The government's expert advisory body on medical treatment is recommending imposing minimum prices on alcohol as a means of combating "hazardous and harmful drinking".
Draft proposals put out for consultation by the National Institute for Health and Clinical Excellence (Nice) today put it on a political collision course with the Department of Health.
The recommendation, hidden away on page 16 of a 78-page advisory document on public health, will stir up public controversy over the issue, adding to the growing list of doctors and politicians in favour of price controls.
Earlier this year, the chief medical officer, Sir Liam Donaldson, backed a minimum price of 50p per unit of alcohol to combat binge drinking. He vowed to pursue the initiative despite Gordon Brown rejecting it. The British Medical Association endorsed the proposal last month, saying it would be one of the most effective ways of stopping young people drinking excessively and damaging their bodies. The Conservative party backed the move at their conference this month, promising to target cheap super-strength beers, cider and alcopops. The Scottish government is already investigating how to introduce a blanket minimum pricing control on all alcohol.
In its recommendation, Nice says: "Making alcohol less affordable appears to be the most effective way of reducing alcohol-related harm. There is sufficient evidence (within the published literature and from the economic analysis) to justify the introduction of a minimum price per unit. The evidence suggests that young people who drink and people who drink harmful amounts of alcohol tend to choose cheaper drinks. Establishing a minimum price per unit would limit the ability of these groups to 'trade down' to cheaper products.
"A minimum price per unit (unlike a tax increase) would prevent retailers from passing on any increase to producers, or absorbing it themselves, so it would prevent them from selling alcohol below cost price."
The document has been put out for comment from Nice's stakeholders, one of which is the DoH. Nice, better known for its pronouncements on clinical treatments and the efficacy of drugs, rejects claims that "those from lower-income groups would be disproportionately affected" by alcohol price rises.
Its proposals was immediately welcomed. Prof Ian Gilmore, president of the Royal College of Physicians, said: "I'm delighted that Nice has looked at the evidence and come to this conclusion. Despite the prime minister having ruled out minimum unit pricing, Nice's draft guidance will put this firmly back on the political agenda."
He added: "Research shows that this does not disadvantage the majority who drink responsibly, despite the prime minister saying that it does, but instead targets those who are drinking at levels damaging to their health."
Norman Lamb, the Liberal Democrat health spokesman, said: "This is a very significant development, which I welcome. I would now like the government to bow to the advice from its own chief medical officer, and a broad swathe of medical opinion, and implement minimum pricing.
"The government is seeking to be populist by avoiding the very clear evidence that is staring it in the face that price is critical to addressing the crisis we have over excess alcohol consumption."
Alcohol Concern said: "The consultation should ignite the debate surrounding the tough decisions government needs to take to save lives and money."
Many Labour MPs back minimum pricing, partly as a way of helping pubs survive competition from supermarkets, some of which sell some forms of alcohol at below cost price as a way of attracting customers. But questions have been raised about whether any attempt to introduce the policy would fall foul of EU competition rules.
The DoH opposed the move, saying: "We are taking robust action across government to tackle alcohol harm. Alcohol-related violence has fallen by around a third since 1995, and a proposed mandatory code will introduce tough new powers to tackle irresponsible sales."
