Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department for Digital, Culture, Media & Sport:
To ask the Secretary of State for Culture, Media and Sport, whether she has had recent discussions with Cabinet colleagues on investigations of gambling-related suicides.
Answered by Stuart Andrew - Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
His Majesty’s Government recognises that, while millions of people gamble without experiencing problems, for some it becomes an addiction with serious consequences. It is particularly important to take steps to protect those, particularly young people, who are at risk of experiencing gambling harm.
In April 2023 the Department for Culture, Media and Sport published a White Paper following our review of the Gambling Act 2005. The White Paper outlined a series of measures to tackle practices and products which can drive harm and to ensure that people who are at risk of gambling harm and addiction are protected, including a commitment to introduce a new statutory levy paid by operators to fund research, prevention, and treatment. We are working at pace with the Gambling Commission to bring these measures into force as quickly as possible.
In October 2023 the Gambling Commission published its decision to introduce a specific reporting requirement requiring gambling businesses to inform the Commission when they become aware of a person who has gambled with them has died by suicide. This requirement will come into force on 1 April 2024. While it is the role of the Coroner to investigate such death, where the Commission is made aware that a customer of a licensee has died by suicide, it will consider whether there is evidence of suspected regulatory failings and whether it would be appropriate and proportionate to take any regulatory action.
Asked by: Lord Bishop of St Albans (Bishops - Bishops)
Question to the Cabinet Office:
To ask His Majesty's Government how many deaths occurred in England and Wales in (1) 2019, (2) 2020, (3) 2021, and (4) 2022, where malnutrition was either the cause of death or was mentioned anywhere on the death certificate.
Answered by Baroness Neville-Rolfe - Minister of State (Cabinet Office)
The information requested falls under the remit of the UK Statistics Authority.
Please see the response attached from the National Statistician and Chief Executive of the UK Statistics Authority.
The Rt Rev. the Lord Bishop of St Albans
House of Lords
London
SW1A 0PW
25 July 2023
Dear Lord Bishop,
As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Questions asking how many deaths occurred in England and Wales in (1) 2019, (2) 2020, (3) 2021 and (4) 2022 where malnutrition was either the cause of death or was mentioned anywhere on the death certificate (HL9519); and how many deaths that occurred in England and Wales in the past four years mentioned gambling anywhere on the death certificate (HL9520).
The Office for National Statistics (ONS) publishes statistics on deaths registered in England and Wales. Mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration. Causes mentioned on the death certificate are converted to International Classification of Diseases (ICD) codes, with the underlying cause of death defined as the disease or injury that initiated the events that directly lead to the death. At the ONS, we use the term “due to” to refer to the underlying cause of a death and the term “involving” where a cause is mentioned anywhere on the death certificate.
The ICD codes for malnutrition are E40 to E46, which come under the endocrine, nutritional, and metabolic diseases sub-chapter. This consists of:
• E40- Kwashiorkor
• E41- Nutritional Marasmus
• E42- Marasmic kwashiorkor
• E43- Unspecified severe protein-energy malnutrition
• E44- Protein-energy malnutrition of moderate and mild degree
• E45- Retarded development following protein-energy malnutrition
• E46- Unspecified protein-energy malnutrition
Table 1 shows the number of deaths due to and involving malnutrition ICD-10 codes, that occurred from 2019 to 2022, and were registered by 7 July 2023, in England and Wales. Deaths due to malnutrition are very uncommon; mortality data and hospital admissions both show that malnutrition is usually accompanied with several other diagnoses. Further information on the nature of malnutrition as a cause of death can be found on our blog [1] .
The ICD codes for gambling consist of:
• Z72.6- Gambling and betting
• F63.0- Pathological gambling
There were no deaths in the past four years involving gambling ICD-10 codes registered in England and Wales. While these codes exist, they are likely to be used only in the case of medically diagnosed gambling addiction. To identify some deaths involving gambling, we can also use the coroner’s text report from deaths registered involving suicide (ICD codes X60 to X84, Y10 to Y34). It is possible that more suicides were related to gambling, but this cannot be definitively stated, as not all the circumstances are necessarily known or reported in the death registration by the coroner. Table 2 shows the number of deaths where gambling was mentioned in the coroner’s text, that occurred from 2019 to 2022, and were registered by 31 December 2022 [2] , registered in England and Wales.
Yours sincerely,
Professor Sir Ian Diamond
Table 1: Numbers of deaths due to and involving malnutrition, deaths occurring from 1 January 2019 to 31 December 2022, England and Wales [3,4,5,6].
Year | Due to malnutrition | Involving malnutrition |
2019 | 76 | 390 |
2020 | 78 | 383 |
2021 | 85 | 398 |
2022 | 67 | 386 |
Source: Office for National Statistics
Table 2: Numbers of deaths involving intentional self-harm and events of undetermined intent where gambling was mentioned in the coroner’s text, deaths occurring from 1 January 2019 to 31 December 2022, England and Wales [4,7,8].
