December 4, 2023

  1. Margaret McCartney, GP

  1. Glasgow

The charity Gambleaware says on their web site that they’re “wholly unbiased.” They make grants for “analysis and analysis to enhance information of what works in prevention” and “present data to assist folks make knowledgeable choices about their playing.” However how is the charity funded? They “ask all those that revenue from the playing trade in Nice Britain, whether or not or not they maintain a licence from the Playing Fee, to donate a minimal of 0.1% of their annual Gross Playing Yield (GGY) (the distinction between the cash gamers wager and the cash they win) on to GambleAware.” They purpose to extend this to 1% in increments in coming years. They’ve a transparent set of insurance policies on refusal of donations, for instance when it leads “to a threat of precise, potential, or perceived affect on charity exercise.” In 2022/23, GambleAware accrued £46.5million in donations from the playing trade.1 Playing is licensed and controlled within the UK by the Playing Fee and is clearly an enormous trade.2 It will possibly additionally do profound hurt to people.

The Royal School of Normal Practitioners lately hosted a convention funded by, chaired by and that includes audio system from Gambleaware.3 They mentioned in a tweet that “This convention goals to raised equip GPs with the identification, evaluation, and administration of sufferers with playing points. GambleAware is an unbiased charity and the playing trade has no enter, affect, or authority over the content material of this occasion.”4

What, precisely, does “independence” imply? GambleAware exists in its present type due to funding from the playing trade. It can’t, as a physique, due to this fact be thought of “unbiased.” Certainly, within the phrases of GambleAware, it “has a framework settlement with the Playing Fee to assist ship the Nationwide Technique to Scale back Playing Harms (April 2019) inside the context of preparations primarily based on voluntary donations from the playing trade.”5

Gambleaware might contemplate its inner determination making to be unbiased of trade—however this can be a completely different declare from being an unbiased charity. They’re removed from the one organisation making comparable claims. I get invites each week from pharmaceutical corporations inviting me to review days or lectures the place they declare they’d no enter into what’s being mentioned, with the inference that due to this fact, it is freed from affect. However the reality is that these periods are taking place about one thing they’re excited about and assume they’ve an answer for. They don’t essentially meet my, or my sufferers’, priorities and most urgent wants. We’re being led to a selected downside and a selected answer and helped to direct our time and sources there to get it.

So, for instance, when GambleAware say, of their 5 12 months plan, that they purpose to “enhance consciousness and understanding of playing harms,” “enhance entry to providers and scale back playing hurt inequalities,” “construct capability amongst healthcare professionals…so they’re higher geared up to answer playing harms” and “ship efficient management of the commissioning panorama to enhance the coherence, accessibility, range, and effectiveness of the Nationwide Playing Therapy Service,” I’m wondering.6 Reasonably than passing duty for decreasing playing harms to people and healthcare professionals, prevention would imply stopping playing harms through system modifications at supply—inside the playing trade itself. They might argue they’re doing a few of this already, however we have no idea what a wholly unbiased physique, not depending on trade funding, would say as a substitute. The emphasis could also be totally completely different. Leaving the NHS to type out interventions for people dangers shedding deal with the larger downside—the way in which wherein playing is allowed to exist.

In 2022, the NHS determined to dissociate from the NHS specialist playing clinics that GambleAware had been co-commissioning and funding with them. The Nationwide Psychological Well being Director wrote: “Our determination has been closely influenced by sufferers who’ve beforehand expressed concern about utilizing providers paid for instantly by trade. Moreover, our clinicians really feel there are conflicts of curiosity of their clinics being part-funded by sources from the playing trade.”6 Independence means being able to work with no concern concerning the hand that feeds. It means having the ability to decide ones’ personal priorities, which can be fairly completely different from the priorities that effectively funded organisations want to ship. Independence can be uncommon, needs to be cherished, and shouldn’t be claimed when it doesn’t exist.


  • Competing pursuits: none declared

  • Provenance and peer assessment: commissioned, not peer reviewed.