Public Health and Alcohol Licensing in the UK

Abstract

This article discusses the role of public health in alcohol licensing in the UK, with a particular focus on the implementation of national legislation and guidance in local regulatory environments. It identifies a number of practical and theoretical challenges through an analysis of historical trends in licensing practice, recent policy developments, and key licensing decisions and appeals. There are strong historical precedents for a focus on strategic harm reduction in UK licensing; however, because licensing primarily addresses the proximate effects of retail, the incorporation of health considerations presents novel difficulties. These center on the identification and deployment of data, the attribution of population-level harms to individual outlets, alcohol industry resistance, local authority risk aversion, and epistemological tensions between public health and licensing. The conclusion proposes that for public health perspectives to gain traction in the licensing environment, clear and realistic goals need to be established, research needs to emphasize local data, and there needs to be a better understanding of the approaches to evidence, knowledge, and decision making that characterize licensing and other local regulatory services.

Implementing a Public Health Objective for Alcohol Premises Licensing in Scotland: A Qualitative Study of Strategies, Values, and Perceptions of Evidence

“…Notwithstanding successes in some areas [20], many were surprised at how little impact health evidence had in the licensing arena. This illustrates the persistence, or perhaps re-emergence, of the idea of an ideal-type model of “ evidence-based policymaking ” [34] which proposes that there “ can and should be a direct and unproblematic link between ‘the evidence’ and policy decisions and outcomes ” [50] (p. 2). In contrast, evidence from policy theory suggests that policy is neither solely nor directly based on scientific evidence, nor should it be [50,51], and this study suggests that licensing policy, as a political process, is no different.…”

“…Licensing has historically had a strategic focus on the public good but health considerations, and particularly long-term health, have had little traction in day to day licensing [34]. An earlier study of the Licensing (Scotland) Act 2005 found that the public health objective of licensing was not well understood and fit poorly within a paradigm traditionally focused on harms at the level of individual licensed premises rather than the population harms of concern to public health [41].…”

“…Local policymakers, therefore, exercise discretion “ to satisfy a proportion of central government objectives while preserving a sense of professional autonomy necessary to maintain morale ” [50]. Thus, national policy can be changed or derailed when implemented locally [34] with local policymaking taking account of multiple aspects not necessarily dictated by the “institution” (or legal provisions) including in this case, economic considerations, perceived public opinion and doubts about evidence [53]—all of which are commonplace and legitimate considerations for policymakers, which are not changed overnight by the introduction of legislation. …”

“…As a function of local government, licensing involves very different “ cultures of evidence ” to those with which public health professionals may be familiar [34,54,55,56,57]. The value of high-level review evidence on health indicators is considerably lower, and may be perceived as having limited transferable value if generated in other countries or contexts [50].…”

“…Historically, UK licensing systems developed as administrative and reactive systems originally designed as a means of limiting public disorder and regulating behaviour, though health considerations have played a part, albeit limited, in motivating legislative change [18,34]. Under reforms to the licensing systems in England and Wales (2003) and Scotland (2005) many discretionary aspects of licensing were formalised.…”