Online Harms and Other Issues

Reduce FOBT stake to £2 says Lord C-J

Earlier this year I put forward a Private Members Bill in the Lords to reduce the FOBT maximum stake currently set at £100 to £2. This is the argument I made. 

Through the Bill I am today pursuing a matter of considerable concern that has been raised in this House on a number of previous occasions by myself and my noble friends in particular, and which reflects great concern outside in the country.

Fixed-odds betting terminals—FOBTs—are touch-screen roulette machines in betting shops that allow the user to bet up to £100 every 20-second spin. They have transformed the betting sector since their introduction in 2001, and the Gambling Act 2005 classified FOBTs as B2s. The noble Baroness, Lady Jowell, stated at the time that if evidence of harm emerged, the £100 stake could be reduced as FOBTs were “on probation”. It is clear that the experiment to allow high-speed roulette in easily accessible betting shops has been a disaster and it is notable that as a result, the noble Baroness, Lady Jowell, herself recently called on the Government to act as the evidence of harm continues to build.

The essence of my Bill is to reduce the stake to £2 a spin. This is the maximum stake on gambling machines in all other easily accessible venues such as arcades and bingo halls. It will reduce gambling-related harm, prevent further betting shop clustering and restrict high-street money laundering.

The human misery caused is enormous. I will not rehearse all the harrowing stories, but many have been reported and they are extremely distressing. Clinical psychologist Anna Henry, who treats gambling addicts, said that FOBTs are designed to foster addiction:

“Basically the industry has created casinos in the High Street … These machines isolate the player, there is nothing to distract him from that screen. Its speed is to encourage frenzy. And thus more spending”.

More crime takes place in betting shops than in any other gambling venue. A freedom of information request to the Gambling Commission revealed 11,232 incidents in 8,980 betting shops from January to December 2014—an average of 1.25 incidents per premises, up from 0.82 the previous year. This compares to just 479 incidents related to the remaining 2,747 venues. These incidents account for 97% of police call-outs to all gambling venues.

The reality is that these machines are highly dangerous products which are a catalyst for problem gambling, social breakdown and serious crime in communities. Just take the case of a gambler in Leeds who was given a two-year sentence for attacking a betting shop worker

with a knife. The man had lost £1,000 playing FOBTs—money that was intended to be a deposit on a flat. He said that he was “utterly possessed” by the machines.

FOBTs are also useful to money launderers, as huge amounts of cash can be inserted into the terminals to legitimise the proceeds of crime. There were 633 suspicious activity reports in betting shops last year related to money laundering, but much of it goes unreported. A Gambling Commission report that will be considered by the Treasury said:

“The betting sector is regarded as high-risk relative to other gambling sectors. The customer base is varied, and often customers remain anonymous to the operator within the non-remote sector. The reporting and detection of suspicious transactions in the non-remote betting sector is often frustrated by the ability of a customer to remain anonymous”.

Bookmakers have a legal duty to comply with the licensing objectives of the Gambling Act 2005, but how can they comply and keep gambling crime-free and harm-free when the FOBT stakes are so high? Each betting shop is permitted four FOBTs, which now account for more than half of bookmakers’ profits. One has only to look at the importance of these machines in the recent figures for William Hill and Ladbrokes. The gross win on each machine is worth £1,000 a week. That led to a 43% increase in the number of betting shops on the high street between 2004 and 2012.

While planning authorities are in a better position to refuse applications, licensing authorities are still required to aim to permit betting shops. They are still powerless to stop the proliferation of betting shops and FOBTs on the high street. One street in the London Borough of Newham has 18 betting shops. As a result, 93 local authorities led by Newham Borough Council submitted a proposal under the Sustainable Communities Act. They called for the stake to be cut to £2 due to the anti-social behaviour, crime and problem gambling that the machines are causing in their local areas. This unprecedented step represents the widest support that any Sustainable Communities Act proposal has ever received. The Government rejected that proposal last year, but the Local Government Association has since resubmitted it under the terms of the FCA. What will the Government’s response be in the coming months, when discussions are due to take place?

There are wider economic arguments. There has been much scaremongering about the economic impact of any action to restrict FOBT machines. The ABB has claimed that 7,800 betting shops and 39,000 jobs would be at risk if there were a reduction in the maximum FOBT stake from £100 to £2 per spin. However, a report by NERA Economic Consulting, The Stake of the Nation—Balancing the Bookies, concluded that cutting the stake on these machines would reduce the number of bookmakers by about 800, primarily where clusters had developed. Moreover, it found that the move would create a net positive 2,000 or so high-street jobs as money returned to other, more labour-intensive and productive high-street shops.

Elsewhere, other Governments are concerned about the impact of these terminals. The machines are already banned in Ireland. Above all, there is the impact of

FOBTs on the vulnerable and the disadvantaged. Research published last year by SPICe, the Scottish Parliament Information Centre, found that problem gambling is seven times higher in deprived areas, seven times higher among harmful drinkers and six times higher among the mentally ill. A 2014 survey by 2CV found that 80% of all betting shop users think that FOBTs are addictive, rising to 89% among FOBT users. The survey found evidence of harmful levels of gambling. Users playing weekly or more often account for 63% of session activity and 90% of cash inserted into FOBTs.

