The Adult Psychiatric Morbidity Survey (APMS) – published in June – has helped to establish a traceable link between problem gambling and bettors who suffer from mental health issues.

However, the APMS results also determined that only 0.3% of the adult population in England would be deemed as a problem gambler under current clinical definitions. 

This is a markedly lower rate than the 2.5% suggested by the UK Gambling Commission’s 2023 Gambling Survey for Great Britain.

Nevertheless, this statistic still indicates that for a small subset of bettors, gambling causes severe psychiatric, financial, and social fallout. 

Here, the survey results concluded that adults suffering from gambling problems are far more likely to report symptoms of depression, anxiety, PTSD, obsessive-compulsive disorder, and, in extreme cases, suicidal ideations.

In addition to this, these individuals are also disproportionately affected by unemployment, mounting personal debts, and incidents of domestic violence.

Gambling in Decline, But Still Deeply Concentrated

Problem gamblers, while only making up a small portion of the population, are also more likely to already be receiving psychiatric medication or therapy. 

Yet, the symptoms of gambling harm often remain underdiagnosed, masked, and categorised as more conventional mental health symptoms.

A recent BBC investigation also revealed that Adult Gaming Centres (AGCs) in the UK are failing to protect problem gamblers. 

In it, it accused AGCs of continuing to display high-risk slot machines despite their links to poor mental health concerns among players.

A key differential in the APMS’s methodology, in comparison to the Gambling Commission’s online self-report approach, is that it conducts its questioning through face-to-face interviews with the aid of validated psychiatric tools.

Due to the differing formats between the two, the release of the APMS survey has sparked an industry-wide debate about the reliability of gambling prevalence figures. 

Critics argue that the study should be a more insightful starting point for helping to shape public policy on the issue.

Most notable of these assertions is the APMS’s calculation that gambling participation in the UK has, in fact, declined steeply, dropping from 66% in 2007 to just 43% in 2023/24. 

This contrasts with the frequent headlines that warn of a gambling “epidemic,” when the data suggest it is receding, albeit still concentrated within a vulnerable minority.

Statutory Gambling Levy to Provide Investment in Problem Gambling

The UK government has already announced its intention to introduce a statutory gambling levy. 

As of April, UK licensed operators now contribute between 0.1% and 1.1% of their gross gambling yield.

The levies raised in this initiative will directly support NHS treatment and research into the harms caused by gambling.

Despite this, the APMS also went on to warn that there is an urgent need to target intervention and routine screening at dedicated mental health services, rather than simply issuing generalised restrictions.

It stated that policies must acknowledge problem gambling as part of a broader pattern of psychiatric comorbidity, not as an isolated behavioral issue.

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Should the recommendations be adopted in practice, it would see gambling addiction screening aligned with checks for smoking and alcohol consumption in the UK. 

The NICE guidelines recommend that GPs and social care professionals “consider asking people about gambling” even if they have no apparent risk factors for gambling-related harm when asking about smoking, alcohol, or the use of other substances. The questions could come as part of a complete health assessment or when registering for a GP or social services. 

NICE’s Gambling Screening Guidelines: Who Will Be Asked?

The language changes from ‘consider asking’ to ‘ask’ when assessing certain people, as under the guidelines, they ‘may be at increased risk of gambling-related harm.’ 

The guidelines outline the following situations in which people will be asked:

• Patients with a mental health problem or concern, in particular thoughts about self-harm or suicide, depression, anxiety, psychosis and bipolar disorder, post-traumatic stress disorder (PTSD), personality disorder or attention deficit hyperactivity disorder (ADHD);
• When a patient is taking medication that may impact impulse control. Examples provided in the guidelines include dopamine agonists for Parkinson’s disease and aripiprazole for psychosis; 
• At each contact with the criminal justice system, including but not limited to police, probation services, courts, prisons, and liaison and diversion services;
• People presented in any setting with problems relating to alcohol or substance dependence, with specific mention of cocaine use;
• When a person is at risk or is experiencing homelessness;
• When concerns over financial stability are expressed;
• Where there are concerns around safeguarding issues or violence, with specific mention of domestic abuse;
• If a professional is made aware of a family history of gambling-related harm or alcohol and substance dependence. 

