Bishop of Portsmouth leads debate on health consequences of problem gambling

Portsmouth 150318

On the 1st November the Bishop of Portsmouth, Rt Revd Christopher Foster led a short debate in the Lords about gambling addiction, numbers of people being hospitalised and the cost to the NHS. A full trancript of the debate is below:
The Lord Bishop of Portsmouth: To ask Her Majesty’s Government what steps they are taking to (1) reduce the number of problem gamblers hospitalised each year, and (2) protect vulnerable people from gambling addiction.
The Lord Bishop of Portsmouth: My Lords, the right reverend Prelate the Bishop of St Albans has had, at very short notice, to remain in his diocese. He apologises for being unable to be here and to ask this Question. On his behalf and with his permission, I beg leave to ask the Question standing in his name on the Order Paper. He and I are grateful to those participating in this short debate, and look forward to their contributions. There is a seamless transition between the last item of business and this one. The right reverend Prelate’s interest in this subject comes from the people who have contacted him directly to explain how gambling has destroyed their lives. The Church has often campaigned on behalf of victims, and we on these Benches want to contribute towards some solutions.

First, I make a few points on the nature and extent of problem gambling. Many people—many of us—enjoy a flutter. The most recent health survey statistics for England reveal that more than half the population have engaged in some form of gambling in the past year. However, about 300,000 people are classified as problem gamblers and 3.6% of the population—around 1.6 million people—are at “low or moderate risk” due to their gambling. These are likely to be conservative estimates, with some research concluding that there are around 430,000 problem gamblers in the UK. Last year, almost 30,000 people called the national gambling helpline, the highest number of calls it has ever received.

Research also suggests that problem gamblers are more likely to be found in areas of deprivation; among people on lower incomes; among the homeless—more than 10% of those without homes are problem gamblers—among the unemployed; among those with mental health issues; among people with “low intellectual functioning”; among people from some minority-ethnic groups; and among children and teenagers. It is not just the problem gambler who suffers, however: it is thought that, for every addict, between six and 10 other people—family, friends or neighbours—are also significantly affected.

In the response to a Written Question from the noble Lord, Lord Chadlington, we discovered that for the first time the UK has seen more than 100 people hospitalised due to gambling addiction, a number that has increased by more than 60% over the past five years. Problem gambling costs the National Health Service between £260 million and £1.2 billion every year.

Then we come to the tragedy of gambling-related suicides. Statistics are a little hard to come by but it is estimated that between one and two suicides every day are wholly or partly due to gambling. The social, financial and human consequences of problem gambling are enormous.

What is to be done? The most immediate action required is for Her Majesty’s Government to bring forward the implementation date for the reduction in stakes on fixed-odds betting terminals from £100 to £2. It is a simple step for the Chancellor to do the right thing and bring the date forward. Secondly, Her Majesty’s Government need to ensure that we have properly funded independent research on problem gambling in this country. The voluntary levy on gambling companies is not working. Simon Stevens, head of the NHS, pointed out that some foreign-owned betting companies refuse to contribute to the £10 million fund to support treatment of gambling addicts. Worryingly, eight gambling firms whose names are on Premier League team shirts are reportedly refusing to contribute. Football risks being compromised by those close links with gambling.

Since it is now acknowledged that problem gambling is a public health issue, various public bodies should have a formal requirement placed on them to collect data. We should consider the possibility of, for example, local authorities identifying when gambling has been the cause, or one of the causes, of homelessness; of accident and emergency departments logging admissions linked to problem gambling; of coroners recording when gambling is one of the contributory factors in a suicide; of police call-outs linked to gambling being logged; of courts and prisons keeping records of those who claim that problem gambling has been one of the reasons for their offending.

I am sure that Her Majesty’s Government took note of the temperature of the Chamber at Question Time on Tuesday and in the House a few minutes ago. Noble Lords from all Benches expressed their frustration that the implementation date has been put back to next October. It is a simple step for the Chancellor to do the right thing and bring the date forward.

We need, also, to find ways to roll out best practice more widely. The Young Gamblers Education Trust is doing excellent work in schools, and its programmes need to be more widely available. The Local Government Association is considering how existing legislation can be implemented more effectively and how public health teams, health and well-being boards and clinical commissioning groups can better co-operate to address this issue.

Finally, we need to take a fresh look at the Gambling Act 2005. The world has changed very significantly in the last 14 years, not least in the way that many gambling companies that operate here in the UK have moved offshore. They have tended to privatise their profits while nationalising the social and financial costs. Through levies and other forms of taxation they need to make a fair and equitable contribution to the costs of supporting and treating those with gambling addictions. I am pleased that Her Majesty’s Government are now looking into that area. That review also needs to take into account, as I mentioned a few minutes ago, the extraordinary growth in gambling adverts. I am sure that other noble Lords will wish to comment on this area.

