The UK government’s new strategy to enhance problem-gambling treatment and prevention will face a challenge in applying an effective population-led approach.
This morning, the Select Committee on Health and Social Care gathered feedback from UK experts on how gambling-related harms have evolved since the implementation of the Gambling Act of 2005.
Feedback is being taken on board as the government prepares to implement a Statutory Levy on problem gambling from 6 April, with funding administered by three bodies: the NHS, the Office for Health Improvement and Disparities (OHID), and UK Research and Innovation (UKRI).
Recognising significant changes, the expert panel noted that problem gambling treatment is at a point of inflection for all stakeholders involved, with the critical task of determining the right strategy to ensure effectiveness and improve outcomes.
Chaired by MP Layla Moran (Liberal Democrats), the committee seeks feedback to support the government’s “cultural shift in the understanding of gambling-related harms and removing barriers to treatment”, highlighting the importance of an effective public health strategy as fundamental to a new system of treatment, research, and care.
The panel noted that the new system is adopted from an existing framework that coincided with the evolution of online gambling in Britain. Figures for 2023 indicate that 25 million adults have gambled, with the sector growing to a gross gambling yield of £15.6 billion.
Industry aware it stimulates harm
Professor Sam Chamberlain, Professor of Psychiatry at the University of Southampton, highlighted that the evolution of gambling harms in communities points to “online gambling as the dominant source of addiction”.
Due to the ease of access to online gambling platforms, Chamberlain believes that specialised treatment must be available to vulnerable communities on a 24/7 basis.
Though the NHS has significantly expanded its gambling-harm facilities and resources, Chamberlain notes that efforts are undermined by the sector actively promoting higher-risk games. The professor believes that operators understand the stimulus that encourages individual gambling behaviours and possess a deeper understanding of addictive gambling, outpacing current academic research.
“There’s this tendency towards more addictive products in general, and I also think that the industry is well ahead of our independent academics in terms of knowing and understanding what makes those products so addictive.”
Chamberlain advised the Committee to recognise that “there’s no completely benign form of gambling, as one or two people in every 100 will develop some form of addiction”.
“We know some products are more harmful than others, but even low-risk ones can be linked to 1-2% of people developing a gambling disorder, based on international data.”
Levy – make it local
Focused on local community initiatives, Lucy Hubber, Director of Public Health Nottingham, emphasised the importance of a community approach in addressing gambling harms. She pointed out that local efforts are significantly challenged by the ambitions of the multi-billion-pound UK gambling sector.
According to Hubber, local authorities should be at the forefront of identifying and supporting vulnerable adults within their communities. However, the current framework presents significant challenges, particularly as the NHS lacks the authority to intervene when gambling businesses encroach on local areas.
“Directors of Public Health are not a responsible authority on planning licensing applications for gambling, so we have to work twice as hard to be able to influence.”
She argued that local councils frequently encounter resource limitations and legal obstacles when opposing the establishment of new gambling venues, especially in deprived areas disproportionately targeted by the gambling industry.
Addressing the future of funding, Hubber stressed the importance of the new RET Levy prioritising localised public health campaigns that address specific gambling-related risks within different communities. A centralised support network should strengthen community-led initiatives, with consistent funding and national guidance:
“We have to make sure that both the treatment and the research is independent of the industry, so that we’re getting truly objective and reliable information to support that.
Population approach
Though the panel’s perspectives align on localised treatment, Professor Heather Wardle, of Gambling Research at the University of Glasgow, expressed concerns about how a new system will implement a population-based strategy to address the general harms of gambling.
She emphasised the need for the government to clearly define a population-level approach, as gambling is deeply embedded in societal norms, requiring stakeholders to understand the full scope of harms.
For the NHS to provide a comprehensive view of gambling harm consequences, monitoring must be managed through centralised resources:
“We absolutely need to be systematic about changing the monitoring and surveillance system that we have and making sure we get that independence into the prevention system.”
Wardle cautioned that the NHS must avoid repeating past failures, where the old system blurred the treatment of high-risk and moderate gamblers. An effective system must coordinate a population-level strategy to broaden intervention beyond those exhibiting gambling disorders.
“The difference, I think, with public health approaches is that we’re interested in populations, and as you rightly say, so much of the focus has been about treating individuals—those people at the top of the pyramid. At that point, we are already experiencing significant harm along that spectrum of harm.”
Wardle noted that her feedback was informed by those with lived experiences of gambling, who advocated for a general intervention before reaching the most severe stages of addiction.
“Taking a population-based approach, we need to understand what the need is for the population. We need to understand those populations that are at the greatest risk of harm—and I do mean risk of harm—and then we need to understand the evidence of what works. So, that’s kind of the principle of taking a public health approach.”
