asked Her Majesty's Government:

In view of the number of alcohol-related attendances at accident and emergency departments, when they will publish their national alcohol strategy.

My Lords, the Government are determined to make life safer for National Health Service employees. We have already set targets to reduce violent incidents. Alcohol can contribute to violent incidents and the Government will be implementing our national strategy to tackle alcohol misuse by 2004.

My Lords, I thank the Minister for that reply. It is a pity that the date is not sooner. Is he aware that at peak periods in some accident and emergency departments as many as eight out of 10 people may have abused alcohol? Crisis teams can be called upon by A&E departments to help with mentally ill patients. Could they be provided for those suffering from alcohol abuse?

My Lords, the noble Baroness is right to point out the serious impact of people attending A&E departments with alcohol-related injuries or problems. It is impossible to say exactly how many A&E attendances are alcohol related, but a Health Education Authority study found that one in six people attending A&E for treatment had alcohol-related injuries or problems, rising to eight out of 10 at peak times. That makes life difficult for dedicated NHS staff working in incredibly difficult circumstances. We have launched a zero tolerance strategy to communicate to the public and staff that violence towards NHS staff will not be tolerated.

A number of good initiatives, such as the one mentioned by the noble Baroness, have been implemented. I especially commend the co-operation that has taken place between NHS authorities and the police, enabling the NHS to call on the police where necessary.

My Lords, in June last year, I think, the Prime Minister announced plans to crack down on violence in hospitals. Guidance was promised later in the year. Has that guidance now been produced? The baseline measurement of offences of violence in hospitals continually shifts. Have the Government now got a grip on the problem? Is it beginning to decline?

My Lords, the figure I have for the number of violent incidents in 1998-99 is about 65,000. The department now has figures for financial year 2000-01, which are currently being analysed but are not yet finalised. They will form the baseline against which we set targets for reduction in violent incidents.

The work announced by my right honourable friend the Prime Minister has been taken forward. Campaign materials—posters and distance learning packages—have been made available. There is an award scheme and the NHS is setting up safety awareness teams and making support available to staff when violent incidents occur. So an enormous amount of activity is taking place. I am satisfied that each individual NHS organisation is taking the matter seriously.

My Lords, does my noble friend agree that if we know that there are 65,000 violent incidents—a horrifying figure—the baseline for reduction does not need much calculation? It should be 65,000.

No, my Lords, I do not entirely agree. There is a feeling that the figure of 65,000 violent incidents may well have been an underestimate because previously the NHS did not collect figures in a robust way. That shows the importance of establishing a proper baseline, which will be done through careful analysis of the figures for 2000-01. It is much better that we establish a robust baseline and then deliver improvements rather than base improvements on a baseline that may not be as accurate as we would like.

My Lords, is the Minister aware that Westminster council is most concerned about the huge numbers of people on Friday and Saturday nights who have to go to University College Hospital with broken bottle injuries and so on? The council feels that the police are needed to control the situation. Does the Minister agree that it is not only the staff but other patients in the hospital who can be attacked or seriously upset by violent people around them? What provision exists for segregation of violent patients from others awaiting treatment?

My Lords, I well understand the local authority's concern, although I do not know of the specific details of University College Hospital. The noble Baroness is absolutely right. Violence in A&E departments is disturbing not only for staff but for other, law-abiding members of the public who have to attend A&E. Attending A&E is in any case a stressful situation for most of us.

The National Health Service has introduced a number of initiatives, including the provision of security staff, closed circuit television and programmes that advise staff on how to deal with such incidents. There is also great potential in closer co-operation with the police. Joint working has helped to deal with the problem in a number of schemes. For instance, at Mid Cheshire Hospitals NHS Trust, a police base has been established in the hospital grounds immediately adjacent to the A&E department. In other examples, the police have opened sub-stations near A&E departments, which have proved effective.

My Lords, is the Minister aware that many of the patients coming into A&E departments are young people and children? Is health education good enough and will public health provision in the new NHS be effective enough?

My Lords, we will see a strengthened public health role in the NHS reorganisation that will come into effect on 1st April. The principal public health authority will be at primary care trust level. I would expect primary care trusts to take a vigorous approach to health promotion. In addition, the alcohol strategy to be introduced in 2004 will place some emphasis on young people and the kind of message that we must get over to them.

My Lords, I declare an interest as the chair of the national treatment agency for drug misuse. Does the Minister think that having a national drugs strategy with targets and a national treatment agency will help to support the treatment of drug misuse? Would it be applicable to the treatment of the misuse of other substances, including alcohol?

My Lords, my noble friend is right to point out the potential of the strategy and the targets. The question of whether the NTA's remit should include alcohol treatment services has been discussed by the NTA with Ministers. We hope to make an announcement about that shortly.