It offers more lenient language around young people who have recently left home for the first time, people with a neurological condition or acquired brain injury that leads to increased impulsivity, and those who have formerly worked in the armed forces or gambling and financial industry and sports professionals. The groups mentioned above ‘may be at increased risk of harm.’ 

The guidelines also ask healthcare professionals to take into account that ticking multiple ‘at risk’ boxes can have a cumulative effect and make it significantly more likely that someone will experience gambling-related harm. 

Professionals are told to use direct questions to ask people about gambling and to be aware that some people ‘may find it difficult’ to speak about the topic. Guidelines suggest using questions such as “Do you gamble?” and “Are you worried about your own or another person’s gambling?” 

How Will Healthcare Professionals Screen for Gambling Addiction?

Anyone with concerns about gambling will be encouraged to complete the Problem Gambling Severity Index (PGSI) questionnaire available on the NHS website, which will be used to evaluate the severity of the gambling-induced harm. Those who score above eight will be advised to seek specialist gambling treatment services, while professionals are free to recommend support intervention where considered pertinent. 

NICE’s chief medical officer, Professor Jonathan Benger, commented. “Gambling-related harm has a devastating impact on those who experience it and the people close to them. Our useful and usable guideline will help healthcare professionals and others to identify those needing help earlier and ensure they get the treatment and support they need.”

Baroness Fiona Twycross, Minister for Gambling, welcomed NICE’s guidelines, stating, “This guidance will support those experiencing harmful gambling to get access to the right support. We know that clinical treatment is not necessarily right for everyone, but it is important that there is a full spectrum of support as we strengthen treatment options.”

The 2023 Gambling Survey for Great Britain found that 2.5% of the adults surveyed were classified as problem gamblers (PGSI score of 8+), while 12% were at an elevated risk of harm (PGSI score 1–7). 

Baroness Twycross continued, “The Government’s plans to introduce a statutory levy, which will generate £100 million each year, will provide the investment needed to further expand the support and treatment on offer for those in need.”

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The conference was the first after confirmation of the new statutory levy and the application of £2/£5 stake limits in the UK, which Gambling Minister Baroness Twycross underlined will ensure Britain has the safest gambling environments.

As the landscape unfolds the NHS will be positioned as the Chief Commissioner with the goal of improving the accessibility, quality, and impact of services tackling gambling-related harms by addressing the individual needs of local communities.

However, the GambleAware conference provided a stage to emphasise just how crucial collaboration will be moving forward and why it’s so vital that the third sector continues to play a crucial role in safeguarding players. 

In spite of this, Dr Claire Murdoch, National Mental Health Director, NHS England, surprisingly took aim at the industry and pinpointed Gordon Moody, for “stoking demand and preying on the vulnerable”, having apparently confused the non-profit with an operator. 

She later took to X to state the comments “badly reflected Gordon Moody’s position on industry. Rushing. I want to thank you for great work. Happy to meet to further address your important questions on procurement and hear more about your work”.

Gordon Moody provided CasinoBeats with the following statement in response: “We are pleased that Dr Claire Murdoch quickly clarified her comment about Gordon Moody made at the recent GambleAware conference during her In Conversation session with GambleAware CEO, Zoe Osmond. We look forward to meeting with Dr Murdoch to explain the work Gordon Moody has been doing since 1971 to help people reclaim and rebuild their lives free from gambling-related harms.

“Gordon Moody is the expert by experience in the gambling harm treatment space. Our unique programmes are delivered by highly qualified professionals who are equipped to focus not just on gambling harm, but also on other comorbidities. We carry out comprehensive assessments that help us integrate appropriate therapies into personalised treatment plans that address each service user’s unique needs.

“The new commissioning framework will fundamentally change how treatment services are funded. It is vitally important that the framework takes into account the work of organisations like Gordon Moody, as well as those within the NGSN and the wider third sector.”

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The new RET Levy statutory measure will ensure that £100m in annual funding will be allocated to projects, initiatives and organisations dealing with the treatment and prevention of gambling harms. 

We are examining how the industry has reacted to such key developments with the need for clarity and further scrutiny continuing. 

Labour

Stephanie Peacock, the Labour Government’s Minister for Sport, Media, Civil Society & Youth, has released a ministerial statement on the statutory levy and the online slot stake limits.

