[Mr. Bill Olner in the Chair] — Alcohol Harm Reduction Strategy

– in Westminster Hall at 12:00 am on 15th May 2007.

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Motion made, and Question proposed, That the sitting be now adjourned.—[Kevin Brennan.]

Photo of David Burrowes David Burrowes Conservative, Enfield, Southgate 9:30 am, 15th May 2007

It is a pleasure to have secured the debate under your chairmanship, Mr. Olner. It is timely and important. When the Government published the alcohol harm reduction strategy they also promised a review of the strategy in 2007, during which they would "take stock" against "clearly defined indicators". The Department of Health and the Home Office will soon publish a revised draft. This is, then, an important opportunity to engage with the Government directly, before publication. However, that opportunity has not been afforded properly to interested groups and individuals, by way of a formal consultation.

The answer to my parliamentary question about consultation, which I tabled on 30 April, reveals the different ways in which the Government deal with their drug and alcohol strategies. The response on the drug strategy was:

"A consultation document is planned to be issued alongside details of the consultation process in May/June 2007. The intention is to consult interested groups and individuals, including service providers and those affected by drugs—users, families and local communities. Subject to cross-Government agreement, the new strategy is likely to be published in late 2007."

Moving on to the question of alcohol, the response was:

"A series of detailed discussions have been held with key stakeholders from the health, police, young people's sectors and the alcohol industry to inform the development of the new Alcohol Strategy. The new strategy is due to be launched in summer 2007. A formal consultation is not planned prior to launch, but consultation is likely to be required on implementation of key aspects of the strategy."

—[Hansard, 2 May 2007; Vol. 459, c. 1771W.]

Why is there no intention formally to consult in the same manner on alcohol and drugs? Does the Minister recognise the concern from different interest groups, including Alcohol Concern and the Wine and Spirit Trade Association, that the Government

"needs to be much more proactive and confident in consulting"?

Have the detailed discussions with key stakeholders included service providers, alcohol addicts and their families, and the local communities that are most affected by alcohol misuse? Even before the launch of the new strategy, a fundamental criticism of the Government's approach is exposed in its process of review. That is the fact that alcohol is the poor relation in drug and alcohol policy.

The debate is important because alcohol consumption and the harm arising from alcohol misuse affect all our constituencies. The debate is less about the millions of people who enjoy drinking responsibly than about the millions who do not do that, and who devastate many lives and relationships around them. It is a debate about binge and chronic drinkers; but such drinkers should not be the only focus of debate. The Government strategy is too limited. It fails to tackle the need to reduce overall consumption and alcohol harms. Indeed, that attitude is supported in many ways by the media, which play to our voyeuristic tendency to be entertained by the antics of binge drinkers. Mr. Olner, you may have seen recent television productions of that kind. We can too easily stereotype the problem of alcohol misuse, and comfort ourselves that it is someone else's problem. However, increased consumption and harm are everyone's problem.

Alcohol consumption has grown and spread. Consumption has doubled in the past 50 years, and it is up 15 per cent. in the past five recorded years. It is estimated that 8.2 million adults have an alcohol use disorder and that up to 3 million are alcohol dependent. Young women have doubled their consumption in the past 10 years, and children have doubled consumption in the past 15 years. Six million under-25s binge drink and 60 per cent. of 15-year-old boys binge drink monthly.

Many of the figures relating to alcohol harm will be familiar to hon. Members who are present for the debate, but it is important to explain the harms at the outset. Alcohol damages the economy. The total loss to the economy from alcohol misuse is estimated to be some £6.4 billion a year. Alcohol damages mental health: 65 per cent. of suicides are linked to alcohol misuse. Anxiety and depression are very common among heavy drinkers. Alcohol damages health: 22,000 people are estimated to have died each year as a direct or indirect result of alcohol—more than the combined number of deaths from breast and cervical cancer and MRSA, which often make the headlines. Deaths from alcohol-related liver disease have doubled in the past 10 years.

