The Lucy Letby case

I've been writing a bit about the Lucy Letby case recently. Some people think she's innocent. One of those people is Peter Hitchens, with whom I had a debate recently. You can watch it below.

Christopher Snowdon on the Drinks Insider podcast

I was interviewed for the latest episode of the Drinks Insider podcast talking about the anti-alcohol lobby. You can listen here or wherever you get your podcasts.

A glimmer of hope for British healthcare

I've written for the Express about how public opinion is slowly changing with regards the NHS:

 

The NHS model is something of an outlier in not only paying for everyone’s healthcare but in owning the infrastructure, employing all the medics and being run by the government. In mainland Europe, it is more normal for people to take out health insurance with a provider of their choice and for hospitals to be running privately.

Governments ensure that everybody is covered, either by paying for everyone’s health insurance or by paying for those who cannot afford it, but none of them has an enormous state-run leviathan like the NHS. This introduces an element of choice and competition that raises standards and promotes efficiency.

Moreover, the NHS is not under-funded by any reasonable definition. According to the latest data, only five OECD countries spend more on healthcare as a percentage of GDP than the UK. NHS spending was ring-fenced in the ‘austerity’ years and there were never any cuts to its budget.

On the contrary, its budget has rocketed since 2018. The good news is that public opinion has started to change. As recently as May 2021, a YouGov survey found that 39 percent of British adults believed that the NHS provided better healthcare than other European countries while only 10 percent thought the opposite.

When the same survey was carried out last month, 33 percent said that European systems deliver better healthcare than the NHS and only 17 percent thought the NHS was superior (the rest said that they either didn’t know or that both systems delivered similar results).

Perhaps more surprisingly, when another poll published this month asked people what the biggest problem with NHS funding is, only 33 percent said it was that "the NHS does not receive enough funding" whereas 55 percent said that "the funding the NHS does receive is not spent as effectively as it should be".

 

Do read it all.

 

And read Kristian Niemietz's new report in which he shows how we can move the NHS towards a social insurance system and end the misery.

The dark arts of Chris Whitty

There was a period during the pandemic in 2020 when the pubs were open but you could only go to one if you sat on your own and had a meal. You were allowed to buy an alcoholic drink but once you had finished your meal you could not buy another one. There was also a 10 p.m. curfew when the pub had to close and everyone had to go straight home.

Whether this did much to stop the spread of Covid is debatable (there were reports of a lot of house parties starting just after 10 p.m.), but it allowed the ‘public health’ establishment to turn pubs into what it thought they should always have been: functional, sterile restaurants where fun is discouraged if not outright illegal. At the top of that establishment sits the Chief Medical Officer, Professor Sir Chris Whitty. Since the pandemic, Whitty has been busy lobbying successive prime ministers for a series of fanatical nanny state measures. He persuaded Rishi Sunak to announce the gradual prohibition of all tobacco sales and, according to the Times, has been ‘leading the push for an outdoor smoking ban’.

An outdoor ban would be a shattering blow for the pub trade, but Whitty is not done yet. According to the Telegraph, the public health minister Andrew Gwynne is considering ‘tightening up the hours of operation’ of pubs and bars. 10 p.m. curfew anyone?

Once again we see the hand of Chris Whitty at work. Speaking at a fringe meeting at the Labour conference, Gwynne explained that Whitty had met him on his first day in the job and shown him a series of slides (of course!). The first slide showed that 40 per cent of NHS spending is on preventable health conditions and that this is projected to rise to 60 per cent in the next 15 years. For Gwynne, the conclusion was obvious. Never mind reforming the NHS, we must reform the public.

Read the rest at the Spectator.

Orwell chat

I was on the Unlicensed Philosophy podcast recently talking about Orwell and Nineteen Eighty-Four. You can watch it below if you so wish.

Taxes. Is there anything they can't solve?

