Sunday 15 May 2022

Gambling as a 'public health' issue

Martin McKee and Mark Petticrew, two of the most inept 'public health' blowhards in Britain, have bumbled into the gambling debate with a letter in Lancet Psychiatry. McKee has form for talking rubbish about gambling, having been an opponent of the National Lottery way back in 1995. Neither he nor Petticrew have conducted any research into problem gambling, but they recognise that efforts to redefine gambling as a 'public health' issue offers them a new dragon to slay and new opportunities to write opinion pieces about industry websites masquerading as research (which is Petticrew's speciality).

The letter is a bit of a blancmange and it becomes clear straight away that they are out of their depth.

Gambling harms have traditionally been viewed through the lens of psychiatry, psychology, and the neurosciences, with a focus on the individual gambler. This approach reflects an international research agenda that originated with the gambling industry and organisations that it has supported for almost 40 years. The ways in which this literature serves to pathologise people identified as so-called problem gamblers...

The clinical term for 'so-called' problem gambling is pathological gambling. The clue's in the name. It is a psychological problem which can be successfully treated. One of Britain's most prominent anti-gambling campaigners was cured of his compulsive gambling through the use of cognitive behavioural therapy and medication. These things work. 

The approach of the modern, morally bankrupt 'public health' movement is to not get your hands dirty working with individuals but to treat everything as a power struggle with the world of business, and lobby for useless legislation. One of the current fads is for levies on industry which amount to self-serving shakedowns. That's what the anti-smokers want and it is what some anti-gamblers want too. 
The thing is that the gambling industry already provides a lot of money for treatment and prevention, and is prepared to offer more. Such is the moral righteousness of the anti-gambling mob that they would rather tax the general public than accept money from industry. I reported such a case involving the mental health director of the NHS back in February. Some of them seem to have convinced themselves that money from industry is somehow laundered if it comes via a levy instead.

McKee and Petticrew are even opposed to a levy because it would supposedly create a 'conflict of interest'.

Bowden-Jones and colleagues propose a 1% levy on industry earnings to fund independent research. Although this funding would be a clear improvement on the current unsatisfactory system, in which voluntary contributions from the industry are channelled through GambleAware (a charity that both raises industry-derived funds and commissions research), the suggested levy is not a panacea. Linking the available funding to the earnings of the industry would create an obvious conflict of interest, because those involved might hesitate if their actions were to curb profits. We do not understand why public funding for gambling research should not be from government revenues, as is the case with any other threat to health.

This doesn't make much sense. Firstly, a levy would contribute to government revenues. Secondly, by the logic of 'public health' at least, if the industry makes less money (and therefore pays less via the levy) then there must be less gambling-related harm. Thirdly, are they seriously suggesting that researchers will refrain from offering effective solutions because the money will dry up somewhat? That would take a pretty unscrupulous and immoral academic. I believe this is known in psychology as projection.

So what do they propose instead? Insofar as they have a plan, it involves leaving problem gamblers to their fate while 'public health' grandees make pompous speeches about the 'commercial determinants of health' which is code for nutty anti-capitalist activism.

We call for a transformational change in how we conceptualise gambling harms, based on a public health framework that moves away from the current individualistic focus on so-called problem gamblers, takes seriously the upstream drivers of harm (eg, harmful business practices, products, and policies), and prioritises prevention of all forms of gambling harms, with funding mechanisms that are consistent with these goals.

It would be bad news for everybody if these ideologues get their way, but they seem to have some support, such as this chap...

Nothing much to worry about there, you might think. Just some bloke on Twitter who wrongly believes that treatment doesn't work. 

But the bloke who thinks treatment doesn't work is the Clinical Lead & Consultant Psychologist for the NHS Northern Gambling Service. Presumably he'll be handing in his resignation in the morning.

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