Year | Involving gambling |
2019 | 4 |
2020 | 4 |
2021 | 1 |
2022 | 0 |
Source: Office for National Statistics
[2] For information on the impact of registration delays please see: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/impactofregistrationdelaysonmortalitystatisticsinenglandandwales/latest
[3] Figures are for deaths occurring in each period and registered by 7 July 2023.
[4] Figures include deaths of non-residents.
[5] International Classification of Diseases 10th edition (ICD-10) codes are as follows; E40, Kwashiorkor; E41, Nutritional marasmus; E42, Marasmic kwashiorkor; E43, Unspecified severe protein-energy malnutrition; E44, Protein-energy malnutrition of moderate and mild degree; E45, Retarded development following protein-energy malnutrition; E46, Unspecified protein-energy malnutrition.
[6] Number of deaths by ICD-10 code are available through our explorable dataset NOMIS from 2013 onwards, this can be accessed here: Nomis - Official Census and Labour Market Statistics - Nomis - Official Census and Labour Market Statistics (nomisweb.co.uk)
[7] Figures are for deaths occurring in each period, and registered by 31 December 2022; death registration data for 2023 are provisional and do not yet provide coroner’s text information.
[8] International Classification of Diseases 10th edition (ICD-10) codes are as follows; X60 to X84 and Y10 to Y34.
Asked by: Lord Bishop of St Albans (Bishops - Bishops)
Question to the Cabinet Office:
To ask His Majesty's Government how many deaths that occurred in England and Wales in the past four years mentioned gambling anywhere on the death certificate.
Answered by Baroness Neville-Rolfe - Minister of State (Cabinet Office)
The information requested falls under the remit of the UK Statistics Authority.
Please see the response attached from the National Statistician and Chief Executive of the UK Statistics Authority.
The Rt Rev. the Lord Bishop of St Albans
House of Lords
London
SW1A 0PW
25 July 2023
Dear Lord Bishop,
As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Questions asking how many deaths occurred in England and Wales in (1) 2019, (2) 2020, (3) 2021 and (4) 2022 where malnutrition was either the cause of death or was mentioned anywhere on the death certificate (HL9519); and how many deaths that occurred in England and Wales in the past four years mentioned gambling anywhere on the death certificate (HL9520).
The Office for National Statistics (ONS) publishes statistics on deaths registered in England and Wales. Mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration. Causes mentioned on the death certificate are converted to International Classification of Diseases (ICD) codes, with the underlying cause of death defined as the disease or injury that initiated the events that directly lead to the death. At the ONS, we use the term “due to” to refer to the underlying cause of a death and the term “involving” where a cause is mentioned anywhere on the death certificate.
The ICD codes for malnutrition are E40 to E46, which come under the endocrine, nutritional, and metabolic diseases sub-chapter. This consists of:
• E40- Kwashiorkor
• E41- Nutritional Marasmus
• E42- Marasmic kwashiorkor
• E43- Unspecified severe protein-energy malnutrition
• E44- Protein-energy malnutrition of moderate and mild degree
• E45- Retarded development following protein-energy malnutrition
• E46- Unspecified protein-energy malnutrition
Table 1 shows the number of deaths due to and involving malnutrition ICD-10 codes, that occurred from 2019 to 2022, and were registered by 7 July 2023, in England and Wales. Deaths due to malnutrition are very uncommon; mortality data and hospital admissions both show that malnutrition is usually accompanied with several other diagnoses. Further information on the nature of malnutrition as a cause of death can be found on our blog [1] .
The ICD codes for gambling consist of:
• Z72.6- Gambling and betting
• F63.0- Pathological gambling
There were no deaths in the past four years involving gambling ICD-10 codes registered in England and Wales. While these codes exist, they are likely to be used only in the case of medically diagnosed gambling addiction. To identify some deaths involving gambling, we can also use the coroner’s text report from deaths registered involving suicide (ICD codes X60 to X84, Y10 to Y34). It is possible that more suicides were related to gambling, but this cannot be definitively stated, as not all the circumstances are necessarily known or reported in the death registration by the coroner. Table 2 shows the number of deaths where gambling was mentioned in the coroner’s text, that occurred from 2019 to 2022, and were registered by 31 December 2022 [2] , registered in England and Wales.
Yours sincerely,
Professor Sir Ian Diamond
Table 1: Numbers of deaths due to and involving malnutrition, deaths occurring from 1 January 2019 to 31 December 2022, England and Wales [3,4,5,6].