Peacock described the current funding system for research, prevention and treatment of gambling-related harms as “no longer fit for purpose”, noting that while there has been an uplift in donations in recent years, the “quantum of funding is not the only requirement for an effective and equitable system”.

As such Peacock confirmed that DCMS will apply the new RET Levy via “secondary legislation” in place by next summer to ensure funding is “flowing to priority projects and services in the next financial year”,

She added that the statutory levy will “deliver increased and trusted investment directed where it is needed most” and “further strengthen the evidence base to inform policy, and build an effective prevention and treatment system across the country”.

“We want the public to be better aware of the risks of gambling, and for anyone suffering from gambling harms to access timely and effective support when and where they need it,” said Peacock.

As for the distribution of the levy funding – 20% to research, 30% to prevention and 50% to treatment – Peacock said it has been allocated in this way to maximise the input of expertise and authority across public bodies.

However, additional evidence collecting for prevention is still taking place. The Government views this area as a “crucial part” of its efforts to reduce gambling harm and wants to take its time to “get this right” before appointing a lead commissioning body in this area.

She added that an update will be delivered in a further response document “in the coming months”.

To govern the levy, a Gambling Levy Programme Board and a Gambling Levy Advisory Group will be established. The programme board will be the central oversight mechanism for the Government, while the advisory group will offer expert advice on funding priorities and emerging issues.

The levy system will be formally reviewed within five years, with assessments of its structure and health and adjustments taking place to ensure the Government is achieving its aims.

Regarding its policy impact, Peacock stated: “While we expect the statutory levy will have some financial impact on gambling operators, we think these are necessary and proportionate. The levy will increase the independence of spending and Government oversight regarding commissioning decisions. 

“It will play an important part in the Government’s wider aim to have a better informed and protected public when it comes to gambling-related harms. 

“This investment will also ensure the Government and the Gambling Commission have the robust evidence needed to strike the right balance between freedom and protection as new challenges arise.

“The publication today is further evidence of the Government’s continued commitment to tackling gambling-related harm. We want to ensure that people across our country can access trusted and quality information, support and treatment when it comes to gambling-related harms. 

“We believe that the introduction of the statutory levy is a crucial step in meeting these aims. I will place a copy of the response to the consultation in the libraries of both Houses.”

As for the online slot stake limits, £5 per spin for adults aged 25 and over and £2 per spin for young adults aged 18 to 24, the Minister said that these limits will go through an implementation period, meaning that following debates in Parliament, operators will have six weeks to implement the limits.

“The introduction of these stake limits is proportionate and is a key step in achieving the Government’s objective of reducing gambling-related harms. Importantly, these changes bring online slot games in line with existing restrictions on slot machines in casinos,” Peacock concluded.

“These limits are also aligned with the recommendation made by the Culture, Media and Sport Select Committee’s Second Report of Session 2023-24, ‘Gambling regulation’, published in December 2023.”

NHS

Director for Mental Health at the NHS, Claire Murdoch, expressed ‘delight’ in welcoming the gambling levy, which she noted that bereaved families and the voluntary sector have been calling for better coordination with the government when it comes to preventing gambling harm. 

“Problem gambling can completely ruin lives and the issue has skyrocketed, with NHS services treating record numbers and our latest data showing a staggering 129% increase in service referrals compared with the same period last year.

“We will continue to work with the government to do all we can to protect problem gamblers from this billion-pound industry.”

The need for action was also highlighted by Professor Henrietta Bowden-Jones, National Clinical Advisor on Gambling Harms at NHS England, who added that 2.5% of the population are experiencing harmful gambling, with many more people around them affected as a direct result of their behaviour. 

“We recognise the need for more action, which is why I am thrilled to support the Government’s new levy, which will help us address the negative impact of gambling harms on communities using treatment, prevention and research through an independent evidence-based strategy, at last.”

GambleAware

In a joint statement, Zoë Osmond, CEO of GambleAware and Professor Siân Griffiths CBE, Chair of GambleAware Trustees, also welcomed the Government’s announcement, but noted that any delay in appointing the new prevention commissioner “could adversely impact the continuity of services.”

Osmond and Griffiths said: “We welcome the Government’s plans for the new statutory levy on the gambling industry, alongside the introduction of lower online stake limits. This represents a significant step towards protecting people from gambling harm.”  

