In January 2016, Sally Davies, the Chief Medical Officer, controversially lowered the drinking guidelines for men and declared that there is ‘no safe level’ of drinking. This was followed in December by a Public Health England report which proposed a raft of heavy-handed measures to tackle alcohol consumption which, they claimed, had doubled in Britain over the last 40 years.
The claim about consumption doubling had to be retracted almost as soon as it was made, as per capita alcohol consumption in Britain is at exactly the same level today as it was in 1980. It was later revealed that the Chief Medical Officer’s guidelines committee was packed to the gunwales with temperance activists. What hasn’t been fully exposed is the close relationship between Public Health England and the temperance movement. In particular, its relationship with the Institute of Alcohol Studies.
Although its name implies academic impartiality, the Institute of Alcohol Studies (IAS) was formed out of the ashes of the UK Temperance Alliance in the 1980s. Its parent charity is the Alliance House Foundation, which started life in the 19th century as the UK Alliance for the Suppression of the Traffic of All Intoxicating Liquors, a pressure group that was entirely dedicated to bringing about the prohibition of alcohol. Having invested in a property portfolio that is now worth £13 million, the Alliance House Foundation distributes its rental income in ways which further its stated charitable objective ‘to spread the principles of total abstinence from alcoholic drinks’.
The IAS, which it founded in 1983, is its main beneficiary. Almost all of IAS’s £400,000 annual income comes directly from the Alliance House Foundation, and four out of five of its directors are directors of the Alliance House Foundation, including the Reverend Stephen Orchard and the Reverend Janet Tollington.
Despite its close ties to gospel temperance, IAS claims to have no view about whether people should drink or not. While there is no suggestion that IAS wants to ban alcohol completely, its research invariably focuses on the negative aspects of drinking, typically concluding with a call to raise prices, ban advertising and restrict licensing laws. It has been particularly active in the campaign for minimum pricing.
Last year it was revealed that four of the people who assisted the Chief Medical Officer in lowering the drinking guidelines were affiliated with IAS. The group complained to the Independent Press Standards Organisation when The Times described it as an ‘anti-alcohol organisation’, but this complaint was rejected after IPSO found that ‘the newspaper had provided a sufficient basis to support its characterisation’.
Emails released to me under the Freedom of Information Act reveal that IAS not only enjoys a close relationship with the Chief Medical Officer, but is also very friendly with Public Health England (PHE). PHE and IAS were in almost continuous contact in the two years leading up to the publication of the agency’s report on alcohol in December 2016. PHE officials gave its members access to unpublished documents, shared their contacts in government, promoted IAS material, invited IAS members on to three committees and even moved their official meetings to the IAS’s offices in Caxton Street, London.
Between November 2014 and December 2016, IAS had meetings with Public Health England almost every month, exchanged more than 330 emails and had numerous off-the-record conversations in person and over the telephone.
For much of the period covered by the emails, Public Health England (PHE) was working on its review of alcohol policy and IAS was working on its own review of the Licensing Act which, when published last year, called for minimum pricing and a more restrictive licensing regime for pubs and off-licences.
By November 2014, PHE had already appointed at least one member of IAS to both its Expert Advisory Group and its Licensing Network. The Licensing Network met every two months, with IAS giving presentations on no fewer than five occasions: in January, April and October of 2015 and February and April of 2016.
It was not until the PHE report was published 18 months later that the names of the Expert Advisory Group’s members were made public, but we now know that the Institute of Alcohol Studies was represented by its director, Katherine Brown, and one of its advisors, Petra Meier. Two other affiliates of the IAS are named as contributors to the PHE report and several other anti-drinking lobby groups, including Alcohol Concern, Alcohol Action Ireland and the Alcohol Health Alliance, sat on the Expert Advisory Group. There were no representatives from consumer groups or the drinks industry.
