Alcohol Harm Reduction Strategy

Part of the debate – in the House of Lords at 1:09 pm on 18 October 2007.

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Photo of Earl Howe Earl Howe Shadow Minister, Health 1:09, 18 October 2007

My Lords, the noble Lord, Lord Avebury, has brought us to a subject that is not only of critical importance for public health but also, in view of this week's press coverage, extremely topical. For that, the House will be grateful, and I congratulate him on a cogent and powerful speech.

As with so many public health issues, including obesity, drug-use and teenage pregnancy, we are dealing here with a societal problem which any government acting alone cannot hope to cure. However, government can do a lot. My worry during the past few years is that the growing problem of alcohol abuse has not sufficiently occupied Ministers' in-trays or red boxes. Of course, the Minister will point to various worthy-sounding initiatives, but as with obesity, we will fight a losing battle unless focused and concerted efforts are made to change public attitudes and patterns of behaviour. As it is, the odds are stacked decidedly against any quick fix. In the past 15 years, children's alcohol consumption has doubled. In the past five years alone, consumption across the board has gone up by 15 per cent, which is a continuation of an upward curve that started 50 years ago, only much steeper. People are starting to drink at a much younger age, with nearly one-quarter of young people aged between 11 and 15 regularly drinking up to 10 units a week. Perhaps the most shocking statistic of the lot is that one in 10 primary school children regularly drinks alcohol.

The cost of all this—to the health service, the criminal justice system and to people's lives—is enormous. The noble Baroness, Lady Finlay, and the noble Lord, Lord Roberts, brought that home very graphically. My personal view is that we have reached a point where, without very major initiatives at national level, these trends are only going to get worse. What might those initiatives look like? The Government's alcohol harm reduction strategy, which was published three and a half years ago, contained some good ideas, such as providing better information to consumers about the dangers of alcohol abuse and clamping down on irresponsible sales promotions. However, if you talk to doctors who practise in this field, they will say that the strategy was not nearly ambitious enough. The principal target of the harm minimisation strategy was binge drinking, which although of course it was worthy of being a target was by no means the only important one. There was no explicit ambition in the strategy actually to bring down the overall level of alcohol-related harm, let alone any timescale for trying to do so. When it was published, Professor Drummond of the National Treatment Agency for Substance Misuse rather brutally remarked that,

"no effective strategies have been used in the making of this document".

Perhaps that was a little harsh but certainly it reflected his frustration that the strategy failed to get to grips with alcohol misuse as well as the underlying causes of it.

Unfortunately, as with the Government's policy on cannabis, the message on alcohol has sometimes been mixed. The alcohol harm reduction strategy of 2004 followed hard on the heels of the relaxation of the licensing laws. The Government strongly defended that relaxation at the time, saying in effect that it was unfair to criticise Ministers for giving the man in the street what he wanted. But if ever there was a case for piloting something, that was surely it. In fact, my own party said exactly that at the time. As it was, we were plunged straight into a giant national experiment, the results of which are still being evaluated. Whatever the findings are—and no doubt the Minister will be able to tell us how the Department of Health views them so far—the messages sent out by the growth of superpubs and longer drinking hours are surely the wrong ones. You have only to read history, not least the history of the l8th century and the arrival of cheap gin, to realise that the introduction of the licensing laws was no accident. It is a good thing that the Government are now looking again at the 2003 Act and, if they decide, on the evidence, to reverse it, we on these Benches will support them.

However, the elephant in the room here is not the licensing laws but, as a number of noble Lords have said, something rather more far-reaching: the price of alcohol. Alcohol is more than 50 per cent cheaper than it was in 1980—and this at a time when people's disposable incomes have increased very considerably. I appreciate the arguments against imposing large tax hikes on alcohol. One of them is that we cannot find ourselves severely out of step with other EU member states; another is the adverse effect on our drinks industry. But it would be helpful to hear from the Minister exactly why the Government resist the notion, if indeed they do, that significant price rises on alcoholic drinks, perhaps introduced over a period, would not be beneficial to the nation. The Government's review of their alcohol strategy was published in June and in it there is a pledge to look at the extent to which low prices and advertisements increase the amount that we drink. Perhaps the Minister could tell us the timescale for doing this.

A lot of people believe that more can usefully be done to reduce children's exposure to alcohol advertising. We already have restrictions on television during the hours when young people are most likely to be watching, but I wonder whether the Minister is aware of the finding by Alcohol Concern that TV advertisements for alcohol increase dramatically between 3 pm and 5 pm, which is the precise time when children return from school. Are the Government looking at that finding?

The other main prongs of the Safe, Sensible, Social action plan are tougher enforcement of the existing law on sales and drunken behaviour and campaigns to promote sensible drinking. It is not particularly profitable in a health debate to spend time on law and order policy, although I wonder whether the policy will be matched by the necessary resources. I should be interested to hear from the Minister a little more about the public information campaigns that are planned.

The report focuses a lot of its attention on,

"the minority of drinkers who cause or experience most harm to themselves".

In view of the findings published this week by the North West Public Health Observatory, I take it that the spotlight is now not only on teenage binge drinkers but on middle class social drinkers. The two are linked, because the evidence is that peer pressure and parental example are the most significant drivers of drinking among young people. Among adults especially, one issue has to be looked at; the level of general public awareness of government health warnings. While a majority of people have heard of the guidelines, a significant proportion of those people say that they do not know what the guidelines are. There is ignorance on another level as well. If you ask people what a unit of alcohol looks like, the chances are that they will give you the wrong answer. A 125 ml glass of wine contains approximately one and a half units. However, a glass of wine that you pour at home is probably going to be larger and may be much more than one and a half units, particularly if it has a stronger alcohol content. If the messages to the public continue to be expressed in terms of units, at the very least those messages have to become more sophisticated.

The Safe, Sensible, Social document is, I fear, an admission on the part of Ministers that their previous initiatives on alcohol abuse have failed. I do not think that any of us can stress enough how important it is for this one to succeed. People point to illicit drugs as the cause of much crime; which is absolutely true. But the evidence is that alcohol abuse underlies much drug-taking, teenage pregnancy, school truancy, crime and the growth in sexually-transmitted diseases. Alcohol abuse is truly at the heart of many of our society's ills. Only a serious and concerted public health campaign, sustained over a long period, can hope to reverse the very worrying trends of recent years. That campaign is now well overdue.