Alcohol damages through violence. At least one in three reported instances of domestic violence are known to be linked to alcohol. The British crime survey's figures show that 44 per cent. of victims of violent crime believe that their attackers were drunk or under the influence of alcohol at the time of their attack. Alcohol damages public services. Hospital admissions resulting from alcohol abuse have increased steadily between 1997 and 2004 from more than 19,000 to more than 25,000. More than 3,000 of those admissions were of children. At peak times seven out of 10 accident and emergency admissions stem from alcohol abuse and the Department of Health estimates that about £1 in every £3 spent in A and E is alcohol-related.

Alcohol damages the young. Home Office figures state that among 16 to 24-year-olds 63 per cent. of males and females who admitted to criminal and/or disorderly behaviour were drunk during or after the event. Alcohol and drug misuse is the cause of permanent exclusion from school for more than one in 16 children. More than three out of 100 babies born could have been damaged by their mothers' drinking during pregnancy. Alcohol fundamentally damages families. It is estimated that 920,000 children in the United Kingdom currently live in a home where one or both parents misuse alcohol. Marriages in which one or both partners have a drink problem are twice as likely to end in divorce as those that are not affected by alcohol. The list could go on.

The Government need to be more open about what they want to achieve by their strategy for alcohol. Do they seriously want to reduce overall consumption and alcohol harms? If so, a more strategic approach is needed, recognising the impact of price, regulation and availability; alcohol misuse should have the same public health status that tobacco and obesity currently have. The 2004 strategy, like many strategies emanating from the Prime Minister's strategy unit, is strong on fine-sounding words but weak on delivery. To take one aim—improving health and treatment services—it is estimated that alcohol-related harm is at least six times worse than the harm related to drugs, but alcohol services continue to receive far less than drugs services.

It is extraordinary that the Government have developed a treatment policy with a pooled treatment budget, targets, monitoring and all the paraphernalia of bureaucracy that go hand in hand with the Government's top-down initiatives, but that they have failed to include alcohol in that treatment policy, leaving it as the almost exclusive preserve of drugs. For a Government who pride themselves on their target-led approach to health and asserting their key health priorities, it is significant that the alcohol strategy discussed the importance of

"Setting goals and monitoring progress" but also stated:

"There is no comprehensive target for reducing the harms caused by alcohol misuse".

Guidance notes for primary care trusts have been published, including on programmes of improvements and models of care for alcohol misusers. The result of the strategy is much paperwork, but the impact in increased access to treatment has so far been limited, as local commissioners have determined their actions without national targets to guide them. The lack of dedicated funding and the absence of alcohol monitoring in the quality outcomes framework have meant that alcohol issues have not been prioritised by many PCTs. The alcohol strategy has failed to set out a framework of national, regional or local targets, or drivers to increase access to treatment for problem drinkers. That has left 17 out of 18 problem drinkers, on average, without access to the specialist support that they require. The Prime Minister's constituency of Sedgefield suffers from being in the region with the highest incidence of problem drinkers and the lowest access to treatment, with barely one in 100 able to find any kind of treatment. I doubt that the other 99 would agree with the Prime Minister's foreword to the strategy, in which he said that it would

"in time, bring benefits to us all in the form of a healthier and happier relationship with alcohol."

In stark contrast to the 2002 drug strategy, there are no targets to increase the number of problem drinkers in treatment, or reduce alcohol misuse in general. Also, no funding is ring-fenced for alcohol treatment services, and it is unclear how much money goes to alcohol services. There are no centrally held figures beyond the global figures that the Minister gives in parliamentary answers, so I have conducted my own survey of primary care trusts across the country. It is significant that of the 66 PCTs that have so far responded, only 39 know how much is spent on alcohol rather than being absorbed by the drugs budget. Most have responded that only a small proportion is given to alcohol treatment and that they do not think that the amount allocated to alcohol is sufficient.