Another aspect of the review should be a close look at online games. While the majority of these are within the strict letter of the current law, they are socialising and normalising the gambling experience among young people. This area is a minefield. Some “loot boxes” are nothing more than a means for the player to buy merchandise. However others are, to all intents and purposes, gambling by another name. It is clear that this normalisation of gambling may have a negative impact on the next generations and condition them in dangerous ways.

The best way forward is for this House to undertake post-legislative scrutiny of the 2005 Act to see whether it is still fit for purpose or needs amending. To that end, the right reverend Prelate the Bishop of St Albans will host a meeting in the House on 20 November to discuss the topic.

I look forward to the speeches that follow and hope that we can make significant progress in confronting and ameliorating problem gambling in this country.


Baroness Bloomfield of Hinton Waldrist (Con): My Lords, I am grateful to the right reverend Prelate the Bishop of St Albans for securing this timely debate and to the right reverend Prelate the Bishop of Portsmouth for taking over at such short notice. The debate is timely because today is the start of Responsible Gambling Week. I commend the right reverend Prelate the Bishop of St Albans for his consistent work in this area, as I commend others present here today, notably my noble friend Lord Chadlington, in whose name we debated gambling advertising last year.

I plan to speak only briefly on this subject, on which noble Lords will know I have been a regular contributor, particularly on reducing the stakes on FOBTs and on the industry’s too-prominent advertising at sporting events. I should also put on the record the recent support secured from Bet365 for the Royal Marsden Hospital, of whose campaign board I am a member.

The more we can highlight gambling addiction and bring it to the attention of the Government, the public and, of course, the industry itself, the greater the chances of slowing the spread of this severe mental illness and researching ways in which it can be successfully treated. Simon Stevens describes gambling addiction as one of the new threats facing the NHS. An estimated 430,000 people in the UK have a gambling problem. We can argue about whether this is a stable or a rising number, but the truth is that each statistic can represent a family in emotional and financial crisis. The link between problem gambling and stress, depression and other mental health problems is proven, so the extra £2 billion announced in the Budget to support mental health is welcome.

DSM-5, or the Diagnostic and Statistical Manual of Mental Disorders, identifies persistent and recurrent problematic gambling behaviours based on nine depressingly observable patterns, any four of which lead to significant impairment or distress. GambleAware is the charity funded by the industry to provide finance for research, education and treatment in relation to gambling. For an industry with a total gambling yield of £13.9 billion, this year’s target of raising only £10 million for this purpose seems a little meagre and, as we have heard, many of the foreign-based online firms are not contributing at all. I acknowledge that many firms invest much more than this in training for their staff and in developing algorithms to identify those with a problem at an early stage, so at least, if not more, important will be the way the industry can focus its efforts on spotting the early signs of addiction. The commitment to reducing gambling-related harm is not a competitive exercise. It is a lot easier for land-based companies to spot problems. There are generally layers of fully trained staff between the entrance and the gaming tables who can spot visible signs of stress or anger and engage face-to-face with an individual in crisis.

There are other harm-minimisation initiatives. Through the Remote Gambling Association, companies across the online industry are working together towards the development of good practice guidelines around responsible gambling. Such companies have systems to track gambling behaviour in real time, identify indicators of problematic activity and then interact with the customer. It is harder to do this online, but that is no reason not to invest in research into more innovative ways of doing so.

All companies—except bookies, which appears a very strange anomaly—are subject to money laundering regulations, including “know your client”. This industry is already heavily regulated but there is even more the Government could be doing to focus on the prevention and control of addictive behaviour. While I wholeheartedly welcome the announcement on restricting the stake on FOBTs to £2, why on earth not for another year? There are 35,000 of these machines located in Britain’s bookmakers. The industry claims that complex technical adjustments need to be made, but these can be done within months. GambleAware research identifies that around 80% of FOBT gamblers exhibit problem gambling behaviour at stakes in excess of £13 per spin, so while problem gambling rates may not be rising, it is important to distinguish overall figures from the capacity of these machines to do harm. Frankly, I am appalled by the delay in implementing a bold and almost universally popular move by the Government.

Be in no doubt about the cost to the UK economy and to the health service of not tackling these issues. The Centre for Economics and Business Research estimates that the cost of problem gambling is some £1.5 billion a year when its impact on wider social welfare is taken into account, including areas such as employment, mental health and financial stability. It is purely a tragic coincidence that the delay in reducing the stake on FOBTs will hand the bookies a £1.8 billion windfall.