Year | Due to malnutrition | Involving malnutrition |
2019 | 76 | 390 |
2020 | 78 | 383 |
2021 | 85 | 398 |
2022 | 67 | 386 |
Source: Office for National Statistics
Table 2: Numbers of deaths involving intentional self-harm and events of undetermined intent where gambling was mentioned in the coroner’s text, deaths occurring from 1 January 2019 to 31 December 2022, England and Wales [4,7,8].
Year | Involving gambling |
2019 | 4 |
2020 | 4 |
2021 | 1 |
2022 | 0 |
Source: Office for National Statistics
[2] For information on the impact of registration delays please see: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/impactofregistrationdelaysonmortalitystatisticsinenglandandwales/latest
[3] Figures are for deaths occurring in each period and registered by 7 July 2023.
[4] Figures include deaths of non-residents.
[5] International Classification of Diseases 10th edition (ICD-10) codes are as follows; E40, Kwashiorkor; E41, Nutritional marasmus; E42, Marasmic kwashiorkor; E43, Unspecified severe protein-energy malnutrition; E44, Protein-energy malnutrition of moderate and mild degree; E45, Retarded development following protein-energy malnutrition; E46, Unspecified protein-energy malnutrition.
[6] Number of deaths by ICD-10 code are available through our explorable dataset NOMIS from 2013 onwards, this can be accessed here: Nomis - Official Census and Labour Market Statistics - Nomis - Official Census and Labour Market Statistics (nomisweb.co.uk)
[7] Figures are for deaths occurring in each period, and registered by 31 December 2022; death registration data for 2023 are provisional and do not yet provide coroner’s text information.
[8] International Classification of Diseases 10th edition (ICD-10) codes are as follows; X60 to X84 and Y10 to Y34.
Asked by: Andrew Bridgen (Independent - North West Leicestershire)
Question to the Ministry of Justice:
To ask the Secretary of State for Justice, , in what circumstances a death certificate will describe a suicide as being related to gambling.
Answered by Mike Freer - Parliamentary Under-Secretary (Ministry of Justice)
The information recorded by the coroner in the Record of Inquest is dependent on the circumstances of the individual case and is at the coroner’s discretion as an independent judicial office holder in the exercise of their statutory functions. The register is completed by the Registrar using the coroner’s certificate after inquest, and will record the medical cause of death and the conclusion of the inquest. A death certificate contains the same information as the register entry.
The Government recognises that quality information on the circumstances leading to self-harm and suicide, including issues relating to gambling addiction, can support better interventions. However, whilst coroners may be made aware of information about the motivation or contributory factors in a suicide, it cannot be guaranteed that consistent and comprehensive information on a deceased person’s background will be made available to the coroner in every case.
In addition, expecting coroners to routinely assess the motivation for individual suicides would take the coronial role fundamentally beyond its legal parameters, which are to determine who died, and how, when and where they died.
However, in addition to the inquest conclusion, coroners have a statutory duty to make a Prevention of Future Deaths (PFD) report to a person where an investigation gives rise to a concern that future deaths will occur, and the coroner considers that action should be taken to reduce that risk. PFD reports are about learning and improvements to public health, welfare and safety and could, for example, raise concerns relating to gambling addiction where the circumstances of an individual case give rise to a concern. To promote learning, all PFD reports and the responses to them must be provided to the Chief Coroner, and most are published on the judiciary website.
Asked by: Andrew Bridgen (Independent - North West Leicestershire)
Question to the Ministry of Justice:
To ask the Secretary of State for Justice, in what circumstances a coroner will register a suicide as being related to gambling.
Answered by Mike Freer - Parliamentary Under-Secretary (Ministry of Justice)
The information recorded by the coroner in the Record of Inquest is dependent on the circumstances of the individual case and is at the coroner’s discretion as an independent judicial office holder in the exercise of their statutory functions. The register is completed by the Registrar using the coroner’s certificate after inquest, and will record the medical cause of death and the conclusion of the inquest. A death certificate contains the same information as the register entry.
The Government recognises that quality information on the circumstances leading to self-harm and suicide, including issues relating to gambling addiction, can support better interventions. However, whilst coroners may be made aware of information about the motivation or contributory factors in a suicide, it cannot be guaranteed that consistent and comprehensive information on a deceased person’s background will be made available to the coroner in every case.
In addition, expecting coroners to routinely assess the motivation for individual suicides would take the coronial role fundamentally beyond its legal parameters, which are to determine who died, and how, when and where they died.
However, in addition to the inquest conclusion, coroners have a statutory duty to make a Prevention of Future Deaths (PFD) report to a person where an investigation gives rise to a concern that future deaths will occur, and the coroner considers that action should be taken to reduce that risk. PFD reports are about learning and improvements to public health, welfare and safety and could, for example, raise concerns relating to gambling addiction where the circumstances of an individual case give rise to a concern. To promote learning, all PFD reports and the responses to them must be provided to the Chief Coroner, and most are published on the judiciary website.