In 2006-07, of the 39 PCTs that supplied separate figures for alcohol and drugs services, the average spent on alcohol was £424,500, compared with the average of £3,832,000 that is spent on drug treatment. So, alcohol treatment receives about 11 per cent. of the amount that is allocated to drug treatment. The survey shows that the 20 PCTs that were able to provide the relevant data for 2006-07 will spend an average of 0.72 per cent. of their total annual budget on drugs and 0.15 per cent. on alcohol.

The situation in Enfield illustrates the reality: the strategy has not made tackling alcohol misuse a priority. The answer to a parliamentary question in March revealed that £1.5 million had been identified

"to support various 'Choosing Health' White Paper initiatives including alcohol treatment services."

But there was, as always, a caveat. The answer goes on:

"It is for PCTs to determine how to use the funding allocated to them to commission services to meet the healthcare needs of their local populations."—[Hansard, 5 March 2007; Vol. 457, c. 1681W.]

The Minister might, in her response, be quick to extol the virtues of PCTs having self-determination, but managers at the cash-strapped and top-sliced Enfield PCT would say that they do not have a choice. It has a £13.1 million deficit and a priority to meet other central targets, which means that alcohol services inevitably lose out. There is no funding for any specialist alcohol treatment services in Enfield to support the good work that is being carried out by Rugby house and the service providers at Central and North West London NHS Foundation Trust mental health and substance abuse services.

Enfield has squeezed out of its drugs budget some support for alcohol addicts. Its focus on excluded and disadvantaged sections of our community is welcome and chimes with the words on page 5 of the alcohol harm reduction strategy, where it proposes

"better help for the most vulnerable—such as homeless people, drug addicts, the mentally ill, and young people. They...need clear pathways for treatment".

However, that is not happening in Enfield or in many other places. It is madness that although patients might be addicted to both illicit substances and alcohol, there is a division between those services. One service might not treat illicit drug abuse until the patient is detoxed from alcohol, and the alcohol services might not detox a patient whilst they are addicted to illicit drugs, hence the patient does not get access to appropriate treatment. Drug action teams are encouraged to take the lead with alcohol strategy, but they refuse to do so in Enfield because they do not receive the funding.

The strategy speaks about piloting schemes to find out whether the earlier identification and treatment of people with alcohol problems can improve health and lead to longer-term savings. That all sounds good on paper, but the PCT in Enfield has cut the £82,000 allocation that was intended for alcohol screening in the accident and emergency department. Will the Minister tell us how that decision fits in with the strategy?

The situation in Enfield is not due to a lack of effort on the ground. The alcohol strategy manager there is doing a fine job, and Enfield is one of only six London boroughs that has such a strategy management consultant. There have been significant results with crime and disorder in Enfield as a result of the dedicated support of a co-ordinator pushing up the alcohol agenda across services in Enfield and because of joint working with the police and probation, particularly on domestic violence. Despite the strong multidisciplinary approach and partnership to tackle alcohol misuse, however, the PCT is unable to allocate funds to plug the funding gap, especially with tier 3 alcohol treatment.

The lack of a serious and resourced strategy to deliver real progress on the ground means that alcohol treatment is left predominantly to small voluntary sector organisations such as local Alcoholics Anonymous groups and 1NE Beulah road, which are beacons in the desert of treatment. There is a highly effective and cost-effective abstinence-structured day care programme for alcohol at 1NE Beulah road, which has no direct or reliable source of funding despite the fact that most of the people who use the service there are referred from the statutory sector.

An area that the 2004 strategy avoids, which I would like the Minister to consider, is the control of supply and availability. Government policy has been to liberalise the main drivers of consumption—regulation and taxation—but where does that policy fit in with the strategy to reduce harm? The rising levels of alcohol misuse in recent years, the state's power to sanction the manufacture and sale of alcohol and its potential power to control the availability and price of alcohol all inevitably give the Government the lead responsibility to minimise the harm that alcohol causes, not least because of the cost to the public purse. However, the 2004 strategy rejected tax as a means of tackling harm. In so doing, it rejected substantial scientific evidence that the price of alcohol is one of the principal influences on levels of alcohol consumption and harm, whether we like it or not. Will the Minister review the evidence that supports the idea that duties should be based on the alcohol content of the drink and should be used as a means of controlling alcohol problems?

