Such refusals would be potentially unlawful under the Equality Act 2010. This legislation provides that it is unlawful age discrimination for a service provider such as a car hire company to refuse, on age grounds, to lease a vehicle to an otherwise qualified person, unless the company can, when challenged, objectively justify its decision.

Where a company cannot, in those circumstances, show that their leasing age policy is a proportionate means of achieving a legitimate aim, the individual affected can bring a claim to the County Court, or Sheriff’s Court in Scotland. The court may determine whether the “objective justification test” has been satisfied, and may award costs and compensation if the claimant wins their case. A range of guidance is available to service providers on their obligations and to service users on their rights, most notably on the Equality and Human Rights Commission’s website: https://www.equalityadvisoryservice.com, and through the Equality and Advisory and Support Service (EASS). The EASS can be contacted via its website, http://www.equalityadvisoryservice.com, by telephone on 0808 800 0082 (or by text phone on 0808 800 0084).

The main source of data for problem and at-risk gambling behaviour in Great Britain is the Health Surveys for England and Scotland, and the Problem Gambling Survey Wales. 2016 data showed that men were more likely than women to be classified as a problem gambler (1.2% and 0.2% respectively). The surveys also indicated that certain other groups are at greater risk of experiencing problems from gambling, including those with poor mental health or who are unemployed. However, further work is needed to understand the nature of these associations.

Government recognises the importance of building understanding of how gambling related harm is experienced and by whom. Public Health England (PHE) is carrying out an evidence review looking at the health harms associated with gambling and the Responsible Gambling Strategy Board (now called the Advisory Board for Safer Gambling, ABSG) published a paper setting out a potential framework for measuring harm. Protecting vulnerable people from gambling-related harm is a priority for the Government and where there is evidence that a particular product or environment is causing harm, we will take action.

In March 2019, government awarded just over £1 million to GamCare for a project to raise awareness of how gambling is linked with a range of issues affecting women and girls and help to better identify women in need of support. One of the core work strands of the programme is to build data in this area.

Health Education England funds and delivers the GP Speciality Training Programmes as part of the Royal College of General Practitioners curriculum. The Government does not collect information on the amount of time and funding allocated to training on specific conditions or issues including gambling harms.

NHS Digital’s Hospital Episode Statistics collects the volume of finished admissions episodes (FAEs) with a primary or secondary diagnosis of pathological/compulsive gambling and volumes for the last five years, broken down by gender is shown in the following table.

Source: Hospital Episode Statistics, NHS Digital

Notes:

1. A FAE is the first period of admitted patient care under one consultant within one healthcare provider.
2. FAEs are counted against the year or month in which the admission episode finishes.
3. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

The government’s Review of Gaming Machines and Social Responsibility Measures included the announcement of a multi-million pound safer gambling advertising campaign, aimed at raising public awareness of the risks around gambling and signposting to support. The campaign will be funded by industry and led by GambleAware, an independent charity which commissions research, education and treatment of gambling-related harms.

GambleAware’s delivery plan for 2018-20 sets out steps it will take around education and harm-prevention, including developing and promoting a ‘knowledge hub’ of resources and guidance for teachers and those who work with young people, working with agencies that support young people’s mental health and encouraging parents to have conversations with their children about safer gambling behaviour.

Schools are expected to promote the spiritual, moral, social and cultural development of pupils. We know that some schools choose to teach about gambling and addiction in an age-appropriate way, as part of their Personal, Social, Health and Economic (PSHE) education. The non-statutory PSHE programme of study, published by the PSHE Association includes teaching about gambling (including online) and its psychological and financial impact.

The consultation to make relationships education compulsory in all primary schools; relationships and sex education compulsory in all secondary schools; and health education in all state-funded schools, closed on 7 November and a thorough engagement process has informed the key decisions on the content of these subjects. The draft content also addresses online behaviour and mental wellbeing. We are currently analysing the responses to the consultation before finalising the regulations and guidance.

Where gambling facilities are offered, operators must have a licence from the Gambling Commission and have controls in place to prevent underage gambling.

Loot boxes do not fall under gambling law where the in-game items acquired are confined for use within the game and cannot be cashed out. However, the Government is aware of concerns that loot boxes and other entertainment products, such as some video games, could encourage gambling-like behaviour and longer term lead to gambling related harm, and will continue to look closely at any evidence around this issue. We welcome the recent introduction by the VSC Ratings Board and PEGI of a new label for video games to warn parents where they include the opportunity to make in-game purchases.