Baroness Benjamin (LD): My Lords, I am grateful for the opportunity to speak in this debate to highlight the fact that the number of young people taking their lives because of gambling addiction is becoming a disastrous epidemic. For many years now Odds/Off has advocated change regarding young people and gambling because research shows a direct correlation between young people’s mental health and well-being and gambling.

It is not rare for university students to fall victim to gambling addiction. We do not have the true statistics because a lot of students are embarrassed. Some tell their parents, who pay off their debts in secret to avoid outsiders’ judgment. Some decide that life is just not worth living any more because they have spent all they have on gambling. The Gambling Commission has said that if the results are reflected across the UK, just over 100,000 students may be in some form of gambling debt. The gambling culture in universities huge, yet it is treated as harmless. Those involved with Odds/Off have seen it first-hand. Just recently, one student told it about how they gambled with their rent and lost it all. Students are struggling financially due to further education costs. So what do they do? They desperately try to make more money, so they turn to gambling, which they see as an easy form of making money, but we all know that in reality there is only one winner: the gambling companies. Anxiety and stress cloud judgment and before students know it, they are problem gambling themselves into devastating debt. So many students have gone down this path. One casino in Leeds is less than 200 yards from student accommodation. It is no coincidence that its bright lights can be seen from the windows of the students’ accommodation. The “Victoria Derbyshire” programme found that one of the UK’s biggest casino brands, Grosvenor Casinos, runs a student poker league and offers free drinks and student discounts at casinos. Betting apps on mobile phones make it even easier for students to spend their entire bank balance in bed while nursing a hangover. This is not a rare occurrence.

A large majority of addicts start gambling aged between 11 and 16. Many problem gamblers start gambling at this age and do not fully understand the seriousness and reality of this dependency until it is too late. Gambling addiction devastates lives under the radar and is extremely embarrassing, especially for pre-teens and teenagers in secondary school. Having no income can force pupils into stealing for a stake and encourages out-of-character actions that will have a negative impact on home and school life.

How can we stop this? To start, as a gesture to show that they are serious, the Government should immediately reconsider their decision and bring forward the date on which the maximum fixed-odds betting stake is lowered to £2. Awareness of the life-threatening effects of gambling needs to start in secondary schools. There must be more education about this danger, more awareness and abuse prevention. Gambling addition should be given the same level of importance as drugs and alcohol, so PSHE classes should also cover gambling abuse and how to resist temptation. Such a crisis deserves some form of government funding and betting companies should be taxed to fund this service, perhaps by increasing the gambling levy. Odds/Off is doing what it can on very little, but the financial strain may eventually dictate that it cannot sustain its services and continue to make a difference to the well-being of children and young people.

We are dealing with a life-or-death situation. Without funding, services cannot exist. I truly believe that creating awareness at grass-roots level in secondary schools, which is what Odds/Off does, would result in a decrease in gambling-related deaths in young people. It would also prevent mental health disorders, as many cases of anxiety and depression in problem and ex-problem gamblers are brought on because of gambling and leave permanent mental scars. The NHS is already overburdened so let us not add to its weight of responsibilities. Let us put into practice preventive measures to deal with the epidemic of gambling addition among our young people. This needs our urgent attention.

As I always say, childhood lasts a lifetime, so let us not create a life of misery for children and young people through gambling addiction as they progress into adulthood. We must not stand by and let that happen.

Lord Alton of Liverpool (CB): My Lords, in preparing for today’s debate, I was struck by some of the observations made by Marc Etches, the chief executive of the charity GambleAware, about the problem of collecting reliable data on the number of cases of people hospitalised as a result of problem gambling. When the Minister comes to reply, it might be helpful if she would tell us how the figures are compiled and what account is taken of comorbidity, which might include, for example, depression, anxiety or substance addiction. If the only issue is gambling addiction, GPs are not in a position to make a referral to an NHS-funded treatment centre. Why can that not be changed?

A better gauge for measuring the scale of the problem would be to look at the number of referrals to GambleAware or the national gambling helpline, which are the gateways to a network of charitably funded treatment services. The charity says that in the 12 months to 31 March 2018 its national problem gambling treatment service helped some 8,800 people, which it estimates is just 2% of the 430,000 estimated problem gamblers. It also believes that there are 2 million gamblers considered as being at risk of problem gambling. GambleAware has plans to triple the number of treatment places in the three years to 2020-21, including funding for a new northern problem gambling centre. However, I echo the words of the noble Baroness, Lady Benjamin, a few moments ago: it cannot do these things without resources.