I am not sure what the Minister's career prospects will be in seven weeks' time or whether she is feeling demob happy, but I invite her to boldly go where no Minister of Health has gone before in terms of alcohol policy. Professor Chris Cook, who is a consultant psychiatrist in alcohol misuse, has said:

"The enormous popularity of alcohol—our 'favourite drug' can make wise evidence based policies politically unattractive...It is not enough that debate about matters of production, distribution and consumption are conducted simply in terms of scientific opinion, political expediency and consumer choice. Alcohol policy should also be based on soundly reasoned ethical principles."

I invite hon. Members and my hon. Friends to debate this matter, and urge the Minister that we should have an alcohol strategy based on such principles.

Photo of Bill Olner Bill Olner Labour, Nuneaton

I want all hon. Members present who want to speak in this very important debate to be able to do so, but we must give sufficient time for the Minister to answer all the questions that are put to her.

K

Alcohol Harm Reduction Strategy should start at in the house of commons. The public spends £5 million on supplying our MPs with...

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Photo of Janet Dean Janet Dean Labour, Burton 9:47 am, 15th May 2007

I am pleased to take part in the debate, and I congratulate Mr. Burrowes on securing it and on raising serious issues of alcohol abuse.

A minority of people misuse alcohol, and most people enjoy it responsibly. Burton-on-Trent is the capital of brewing, so alcohol is important in my constituency for jobs in the brewing industry and pub companies present in the town. Like the industry, I believe that it is important that people drink responsibly. We can tackle the misuse of alcohol only if we all work together. That includes local and central Government, the industry and the police, where necessary. Of course, individuals must also be involved—they must be responsible for their own drinking habits.

We have made progress in the past few years. One example of progress is the "Challenge 21" initiative to tackle under-age sales. I do not know whether other hon. Members have been into retail establishments in their areas to promote "Challenge 21", and encourage vendors not to sell alcohol to young people unless they appear to be over 21. That approach gives more leeway and makes it easy to identify people who should be challenged to produce proof of age cards if they do not look over 21. All sectors of the industry—both on-trade and off-trade—have been responsible in developing that policy.

The on-trade self-regulatory regime has been developed to eradicate irresponsible retailing, and there has been a great deal of progress there. Pubs, in general—this is certainly true of responsible pubs—try not to have happy hours or two-for-the-price-of-one offers, and do not encourage people to drink as much as possible in the first hour that they are in the pub. There has been movement on this, and we should thank the industry for developing and working with the on-trade.

Recently, the Drinkaware Trust was established. It is supported by the alcohol industry: producers and both the on-trade and the off-trade. I am trying to give credit to all those who have been involved. It is early days for the Drinkaware Trust, but I am sure that it will help to promote sensible drinking and to educate young people, in particular, about the importance of not abusing alcohol.

Ongoing discussions are taking place about labelling alcohol in respect of its strength. That is particularly important, because much stronger wines are now available and because although cider may not seem to be strong, it is tremendously strong. We need to know the exact strength of the alcohol that is on sale.

The changes in the licensing hours have not had the dire consequences that many predicted. In fact, there is evidence that staggered hours are helping to change the culture, but that process will take time and it is still early days. The all-party group on beer held an inquiry in the late 1990s into what should be done about licensing hours, and there was general agreement that changing them and having a more relaxed system would help to change the culture. Just before the changes were introduced, the media were saying that every pub was going to be open 24 hours a day. We know that that is not the case, and that such pubs are the exceptions. One pub may be open until 11 pm whereas another may be open until 1 am, thus staggering the leaving times from the establishments.