The Institute for Public Policy Research (IPPR) has published what it calls “the most ambitious blueprint for the nation’s health since Beveridge”. I wouldn’t get too excited. Their previous contributions to the debate about the nation’s health include demanding plain packaging for crisps and sweets. Surprisingly, that doesn’t get a mention this time around but the report does include 20 recommendations, many of which don’t have much to do with health but are things that left-wing think tanks always want, including “a full restart of Sure Start”, a legal “Right to Disconnect” at work, abolition of the two child benefit cap, more spending on research, more work for quangos, even more “free” school meals, etc.

But the IPPR also wants a “healthy industrial strategy” based on the “polluter pays principle”. Their thinking is rooted in two absurd beliefs that have become the orthodoxy in ‘public health’ through repetition. The first is that if you drink yourself to death, it has nothing to do with you and is instead the fault of Heineken or the French wine industry or some other commercial entity. The second is that the greatest public health win of the last ten years was Lucozade putting more artificial sweeteners in their drinks. Despite the sugar tax having no effect on childhood obesity, the IPPR reckons it was “among the most successful government policies of the last decade” (to be fair, it hasn’t been a great decade for government policies) and wants it to be “expanded’, not just to food and drink but to a bunch of products and services that are already heavily taxed.

 

Read the rest at The Critic. 

 

Meanwhile, EU countries have got their own problems...

European Union countries should consider extending smoking bans to cover children’s play areas, outdoor pools, amusement parks, and terraces, the European Commission will recommend Tuesday, according to a document obtained by POLITICO.

The EU executive will also recommend stricter rules on e-cigarettes “whether containing nicotine or nicotine-free” as it looks to tackle the “uptake and appeal” of vapes among children and young people.

 

The fun police are out of control.

The runaway train of the nany state

There was never any doubt that the government would introduce its so-called “junk food” advertising ban next October. After all, that was the date set by Rishi Sunak last year and Keir Starmer is even keener on big government than he was. The only interesting thing about yesterday’s “announcement” is that it came on the same day as Starmer’s big speech about reforming the NHS. As I mentioned last week, the Prime Minister genuinely believes that the slovenly public are to blame for Britain’s dismal health service. I very much doubt that he is going to reform the NHS. It is beyond reform. Instead, he is going to try to reform us.

For the next five years, the UK will be the playground of every “public health” blowhard and nanny state crank. The slippery slope of lifestyle regulation will become a runaway train. If resistance is futile, we should at least demand accountability. The advertising ban, for example, is supposed to reduce child obesity. If it fails to do so, we should repeal it and strip the academics who promoted it of their government grants. It’s only fair.

 

Read the rest at The Critic.

Economically illiterate nonsense about online gambling

Online gambling is holding the economy back, according to the economic consultancy firm National Economic Research Associates (Nera). In a report commissioned by the Campaign for Fairer Gambling, a lobby group set up by the former casino entrepreneur Derek Webb, Nera claim that the economy would have grown by £1.3 billion a year between 2015-16 and 2022-23 if it weren’t for people gambling online. This news inspired Will Prochaska of the Coalition Against Gambling Ads — another of Mr Webb’s pressure groups — to call on the government to “consider taxing gambling like cigarettes” in order to “reduce consumption”, although how that would work in a business where customers choose how much to spend is unclear.

The general idea is that if people didn’t spend their money on online gambling, they would spend it on things that the authors of the Nera report claim have more “overall economic value”. This, they say, means that “online gambling is detrimental to the British economy”, and from this tendentious conclusion the Campaign for Fairer Gambling suggests that the government should deter people from doing it, which, by a happy coincidence, is what they already wanted.

This is wrong-headed from the start. The point of the economy is to allow individuals to access the goods and services they most want to use. If the government intervenes to make their first preference too expensive, too inconvenient or too illegal, he or she will have to settle for second best. In so doing, the government is imposing an economic cost on that person. The idea of using state coercion to make people spend money on things they don’t really want for the good of the economy (“Buy British!”) is silly. 

Claims about certain industries having bigger multiplier effects than others are usually dubious and self-serving, but they are particularly suspect in the Nera report because the authors define an economically productive industry as one that is “labour intensive”, which is to say that it has to employ more people to generate the same amount of revenue.

 

Read the rest at The Critic.