Surely it is a matter of principle that the highly profitable gambling industry should fund treatment for gambling addiction. I pressed the noble Viscount, Lord Younger of Leckie, on that very point on Tuesday, arguing that the voluntary levy should be compulsory, as many companies simply do not pay the voluntary one. I was disappointed that the noble Viscount once again repeated the mantra that,

“we do not intend to make it compulsory”.

He said:

“The voluntary system is working well at the moment”—

which many of us contest. At least he added,

“but we always keep it under review”.—[Official Report, 30/10/18; col. 1220.]

Perhaps this Minister could tell us how many companies pay the levy, which ones do not, and what the Government will do with the findings of the review that is to be undertaken. Will they also immediately raise the levy from 0.1% to 1%? That would provide a yield of £130 million to help those who have become addicted. GambleAware says:

“This national problem gambling treatment service needs to be expanded, better publicised, and integrated with NHS and other statutory services …Gambling needs to be addressed as a public health issue”.

Last year the Chief Medical Officer for Wales focused on gambling addiction in his annual report. It would be good to know what evidence has been collected by his counterparts in England. Perhaps the Minister will be able to tell us. However, in the repeat of the Urgent Question earlier on, the noble Earl, Lord Courtown, said it was only part of the required strategy, and in many ways it is simply dealing with symptoms rather than causes.

We were all delighted, as the noble Baroness, Lady Bloomfield, reminded us, when the Government announced their readiness to reduce the stakes on fixed-odds betting machines from £100 to £2—but, as the noble Lord, Lord Stevenson, said in his intervention earlier, we were deeply disappointed that the new stakes will not come into effect for another 12 months. These machines are to be found in every community where there is poverty. They target and exploit the poor and for too long Governments have been complicit, happy to take their share of the stakes—hundreds of millions of pounds—while wholly aware of the extraordinary social costs involved. That is a dereliction of duty. I look forward to the reply of the noble Earl, Lord Courtown, who promised to answer my question on what the exact yield will be between this year and next as a result of not implementing this decision immediately.

Then there is the question of advertising, raised so often by the admirable noble Lord, Lord Chadlington, and others during our debate in Grand Committee on 12 September. The gambling industry will spend around £312 million this year on seductive advertising, much of it aimed at the young and the poor. Despite the noble Earl’s remarks, this advertising is too often linked to sporting events. The noble Baroness the Minister followed up on our debate and said in a letter to me:

“The average child sees around three gambling adverts on TV per week”.

She said that there would be,

“significant new research into the effects of marketing and advertising on children, young people and other vulnerable people”.

So once again there is to be a review, but I cannot help thinking that we need action rather than more reviews and consultations. On several occasions I have asked whether the Government would consider changing the Gambling Commission’s licensing codes and provision 3.2.11 of its social responsibility code, which concerns not promoting gambling to children, particularly as it applies to remote gambling in the same way that it is currently applied to non-remote gambling. Again, I would like to hear from the Minister what progress we are making on that.

On Tuesday I asked about the way in which virtual games such as “Fortnite” specifically target children and seek to normalise the idea that gambling is fun and a good thing to do. Tell that to the families of those who have committed suicide. As the right reverend Prelate the Bishop of Portsmouth reminded us, around 500 young people are believed to commit suicide every year, while many others become seriously ill. In answering me on Tuesday the noble Viscount was unable to say what action was being taken to control these games, other than that a parent had smashed an appliance on which he saw his son viewing such a game. If the Government approve of this direct action, would it not save a lot of trouble and aggravation simply to ban the use of advertising and virtual gambling targeted at children?

Britain is suffering from a gambling epidemic. We need to accept that this is not a fringe issue but one that requires a coherent and strategic approach. I hope that this timely debate initiated by the right reverend Prelate takes us another step in that direction.

Lord Chadlington (Con): My Lords, I join others in thanking the right reverend Prelates the Bishop of St Albans and the Bishop of Portsmouth for initiating and introducing this debate. I also look forward to co-hosting on 20 November the seminars to which the right reverend Prelate referred.

It is not the absolute numbers of those hospitalised that led to my Question, but the fact that the trend is so clearly and inexorably upwards—as is gambling advertising spend, as is the number of problem gamblers, as is the number of young people playing gambling games that groom them to gamble, and as is the number of people taking their lives where gambling is either a comorbidity factor or the single factor. It is no longer enough to recite a litany of statistics that are all well known in your Lordship’s House. We must be more practical. So the question is: what can be done to reduce the number of problem gamblers who are hospitalised? Here is a proposal.