Coors, which is the biggest brewer in Burton-on-Trent, has been supportive of two organisations in my constituency: the Burton addiction centre, which has an abstinence-based approach and deals with people with both drug and alcohol problems; and ADSiS—Alcohol and Drug Services in Staffordshire—which prevents and minimises harm. One of the good things that has come from ADSiS is its development of a commercial arm. That involves going into businesses and developing workplace policies on alcohol and drugs with local industries, so that they can best advise, and deal with, their work force in a helpful way where they think people have alcohol and drug problems. That is another way forward, and we should use it. The help needs to be in place when people develop the problems, because we are talking about how we deal not just with binge drinking, but long-term alcohol abuse. Just giving somebody the sack will not help them to deal with their problem, but keeping them in work and trying to help them within work can help them to overcome it.

We have made a start, but we need to do more. I have mentioned the responsible behaviour of the on-trade, and I should like to draw hon. Members' attention to early-day motion 495, which was tabled by my hon. Friend Mr. Grogan and secured 193 signatures. It states:

"That this House believes that the substantial price differential between alcohol sold in pubs and that sold in the off-trade is exacerbating the problem of binge drinking; continues to support the pub trade's efforts to curb irresponsible drinking and promotions; and urges supermarkets and off-licences to follow the example of pubs and act to end irresponsible drinks promotions and agree not to use alcohol as a loss leader on their premises."

There is considerable feeling in the House about that issue. The all-party group on beer recently met representatives of supermarkets and we questioned them on their policies regarding the sale of alcohol. There seemed to be a reluctance to recognise the difference between the price promotion of alcohol and that of tins of beans, and there seemed to be the idea, "If we can get people in to buy alcohol cheaply, we can sell other food." The point was put to them that they could encourage people to come in for other goods, which do not have the detrimental effect that cans of beer can have in the wrong hands. If the on-trade can do it, so too should the off-trade. This is not just about supermarkets selling at prices at which it is hard to believe that they do not loss lead and the health dangers of that; it is also important that prices in the off-trade are fair to producers and customers, and do not promote the irresponsible use of alcohol.

Following on from that point, there is evidence that young people drink cans of beer at home before they go out to pubs. I know that the evidence is anecdotal, but there is a feeling that they drink the cheap stuff at home and then go out, which leads to pubs taking the blame for people drinking too much when they have already had their share before they even get to a pub. We should make parents more aware of the dangers of allowing young people to take alcohol out from the home to drink with their mates. One of the worst dangers involves young people and alcohol on the streets—they drink in parks and so on with their mates. It is possible that alcohol bought in bulk from supermarkets is the source of some of the alcohol drunk on our streets.

We ought to consider charging those who attempt to buy alcohol when under age, as opposed to charging merely those who sell it. That would send out the strong message that those who are under age should not even attempt to buy alcohol. We rightly concentrate on the seller of alcohol, but perhaps we should, on occasion, also examine those who buy it illegally.

s

The statement re cider strength is as ill informed as similar statements re marijuana.
Some types of cider are very strong some less so and so on down the scale, this is with few exeptions true with all types of alcohol ic drink.

When a police cheif was asked how the new licencing hours affected his force he said that most pubs opted to keep normal hours and the pubs that stayed open untill later just meant that he had to send out officers at times they would not normally be out dealing with alcohol related trouble.

As far as pubs taking the blame for people drinking to much they should.If somebody were to consume alcohol at home to the extent that it was the major factor in them later being overly intoxicated,it would be an irresponsable landlord that would serve them anymore in the first place. Pubs dont stop selling alcohol to people who in some peoples opinion have had enough/to much if they did there would be pubs closing by the score,this fantacy of the gov that everybody will be sitting around sipping their pints enjoying cultured social intercourse is just that a fantacy.

Submitted by stinky will

Photo of Bob Spink Bob Spink Conservative, Castle Point

Perhaps the hon. Lady would like to moderate her sensible suggestion by saying that we should prosecute those who buy alcohol to provide subsequently to younger people, rather than charging young people themselves—they have enough ways of getting into trouble at the moment.

Photo of Janet Dean Janet Dean Labour, Burton

Most young people are great; too often, we hear in the media about when they do things wrong rather than about the vast majority who do not do things wrong. It is sometimes difficult to pinpoint when people deliberately buy alcohol for young people, but where it is clear that they have done so, they should be charged. I do not want to lock all young people up or any such thing, but if people realised that they could be charged with buying alcohol under age, it might, on the odd occasion, deter a few.

