Levy or Not?

Problems with coercive charity

A proposed gambling harms levy has potentially wide-reaching implications for healthcare provision, the tax system and the concept of charitable giving, writes Dan Waugh.

Photo by Carl Raw on Unsplash

Recent weeks have seen a growing clamour of voices calling for the imposition of a new tax on consumer spending to fund treatment services for gambling disorders. The former Conservative Party leader, Sir Iain Duncan Smith, is one of the leading figures championing a mandatory levy on betting firms. He has declared ‘war’ on the government if proposed gambling reforms are watered down. But amid the sound and fury, campaigners have yet to clarify two key points – why a specific gambling harms levy is needed; and what it is intended to achieve.

Treating gambling disorders

While the debate over a gambling levy is vexed and divisive, there is at least one point that all stakeholders tend to agree on – that greater resources are required to provide treatment and support for those with a gambling disorder as well as others experiencing gambling harms. Until this year, such services were funded almost entirely through hand-outs from betting and gaming operators (who have a licensing obligation to provide financial support but with wide discretion on how much) and the allocation of grants relating to regulatory sanctions. The state had not previously considered treatment of gambling disorder to be a suitable use of its funds.

At the start of 2022, more than four decades after gambling disorder was formally recognised as a mental health condition in the DSM-III (the American Psychiatric Association’s ‘bible’), there were just two specialist NHS clinics for the whole of Great Britain – both funded almost entirely by industry contributions. The broader support network for those suffering from gambling harms was – and continues to be – provided by Third Sector organisations (principally GamCare and its network partners); community groups (notably Gamblers Anonymous and GamAnon); and several private organisations.

The announcement earlier this year that NHS England would provide gambling disorder treatment services from general funds was symbolically important – providing state recognition of the seriousness of the condition. Even with this change, fewer than 5 per cent of those receiving treatment for ‘problem gambling’ do so at the taxpayer’s expense. Although this figure is likely to grow as the NHS builds towards its target of 15 clinics in Great Britain, Third Sector, community groups and private practitioners will continue to shoulder the lion’s share of the work for the foreseeable future.