The sickly NHS 'sugar tax'

Posted on January 19, 2016

At a time of constant complaints about NHS resources, you would think that the head of the NHS in England, Simon Stevens, might have one or two bigger things on his plate than the fare on offer in hospital and health centre cafés. But this week, Stevens told the Guardian he was proposing to implement a 'tax' of 20 per cent on sugary food and drink.

'Because of the role that the NHS occupies in national life, all of us working in the NHS have a responsibility not just to support those who look after patients, but also to draw attention to and make the case for some of the wider changes that will actually improve the health of this country', he said. The plan would be to enforce additional charges with suppliers as contracts came up for renewal, with the new costs being in place nationwide by 2020.

Of course, the NHS has no power to impose a 'tax' - it would just put up the prices of sugary products. However, beyond some very obvious comparisons - for example, between full-sugar and diet versions of soft drinks - it might be hard to notice any difference in prices. After all, if you want to buy a chocolate bar or a piece of cake, you're hardly going to start comparing it with the price of salad to see which is better value and alter your behaviour accordingly. Any effect of such a price increase would be merely to extract more cash from patients, their families and the biggest users of NHS catering - the staff.

No, this is pure PR with the aim of building 'momentum' for legislation for a sugar tax right across society. With the prime minister, David Cameron, already preparing the ground for a sugar tax by refusing to rule it out, and bodies from London's City Hall to Brighton Council trumpeting the benefits of a taxing sugar, it seems the stage is being set for another pointless 'sin tax'.

Such a tax will be as good as useless in achieving its supposed aims, however. The best argument for a sugar tax is the experience of Mexico, which introduced a tax of one peso per litre at the start of 2014. The initial results are in and they are, to say the least, underwhelming. Consumption of sugary drinks fell by six per cent in the first year and was compensated for by increasing consumption of dairy and juice drinks. The fall in calorie consumption was negligible.

Of course it was. Sweet-toothed Mexicans drink, on average, 137 litres of soft drinks each per year - an apparently whopping 54,400 calories per year. But that's still only 149 calories per day. Even if Mexicans gave up sugary pop entirely and didn't swap it for another calorific drink - fruit juice is just as calorific and sugary as Coke and milk can be even more calorific - that would amount to just six per cent of an average man's calories per day. The kind of average reduction suggested by a recent BMJ paper on Mexico's tax amounts to 12ml per day - just five calories.

This trivial 'success story' will make no difference to the waistlines or health of Mexicans, but it is another source of revenue (if a rather small one) for the government. In other words, whatever the claims of sugar-tax cheerleaders, this is a stealth tax, not a health tax. Why on earth would Cameron even consider it? Apart from a bit more cash in Treasury coffers, for politicians, being seen to Do Something about the nation's health is more important than actually having any beneficial effect. For principle-lite politicos, further stripping away the right of consumers to choose for themselves is a price worth paying for a positive write-up in the press.