Alcohol Harm Reduction Strategy

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

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Photo of Baroness Royall of Blaisdon Baroness Royall of Blaisdon Government Whip 1:18, 18 October 2007

My Lords, I, too, congratulate the noble Lord, Lord Avebury, on securing this important and timely debate. I am grateful for his expertise and for the close interest that he takes in the Government's efforts to tackle the harms that are associated with alcohol misuse. I also thank him for his clear exposition of the challenges that we face; the demands on all of our services and the blight on so many people's lives, which are unnecessary. He is right that alcohol can be an addiction. I very much like his suggestion that lunches hosted by public bodies should be alcohol-free and that that should be an example for the rest of society. I will take that back.

I also warm to the suggestion made by the noble Baroness, Lady Finlay, that if you have the car keys you have a soft drink, but I am told by my colleagues at the Department for Transport that the department will keep the blood alcohol consumption limit under review, and there are no plans to change that at present. But it does not harm us or stop us from saying, "If you have the keys, please take a soft drink".

Too many people are drinking above sensible levels and are unaware of the harm that they may be causing to themselves. This week's publication of the local alcohol profiles for England provides clear evidence of the problems we face. The hazardous drinking of the middle classes hit the headlines, but the problems are much deeper. The important work undertaken by the North West Public Health Observatory was commissioned by the Government to enable public health directors to identify action that needs to be taken in their areas to tackle the impact of harmful drinking. The figures are disturbing, but the fact that we commissioned this study shows that we do not seek to hide the data and statistics.

Alcohol-related illness or injury accounts for 180,000 hospital admissions per year and, in 2005, more than 4,000 people in England and Wales died from alcoholic liver disease. These are matters of deep concern. Since 1979, alcohol-related deaths have more than doubled for men over 35, with more people dying at a younger age. Then there is the third-party damage, graphically illustrated by the noble Baroness, Lady Finlay. Against this backdrop, the Government launched in June their renewed alcohol strategy, Safe. Sensible. Social.The Next Steps in the National Alcohol Strategy. In the main, the strategy reflects that of the Government's first ever national strategy to tackle alcohol misuse in England, published in 2004. In the run-up to its publication, it was the subject of an extensive consultation exercise eliciting more than 300 responses.

Safe. Sensible. Social. builds on and refines the 2004 strategy, rather than heading off in a new direction. It does not mean that the previous strategy was not successful; we are building on its success. Although we did not feel it necessary to repeat the earlier consultation, we worked closely with around 80 stakeholders and representatives of key stakeholders from the medical profession, the alcohol industry and NGOs in developing our proposals.

Noble Lords, including the noble Viscount, Lord Falkland, mentioned specific problems related to young people and alcohol—the peer pressure and the dreadful consequences of alcohol abuse. That is why the strategy will focus largely on young people, and stakeholders broadly share our analysis of progress since 2004. They support our proposals to focus activity on three groups most at risk—binge drinkers aged 18 to 24, young people under 18 who drink alcohol, and harmful drinkers, including middle-class drinkers whose drinking is damaging their health, often without their realising it—while challenging the social acceptability of drunkenness and driving which causes harm.

To help young people and their parents make informed decisions about drinking, the Government will provide authoritative, accessible guidance about what is and is not safe to drink. We have announced that we will convene a panel of experts, including paediatricians and psychologists to examine the effects of alcohol on the developing child.

When there are new proposals, the Government have published a commitment to consult in more detail with a wide range of organisations on how best to implement them. These consultations will take place in 2008, when a number of reviews that we have commissioned will have reported their findings. In the mean time, the Government are keen to ensure the continued engagement and support of both industry and non-industry stakeholders. Therefore, the Department of Health and the Home Office are convening an alcohol corporate social responsibility group, comprising departmental representatives, the Office of Fair Trading and the Advertising Standards Authority, as well as representatives from the on-trade and off-trade and public health bodies. The group will provide the key mechanism for securing stakeholder support to ensure that we make progress on strategy actions.

The noble Lord, Lord Avebury, and many other noble Lords raised the issue of price and availability. The Government recognise that many people are concerned that the practice of "deep discounting" could encourage customers to purchase more alcohol than they would otherwise do, which could lead to harmful drinking.

The noble Earl, Lord Howe, asked why the Government resist a stepped increase in tax on alcohol. Tax is a matter for the Chancellor, with decisions taken every year at the time of the Budget. The Government have announced that they are commissioning an independent review of the relationship between alcohol policy and harm. This crucial review will seek to establish, through a systematic review of the evidence, how and in what circumstances price—including discounting, advertising and other forms of promotion—drives consumption of alcohol and all forms of alcohol-related harm. The Government will use the review's findings, which they intend to publish in July 2008, to assess whether particular types of discounting, linked to purchasing of bigger quantities, and promotional activities contribute to alcohol-related harm. They will, if necessary, consider the need for regulatory change in the future, following public consultation.