In September 2018, the Gambling Commission, along with 16 other regulators from Europe and the USA signed a declaration which outlined common concerns around gaming and gambling. The regulators agreed to work together to monitor the characteristics of video games and social gaming and where there is potential cross-over into gambling.

Neither Government nor Gambling Commission holds data on the number of problem gamblers aged 18 and over or under 18.

The Health Survey for England and Scotland 2016 and Problem Gambling Survey Wales 2016 estimated the number of problem gamblers aged 16 and over in Great Britain as approximately 340,000, 0.7% of the population. Of these, approximately 280,000 were in England (based on 40 individuals identified as problem gamblers), approximately 40,000 in Scotland (based on 24 individuals) and approximately 20,000 in Wales (based on 29 individuals).

All estimates are rounded to the nearest 10,000 and due to the low prevalence of problem gambling among respondents to the survey have large confidence intervals. There is 95% confidence that the true estimate for the total number of problem gamblers aged 16 and over in Britain is between 250,000 and 460,000.

The Gambling Commission’s 2018 Young People and Gambling Report estimated that 1.7% of 11-16 year olds were problem gamblers, or approximately 55,000 if extrapolated to the population of Great Britain. This number is based on a survey completed by 2,865 children in schools in England, Scotland and Wales. Of these, 37 children were identified as problem gamblers: 30 in England, 3 in Scotland and 4 in Wales. Due to the low number of respondents it is not possible to provide robust estimates for the number of problem gamblers in each country.

All estimates of the total figures of problem gamblers in Great Britain should be treated with caution due to the low numbers of individuals on which they are based.

Loot boxes do not fall under gambling law where the in-game items acquired are confined for use within the game and cannot be cashed out. However, the Government is aware of concerns that entertainment products, such as some video games, could encourage gambling-like behaviour, and will continue to look closely at any evidence around this issue.

We welcome the recent introduction by the VSC Ratings Board and PEGI of a new label for video games to warn parents where they include the opportunity to make in-game purchases.

The Gambling Commission, as the regulator for gambling in Great Britain, has strong powers and can take action where it needs to address emerging risks.

In September 2018, the Gambling Commission published a declaration signed by 16 gambling regulators, which outlined common concerns around gaming and gambling. The regulators agreed to work together to monitor the characteristics of video games and social gaming and where there is potential cross-over into gambling.

NHS England is not responsible for the provision of general practitioner training. The standard of medical training is the responsibility of the General Medical Council (GMC) and the training curricula for postgraduate trainee doctors is set by the relevant medical Royal College, which has to meet standards set by the GMC. Whilst curricula do not necessarily highlight specific conditions for doctors to be aware of, they instead emphasise the skills and approaches that a doctor must develop to ensure accurate and timely diagnoses and treatment plans for their patients. NHS England expects clinicians to use their professional judgement with patients presenting with particular symptoms and keep up to date with current developments and treatments.

Information on the number of trips to a hospital or safe place made by police or ambulance crews connected with gambling associated with mental health are not collected centrally.

NHS England is not responsible for the provision of general practitioner training. The standard of medical training is the responsibility of the General Medical Council (GMC) and the training curricula for postgraduate trainee doctors is set by the relevant medical Royal College, which has to meet standards set by the GMC. Whilst curricula do not necessarily highlight specific conditions for doctors to be aware of, they instead emphasise the skills and approaches that a doctor must develop to ensure accurate and timely diagnoses and treatment plans for their patients. NHS England expects clinicians to use their professional judgement with patients presenting with particular symptoms and keep up to date with current developments and treatments.

Information on the number of trips to a hospital or safe place made by police or ambulance crews connected with gambling associated with mental health are not collected centrally.

The Government is committed to supporting all those identified as suffering from problems with gambling. Dedicated treatment for gambling disorders is commissioned by GambleAware who fund the National Gambling Helpline and commission a national network of treatment services, mostly through GamCare, which are locally accessible across Great Britain and are available to people of any age, including young people. Children with gambling problems can also access treatment in primary and secondary care, which includes specialised mental health services.

The Government considered the evidence on gambling advertising as part of the Review of Gaming Machines and Social Responsibility Measures.

The review found that although the number of gambling adverts on TV rose from 2007, reported rates of problem gambling remained below 1% during this period. The most recent survey estimated the number of adult problem gamblers in Great Britain as approximately 340,000, 0.7% of the adult population. A major research survey concluded that the impact of advertising on problem gambling prevalence is likely to be relatively small, but identified areas for further research.