Hell is too cold for these joyless gimps

I was on Radio 4 for a whole hour on Friday discussing smoking and the nanny state with ASH's Deborah Arnott on the show AntiSocial. You can listen back here or download the AntiSocial podcast. 

It's always nice to get a decent amount of time to talk about any issue, although it is a little frustrating when you have to spend most of your time correcting the other person's lies. Amongst other things, Arnott claimed that an outdoor smoking ban won't hurt pubs, that there were more pubs after the 2007 smoking ban than before and that smoking imposes a net economic cost on nonsmokers. Tiresome stuff.

David Mitchell wrote an excellent article about the proposed ban at the weekend...

 

The indoor smoking ban was bad enough. I know it’s been successful at reducing smoking and, on balance, I wouldn’t go back on it now. Nevertheless it is my belief that that is not the sort of law governments should make. Smoking is a stupid thing to do but, in a free society, we should be allowed to do stupid things unless they impinge on the freedom of others. But the advocates of the ban tried to claim that it was not an assault on liberty, by citing the health impact of passive smoking.

Are they really going to make the same claim when it’s being done outdoors? That smoking in pub gardens significantly shortens the lives of significant numbers of non-smokers? More than driving non-electric vehicles or smelting steel or lighting bonfires on 5 November, activities the government is not proposing to ban?

Feeble though that argument would be, it is troubling to me that it is not how Keir Starmer proposes to justify the ban. His reasoning is more radical. He thinks it should happen in order “to reduce the burden on the NHS and reduce the burden on the taxpayer”. So he proposes to place legal restrictions on unhealthy behaviour in order to cut down what it costs the state to provide medical care. “That’s why I spoke before the election about moving to a preventative model when it comes to health,” he explained.

This is chilling. I assumed the “preventative model” meant things like offering regular checkups, screening for cancers and encouraging healthy lifestyles, not placing legal barriers in the way of unhealthy ones. That sets quite the precedent: the state will stop you doing things that are bad for you in order to mitigate its hospital spending. With that principle established, what liberty might not be curtailed: fatty foods, contact sports, sexual promiscuity, motorbikes, stressful jobs? All this stuff could place a burden on the NHS and the taxpayer. In Starmer’s vision, is a welfare state only affordable if the populace is compelled to be prudent?

 

Indeed. As I said in The Critic, an outdoor ban would be extraordinarily spiteful and vindictive and yet somehow the justification for it is even worse.

 

Madeline Grant also wrote a great article about this for the Telegraph... 

 

There is a real absence of “live and let live”. Grumbling over a slither of cigarette smoke several yards away in a beer garden, demanding that already hard-pressed publicans lose custom or even their livelihoods to suit your whims isn’t kindness, but the height of entitlement. It recalls those people who choose to live in Soho yet spend their time bombarding the council with noise complaints, or those who move to the countryside only to bemoan the sound of church bells. Part of being an adult is the capacity to endure mild inconvenience, to witness habits you dislike, without screeching for them to be banned. We’re being turned into children – and worse still, applauding the Government for it.

 

As Madeline said on Twitter, "Hell is too cold for these joyless gimps".

 

Christopher Snowdon on the Fire at Will podcast

I did the Spectator's Fire at Will podcast recently talking about (you guessed it) the nanny state. You can listen to it in the YouTube vid below.

Banned for your own good

With smoking, the Rubicon is now in the rear view mirror. It is less than a year since Rishi Sunak announced his plan to gradually prohibit the sale of tobacco. His successor, Keir Starmer, recently admitted that his government is considering some form of outdoor smoking ban. These developments are remarkable not just because they are illiberal but because they do not even pretend to respect freedom of choice. Until last year, anti-smoking campaigners would swear on a stack of Bibles that they were not prohibitionists. Their policies might have a negative impact on adults who choose to smoke but that was not, supposedly, the intention. For most of their campaigns it was children who were weaponised. Tobacco advertising had to be banned because it seduced children. Branding and shop displays had to be banned for the same reason. Taxes had to rise to make cigarettes unaffordable to children. Occasionally, they would claim to be acting on behalf of other groups of people — slim cigarettes had to be banned because they appealed to women, and smoking in pubs had to be banned to “protect” bar staff — but the activists still insisted that they were not infringing on adults’ right to smoke. Your cigarettes might be covered in disgusting photos but you could still buy them. You might not be able to smoke in a pub, but you could always nip outside. 