We have all seen that the Responsible Gambling Trust is now facing problems with the Charity Commission as a result of conflicts of interest on its trustee board. I do not want to add to its woes but its lengthy research programme failed to carry out its primary purpose—establishing whether FOBTs are safe. It did, however, provide some insight into worrying trends in machine gambling, including the fact that a person gambling with higher stakes is more likely to make a poorer judgment than when gambling with lower stakes, that the number of people betting the maximum £100 stake doubles between 10 pm and midnight, and that 37% of FOBT gamblers are problem gamblers. The Gambling Commission has stated that, in interpreting the available evidence where the evidence is mixed or inconclusive, it will take a precautionary approach in accordance with its principles for licensing and regulation. So surely, in the face of this evidence, the stake should be reduced until there is an indication that it can be safely increased above £2.

The fact is that government measures to date have been ineffective. After months of grass-roots pressure and concerns expressed across the country, last year the Government introduced the Gaming Machine (Circumstances of Use) (Amendment) Regulations 2015, which were implemented on 6 April. These regulations require FOBT customers to authorise stakes of £50 or more either via account-based play or via over-the-counter staff authorisation. In January 2016, the DCMS published an evaluation of the impact of the regulations. However, a study by Landman Economics has demonstrated that the DCMS was completely unable to determine whether the regulations on the £50 stake had led to an increase in player control, let alone a reduction in the number of problem gamblers. The DCMS argues that increased session length may have led to more considered decision-making, but the time between spins increased only very marginally. It is much more likely that players who used to stake up to the £50 to £100 range are simply losing their money more slowly. This would not represent more controlled play. The report concludes that the DCMS evaluation is flawed and cannot realistically be used as a reliable guide to policy.

Where one has regard to the scale and nature of the problems that FOBT machines are causing, on the precautionary principle a very much more serious and more appropriate response is required, as set out in the Bill before us. The time for tinkering has gone, and there is no doubt that the public support action against FOBTs. In fact, a YouGov poll showed that only 4% of the public would oppose a ban on them, with 58% of those who gamble more than once a month being in favour of an all-out ban. ComRes polling showed

that two-thirds of people in marginal constituencies believe that FOBT machines are harmful and they support the reduction of the maximum stake to £2. FOBTs are destroying lives and damaging communities. The Bill will reduce the maximum stake on FOBTs to £2 a spin. I believe that it will reduce the serious harm caused by the machines, deter money laundering and reduce betting shop clustering on the high street.

I am an optimist and I very much hope that the Government will support the Bill. Modest though it is, if the Government reject it, and especially if they claim that they can achieve the same goals by other means, I believe they will be obliged to answer some vital questions. Will the Minister confirm when the next review of stakes and prizes is due to take place, and that the issue of FOBT stakes will be included within it? Does he agree that, as proposed by the Gambling Commission, and given the evident harms that FOBTs are causing, the Government should act on a precautionary basis and reduce the stake on FOBTs? In that context, does the Minister believe that a substantial review of FOBTs stakes is the best way to deal with the harms the terminals are causing? Will he make sure that FOBTs are properly regulated through harm-mitigation measures to ensure that they no longer present a risk to the vulnerable? If so, how? And how will the Minister ensure that the Government properly address the money-laundering risk that FOBTs present?

The remainder of the debate and the Minister's reply is at :

http://www.publications.parliament.uk/pa/ld201516/ldhansrd/text/160311-0001.htm#16031122000325

by Tim Clement-Jones

Lord C-J launches bill to cut FOBT stakes

The first serious legislative attempt to enforce a reduction in the maximum stake for Fixed Odd Betting Terminals (FOBTs) is underway as my new Gambling Bill was published this week

FOBTs were first introduced in 1999 but particularly in the last five years, concerns have grown as it has become increasingly apparent that they account for the most addictive form of gambling with disturbing socially destructive consequences.

The growing level of public disquiet coupled with clear evidence of a link between the placements of FOBTs and social deprivation has led to the issue being called the ‘crack cocaine of gambling’.

The Gambling (Categorisation and use of B2 gaming machines) Bill proposes to cut the maximum stake on FOBT machines from £100 to just £2.

Leading social policy charity CARE, who campaign for legislative changes to the law to address problem gambling, has called on the government to recognise the need for urgent action by giving the Bill time in the House of Lords for a proper debate to take place.

The social disruption left in the wake of FOBTs, and growing level of public concern associated with them, is now such that the status quo is unsustainable.The law needs to change.

The reduction of FOBT stakes from £100 to £2 proposed by my Bill will transform FOBTs so that rather than being the source of real suffering and hardship as is the case today, they become instead relatively benign forms of entertainment.”

The addictive challenge arising out of FOBTs results from the combination of the £100 stake and the very rapid speed of play that is the FOBT’s trade mark.