“Gambling harms affect millions of people, including children, and exacerbates inequalities across Great Britain. The introduction of the lower online stake limits for under 25s is a positive step as we know those using online casino games, including slot machines, are almost four times more likely than average to experience ‘problem gambling’ compared to other kinds of gambling.

“The levy is also a crucial step towards ensuring continued support through a statutory system and is something we have been calling for since 2017. GambleAware is committed to supporting the new system which we hope will build upon the effective work of the National Gambling Support Network and others in the third sector, as well as harnessing the strategic commissioning and campaigning expertise that already exists.” 

The joint statement continued: “We are however concerned that the delay in appointing the new prevention commissioner could adversely impact the continuity of services. 

“Clarity on this role is urgently needed to prevent system degradation as we know that prevention is at the core of tackling gambling related harms and needs to be integrated with the treatment offering. This includes impactful public health campaigns, self-help tools, and education programmes which we know are essential to addressing this serious public health issue.

“We also welcome the announcement of the cross-Government levy board and advisory group. We believe it is vital that the levy board urgently develops a national strategy to address gambling harms as part of its remit, to ensure the new RPT system is as effective as possible.”  

EPIC

Paul Buck, the CEO & Founder of EPIC Global Solutions took to Linkedin to respond to the decision revealing that “the devil will be in the detail over the next few months”.  

Buck produced five core views on DCMS’s RET levy, signifying how it will align with EPIC’s work going forward. 

He kicked off by underlining: “We should never forget that the main people that matter are those who need the services. We are already seeing organisations claim ‘victory’ in the last few hours. The only thing that matters should be that gambling harm is prevented in the first place, and then treated effectively for the small percentage (but significant number) of people who do suffer issues.”

He noted that it was the decision to split the levy at 50% treatment, 30% prevention and 20% research, with EPIC having advocated for this in previous debates. 

Furthermore, Buck cited that treatment should reflect that “gambling problems are not one size fits all”. 

He added: “The NHS is probably the right commissioner, but how they manage the incredibly important wider ecosystem and provide choices of treatment & aftercare that will be genuinely life saving or not. There are some amazing treatment options out there such as Gordon Moody the NGSN and some incredible peer support and aftercare organisations such as Betknowmore UK and EPIC Restart Foundation who all should be supported to provide choice and diversity of options.”

Lastly, he pinpointed prevention, an element he stated has still not been fully decided on at this point other than it warrants 30% of the levy. 

“As an organisation that has helped lead this area since 2013, and the largest gambling lived experience employer globally, EPIC have fed their thoughts comprehensively on this area and have felt listened to. However, we are no nearer knowing who is the commissioner (right that this isn’t NHS England) and timescales. 

“Certainty needs to be brought into this area as soon as possible so that the great organisations on the Gambling Commission approved RET list can continue their life changing work. This cannot be about anti-gambling campaigning.”

He concluded: “The public & political scrutiny on the levy will be enormous going forward and hopefully the points above will be prominent to ensure that this levy doesn’t have unintended consequences and actually do more harm than good.”

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Addressing a lack of such services in the country, as well as Scotland, this absence is criticised as “unacceptable”, as well as one that must be “urgently addressed” by the devolved government as part of its health and social care portfolio.

In an article published in Frontiers in Psychiatry, a total of six contributors have called for “equal and assured access” to address a “current glaring gap in provision”.

“The need is acute, and we call on the Welsh government and key stakeholders to put words into action and give the Welsh people a specialised gambling harms treatment service that meets their needs,” it is written.

A team from Swansea University’s School of Psychology led the call, alongside members of the Gambling Research, Education and Treatment Network Wales, University of Cambridge, University of South Wales and the National Problem Gambling Clinic and National Centre for Gaming Disorders. 

The article suggests that research highlights that “people in Wales are as much at risk of experiencing harms from gambling as anywhere else in the UK”.

However, despite referrals to the NHS Gambling Harms Services increasing to 1,400 in 2022, a further seven clinics have taken the total available across England to 15, with this figure standing at zero across Wales and Scotland.

The seven new clinics are in Milton Keynes, Thurrock, Bristol, Derby, Liverpool, Blackpool, and Sheffield, which join those available in London, Leeds, Newcastle, Manchester, Southampton, Stoke-on-Trent, and Telford.