Yesterday I was privileged to take the Secretary of State for Health to the National Problem Gambling Clinic in London, the only dedicated NHS gambling clinic in the United Kingdom. The Health Secretary could see first-hand the professional work and pastoral care that the clinic has been undertaking for the last 10 years in treating some 5,000 patients, over 90% of whom were self-referrals. Although we do not have a geographical breakdown of the hospitalisation analysis to which the QSD refers, we have enough reliable research to identify the key areas in the UK where problem gambling is most rife. Sadly, as I have commented before, they are often the most deprived areas of the country.

Each gambling clinic requires funding of, broadly speaking, £500,000 a year. We could establish 10 or even 20 of these centres in those key areas of the UK where we know there is an intense gambling problem. It would cost us upwards of £10 million. That is a lot of money but a very modest sum compared with the £1.2 billion that gambling costs the Exchequer every year.

Before establishing such centres we need some demand analysis and, as none was readily available, I conducted my own. One of the most interesting results is that, unlike with other addictions such as alcohol and drugs, 60% of the public do not know where to get help if a loved one, employee or friend develops a gambling habit. Even health professionals struggle to know where to refer a problem gambler.

With a network of gambling clinics in the UK, there would be national signposts and support in the most distressed areas where help could readily be found. The cost of establishing the centres should be met by the gambling industry itself, with the centres run independently by the NHS. That is a further reason for the Government to review the voluntary gambling levy, currently producing about £10 million or £12 million. Raise it to 1% and we would have £130 million or £140 million. With those funds, we could not only get those clinics up and running around the country—they could be based on the west London model, which has been so successful—but conduct better research, educate young people on the dangers of gambling, provide more support for affected families and train more doctors and nurses.

The Gambling Act 2005 has, as one of its three objectives,

“protecting children and other vulnerable persons from being harmed … by gambling”.

But we are failing to do that—dramatically. Of the 430,000 problem gamblers in this country, nearly 10% are young people aged between 11 and 15. Just 8,000 of those 430,000 are in treatment. This equates to just 2% of all gambling addicts in the country, compared with up to 20% of those addicted to alcohol or drugs.

If the Government are to take up the challenge, establish the centres and reduce hospitalisation as a result, they must do so with more energy than they have shown over the implementation of the FOBT decision. We know that these are incredibly dangerous products. More than half of FOBT users are either addicted or in danger of becoming addicted to gambling. I am working with 17 families in which a child has committed suicide. They started their gambling life on FOBTs.

This is the beginning of a constructive plan to reduce hospitalisation of gambling addicts, reduce the cost of gambling to the Exchequer and begin to stop the gambling epidemic that threatens our country. To make it a success, the Government have to act more decisively, pay less attention to the gambling lobby than they have on FOBTs and put the people, particularly the young people, of Britain first.

Lord Thomas of Gresford (LD): My Lords, when the fun stops, stop gambling. I think that that was intended as a government warning, in tiny letters at the bottom of the television screen which you need a microscope to see. But the message is ambiguous and insidious. It is not surprising that one gambling organisation has taken over the warning as its own message. It is flashed up fully on Sky Sports screens at frequent intervals with the word “fun” in the largest capital letters, lit up with flashing light bulbs. The message is not that gambling is dangerous but that it is fun.

GambleAware has found that 370,000 children under 16 have spent their own money on gambling, and 25,000 may be problem gamblers. The noble Lord, Lord Chadlington, gave similar figures a moment ago. This is the effect of gambling advertisements on television, especially during sports coverage. The watershed at 9 pm is meaningless.

The problem is highlighted by the campaign by casino operators 32Red. On its website, it is proud of its strategy to use sports sponsorship as an effective route to drive up brand growth. It states:

“Our football, racing and boxing sponsorships helped see 32Red separate itself from our competitive set of casino first operators from 2016-17”.

It has deals with six leading football clubs in the Champions League and the Premier League and estimates that football shirts branded with its logo get continuous exposure of the brand in 26% of football coverage on television on a Saturday afternoon. It follows that up with the sponsorship of the Ant and Dec show on ITV on Saturday evening. I do not know whether it is one of the eight firms to which the right reverend Prelate the Bishop of Portsmouth referred as refusing to contribute to the levy, but I would not be at all surprised.

The important point is that logos on football shirts and TV sponsoring get around the restrictions in the UK code of advertising practice, the CAP code. True it is that shirts for youngsters must be marketed without the logo, but that is insidious in itself. Children want the big shirt, the adult shirt, with the same logo as the players. Gambling becomes legitimised as an adult activity and makes children and young people want to do it when they are old enough. I remember cigarette advertising in my youth when it seemed cool to smoke. Long drags were supposed to be the way to a girl’s heart; we now know that they are the way to a heart disease. The CAP code expressly forbids adverts which suggest that gambling is a rite of passage, but there are subtle ways of implying that it is. I listened with great care to the passionate and powerful speech of my noble friend Lady Benjamin, who talked about the problems that students face.