I urge the Minister to consider changing all drug action teams to drug and alcohol action teams. Some areas already have such teams—I understand that Stoke-on-Trent has a drug and alcohol action team whereas the rest of Staffordshire has drug action teams. It would be helpful if they could all become drug and alcohol action teams so as to equalise the emphasis. It is also important that we ensure that primary care trusts give priority to funding both treatment and prevention and that a key message from the Government to PCTs is that they should do so.

Overall, this is about treating alcohol with respect. I want to end on a light note by commending the Coors brewery in my constituency, which has recently reopened its brewery tap bar and is linking food with alcohol. One way of ensuring that we treat alcohol with respect is for that connection to be made. There is a recommendation in that tap bar's restaurant of what beer to have with what food. The museum has just gained the anchor point of the European route of industrial heritage, which is recognition of the part that brewing has played in our heritage. It produces Worthington White Shield in the museum brewery, so it is well worth a visit.

It is also important to encourage people to recognise quality in alcohol rather than quantity. Burton has the quality of Marston's pedigree, and ales produced by microbreweries, such as Burton Bridge brewery, which has just had its silver anniversary.

Photo of Bob Spink Bob Spink Conservative, Castle Point 10:01 am, 15th May 2007

It is a pleasure to follow Mrs. Dean, who was right to represent the interests of the Burton brewing industry, which is a traditional, well known and responsible industry in that area.

I congratulate my hon. Friend Mr. Burrowes on securing this important and timely debate. He is the epitome of a decent, hard-working and caring MP.

I also congratulate the Government on their alcohol reduction strategy, which is delivering some successes, not least, as I freely admit, that binge drinking is no longer rising. The Minister is a bright lady, so she will acknowledge that there is much still to be done, especially on alcohol-driven yob behaviour, which is one of the many areas in which party politics does not play well. We should all work together to make our communities safer places.

I agree with my hon. Friend that the reply from the Under-Secretary of State for the Home Department, Mr. Coaker, in response to his parliamentary question was a little surprising. The Under-Secretary said:

"The new strategy is due to be launched in summer 2007. A formal consultation is not planned prior to launch, but consultation is likely to be required on implementation of key aspects of the strategy."—[Hansard, 2 May 2007; Vol. 459, c. 1771W.]

I await the Minister's explanation of why she has decided that consultation is not appropriate, because this is an area in which the public have strong opinions.

There is a clear and unequivocal cause-and-effect association between alcohol and risky and bad behaviour by young people in particular, but not exclusively. I shall focus this morning on young people. Alcohol causes aggression and loutish conduct. More than 90 per cent. of young people's first use of drugs occurs when they are under the influence of alcohol. That problem affects every constituency, and I recommend the most used non-traffic law as the basis for control action. The Confiscation of Alcohol (Young Persons) Act 1997 has a number of excellent characteristics. One is that we empowered the police to act, but did not criminalise young people for possession or consumption of alcohol—they have enough ways of getting into trouble without us creating gratuitous new ones. Another good characteristic is that the police should always inform and involve parents when they catch a youngster consuming alcohol and remove it from them.

I want parents to be clearly involved in the alcohol harm reduction strategy. I do not want a strategy that takes responsibility away from them.

Photo of Patrick Hall Patrick Hall Labour, Bedford

Does not the hon. Gentleman realise that young people and children copy adults, and that many parents drink to excess?

P

It's not just children emulating adults, there are parents who actively...

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Photo of Bob Spink Bob Spink Conservative, Castle Point

Yes, I think I said that it was not exclusively a problem involving youngsters, but the vast majority of parents want what is best for their children. They have a responsible attitude to bringing up their children and want to set a good example for them. I will return to the hon. Gentleman's point.