In May 2015, after arranging a private meeting to discuss ‘price interventions’, IAS was appointed to PHE’s Alcohol Leadership Board. This is a select group of advisors on alcohol policy co-chaired by Ian Gilmore, who is also the chair of the Alcohol Health Alliance, a pressure group which campaigns for higher taxes, minimum pricing and more restrictive licensing laws. The Institute of Alcohol Studies is one of its most prominent members. The other chair of the Alcohol Leadership Board is Rosanna O’Connor, PHE’s director of alcohol, tobacco and drugs.
Thus Ian Gilmore, the leader of a strident campaign group, was put on an equal footing with PHE’s overseer of alcohol policy. As with PHE’s other alcohol committees, minutes of Leadership Board meetings are not made public.
By the summer of 2015, the Institute of Alcohol Studies was well represented at every level of Public Health England’s alcohol policy network. It was attending regular meetings of the Alcohol Leadership Board in addition to the bi-monthly meetings of PHE’s Licensing Network and its Expert Advisory Group. Changing government policy is at the core of the Institute of Alcohol Studies’ mission and it wasted no time in capitalising on its access to PHE officials.
After attending its first Leadership Board meeting, IAS emailed PHE to say it ‘was really great to see so many government reps from different departments in the room together’ and asked for the email address of a Department for Transport official, which PHE provided.
After another meeting, IAS emailed Rosanna O’Connor lamenting the fact that no one from the Department of Health or the Treasury had ‘found the time’ to be lobbied by them for higher alcohol taxes. They followed this up with a heavy hint that PHE should assist them with their campaign, saying that it ‘would be great if PHE could make representations to the Treasury outlining the public health risks associated with reducing alcohol duty’.
On Friday January 8, 2016, PHE arranged to have a telephone conversation the following Monday in advance of a meeting IAS was having with the Treasury to discuss alcohol taxation. In another email, IAS asked PHE for the name of an MP who might ask a question for them: ‘Nice to see you the other day,’ they wrote. ‘If a parliamentarian wanted to raise questions behind closed doors about the life chances strategy, are you able to say who it would be best to contact?’
PHE suggested someone in the Department of Work and Pensions or the Cabinet Office, naming Ben Gummer and Chris Skidmore as possibilities.
IAS’s requests for insider information were not always fulfilled. In June 2015, IAS told PHE that it had heard about ‘some important meetings’ going on regarding licensing and public health and asked ‘are you able to say anything about how things are looking, or is it too early to say?’ PHE emailed back: ‘How many spies do you have [smiley face]’.
Throughout 2015 and 2016, PHE and IAS shared confidential information and swapped notes so that they could maximise the impact of each other’s work. In early October 2015, for example, PHE sent IAS an (unnamed) document that is ‘not for wider circulation as it hasn’t been signed off’. Two weeks later, a PHE official shared her slides with the IAS’s Jon Foster ahead of a conference. In November, with the conference drawing closer, Foster sent PHE the slides he intended to use in his presentation and expressed his hope that they ‘will hopefully complement what you’re both saying’.
PHE was particularly interested in working with IAS to change the licensing laws to make ‘public health’ a fifth licensing objective for local authorities. This would allow campaigners to object to new bars and off-licences being opened by claiming that access to alcohol could be bad for people’s health. The government has always opposed this idea because it is impossible to attribute broad measures of alcohol harm, such as chronic liver disease, to individual licensed premises.
Nevertheless, PHE and IAS were both enthusiastic about the scheme as a way of clamping down on alcohol consumption. The emails show an unnamed PHE employee making frequent requests for help in this regard and it is clear that PHE intended to use the IAS’s report on licensing to support their case. In July 2015, for example, PHE told IAS that it expected its report to be ‘really useful’ in the ‘conceptualising of a fifth health objective’.
There was little doubt that IAS report’s would support the idea of a fifth licensing objective and, when it was published in March 2016, PHE congratulated them on their work, attended the launch at IAS’s office and invited them to present the findings at a ‘shared learning’ event the following month.
