Commentary on Maclennan et al. (2013): Is local alcohol policy possible?

Authors


The paper ‘Local government alcohol policy development: case studies in three New Zealand communities’, by Maclennan et al. [1], reports on a small study that raises big questions. Life-style-related problems are at the top of health and social burdens, especially in the high- and medium-income countries, alcohol use among them. Effective methods of preventing these problems exist [2] but arouse moral concerns, as they interfere with the freedom of consumers and the market [3]. Since the 1980s the solution has been to shift responsibility closer to users and their communities, away from nation states. This study is an attempt to evaluate how well this works in New Zealand.

The result is a contradiction, but not unusual: restrictions of alcohol availability tend to be very difficult to implement at the local level, and more difficult in the two small communities compared to the metropolitan city. The authors conclude that this may be because local communities do not have the power and legal resources to implement trade restrictions. This may be the case in New Zealand; in other countries the reverse may be the case: if local communities are given the option—the solution preferred by the temperance movement in the first half of the 20th century—competition for customers to shopping centres may result in increased availability of alcohol outlets, both on- and off-sale [4].

Advocates of the community approach in alcohol prevention often argue that combining several types of intervention simultaneously can work [5]. Using the terminology of the model presented by Kingdon [6] applied in this paper, community projects that mobilize streams of problem awareness, policy options and political commitment can reduce problems efficiently. The weakness of the approach is that such interventions seldom have lasting impact. When the project is over, the policy window closes and other types of stakeholder interests take over.

The type of policies that the authors have in mind—alcohol availability restrictions—are efficient when they are targeted at populations rather than groups or individuals. In very small communities they tend to discriminate against specific groups [7], as the authors also observed. In medium-sized cities they create competitive disadvantages and stakeholder interests are strong. In larger cities they might work better, but cross-border problems are difficult to handle. Even enforcement of serving and trading rules, which must be organized locally, or at least regionally, usually require that normative standards are set centrally.

Policies that aim to reduce alcohol problems by restricting availability must be justified in terms of the public good over private interests. This requires moral authority that only parliamentary democracy can provide. As the authors observe, even in New Zealand, one of the earliest parliamentary democracies in the world, this functions less well at the local level than the priority of the public good requires. The restrictive alcohol controls set up in the early 20th century were contemporaneous with the establishment of democratic political institutions in nation states. Only representative democracy is able to establish what Rousseau called ‘the general will’ of the society, and reduction of alcohol problems or any other life-style regulation policy requires that the common good gains priority over stakeholder interests.

This is what the ‘deliberative’ or stakeholder democracy of local communities—cannot do—and it works even less well at the supranational level of the European Union, in which stakeholder democracy is emphasized strongly at the moment in all policy areas. To recognize the common good in terms of rates of problems requires expert knowledge, and this knowledge must be turned into policy that cannot be negotiated case by case.

The ‘devolution’ of state power down to communities, citizen groups and other stakeholders was part of the same neoliberal wave of ideology that justified the deregulation of the financial markets in the 1980s [8]. However, the power of corporations is only part of the problem; the other part is what happened to representative parliamentary democracy. If it is more or less gone, other solutions must be found, not only in alcohol policy but in all areas of life-style regulation, where the public good must be set against stakeholder interests. As the paper shows, local action is not sufficient. There is still a long way to go to a really working answer.

Declaration of interests

None.

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