A binge drinker is like an elephant: difficult to describe, but we know one when we see one. The definition of binge drinking is a problem. The Government use twice the recommended limit in any 24-hour period as a definition, even if no alcohol has been consumed on all the other days of that week. I know that you rarely imbibe, Mr. Olner, but if you consumed six or eight units in 24 hours, or if Mrs. Olner consumed four or six units, the Department of Health would officially consider you to be binge drinkers. That definition is too tight—if you will excuse my pun, Mr. Olner—to be acceptable to the majority of the public. If a target is believed to be wrong, it becomes totally ineffective.

During a hot barbecue lunch, and an afternoon and evening with friends in my garden, I can consume six or even eight units—that is three or four pints to you and me, Mr. Olner—without getting the least bit squiffy. If we adopt unreasonable targets and limits, we lose the argument and fail to change behaviour. The public believe that binge drinking occurs when someone becomes drunk in a few hours, and loses control and inhibition.

Let me suggest a definition of binge drinkers. They are people who consume, for argument's sake—we certainly need professional guidance on a new definition—double the daily limit within two or three hours, or who consume four times the limit in a single day. With reasonable limits, we have a chance of changing behaviour, but if we do not get the definition right and win public credibility and acceptance for the definition, we will miss our chance to change behaviour.

Some associated issues include alcohol-related attacks on NHS staff. I declare an interest because my son works in the NHS and, like many doctors and nurses, he has been attacked a number of times by drunks in accident and emergency. Such attacks are too frequent, and should receive zero tolerance from the police and the courts. We owe it to our nurses and doctors, who try to help people who are ill or who have had accidents, to give them maximum protection.

On a different but topical note, we should not get carried away with silly politically correct calls to make criminals of parents who introduce their children to alcohol. Moderation and reasonableness by parents are, of course, necessary. French parents introduce their children to wine responsibly and that prevents binge drinking problems in the so-called Kevin teenage years. Let us use common sense and moderation. We should persecute not the parents, but the PC pedlars. Parents who want to prepare their children for the real world should be congratulated. Children should sit with the wider family at important meals throughout the year in a civilised way, and if parents wish to introduce a little alcohol responsibly, that may be rational and a good thing to do.

Another issue is that of tackling unhelpful advertising of alcohol, especially when it is targeted at or designed to impress youngsters. The Government's 2004 strategy started good work to tackle that, and Ofcom and the Advertising Standards Authority moved it forward with the 2005 code. However, action is needed to police advertisements more effectively. Perhaps I could gently hint that this is an area where the Government should show a little more leadership. They are trying to stay out of the matter and leaving it to the various regulatory bodies. A little leadership from the Government would be welcomed.

I shall move on to an issue that the hon. Member for Burton raised. Some retailers are flouting the purchase age limit of 18 years old. There are good and bad retailers in all our constituencies, of course, but in Castle Point, Shopright on Benfleet high road is excellent. The owner, Mark Baddeley, is fierce in protecting youngsters from alcohol, and he therefore saves the rest of our community from loutish behaviour. Other retailers are sometimes less scrupulous, and we need more aggressive checks on trading. It may even be right in certain circumstances to use young, set-up children to trap the culprits. We should then take very tough action against those culprits.

Let me put the issue into local and national perspectives, as the hon. Lady sought to do. She rightly said that alcohol abuse is a minority problem, which is especially true with youngsters. We have excellent, hard-working youngsters of the highest integrity, and their reputation is spoiled in all our constituencies by just a few yobs. Youngsters have more money, and sadly, more pressure than we had when we were growing up, but they are generally reasonable and sensible with drink. In response to the intervention from Patrick Hall, I should say that they are proportionally more reasonable and sensible than adults. I may receive slight criticism for saying that in the local pubs and clubs where I can often be found, but if the truth hurts, what can I do?

Let me address the defining issue of the price and availability of alcohol. Price and availability have changed in recent years, and they control the market and consumption levels of our youngsters in particular. The supply of alcohol, which is bought cheaply and illicitly resold, largely drives the issues of harm to our youngsters and of bad behaviour on our streets, from which we all suffer and for which we all pay the price. The key villain in the piece is the European Union, which has swamped us with cheap alcohol and made it readily available to our British kids through nefarious supply chains, circumventing parental control and the use of our mostly decent and carefully controlled retail outlets and pubs.