The 32Red campaign was highly successful. It set itself a target of achieving £100 million turnover in four years and achieved it with a year to spare. In 2017, it sold the business for £176 million, four times the value of the company at the start of its campaign three years before. Under new owners but using the same strategy, the company is looking to be the number one UK casino operator. It is interesting that, in June this year, it was fined £2 million by the Gambling Commission as a penalty for failing to take steps to protect an addict who had fallen under its spell.

These gambling companies constantly look for new blood to suck. If a person has a bet online, his email address is captured. He will consent to the receipt of electronic marketing. Unless he expressly withdraws their consent, he can expect to receive to his mobile, iPad or PC tailored offers in the nature of free bets or cash incentives, beamed at him at frequent intervals to deepen his commitment.

No doubt that is good business for the operators, but what about the societal costs to which noble Lords have referred? These loopholes must be closed. The IPPR study for GambleAware in December 2016 charted the costs associated with gambling at £1.2 billion per year. Mental health services, police intervention and homelessness are major components of that figure. The largest costs are wrapped up in the health service and the welfare and criminal justice systems.

The problem is that the Government pocket more than £2 billion a year from their various levies, and their announcement this week, to which noble Lords have referred, to delay the introduction of the £2 ceiling for fixed-odds betting terminals is an indication that they are reluctant to lose this nice little earner. When the noble Earl, Lord Courtown, spoke about “extreme losses”, I think he had the Government in mind, rather than gamblers. The PwC report covered by the Guardian in 2016 demonstrated the weakness in the industry’s own attempt to tackle addiction.

“When the fun stops”? What fun for the tens of thousands for whom gambling is an addiction that destroys their lives, sometimes literally, and the lives and living of their families?

Lord Stevenson of Balmacara (Lab): My Lords, after the brief aperitif of an Urgent Question, we come to the main course. It has been a very good debate, although with vestiges of the resonances of the response from the Minister at the Dispatch Box—the Alice in Wonderland approach of the Government. I very much hope that we will hear more concrete proposals when we hear from the noble Baroness when she responds.

Taking up the theme of Alice in Wonderland, I was struck while listening to the debate that we often engage with the issue of gambling by using language which does not reflect its seriousness. We talk about having a flutter. I mean no disrespect to the right reverend Prelate, but talking about a flutter and having fun is exactly the problem that we have to face in this issue. I am glad that he mentioned it, although, on reflection, he might feel that that was not the right way to do it. Even the term “problem gambler” takes us on a different and wrong path. People with an addiction who happen to gamble is what we are talking about, and they need to be taken seriously on their terms.

Why on earth do we live in an Alice in Wonderland world where a problem as serious as a gambling addiction does not have an appropriate response in the National Health Service? Our NHS should be able to receive referrals wherever people are in the country, instead of having the opportunity only, as we heard, of an excellent but very small clinic dealing with only a small proportion of those involved.

I am very grateful to the right reverend Prelate the Bishop of Portsmouth for introducing the debate today. He spoke as if he were the Bishop of St Albans, with his long campaigning career. We have also had others contributing, who have their own records, which I admire and wish we could emulate in a more complete way.

This is such a serious issue, and what is so extraordinary is its growth. We do not seem to know enough about the rate of gambling and the increasing understanding that it is a substanceless addiction. It is different from other addictions because it seems to be that people with this addiction are more likely to relapse. There are estimates that a large number of people with the problem also think about suicide, which is not necessarily the case in other areas. The rate of suicide is so high as to make one wince that we are even considering these issues without a strong campaign and policy to try to resolve it.

Even so, the costs in themselves are worth considering. I am surprised that the Government do not want to look at them more closely. As we have heard, we may not have seen the worst, which may well come, as new technology opens up new opportunities for people to get involved in this dreadful world.

What can we do? That is a question that many people have asked. First, I would start with the advertising industry. We have to sort it out—both the direct advertising that we see on screen and when looking at newspapers and in other places, and the indirect stuff that is picked up peripherally, along with live and recorded football matches, for example. They have to be addressed. As the noble Lord has just said, we must look back to what we have done in the past, such as for tobacco in 1965, and stop all advertising promoting gambling on television, particularly during live or recorded sporting events before and after, so that it does not catch people tuning in or staying on afterwards. Other countries have done this, and we must learn the lesson. Also in this area, it is absolutely time to put the Advertising Standards Authority on a statutory basis and remove the link between it and the industry which funds it, which makes a mockery; it could be an independent body.