There are already strict rules on the tone, content and placement of gambling adverts, and while the Review did not conclude there was a case for a ban, it set out measures to strengthen protections further. Further research has been commissioned by GambleAware into the impact of gambling advertising on children, young people and those vulnerable to harm. This is due to be completed next year. We will keep these issues under review including examining new evidence as it emerges.

The Government has made no estimate of the cost of gambling related harm to the National Health Service.

The volume of finished admissions episodes (FAEs) with a primary or secondary diagnosis of pathological gambling for the last five years, by commissioning region of treatment, is shown in the following table.

Source: Hospital Episode Statistics (HES), NHS Digital

Notes:

A FAE is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

In order to protect patient confidentiality '*' appears in the table for all sub-national breakdowns, where it is possible to calculate a value between one and seven from the data presented. All other sub-national data has been rounded to the nearest five.

The Home Office annually reviews the data it collects from police forces under the Annual Data Requirement. We need to ensure we have the right data to inform national policies and better understand the picture from the frontline, but we need to balance this against overburdening the police with added bureaucracy.

The police do have a role in responding to people in mental health crisis and that remains the case irrespective of whether the crisis is related to gambling, substance abuse or something entirely different. There will be difficulties for the police in identifying mental health problem connected to gambling-related harm, which means it will be problematic to collect data on the number of call outs from the police forces in a consistent and reliable way.

However, we continue to work with the police and health colleagues to ensure that those in mental health crisis receive the support that they require.

It is not possible to assess any meaningful trend in referral data. The current data available through the mental health services monthly statistics releases are experimental data and the data quality and coverage is improving over time.

The information in the Education Policy Institute’s report is based on 54 Freedom of Information responses. We cannot be certain whether the 54 responses received are representative of all providers. It is difficult therefore to be confident in the rise in referrals suggested in the report.

The Review of Gaming Machines and Social Responsibility has taken action to reduce gambling-related harm and ensure that those experiencing problems can access the help they need. As well as reducing the maximum stake from £100 to £2 on B2 gaming machines, government's response announced increased safeguards on online gambling and strengthened protections around gambling advertising. We also set out measures to improve understanding of gambling-related harm, how to prevent and reduce it, the need for treatment and the most effective means of delivering it. We are working closely with the Gambling Commission, Public Health England, GambleAware and health bodies on the follow up to these initiatives.

Prior to the Review, the Responsible Gambling Strategy Board (RGSB), the independent advisors to the Gambling Commission, published a three year National Responsible Gambling Strategy in 2016. The strategy identified 12 areas for action by a range of bodies, including developing a better understanding of gambling-related harm and identifying improvements in treatment. Regular progress reports have been published and the Commission is working with the RGSB and partners on the shaping of a future strategy.

The Home Office does not hold the information requested centrally.

The draft Statutory Instrument needed to reduce the maximum stake on sub-category B2 machines to £2 was notified to the European Commission in September under the requirements of the EU Technical Standards and Regulations Directive. We intend to lay the draft affirmative regulations before Parliament, for the usual process of approval, in the Autumn term.Questions about gambling participation are included in the large scale English and Scottish Health Surveys and an alternative omnibus survey for Wales. The Combined Health Survey for England, Scotland and Wales 2016 results were published on 6 September 2018 and can be found at https://www.gamblingcommission.gov.uk/PDF/survey-data/Gambling-behaviour-in-Great-Britain-2016.pdf. A copy of the survey is attached.

In addition, the Gambling Commission collects participation data through smaller scale quarterly telephone and online surveys and monitors underage gambling through its young persons survey. The latest information can be found at: https://www.gamblingcommission.gov.uk/news-action-and-statistics/Statistics-and-research/Levels-of-participation-and-problem-gambling/Gambling-participation-and-problem-gambling.aspx. A copy is attached.

The Government takes all fraud extremely seriously and recognises the harm that authorised push payment scams can cause. The Government has created the Joint Fraud Taskforce, which brings together government, the banks and law enforcement to develop a collective response to fraud. The objectives of the Taskforce are to protect the public and businesses from fraud, reduce the impact of fraud on victims, and increase the disruption and prosecution of fraudsters.

Furthermore, the government has established the Payment Systems Regulator (PSR) with a statutory objective to ensure that the UK’s payment systems work in the interests of their users. The PSR has convened an Authorised Push Payment (APP) Scams Steering Group, made up of an equal number of both industry and consumer group representatives. On 28 September 2018 this steering group published a draft voluntary code which sets out the circumstances in which payment services providers (e.g. banks) would be responsible for reimbursing APP fraud victims who have acted appropriately. This draft voluntary code is an important step forwards towards better and more consistent protection for consumers and standards for industry.