Health Above Profits – We Need a New Gambling Act

Health Above Profits – We Need a New Gambling Act

May CI van Schalkwyk1, Rebecca Cassidy2, Jenny Blythe1, & Niko Ovenden2

1London School of Hygiene and Tropical Medicine

2Goldsmiths, University of London


 This non-peer reviewed entry is published as part of the Critical Gambling Studies Blog. To cite this blog post: van Schalkwyk, M., Cassidy, R., Blythe, J., & Ovenden, N. Health Above Profits – We Need a New Gambling Act. Critical Gambling Studies.


In Great Britain, we know that people who gamble and those close to them are being harmed. Current regulation fails to protect people from harmful products and practices of the gambling industry. This makes the Westminster Government’s review of the Gambling Act 2005 an exceptionally important exercise, and a concern for everyone, as clearly the situation is unacceptable. So much of this harm is preventable. This is why we previously said that the review of the Gambling Act was a test of the Government’s commitment to public health and that we need a paradigm shift in how we regulate gambling.

The content of the much-awaited publication of the UK Government’s White Paper drew immediate reaction. While much has been said about the individual proposals, we pose two broader questions: ‘Can the changes proposed be described as reform?’ and ‘Are claims to have been led by the evidence justified?’

As researchers who have dedicated time to understanding gambling policy, and given the scale of gambling harm, we see a concerning lack of progress in the pages of the White Paper. We need to ask whose evidence was used, why and how?

Can the changes proposed be described as reform?

Reform suggests making “an improvement, especially by changing a person's behaviour or the structure of something”. Despite government claims that an aim of gambling regulation is to prevent harm, the White Paper leaves intact the principles which have allowed harmful products and practices to flourish. In particular, the White Paper continues to frame the industry as part of the leisure sector, meeting the needs and desires of millions of people who gamble safely, while it is “the vulnerable” who need to be protected.

The apparent benefits of the industry (employment, tax revenue and the funding of good causes) are weighed up against the industry’s dependence on those experiencing harm, quite against the principles of public health, and as though these two elements should be placed on a single scale. We would not create legislation favourable to the tobacco industry simply because they create a lot of jobs, sponsor football teams, and contribute to the Treasury: the aim of legislation is to prevent people smoking and dying from preventable cancers, and to protect people, including children, from second-hand smoke.

The White Paper rests on an edict that we may not question the underlying logic, aims and objectives of the Gambling Act 2005. Why not? These principles were not discovered etched onto tablets of stone in the Las Vegas desert. They are choices made by policy makers in the 1990s. Now that we know they don’t work, we should be free to change our minds and our legislation.

Why must we continue to find a way to make this broken and harmful system work – fining companies who cynically exploit people who are unwell – while desperately trying to support and treat people already impacted by harmful products?

Are claims to have been led by the evidence justified?

The White Paper’s ministerial foreword states that the review aimed to “take an objective, comprehensive look at the evidence”. However, when presented with evidence from Local Authorities, for example, that the “aim to permit” is hampering their ability to keep their residents safe, the evidence is dismissed, because this principle is not up for discussion:

“Some submissions from licensing authorities suggested the ‘aim to permit’ provision should be removed altogether from the Act. However, this change would challenge a principle at the core of the Gambling Act…”

Consistent evidence from Local Authorities that the Act does not equip them with the tools they need to protect residents from harmful products including Fixed Odds Betting Terminals, and licences for gambling outlets, has been ignored in this and previous consultations.

The White Paper continually refers to the need to protect “the vulnerable”. However, evidence shows unequivocally that everyone is at risk of being harmed by the gambling industry, both online and in land-based venues. The business model is to exploit universal biases and normal cognitive functions in order to extract as much money as possible, using products and practices designed for this purpose.

Asking for more research without acknowledging why we are working in the dark is unfair and the public has a right to know why this is the case. That there is limited high-quality evidence is a result of the current regulatory system that sees the industry as a legitimate stakeholder and a source of funding for research, education and treatment, and the absence of regulatory structures that can safely acquire and use industry-derived data.

