Can tax be a “success”?
I am not sure how one might judge a tax to be a success, I suspect it depends on whether you pay it and what its function is.
Successive Governments have used taxation for centuries to influence markets and spending choices as well as the obvious function of raising money. In Victorian times the Corn Laws were used to protect the incomes of wealthy farmers and landowners, not popular with the majority of the population who needed flour to make their bread.
In recent times successive Governments have used taxes to influence choices made around health but the revenue raised is not specifically directed at any particular use but just goes into the general taxation income for the Government.
In some ways this has worked well over the years; raising taxes on cigarettes has probably been the biggest factor in the massive fall in the number of people that smoke. Public health campaigns, better education, changing social attitudes and laws restricting where you can smoke have all had an impact, but studies have repeatedly shown that increased cost, as a result of taxation, has probably been the most influential factor.
The newly introduced sugar tax could be said to have been a success even before it came into force as the manufacturers of products containing ridiculous quantities of sugar (in my view) have, in many cases, miraculously found ways to reduce the sugar content in order to avoid the higher levels of tax. This means that even before any revenue is raised there will have been a positive impact on obesity levels, probably the Government’s highest priority at the moment, but also significant ongoing benefits for oral health.
Although obesity and dental caries are both linked to sugar in the diet there are significant differences between how they impact. Obesity is directly linked to the amount of sugar in the diet and when it is consumed is relatively unimportant, the relationship between sugar and dental caries is slightly more complicated and needs more nuanced messaging. The amount of sugar consumed is obviously important but the frequency and timing is just as important, a relatively small amount of sugar consumed slowly over a long period of time, particularly if consumed after brushing at night, can have a devastating effect.
The most interesting thing, for me now, is whether the Government will break from previous custom and practice and allocate the revenue raised to the organisations tasked with improving health and reducing inequalities.
One of the most significant changes brought about by the Lansley reforms in 2013 was the devolution of responsibility for improving public health to the Local Authorities. It instantly became easier for the Government to deflect criticism of rising obesity levels and inequalities by saying that this responsibility now lay with Local Authorities. It was a pity that at the same time as this happened Local Authority budgets were significantly reduced in real terms and public health has to compete with social care, education and potholes for a share of this reduced budget.
The really courageous thing (to quote Sir Humphrey) would be to allocate all revenue raised from the sugar tax to Local Authorities with a clear and unambiguous statement that the extra revenue should be used to improve public health infrastructure and operations at local level, and social care to which it is inextricably linked.
This sounds easy but the reality is that over the years ring-fencing has been difficult to manage and unless there is a buy-in from the organisations receiving the funding the Government will worry that the money will not be spent as intended. There is one quick and easy way that the Government could use this money almost straight away without worrying about the revenue being misspent; after many years of hard and often fruitless work by many people there appears to be a glimmer of light in the area of water fluoridation. Many local authorities are now looking at the introduction of new schemes but are concerned about the costs involved in the process. If the DH, with funding from the sugar tax via Government, were to say to local authorities that they would underwrite any expenses incurred by the local authorities in carrying out feasibility studies and consulting they could genuinely be said to be getting real about supporting prevention and reducing inequalities.
Wouldn’t that be great!
Dental Directory, one of the largest full-service suppliers of dental materials and equipment in the country, has announced the appointment of Paul Adams as its new Managing Director.
