Public Health England: Gambling-related harms review

Sally Dray

Image shows a row of slot machines in a casino for gambling

On Thursday 14 October 2021, Lord Bishop of St Albans is due to ask the Government:

what assessment they have made of the report by Public Health England Gambling-related harms evidence review, published on 30 September.

How prevalent is gambling in Britain?

The Gambling Commission’s most recent survey on gambling participation found that, in the year to June 2021, overall participation in any gambling activity was 42%. This was a 3.5 percentage point decline compared to the same survey held in the year to June 2020. The survey was conducted by a consulting firm which asked a nationally representative sample of 4,010 adults if they had participated in any gambling activity in the last four weeks. The surveys were carried out over the telephone and took place in September and December 2020 and in March and June 2021.

The survey also estimated that:

The overall problem gambling rate is 0.4%. This is gambling with negative consequences and a possible loss of control. For example, they may often spend over their limit, gamble to win back money and feel stressed about their gambling.
The overall moderate risk gambling rate is 0.7%. This is gambling with a moderate level of problems that could lead to some negative consequences. For example, they may sometimes spend more than they can afford, lose track of time or feel guilty about their gambling.
The overall low-risk gambling rate is 2%. This is gambling with a low level of problems with few or no identified negative consequences. For example, they may very occasionally spend over their limit or feel guilty about their gambling.

The Government, as part of the NHS Long Term Plan, has estimated that over 400,000 people in England are problem gamblers and two million people are at risk.

In its 2020 GB Treatment and Support Survey, the charity GambleAware found an increase in the numbers of problem gamblers accessing treatment and advice in the last year. It found that 63% of problem gamblers surveyed said they had accessed treatment in the last 12 months, compared to 54% who said the same in 2019.

What was in Public Health England’s review into gambling-related harms?

On 30 September 2021, Public Health England (PHE) published its review into gambling-related harms. The review looked at the prevalence, risk factors and public health harms associated with gambling, as well as the economic and social burden. The review was made up of a summary of PHE’s findings, as well as six technical reports, covering:

The review sought to answer a number of questions related to gambling, such as how prevalent it is across different sections of society, what harms are associated with it, and whether the Covid-19 pandemic had an effect on gambling behaviour. For its review, PHE analysed existing papers, including the annual Health Survey for England and a previous consultation from the Gambling Commission which was held from December 2018 to February 2019.

In its summary, PHE identified the types of harms associated with gambling as:

Financial
Relationship disruption, conflict or breakdown
Mental and physical health
Cultural
Reduced performance at work or in education
Criminal activity

How prevalent is problem gambling?

PHE estimated that 0.5% of the population have a problem with gambling. Additionally, 3.8% are gambling at at-risk levels, and 7% of adults are affected negatively by another person’s gambling.

The review found that the highest rates of gambling participation are among people who have higher academic qualifications, people who are employed, and people in relatively less deprived groups. In contrast, problem gambling is associated with people who are unemployed and people who live in more deprived areas. PHE said this suggests a link between harmful gambling and health inequalities.

What is the impact of gambling-related harm on the economy?

In its summary, PHE estimated that the annual economic burden of harmful gambling is approximately £1.27 billion. It further estimated that £647.2 million of this total is a direct cost to government. This figure comprised: £62.8 million in financial harm; £342.2 million in mental and physical health harms; £79.5 million in employment and education harms; £162.5 million in criminal activity; and a further £647 million in excess costs.

What did the review conclude?

PHE concluded that harmful gambling should be considered a public health issue. It stated that more needs to be done to prevent and reduce harms associated with gambling. It said it is undertaking another study to identify what policies and interventions could be adapted from public health to address the harms considered in its review. It also noted that the Office for Health Improvement and Disparities will work with other government departments to make changes in this area.

What has the Government said about gambling and gambling-related harm?

In response to a written question on 15 September 2021, John Whittingdale, the then Minister of State for the Department for Digital, Culture, Media and Sport (DCMS), said that the Government views gambling-related harm as a public health issue.

NHS Long Term Plan

As part of the NHS Long Term Plan, the Government committed to investing in NHS specialist clinics to help more people with serious gambling problems. Giving further information about the expansion in response to a written question in September 2021, Mr Whittingdale said that up to 15 new specialist clinics would be created by 2023/24, as well as £15 million of funding being made available in the same period.

Review of the Gambling Act 2005

On 9 December 2020, the Government published a review into the Gambling Act. The review’s objectives were to examine whether changes were needed to the act, to ensure balance between consumer freedoms and prevention of harm to vulnerable groups, and to make sure customers are suitably protected when gambling. A call for evidence as part of the review was held between 8 December 2020 and 31 March 2021.

On 16 September 2021, the Parliamentary Under-Secretary for the Department for Digital, Culture, Media and Sport, Nigel Huddleston, said that the Government received 16,000 submissions of evidence. He said the Government aimed to publish a white paper in this area by the end of the year.

National Strategy to Reduce Gambling Harms

On 25 April 2019, the Gambling Commission launched a three-year strategy to reduce gambling-related harms. The strategy had two objectives:

Prevention and education: for a collective and clear prevention plan and intervention options.
Treatment and support: to make progress towards national treatment and support options to meet the needs of current and future service users.

The actions map on the Commission’s website outlines the actions to be taken by the commission and other stakeholders to reach these objectives. The map is updated when progress has been made in an area.

The Advisory Board for Safer Gambling (ABSG) is overseeing implementation of the strategy. In the ABSG’s latest progress report, published in June 2021, it said that some progress had been made towards the goals of the strategy, despite the impact of the Covid-19 pandemic.

The ABSG noted that progress had been made in areas such as including people with lived experiences of gambling harms in the strategy’s delivery, and an increase in the number of financial institutions offering blocking tools and support when asked to by customers. However, it also said that there has been little progress on addressing gambling-related suicide and that stakeholders had not yet agreed on how to measure the progress and impact of the strategy. It made a number of recommendations on the delivery of the strategy, as well as for the two stated objectives.

What have others said about the issue?

In July 2020, the House of Lords Committee on the Social and Economic Impact of the Gambling Industry published a wide-ranging report calling for urgent government action in this area. It made over 50 recommendations in a number of areas, including gambling-related harm. On this issue, one recommendation was to reinstate the British Gambling Prevalence Survey (last undertaken in 2010) to better understand the prevalence of gambling in the UK.

The Government, in its response to the report published in December 2020, said it is necessary to maintain the right balance between the freedom to enjoy gambling as a leisure activity, and the need to protect vulnerable people. It said work was already underway to deliver many of the committee’s objectives. Commenting on the British Gambling Prevalence Survey, the Government said that the Gambling Commission was undertaking similar work, such as a review of how it gathers information on gambling in Great Britain and implementing new questions on harms as part of its quarterly omnibus survey.

The Gambling Health Alliance has said that the Gambling Act 2005 is no longer fit for purpose, which has resulted in a great deal of harm to the public. It has recommended that the Government take a public health approach to its review of the Gambling Act by taking steps such as: taking a precautionary approach; reducing exposure to gambling; introducing equivalent measures for online and offline gambling; and investing in research, education and treatment.