Secondly, we need to look at independent research, which has been raised by many people. Yes, there is research, and it does good work sometimes. The amounts are tiny and are raised by a voluntary levy, which is not paid by all. It is time to get that sorted. It is not working, so let us fix it.

Thirdly, we have to protect children better by banning games that encourage and groom them to gamble. I would include bingo, which is one of the biggest scandals happening at the moment. It used to be a social game for grannies, but it now seems to be a way into the wider world of gambling because of the opt-in payments and the ability to get on to it. This may be addressed by the excellent amendment to the Data Protection Act made by the noble Baroness, Lady Kidron. I will want to come back to that.

Fourthly, we must invest properly in offering help to those who are in danger of being or have become addicted. All this activity needs to have an end product so that GPs can refer people to receive the treatment they need.

Fifthly, the number of suicides is such an extraordinarily worrying issue that there has to be some way of looking more closely at the figures to make sure that we get the correct information. If the figures become clear, and coroners have a statutory obligation to record them when there is some link, we will get the action that is required.

The helpful suggestion by the right reverend Prelate of a post-legislative review of the Gambling Act 2005 was a very good one, and it should be added to our list. It is said that 69% of people in the UK think that betting is dangerous for family life, and 78% fear that there are too many opportunities to do it. I think that the political parties should come together and agree across party that this is something that now needs to be dealt with as a matter of priority. The majority of people think that gambling should not be encouraged, so it would be appropriate to put in the sort of bans I have been talking about.

It used to be the case that the betting shops on our high streets were primarily for betting on horse racing. As they have become broader in their approach, and particularly because of FOBTs, they have become places where gambling can take place, and danger resides in that. It went wrong at the point when casinos were not the only places; they were properly staffed and properly organised to make sure that those who went in and had problems were looked at properly.

As I said before, there is a real problem that the epidemic to come, arising probably from new technology, needs much more radical measures. I wonder whether the Minister might reflect on the issues that have now come up in a number of government departments about the idea of placing a duty of care on gambling organisations to make sure that they have responsibility to those who join them in gambling.

Baroness Manzoor (Con): My Lords, I am sorry that the right reverend Prelate the Bishop of St Albans has been taken ill, and I wish him a speedy recovery. The right reverend Prelate the Bishop of Portsmouth, in stepping in at very short notice, outlined that there are wider societal costs related to gambling. That was echoed by the noble Lord, Lord Thomas of Gresford.

The debate has been very thoughtful, interesting and indeed, passionate. I recognise the strong feelings across the House on this issue. As noble Lords have said, good policy starts from good data. I agree with the right reverend Prelate that statistics are important, but we need data. The noble Lord, Lord Alton, also raised that issue. We have estimates that currently, some 340,000 people in Britain are problem gamblers. We also know that the rates of problem gambling in Britain have remained relatively stable over many years at under 1% of the population.

However, I agree with the noble Lord, Lord Alton, that we do not know enough about where and who these people are, what works in terms of support, and how we can effectively stop people tipping over into problem gambling in the first place. We are therefore taking steps to improve our knowledge. The National Institute for Health Research has launched a call for research in this area and is now analysing the results. A decision is expected early next year. Furthermore, Public Health England is being commissioned to carry out an evidence review of the health aspects of gambling-related harm to inform action on prevention and treatment.

I agree with the noble Baroness, Lady Benjamin, and others, that prevention is better than cure. We take gambling-related harm seriously and have announced a strong package of measures to tackle it. That is not to say that more cannot be done, which I recognise. The Chancellor of the Exchequer confirmed in the Budget that the new stake limits for fixed-odds betting terminals will come into force when the remote gaming duty is increased to 21% in October next year. We are committed to reducing harm from gambling by limiting the ability to suffer high session losses and, as the right reverend Prelate said, mitigating risk for the most vulnerable players for whom even moderate losses might be harmful. The noble Baroness, Lady Benjamin, highlighted the issue of student gambling and made a passionate case. Others across the House will recognise those issues.

However, we are clear that gambling-related harm is not just about one product or a limited set of parameters such as stakes and prizes. The Government’s response to the gambling review, to which noble Lords have alluded, announced decisive action across a range of areas, including improving player protection measures on gaming machines and strengthening protections on gambling advertising and online gambling. It also outlined initiatives to boost research, education and treatment for problem gamblers. Here I apologise, because I recognise what the noble Lord, Lord Stevenson, said about identifying it as “problem” gambling rather than an addiction. We need to look at our language; I take that point on board and will ensure that I, at least, talk about “addiction”. We are looking at improving the evidence on treatment and strengthening the voluntary system for funding support.