Similarly, when a new IAS report about alcohol and A&E services was due to be released on Monday October 26, IAS emailed Rosanna O’Connor three days earlier congratulating PHE on its recent obesity report and supplying ‘an advanced copy of our report’. ‘Well done!’ replied O’Connor, ‘I will suggest to our press office that we might like to issue a supportive statement or, at least, supportive tweets.’ IAS said it could send over ‘some images and suggested tweets’.
By this time, PHE’s cosy relationship with IAS had extended to holding its Alcohol Leadership Board meetings at the IAS’s London office. PHE were no strangers to the building, having held private meetings with IAS on several occasions, and, on March 14, 2016, they asked them if they ‘hire out the boardroom at your IAS headquarters? As we are looking for venues for our Alcohol Leadership Board (which is approximately 25 people).’ IAS replied, saying that PHE could have it for free because ‘we’re happy for partners to use the space’. Thereafter, Britain’s leading public health agency reviewed alcohol policy in office space paid for by an organisation whose stated objective is ‘to spread the principles of total abstinence from alcoholic drinks’.
By the end of the year, PHE’s alcohol report was finally published and IAS had a chance to repay the agency for its earlier promotion of its work. IAS already had a good idea of what the report would say because its members had been feeding into it for nearly two years. In January 2015, following a private meeting between the two organisations, PHE invited an unnamed IAS member to become ‘one of our go-to experts for the evidence on pricing’. IAS naturally said that they were ‘more than happy to help’ and were immediately sent an unpublished draft of the PHE report with a request that IAS check ‘that our interpretation of the included evidence is correct.’
As published in December 2016, the PHE report’s section on pricing reflected IAS policy to the letter and IAS were delighted. On the morning of December 2, with the PHE report hot off the press, IAS emailed them to say: ‘Am just wading through it all, great stuff! Have a great weekend when it comes – you certainly deserve it’. At midday, IAS informed them that ‘we’ve just issued’ a press release (under the name of the Alcohol Health Alliance) calling for minimum pricing and higher taxes in light of the PHE alcohol review. PHE told IAS they will ‘send [the Alcohol Health Alliance press release] to members with tweets’.
On the same day, the Alcohol Health Alliance wrote an open letter to the Chancellor of the Exchequer, which it published on its website, calling for higher taxes and minimum pricing ‘in response to the compelling evidence published today by Public Health England about the most effective measures to reduce rates of alcohol harm’. The letter was signed by 43 people, suggesting that the Alcohol Health Alliance had access to the report long before it was released.
With Ian Gilmore acting as chair of the Alcohol Health Alliance and as co-chair of PHE’s Alcohol Leadership Board, it would hardly be surprising if the gist of the PHE report was known to him. Within hours of publication, he gave a quote to the press on behalf of the Alcohol Health Alliance, saying: ‘This report provides yet more evidence of the effectiveness of raising the price of the cheapest alcohol to tackle alcohol-related harm.’
The extent of the collaboration between IAS and PHE’s alcohol network would be remarkable if it were between any private organisation and a government agency, but it is particularly extraordinary given IAS’s obvious biases and its roots in the temperance movement.
IAS can hardly be blamed for making the most of its access to a government agency, but PHE’s encouragement of the organisation went beyond routine stakeholder engagement and entered the realms of collaboration. Along with Ian Gilmore, Alcohol Concern and other campaigners for extreme anti-drinking legislation, IAS was given extensive access, promotion and support from PHE while consumer groups, the drinks industry and other think tanks were excluded.
The decision to appoint IAS members to several committees, as well as to make Gilmore the co-chair of the Leadership Board, suggests that PHE had a strong bias of its own long before it published its evidence review. By surrounding themselves with hardline activists, PHE officials soon began to resemble campaigners. Reading the emails, it is difficult to see where the activism ends and the government agency begins.