Professor Simon Dymond of Swansea University and Director of GREAT Network Wales commented: “In 2020, we showed that the need for NHS-commissioned gambling harms services in Wales was stark. 

“Here, we repeat our call for the Welsh government and key stakeholders to put words into action and give the Welsh people a specialised gambling harms treatment service that meets their needs. 

“The time is long overdue for Wales to be on a par with the support and treatment services available for those experiencing gambling harms in England.

“Indeed, the National Institute for Health and Care Excellence recommends that people with high gambling severity should seek treatment and support from NHS-commissioned specialist gambling treatment services. Such an option is not currently available for the people of Wales.”

Adding: “We hope that the proposed introduction of a statutory levy will provide a potential means of funding this essential service, but we shouldn’t wait for that to happen. We need NHS investment in gambling harms services for Wales, now.”

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Released earlier this year, the white paper stated that a statutory levy would be created to provide independent and sustainable funding to improve and expand services across the full treatment pathway.

The UK Government has now opened an eight-week consultation period to see the opinion of gambling stakeholders on how the levy should be conducted, including views from the industry, clinicians, practitioners, academics, those who have experienced gambling harm and the general public.

To be underpinned by legislation, the white paper proposes a new one per cent fee on gross gambling yield for online operators, while traditional betting shops and casinos will pay a proposed fee of around 0.4 per cent.

The new levy is estimated to raise £100m for gambling research, prevention and treatment across England, Scotland and Wales, developing “a truly national approach to prevention and fund independent, high-quality research to inform policy and practice”. 

The UK Gambling Commission will distribute funding to the NHS, which will take the principal role of ‘main commissioner of treatment’ with the support of UK Research and Innovation, coordinating research and innovation funding under the strategic direction of the government.

“The introduction of this levy will strengthen the safety net and help deliver our long-term plan to help build stronger communities while allowing millions of people to continue to gamble safely.”

Culture Secretary Lucy Frazer

The government believes the proposed levy rates offer a “fair and proportionate approach”, taking into account “operating costs and the levels of harmful gambling associated with different gambling activities”.

“We are taking the next step in our plan to protect those most at risk of gambling harm with a new levy on gambling operators to pay for treatment and research,” commented Culture Secretary Lucy Frazer.

“All gambling operators will be required to pay their fair share and this consultation is an opportunity for the industry, clinicians, those who have experienced gambling harm and the wider public to have their say on how the proposed gambling operator levy should work. 

“The introduction of this levy will strengthen the safety net and help deliver our long-term plan to help build stronger communities while allowing millions of people to continue to gamble safely.”

The levy will support services such as the National Gambling Helpline, counselling services for gambling-related harm from the third sector, specialist services for gambling addiction in the NHS and residential treatment for those experiencing severe gambling disorder.

Outside of treatment, services such as gambling-related debt advice and support for affected others of gambling harm will also receive funding.

The government noted that the levy provides “an opportunity to integrate services across the full support and pathway for gambling-related harm making sure that people across the country can access the right help they need where and when they need it”.

Gambling Minister, Stuart Andrew, added: “We know that gambling addiction can devastate lives, which is why we are working quickly to implement our bold plans for reform. 

“GAMBLING FIRMS SHOULD ALWAYS PAY THEIR FAIR SHARE AND THIS NEW STATUTORY LEVY WILL ENSURE THAT THEY ARE LEGALLY REQUIRED TO DO JUST THAT.”

Gambling Minister Stuart Andrew

“This consultation brings us a step closer to being able to provide £100m of new funding for research, prevention and treatment, including ring-fenced investment for the NHS to help gambling addicts.

“Gambling firms should always pay their fair share and this new statutory levy will ensure that they are legally required to do just that.”

Health Minister, Neil O’Brien, noted: “Harmful gambling can affect people’s savings, ruin relationships, and devastate people’s lives and health.

“Gambling companies should pay their fair share towards the costs of treatment services, but we want to hear from as many people as possible about how the new statutory levy should work.

“We continue working to support those affected by gambling harms. Twelve of the planned fifteen NHS gambling addictions clinics have now opened across the country providing vital support services for thousands of people experiencing gambling-related harms as well as their loved ones. The remaining three are expected to open by the end of the year.”