The £100 stake and rapid speed of play means that it is possible to lose large amounts of money in very short periods of time.

The best way to address the problem is to end this dangerous combination by reducing the stake from £100 to £2 which is exactly what the Gambling Bill does and CARE very much hopes that the Government will recognise that something must be done and give time for my FOBT Bill.”

The Bill has been published on the Parliament’s website and can be read here:

http://services.parliament.uk/bills/2015-16/gamblingcategorisationanduseofb2gamingmachines.html

Since their introduction FOBTs have yielded almost £1.6million for bookmakers. According to the Campaign for Fairer Gambling, mapping of betting shops and estimates of FOBTs gambling and losses revealed that high stakes gambling machines suck money from the poorest communities.

Research published in 2012 compared 15 different gambling activities and estimated that the percentage of FOBT losses from problem gamblers was 23 per cent:

http://www.tandfonline.com/doi/abs/10.1080/14459795.2012.689001

A BBC Panorama investigation in 2012 published police statistics showing there had been a nine per cent increase in crimes associated with betting shops since 2008:

http://www.bbc.co.uk/news/uk-20182750

by Tim Clement-Jones

Why I am against the Assisted Dying Bill

Sadly I am unable to be present for and take part in the Debate on the Second Reading of the Assisted Dying Bill this Friday and I have been unable to reply to the huge volume of correspondence but I want to put my views on record beforehand

Some colleagues have changed their minds on the subject since Lord Joffe's Bill came to parliament a few years ago. I have not.

The Bill is designed allow doctors to give lethal drugs to adults thought to be mentally competent and diagnosed with less than six months to live.

There are many who view the safeguards in the Bill as inadequate and the systems to tackle undue influence inadequate . Mine are more fundamental-the inability of doctors and modern medicine to be at all sure about prognosis and life expectancy.

My late wife Dr Vicky Clement-Jones for example was given 3 months to live with late stage Ovarian Cancer but survived for 5 years and in that time established Cancer Bacup's Cancer Information Service now run by Macmillan Cancer Support.

This is an extract from Dr Ruth Johnston to Lord Carey, formerly Archbishop of Canterbury which sums up my thoughts entirely:

I write as a doctor working in oncology, with relation to the article you authored in the 'Daily Mail' on 12th July 2014.

I work primarily with patients who have lung cancer. The majority of these patients have Stage IV (metastatic) disease, which is inoperable and incurable, and in whom the median survival is generally of the order of 6 months.

I offer my patients the opportunity to discuss prognosis, and if they want to know this information, I explain that median survival is the time when 50% of patients (with their particular disease type and stage) are alive and 50% are dead. I always explain that predicting survival times is difficult and that some patients do much better than their doctors initially expect. I still review several patients who were originally considered by their oncologist to have a prognosis of less that one year, yet who are alive between 3-5 years after the initial diagnosis.

I write this to explain that determining prognosis, even in a quite predictable disease such as cancer where there are survival statistics available, is difficult, non-exact, and prone to error even among the most experienced practitioners. It is important to recognise that there can be a considerable range of survival times and that long term survivors are known in patients assessed by an oncologist and considered to have 'terminal cancer'.

The ability to determine prognosis in other diseases, such as progressive neurological diseases, chronic heart, lung or kidney disease etc. is much more difficult, and prediction of survival times is prone to even more significant error.

In a Bill which allows there certifying doctors no requirement to know the patient in question, I think it is unlikely that a doctor who has not met the patient can provide accurate information on prognosis for differing disease types and stages.

I have reflected on the effect implementation of an Assisted Euthanasia Bill would have on my practice: while advising a patient with Stage 4 lung cancer of their diagnosis and treatment options and providing prognostic information, my patient and I would be aware that the an assisted death would be a possible 'option' given their short survival times (i.e. as per the proposed Bill 'reasonably expected' to die within six months). I think that an 'assisted dying' option would negatively impact my relationship with my patient, who might fear that I and the other health professionals involved in their care might not offer the full options of treatment available, or that by discussing survival times doctors might have the motive of opening up the patient's consideration of assisted dying.

Symptoms of fatigue, depression and, not infrequently, disability, are often seen in patients with advanced malignancy. Assisted dying is conceivably going to be offered to patients who have the potential for reversibility of symptoms and alleviation of distress with the help of (among others) oncology, palliative medicine and general practitioner services. I am concerned that my cancer patients who often have understandable anxiety and depression at their diagnosis, may fear being a burden to their family and the health service, and choose an assisted death. A painful death or terminal suffering is not common in cancer patients: raising the fear of the death process may cause my lung cancer patients to feel they should end life early, rather than risk a difficult death.

To me the Bill is completely perverse to a medical practitioner. I trained and practice in medicine to help patients, to preserve life and to 'first do no wrong'. Killing is wrong, and it is wrong to ask a doctor to prescribe a deliberately lethal dose of medicine, while also anticipating the same doctor will care and cure.

by Tim Clement-Jones