The industry will always put commercial objectives first, this is what it is obliged and designed to do. The White Paper neglects decades of evidence on how commercial actors protect their interests, often at the cost of the public’s health, including by distorting the evidence-base and exploiting the consultation process. How would gambling industry submissions be handled if reform was directed at preventing the harm associated with their pursuit of profits? More pressingly, how will these conflicts of interest be taken into account in the coming consultations? These are key questions if reform is to be based on evidence – including the evidence (not referred to in this White Paper) on how corporate actors act to protect their interests at the expense of public health. That’s a reform process fit for the current age.

We need a new Gambling Act

We would like to see a much broader debate in the UK than is taking place in the White Paper. Do we want to be the largest regulated gambling market in the world? Can we prevent harms to those who gamble and those close to them with legislation that is designed to support a flourishing gambling industry? Why not reframe legislation to focus on the problems that occur when commercial actors seek to profit from gambling?

The Gambling Act 2005, the ideas and assumptions that it rests on, can and should be questioned and changed. Reframing gambling as a leisure activity and regulating it as such has not worked. To prevent harm and stop the exploitation of vulnerabilities that we all share, we need a new Gambling Act that prioritises public health and not the profits of the gambling industry.

May CI van Schalkwyk is Public Health Specialty Registrar and is writing in her capacity as an Honorary Research Fellow at the London School of Hygiene & Tropical Medicine. Her research focuses on the analysis of health policy and the commercial determinants of health.

Rebecca Cassidy is Professor of Anthropology at Goldsmiths, University of London, author of Vicious Games: capitalism and gambling (2020) and co-author of Fair Game: producing gambling research (2014).

Jenny Blythe is a General Practitioner based in London, UK, and is writing in her capacity as an NIHR Doctoral Research Fellow at the London School of Hygiene & Tropical Medicine.

Niko Ovenden is an independent scholar and co-author of ‘Frequency, duration and medium of advertisements for gambling and other risky products in commercial and public service broadcasts of English Premier League football.’ (2017)


May van Schalkwyk is funded by the National Institute for Health Research (NIHR) Doctoral Fellowship (NIHR3000156) and her research is also partially supported by the NIHR Applied Research Collaboration North Thames.

Rebecca Cassidy has not received any funding relating to this publication. Between 2019 and 2020 she was paid specialist advisor to the House of Lords Select Committee on the Social and Economic Impact of the Gambling Industry. In 2019 she received support for travel and accommodation in Canada from the Alberta Gambling Research Institute in 2019 and an honorarium, travel and accommodation from the World Health Organisation and Turkish Green Crescent Society to attend a meeting in Istanbul. She also received travel, accommodation and subsistence costs to attend the International Think Tank on Gambling Research, Policy and Practice (ITTGRPP) in Banff, Canada in April 2017, partly funded by the Alberta Gambling Research Institute (AGRI) and partly by participant registration fees. Also travel, accommodation and subsistence costs to attend the Auckland meeting of the ITTGRPP in February 2017. The Auckland meeting was partly financially supported by the New Zealand Ministry of Health and by participant registration fees. Accommodation, travel and subsistence to speak at a conference on gambling in Helsinki from the University of Helsinki Centre for Research on Addiction, Control and Governance in 2017. The centre is supported by an annual grant from The Ministry of Social Affairs and Health. She has also received funding from the European Research Council (2010-2015), Economic and Social Research Council UK and Responsibility in Gambling Trust (now GambleAware) (2006-2009) to conduct gambling research.

Dr Blythe undertakes independent research funded by the National Institute for Health and Care Research ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research and Care or the Department of Health and Social Care.

Niko Ovenden has not received any funding related to this publication.  Work related to the 2017 article he co-authored was entirely funded by Goldsmiths, University of London. 


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