The levy has received a mixed response from stakeholders. Some have welcomed it, while others have said it doesn’t go far enough to cover all forms of gambling and that the distribution of funds needs to be managed correctly.

The structure of the RET levy is recognised as the most complex issue of the gambling review’s white paper, in which the government must settle long-standing disputes on funding, independence from gambling, and the management of third-sector organisations providing existing support services.  

“I welcome this Levy which reflects the government’s decision to fund gambling treatment, prevention, research and education in an independent and evidence-based way allowing us to continue our work of eradicating all gambling harms from society,” noted Henrietta Bowden-Jones, National Clinical Advisor for Gambling Harms.

Prominent charities involved in gambling harm treatment across the UK, such as GambleAware and GamCare, have yet to comment on the proposal. However, their opinions will likely be made clear to DCMS and the UKGC during the course of the upcoming consultation.

NHS Mental Health Director, Claire Murdoch, commented: “Gambling addiction destroys people’s lives and with record numbers turning to the NHS for support, the health service has met this demand head-on by opening four new specialist clinics in recent months, with a further three opening later this year.

“The NHS has long called for a statutory levy because it is only right that this billion-pound industry steps up to support people suffering from gambling addiction and I am pleased that action is being taken to prevent people from coming to harm in the first place.

“The BGC supports a new mandatory levy – indeed we proposed this to the government ahead of the white paper.”

Betting and Gaming Council spokesperson

“It is now vital we continue working in partnership to ensure we provide effective prevention, education and treatment for this condition.”

A spokesperson from the Betting and Gaming Council stated that the levy should also be applied to the UK National Lottery as well, whilst reiterating the significance of the voluntary donations already made by the industry to the UK’s independent charity support network.

“BGC members pledged £100m over four years to fund Research, Education and Treatment services to help prevent gambling-related harm and tackle problem gambling, which is paid through a unique voluntary levy scheme. They have gone further and will have donated £110m by March 2024, helping to protect the vital work of third-sector RET providers.

“This current voluntary levy funds an independent network of charities which treats around 85 per cent of all problem gamblers receiving treatment in Great Britain. RET donations only go to charities accredited by the Gambling Commission and BGC members have no say on how the funding is spent.

“The BGC supports a new mandatory levy – indeed we proposed this to the government ahead of the white paper. Our industry has been the majority funder of RET for over 20 years. However, we believe it should apply to all operators including the National Lottery, without affecting good causes, who are not immune to having problem gamblers gamble with their products like scratch cards and instant win games.

“It must also be applied on a sliding scale, with smaller percentage contributions from land-based operators, including independent betting shops on our high streets that have struggled to recover after the pandemic and incur disproportionately higher fixed costs.

“There must also be adequate oversight to ensure levy funds are only distributed to charities and organisations delivering genuine RET services to ensure long-term, sustainable funding – including protecting existing third sector providers who are already doing vital work and who may now be at risk.”

The UK government and the UKGC have stated they expect to have key elements of the white paper in place by next summer.

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Looking into gambling participation, the report published statistics that have drawn some parallels with the insights made in a recent survey from the UK Gambling Commission. 

According to the health service, 0.3 per cent of the UK population are considered to be ‘engaging in problem gambling’ according to Problem Gambling Severity Index results, while 2.8 per cent  can be identified as ‘engaging in at-risk’ gambling behaviour.

Meanwhile, the UKGC’s quarterly telephone survey published its own statistics, placing the UK’s problem gambling rate at 0.2 per cent as of February 2023, a decrease of 0.3 per cent from the previous quarter. 

While the PGSI offers a broad spectrum of samples and responses, participants answering ‘yes’ to the survey’s eight questions were considered to be actively problem gambling, whilst answering ‘yes’ at least once considers them the ‘at-risk’ classification. 

According to the NHS figures, those who spent money on four or more types of gambling over the 12 months preceding the survey were ‘more likely to engage in at-risk or problem gambling’ at 27.8 per cent, compared to 4.6 per cent for those participating in two to three forms of gambling and 1.6 per cent for just the one form. 

When examining gambling activity over the last 12 months, the health service found that 50 per cent of people aged 16 and above had conducted ‘some form of gambling’, citing National Lottery as the leading product. 