In November 2005, the alcohol industry launched its Social Responsibility Standards document, a landmark set of principles and standards that are intended to underpin responsible production and sale of alcohol. There are now many examples of industry good practice. What is less clear, though, is how widely these standards have been implemented across industry, how visible they are to the public and whether they go far enough in protecting those at most risk, such as young people. Safe. Sensible. Social. therefore includes a commitment by the Home Office to review the effectiveness of the alcoholic drinks industry's Social Responsibility Standards in contributing to a reduction in alcohol harm in England and, following public consultation, to consider the need for regulatory change in the future, if necessary.

Noble Lords are correct to point out that current advertising in our cinemas portrays alcohol as being cool and attractive, whereas we know that it is not. The Advertising Standards Authority is assessing the extent to which implementation of the code has reduced the appeal of alcohol advertising to under-18s. We look forward to seeing the results of the review later this year.

The noble Lord, Lord Roberts, mentioned the role of schools. In England, education about alcohol is part of the national curriculum. Perhaps either the contents or the way in which they are taught need to be improved, but parents also have a responsibility, as many noble Lords have pointed out. As the mother of three young people, I know just how difficult it is, even as a responsible parent, to inculcate these values into young people. I certainly note the points made about catching people at certain points of their vulnerability and the need for counsellors to deal with them at this stage. I will take those points back to the department.

Nearly two-thirds of male prisoners and over one-third of female prisoners have an established alcohol problem. All prisoners are assessed, including for alcohol problems. As we know, primary care trusts are responsible for commissioning advice, support and treatment for those in prison with alcohol-related problems. There is much to be done and I well understand the concern that has been expressed.

The Government announced in May a groundbreaking agreement with the drinks industry to include alcohol unit and health information on drinks labels. We are looking to the alcohol industry to ensure that most bottles and cans carry this information by the end of 2008. In addition, the Government are seeking to ensure that there is on labels information for pregnant women about alcohol. In response to the noble Baroness, Lady Coussins, I am pleased to clarify the Government's position on alcohol and pregnancy. There is no change in government policy. The advice is that, as a general rule, pregnant women or women trying to conceive should avoid drinking alcohol. If they choose to drink, to protect the baby they should not drink more than one to two units of alcohol once or twice a week and they should not get drunk.

Most people are aware of units as a measure of alcohol consumption. However, as noble Lords have pointed out, consumers find it hard to relate them to what they drink, with only 13 per cent of people keeping a check on the number of units that they drink. Including alcohol unit content consistently and visibly on containers should help to fill this gap. Like many people, I am not really aware of what a unit constitutes, and it is getting more and more difficult to buy small wine glasses for consumption at home.

The Comprehensive Spending Review, published by the Government on 9 October, announced a Home Office PSA target to reduce drug and alcohol harm. This includes a new national indicator to measure change in the rate of hospital admissions for alcohol-attributable conditions. It is the first ever national commitment to monitor how the NHS is tackling alcohol harms through both intervention and treatment. This will operate from April 2008. Jointly with the Home Office, we shall be embarking on a sustained national £10 million communications campaign to challenge public tolerance of drunkenness and drinking that causes harm to health and to raise the public's knowledge of units of alcohol so that everyone has the information they need to estimate how much they really drink.

The Government will support the development of a range of new kinds of information and advice aimed at people who drink at harmful levels—about twice our guidelines for regular drinking. For example, the Department of Health has invested £3.2 million to facilitate the development of the most effective and appropriate screening tools and brief intervention techniques. These will help to identify people who are drinking at harmful or hazardous levels and offer them help and advice to reduce their alcohol consumption.

A consortium headed by St George's Medical School and Newcastle University is establishing a series of intervention and brief advice "trailblazer" projects in primary care and other healthcare settings, including A&E, as well as criminal justice settings. We expect that the final report will be issued in 2009, although I realise that the timescale is disappointing.

The Government are determined that the steps that are set out in Safe, Sensible, Social will shape an environment which will minimise the health harms, violence and anti-social behaviour associated with alcohol, while ensuring that people are able to enjoy alcohol safely and responsibly. The noble Baroness, Lady Falkner, is absolutely right about the need for a change in culture, and that takes time.

This has been an excellent, well-informed and deeply disturbing debate, and I shall ensure that the Secretary of State and the Minister responsible are aware of all the comments made.