Since the response was published, the Responsible Gambling Strategy Board has published a paper proposing ways to measure and monitor the impact of gambling-related harms. My noble friend Lord Chadlington and the noble Lord, Lord Stevenson, highlighted the importance of support and treatment for people for whom gambling has become a problem. I am sorry that we have to have such centres, but I am delighted that noble Lords were able to go with the Secretary of State to see the centre. Indeed, I believe that the previous Secretary of State also visited it.

The Gambling Commission requires all operators to make a contribution towards research into, education about and treatment of gambling-related harm. As noble Lords know, GambleAware, as the principal funding body, commissions treatment services, including a national gambling helpline and counselling services, and funding for the National Problem Gambling Clinic, which provides a valuable addition to publicly funded treatment for other addictions and mental health conditions. As my noble friend Baroness Bloomfield said, the Chancellor also recently announced a real-terms increase of £2 billion over the next five years for mental health services. There is a strong link between mental health issues and forms of addiction.

The noble Lord, Lord Alton, stated that we need to start looking at how we can separate these various issues. I recognise, as indeed does the department, that as we move into collating more data we will be able to address this particular issue. There is still a lot more we need to know about the scale of the problem, and the evidence review by Public Health England on the health aspects of gambling-related harm will inform action on prevention and treatment. I am glad to say that the National Institute for Health and Care Excellence, NICE, has also been commissioned to explore guidelines on non-chemical addictions, including gambling, which will in time give further support to clinicians seeking to support addicted gamblers.

The right reverend Prelate and other noble Lords, including the noble Lords, Lord Alton, Lord Stevenson and Lord Chadlington, highlighted the risks associated with gambling and, in particular, increased levels of suicide. Every suicide is a preventable tragedy and it is vital that we are doing all we can to address this problem. I am delighted to say that my honourable friend Jackie Doyle-Price has been appointed as the first ever Minister for suicide prevention and will be driving implementation of the National Suicide Prevention Strategy. I am pleased that the National Suicide Prevention Strategy Advisory Group has already met GambleAware, the Responsible Gambling Strategy Board and GamCare to discuss the risks of suicide related to gambling addiction and is keen to engage further as the research in this area develops. The outcomes from research will help us to develop policies that will focus on the right interventions for the right people at the right time. We are not quite yet there, though, without the data.

I turn now to specific issues that noble Lords put to me. If there are any issues or questions that were put to me that I do not answer, I will write to all noble Lords who have taken part in the debate and place a copy of that letter in the Library.

The right reverend Prelate the Bishop of Portsmouth asked about online operations. All online operations are regulated by the Gambling Commission and must help to fund treatment. The Gambling Commission is working with other regulators to monitor issues of loot boxes in video games. I hope that the right reverend Prelate realises that that is an issue we are keen to move forward on.

My noble friend Baroness Bloomfield stated that more money is needed. As I have said, we are building evidence on what treatments are needed and what works. We have been clear that funding will need to increase in the future. Donations are well on track to meet target for this year, which I think is £10 million—forgive me if I have got that wrong.

The noble Baroness, Lady Benjamin, talked about the need for more awareness of this issue. It is a major responsibility of gambling advertising companies and we will work with them to ensure that we help to raise awareness of the risks. Of course, GambleAware is increasing funding for gambling education.

The noble Lord, Lord Alton, asked how the figures on gambling addiction are compiled. Improving access to psychological data is under review and NHS England will consider introducing gambling addiction within this data. Research has also been done on how suicides are linked to gambling. I am afraid that we do not yet have accurate figures on that.

My noble friend Lord Chadlington asked about the need for a network of NHS clinics. GambleAware is working with the NHS and partners in Leeds to provide more specialist support, and pilots could be rolled out across the country.

The noble Lord, Lord Thomas, and other noble Lords raised the important issue of the normalisation of gambling by advertising. Of course, gambling is a legitimate leisure activity for adults, but I recognise the issues he raised about the timing of advertisements during sports activities and so on. I understand that strong safeguards have been put in place. Advertising and sponsorship must be responsible and must not be targeted at children. The noble Lord will be aware that GambleAware and others, and the codes of practice, ensure that there is a watershed, which is 9 o’clock.

I have been handed a note to say that my time is up. I will conclude by saying that we have taken some important steps, but I know that there is a lot more we can do. It is vital that we continue to invest in research, monitor the progress and keep action under review to ensure that our ambitions are met. It has been an excellent debate and I thank all noble Lords who have taken part.

Via Parliament.UK