These draws account for 34 per cent of respondent gambling activity in the previous 12 months, with a further 15 per cent purchasing tickets for ‘other lotteries’ and a further 14 per cent purchasing scratchcards.

Meanwhile, 36 per cent had conducted another form of gambling, separate to the lottery. 

With regards to wagering, either per cent bet on sports via an online bookmaker, while five per cent placed a stake on horse racing either at a betting shop, on their phone or at a racing venue. 

Other gambling activity, consisting of land-based casinos and online casino, had participation rates below five per cent, with 10 per cent of adults participating in some form of online gambling in the previous 12 months.

The NHS report noted: “The prevalence of at-risk and problem gambling was higher still amongst gamblers who gambled online. 18.2 per cent of individuals who participated in online gambling activities were identified as engaging in at-risk or problem gambling.”

Additionally, the report examined differences in problem gambling and participation according to age, sex and geographical location, finding that men were more likely to gamble at 55 per cent against 45 per cent for females.

The North East was the region with the highest proportion of adults who gambled in the past year, standing at 59 per cent, whilst the South West had the lowest with 41 per cent.

Looking at age, the survey outlined that gambling participation increased as age increased, with 61 per cent in the 45-54 bracket betting, although this did fall to 45 per cent for those aged 75 or over.

While the impact of gambling on young people became a distinct priority for the government’s Gambling Act review, the NHS report found that 39 per cent of those between 16 and 34 participated in gambling activity. 

As 16 and 17 year olds were included in the survey, the influence that gambling has on the nation’s youth will remain cause for concern in the ongoing debate of UK regulation. 

Although the DCMS white paper on the Gambling Act review has been set out for further consultations with its proposals not yet final, it is unclear whether the NHS report will influence any changes to the review’s proposed legislation.

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Shortly after DCMS Secretary Lucy Frazer announced the reforms to parliament, and the white paper was published to the DCMS website, the BGC issued two separate statements to address the legislative changes. 

Michael Dugher, BGC CEO, highlighted that the association has worked ‘extremely hard and closely’ with the government over the 28 months of the Gambling Act review. 

Dugher reinforced that the BGC was established to examine reforms, while representing the industry and the 110,000 jobs within it when formed in July 2019, just 18 months before the review began in December 2020. 

“On behalf of our many members, the 110,000 people whose jobs rely on the regulated betting and gaming industry, and the 22.5 million people who enjoy a bet each month, we welcome the much-delayed publication of the Gambling White Paper,” explained Dugher. 

“We need time to consider the full detail and impacts of these proposals, but it is important to recognise the BGC has worked closely with the government to deliver a wide-ranging package of balanced, proportionate and effective reforms.

“Our members generate £7.1bn for the economy and raise £4.2bn in tax every year, and the measures announced today should protect jobs and sustain that vital contribution, while also building on our own work to drive world-leading standards in safer gambling.”

Reflecting on the legislative proposals, some of the BGC’s desired outcomes have been achieved as the DCMS proposed to create a new ombudsman to handle customer complaints and redress. 

Additionally, Dugher welcomed the introduction of stake limits on slots – varying depending on the age of customers – and ‘overdue plans to modernise the regulation of the casino sector’.

Regarding the research, education and treatment levy that was also proposed, Dugher maintained that the BGC has long-called for ‘enhanced contributions’ of its members in the industry to be made mandatory, noting that voluntary industry donations between 2019 and 2024 have amounted to £110m. 

Dugher added: “We welcome the decision to reject proposals from anti-gambling prohibitionists for blanket, low level and intrusive affordability checks, as well as their calls for bans on advertising, sports sponsorship and consumer promotions, which would harm our best-loved sports like horse racing and football, threaten jobs and drive customers to the growing unsafe, unregulated gambling black market online.

“These proposed measures will mean significant change but hopefully much needed regulatory stability to ensure our members can focus entirely on delivering for customers.”

Remaining hopeful that Ministers will ultimately reject proposals made from ‘anti-gambling prohibitionists’, the BGC CEO explained that the council retains its long-held view that gambling is ultimately a case of ‘freedom of choice’. 

Despite all of this, it remained apparent that many of the review’s proposals were not concrete decisions, with many waiting on further stakeholder consultation, such as with the UK Gambling Commission and the NHS. 