To put it in economic terms, they appealed to market failure and negative externalities. The arguments were disingenuous, but if you squinted enough you could squeeze them into a framework that was just about consistent with British liberalism.

Not any more. The justification for the latest diktats is distinctly more Iranian and can be summarised as “Smoking is bad for you, we don’t like it and we’re going to stop you doing it.” 

 

Read the rest at The Critic.

Why minimum pricing is bad news for pubs

Excited by the thought of an outdoor smoking ban, Prof Ian Gilmore of the Alcohol Health Alliance has written to the Telegraph. Pretending to be a friend of the pub trade despite supporting everything that has hampered it and opposing everything that could help it, he says they needn't worry about all their smoking customers disappearing and should embrace minimum pricing.

 

Cheap alcohol from supermarkets has turned us into a nation of home-drinkers, reducing foot traffic to local pubs and bars and threatening the closure of important social spaces. By setting a minimum price, the Government can level the playing field, making pubs a more attractive option for those who might otherwise choose to drink cheaply at home.

... MUP has saved lives in Scotland without damaging the hospitality trade. By aligning the price of alcohol more closely across different outlets, MUP offers a rare dual benefit, supporting both the survival of pubs and the health of the public.

 

Lying comes as naturally to these people as breathing. MUP did not save lives in Scotland and pubs in Scotland "are closing at twice the rate as those in England". A study in BMJ Open found that men under 45 reacted to MUP by buying less alcohol in pubs and more alcohol in shops.

This shouldn't be too surprising. Higher off-trade prices means drinkers have less money to spend in pubs. I predicted this would happen in 2017. The Spectator Health article is no longer available online, except via the Wayback Machine, so here it is again....

 

There was a reminder last week that politics produces strange bed-fellows when the Institute of Alcohol Studies (formerly known as the UK Temperance Alliance) promoted the pub industry’s view of alcohol policy.

Pubs have traditionally been the temperance lobby’s greatest foe. The American prohibition movement was not spearheaded by the Anti-Alcohol League or the Anti-Drunkenness League but by the Anti-Saloon League. Concerns about people drinking at home are a more recent, British phenomenon. For decades, the temperance lobby preferred people to be drinking at home than in bars, but years of excessive regulation and high taxes have led to thousands of pub closures and they are no longer seen as such a threat. People are now buying most of their drink in the off-trade and so, like Willie Sutton who robbed banks because ‘that’s where the money is’, the temperance lobby targets the off-trade because that’s where the drink is.

In a classic example of Bootleggers and Baptists behaviour, the hospitality industry has found common cause with anti-alcohol campaigners in going after supermarkets. The survey found that most publicans want higher taxes on alcohol in supermarkets and lower taxes on alcohol in pubs. Rent-seeking doesn’t get more blatant than this, but the Institute of Alcohol Studies half-agrees. It never wants lower taxes anywhere – so it ignored the issue of pub prices in its press release – but it is firmly behind the call for higher off-trade prices.

The IAS was even more excited by the pub trade’s support for minimum pricing. Putting a minimum price on a unit of alcohol had the backing of 41 per cent of the publicans surveyed, against only 22 per cent against. Partial support from the drinks industry for this temperance policy is nothing new. When David Cameron was weighing up the policy in 2013, the chief executives of several pub chains publicly urged him to go ahead with it.

A minimum unit price of around 60p will raise the price of most of the alcohol sold in supermarkets but will have virtually no effect on pubs. It is easy to see why this appeals to publicans. They are, however, being short-sighted. Once the government starts setting prices for one part of the market, it is likely to extend its reach into others. In Canada, where a form of minimum pricing exists in several provinces, campaigners want a minimum price in bars and they want it to be twice as high as the minimum price in off-licences. In Alberta and Manitoba, bars have been subject to minimum pricing laws for years.

