategies focus on four key areas of activity: prevention, harm reduction, treatment and availability. Each of these areas has implications for social workers and social care staff.

Introducing MPA was a recommendation within the last evaluation of the Welsh Government Substance Misuse Strategy. Here is a comprehensive policy review outlines how social care is located within the Welsh Government approach in responding to the four key activities.

Both the Scottish and Welsh governments are using Theory of Change evaluation approaches and Contribution Analysis. An overview of these approaches is available on YouTube.

What next?

The introduction of MPA in Wales has been overshadowed by the Covid-19 pandemic, with Wales moving into lockdown on 23 March 2020 and other restrictions on alcohol consumption.^. The response to the pandemic has also affected access and provision to support services. Even so, the price and availability of alcohol in Wales has changed and the impact is being felt by drinkers and their families.

Going forward, expect more reports from Wales and Scotland. It is also possible that the unit price may increase from 50p, both in line with inflation and if the evidence shows that MPA leads to reduced consumption (and therefore harms). This might increase the pressures on certain groups supported by social care.

In 2020/21 we will report on a Scottish study examining the impact on Harmful Drinkers with nearly 1,000 interviews over 3 years. We are also beginning work on three studies in Wales that run up to 2024, with an interim report in 2021.

Please contact me for updates and emerging messages for social work and social care as MPA becomes better established.

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