While the government prepares to move ahead with the proposals, Dugher remained adamant that the BGC’s members will continue to focus on finding a balance between player protection and retaining the enjoyment of those that aren’t vulnerable to problem gambling.

The BGC Chief Executive concluded: “This White Paper is a once in a generation moment for change and its publication must draw a line under the lengthy and often polarised debates on gambling. 

“Betting and gaming is popular, contrary to misconceptions, the numbers of people betting are stable and not increasing, problem gambling rates are stable and low, and our members are a genuine British business success story, ploughing billions into the economy. 

“The focus should now be on continuing to drive higher standards, whilst investing in jobs and businesses in the UK’s world leading regulated industry.”

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Opening in May, the two centres, located in Southampton and Stoke-on-Trent, will join the five current NHS clinics in London, Leeds, Manchester, and Sunderland, as well as the pilot children’s and young person’s clinic. 

“Gambling addiction is a cruel mental health condition that can devastate people’s lives – our pilot clinics are already having a lasting impact in helping people to take back vital control of their lives,” expressed NHS’s Mental Health Director, Claire Murdoch.

“The opening of two new gambling clinics in May, as a part of our £2.3bn investment into mental health services, will mean we can help even more people with the most serious gambling problems.”

In addition to the aforementioned, the service also plans to initiate a Gambling Harm Network and Clinical Reference Group later this year, with the goal of consolidating “expertise together” and enabling clinical teams to share best practices on the treatment of problem gambling.

This comes after the NHS made the decision to cut its financial ties with the gambling industry, stating that it will no longer be accepting contributions from operators and fully funding its treatment services – including the newly planned clinics – via its own resources. 

Patients and clinicians asserted through feedback that they had reservations about the potential for conflict of interest from the gambling industry, due to the sector generating £14bn annually whilst funding treatment for addiction. 

In an open letter to Zoe Osmund, CEO at GambleAware, Murdoch revealed that the NHS will cease accepting RET contributions from the betting sector, a development that had been anticipated by industry stakeholders. 

Murdoch noted: “It is also absolutely right that the NHS now funds these clinics independently, recognising the harmful effects this addiction can have on the nation’s mental health, and that predatory tactics from gambling companies are part of the problem, not the solution.”

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In an open letter, penned by Claire Murdoch, NHS England’s National Mental Health Director, it was confirmed that the service will no longer accept grants from the gambling sector to help co-fund its UK-wide problem gambling clinics and research, education and treatment programmes.

“We are very grateful to GambleAware for the funding that you have provided over the last three years, which has allowed us to roll out treatment services faster than would have otherwise been possible,” Murdoch explained. 

“However, as these become part of normal recurrent spending commitment and the number of clinics is expanded, we want to move the funding into general NHS funding, as is standard for other similar services. 

“Our decision has been heavily influenced by patients who have previously expressed concern about using services paid for directly by industry. Additionally, our clinicians feel there are conflicts of interest in their clinics being part-funded by resources from the gambling industry.”

However, it is further noted that “the NHS cannot address the harms caused by gambling alone, nor is it the NHS’s job to tackle this on its own,” with it confirmed that a “constructive operational relationship” with the charity will be maintained.

“Gambling treatment services do not prevent people being harmed in the first place and we would like to see the industry take firm action so that people do not need to seek help from the NHS,” the open letter ends. 

“We hope that you will continue to join us in calling for the gambling industry to be more heavily regulated and taxed to generate public funding to address gambling harms.”

Prior to the decision, GambleAware CEO Zoë Osmond had declared that all concerns on the independence RET funding would be immediately resolved by a fixed safer gambling levy being imposed on licensed operators.

Osmond and GambleAware trustees have recommended the mandatory levy as the charity’s headline reform to the DCMS amid the ongoing review of the 2005 Gambling Act.

“GambleAware has long called for the creation of a mandatory funding model to address gambling harms to ensure all operators are held accountable,” Osmond previously stated to SBC.

“GambleAware is an independent charity, working to deliver the national strategy to reduce gambling harms. We recognise that a whole system approach is needed which involves a coordinated and coherent approach, in partnership with others including the NHS.

“We support a mandatory levy of one per cent GGY across all operators to ensure consistency and transparency across the industry.”

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