Appeasement is always a risky strategy and it is doubtful whether the pub trade’s support of minimum pricing would pay off even in the short-term. They are assuming that people are forsaking pubs because of the gulf between pub prices and supermarket prices. They are further assuming that people would visit pubs more if this gap were narrowed, even if pub prices did not fall.

This logic is appealing because a drink bought in a supermarket is a substitute for a drink bought in a pub, but there are good reasons to think that minimum pricing could have quite the opposite effect on pubs. To see why, we need to consider the counter-intuitive finding of the economists Jensen and Miller who noticed that low income consumers in China buy more rice when the price of rice goes up. The same phenomenon is said to have taken place when the price of potatoes rose in nineteenth century Ireland: people bought more of them. The law of demand predicts that a rise in price should lead to fewer sales, so how do we explain this Giffen behaviour?

Like most economic issues, it comes down to limited resources. If your budget for food is tightly constrained, you need to get the most calories for your dollar. Carbohydrates such as rice and potatoes are the cheapest sources of energy in many countries. When times are relatively good, the poor can afford to buy meat, but if the price of carbohydrates rises, they have a choice between eating less meat or eating less food.

Let’s say that 50 cents buys you rice containing 2,000 calories or meat containing 500 calories. If you have a food budget of one dollar a day, you can buy both, but if the price of rice suddenly rises by 50 per cent, what do you do?

2,000 calories of rice now costs you 75 cents. If you keep buying your 50 cents of meat, you will have to buy a third less rice and go hungry. It makes more sense to sacrifice the relative luxury of meat and buy more rice.

This may seem an extreme example that has little to do with the pub trade in wealthy countries, but it is really just a question of budgeting. If you have a set budget and fixed preferences, a rise in prices is likely to push you towards the cheapest option.

Now let’s say you want to drink ten beers a week and have £20 to spend. You have one beer a day from the supermarket at £1 each but on Saturday you go to the pub and have four beers at £3.50 each. The effect of minimum pricing will be to raise the price of your supermarket beer to £1.50. If you want to keep drinking ten beers a week, you will have to cut down to three bottles in the pub and buy an extra bottle from the supermarket.

In practice, that is only one option reflecting one set of preferences. A consumer might instead decide to increase their beer budget or to do without a couple of beers in mid-week. But of all the options available, surely the least tempting is to cut down to five or six beers a week and buy them all in The Dog and Duck – and yet that is what the consumer would have to do for minimum pricing to benefit pubs.

If the price of food in supermarkets rose by 50 per cent, no one would predict a surge in demand for expensive restaurants. On the contrary, higher supermarket prices would make consumers eat out less to save money for groceries. So it is with alcohol. Consumers are well aware that pub prices are higher than supermarket prices. If pubs were no more than an alternative location in which to buy alcohol, everybody would go to the supermarket and the pubs would be empty.

Pubgoers are buying much more than a drink. They are buying an experience, with ambience, company, service and entertainment. There is no doubt that some consumers would prefer to drink at home less and visit the pub more, but they are unable to do so because of high prices in the off-trade. But minimum pricing is not going to make a pint in a pub cheaper. It is just going to leave people who buy alcohol in supermarkets with less disposable income. Unless these people have a highly inelastic demand for pubs and a highly elastic demand for alcohol – a strange combination of preferences – they will need to cut expenditure elsewhere to maintain their alcohol intake. Buying fewer drinks in the on-trade is one way of doing this.

I am not saying that alcohol is a Giffen good (ie. a product that sells more when the price goes up) but if you look at on-trade and off-trade drinks as rival products it is easy to see how raising the price of the latter could lead to Giffen behaviour. For consumers who have a particular desired consumption level and are quite indifferent as to where they drink it, buying more of the cheapest option and less of the pricier option is a rational response, even though the cheapest option is more expensive than it used to be. Supermarket beer should be seen as the equivalent of rice and potatoes, and pubs as the equivalent of meat. When budgets are tight, we cut down on the luxuries first.

Originally published 5 September 2017.