Asked by: Lord Bishop of St Albans (Bishops - Bishops)
Question
To ask His Majesty's Government, further to the Written Answers by (1) Baroness Neville-Rolfe on 11 January (HL4504), and (2) the Parliamentary Under-Secretary at DCMS on 14 December 2021 (88799), why they provided statistics on the amount of customer suicides that have been reported by gambling operators in the past three years in 2021 but not in 2023; and whether they will now provide updated statistics.
Answered by Lord Parkinson of Whitley Bay - Parliamentary Under Secretary of State (Department for Culture, Media and Sport)
In the past three years, the Gambling Commission has published details of two enforcement cases which have had links to deaths by suicide.
The Office for National Stastics’s process of collecting mortality statistics is separate from gambling operator data. The Gambling Commission asks operators to notify the Commission if they are made aware of a death by suicide which may be linked to their gambling facilities. This enables the Commission to make enquiries to determine whether there has been a breach of social responsibility codes and licence conditions and whether compliance or enforcement action is appropriate.
To strengthen provisions further, the Commission has recently opened a consultation on reporting deaths by suicide. The proposals would require licensees to inform the Commission when they become aware that any customer has died by suicide, whether or not there is a clear link to their gambling activity.
Asked by: Liz Twist (Labour - Blaydon)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment has he made of the potential merits of recognising gambling as a public health issue; and what steps is he taking to address the relationship between gambling and suicide.
Answered by Neil O'Brien
The Government remains committed to tackling gambling-related harms and prioritising gambling as a public health issue. The Department for Digital, Culture, Media and Sport (DCMS), the lead Government department responsible for gambling policy, is currently leading a review of the Gambling Act (2005). The Department of Health and Social Care continues to work with DCMS to strengthen the current public health approach, including encouraging actions to prevent harms from arising in the first place.
To address the relationship between gambling and suicide, we are focused on ensuring those experiencing harms are able to access the right treatment and support in a timely manner. NHS England remain on track to deliver against their Long Term Plan commitment to create 15 specialist gambling treatment clinics by 2023/24. As at time of writing, there are now eight of these clinics in operation across England.
On 24 January 2023, we announced that we will publish a new National Suicide Prevention Strategy later this year. As part of the development of the strategy, we will consider the changing pattern of risk of suicide associated with issues such as harmful gambling and the Department will engage with key stakeholders, across both the gambling and health sector, during this process.
Asked by: Lord Bishop of St Albans (Bishops - Bishops)
Question to the Cabinet Office:
To ask His Majesty's Government how many customer suicides have been reported by gambling operators in each of the past five years.
Answered by Baroness Neville-Rolfe - Minister of State (Cabinet Office)
The information requested falls under the remit of the UK Statistics Authority.
A response to the noble Lord’s Parliamentary Question of 21 December is attached.
Professor Sir Ian Diamond | National Statistician
The Rt Rev. The Lord Bishop of St Albans
House of Lords
London
SW1A 0PW
10 January 2023
Dear Lord Bishop,
As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking how many customer suicides have been reported by gambling operators in each of the past five years (HL4504). The Office for National Statistics (ONS) publishes statistics on deaths registered in England and Wales. Mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration. As gambling operators do not contribute to this process, the ONS does not hold any information on suicides that have been reported by gambling operators.
Yours sincerely,
Professor Sir Ian Diamond
Asked by: Scott Benton (Independent - Blackpool South)
Question to the Department for Digital, Culture, Media & Sport:
To ask the Secretary of State for Digital, Culture, Media and Sport, if she will make an assessment of the (a) adequacy of the methodology used and (b) accuracy of the estimates of the level of suicides associated with problem gambling in the report by Public Health England entitled Gambling-related harms: evidence review, published on 30 September 2021.
Answered by Paul Scully
The Department for Health and Social Care is undertaking a review and update of the Public Health England report ‘Gambling-related harms evidence review: the economic and social cost of harms’, to assess the accuracy of its estimates of suicide numbers. The updated report is in the final stage of review and will be published soon.
Asked by: Scott Benton (Independent - Blackpool South)
Question to the Department for Digital, Culture, Media & Sport:
To ask the Secretary of State for Digital, Culture, Media and Sport, what the Governnet's planned timetable is for the publication of Public Health England's cost estimates of harmful gambling and the addendum showing specific calculations.
Answered by Paul Scully
The Department for Health and Social Care is undertaking a review and update of the Public Health England report ‘Gambling-related harms evidence review: the economic and social cost of harms’, to assess the accuracy of its estimates of suicide numbers. The updated report is in the final stage of review and will be published soon.