If we got out of the EU, there would be a number of important and very helpful consequences. One of the smaller but significant benefits of our exit would be to help our responsible and excellent traditional brewing industry, the retail trade and pubs and clubs. It would help cut youth binge drinking, tackle antisocial behaviour, give the police and parents more control and help protect our kids.

Photo of Janet Dean Janet Dean Labour, Burton

Does the hon. Gentleman accept that the problems a few years ago of the white van trade were mainly eliminated, and that the illegal importation of alcohol was tackled through better controls at our ports? Perhaps he was referring to those problems when he talked about the European Union and activity on our streets. I hope that he would recognise that the issue has been tackled. I am a member of the all-party group on beer, and we went to Calais to analyse the problem, which I understand has now diminished.

Photo of Bob Spink Bob Spink Conservative, Castle Point

I am grateful for that intervention. Perhaps my view of the situation is coloured by the proximity of my constituency to the ports. In Kent, Essex and other areas of the south-east, the uncontrolled supply and resale of cheap EU booze is still a major problem that affects trade badly. In the industry, it is still a factor that drives the massive growth in street disorder and problems for our children. My hon. Friend the Member for Enfield, Southgate provided statistics on the number of young children who are binge drinking, and we all know where much of that booze comes from, at least in that area of the country.

I am delighted that some Members agree with the vast majority of the sensible British public, who say that we would be better off out of the EU. I wish more Members would stand up to the vested interests of their parties, listen to the people and provide leadership on that issue. We should return to the original trading relationship and take control of our laws, taxes, borders and imports. It would, in a small but significant way, help our alcohol harm reduction efforts as well as our economy. It is sad that the Prime Minister is so obsessed with his legacy that he is currently trying to row us in the opposite direction.

Photo of Bill Olner Bill Olner Labour, Nuneaton

Order. The debate is not about taxes and VAT; it is about alcohol misuse.

Photo of Bob Spink Bob Spink Conservative, Castle Point

Yes, Mr. Olner, I accept your advice. However, taxes, VAT, and import and border controls affect in a small way the supply of alcohol to our kids on the streets, and that is the point that I was making. I accept your ruling so perhaps I had better call time on my speech. However, the Labour and Conservative Front-Bench spokespeople must realise that the subject will not go away for the British people.

Photo of Patrick Hall Patrick Hall Labour, Bedford 10:15 am, 15th May 2007

I congratulate Mr. Burrowes on his success in having his name picked out of the hat. He knows that, on an all-party basis, a number of us were seeking to secure the debate, and I congratulate him on being the one to do so.

I shall not get distracted—tempted though I am—by the entertainment that we have just had from Bob Spink; perhaps others will have time to refer to that. The hon. Member for Enfield, Southgate set the national scene ably, so I intend to concentrate on the situation in Bedfordshire, where some of the most valuable work on the treatment, awareness and prevention of alcohol abuse is carried out by the non-statutory body Alcohol Services for the Community, a charity that was set up in 1979 as a treatment and prevention organisation. It started in Luton, but it has expanded to cover the whole of Bedfordshire, including Bedford and, indeed, Kempton, which is in the constituency that I represent.

Under the umbrella of ASC, there are four services. First, there is a preview prevention service, which seeks to raise knowledge and understanding of alcohol through the media, community events and groups, and which provides training and resources. Secondly, ASC delivers a licensees' course to help them to prepare for the national certificate for licensees exam. Thirdly, the James Kingham project, which is based in Luton and Bedford, is a rehabilitation service that supports people and families who want to resolve an alcohol-related problem. It also operates an outreach service throughout the community, helps to build self-esteem and encourages people to retrain and re-skill.

The fourth project, which is aimed at young people and children, is called prevention, understanding, knowledge and education—better known as PUKE. It is linked to the James Kingham project, and mainly through schools, it provides an outreach information and support service to young people and children throughout Bedfordshire. Some have a drink problem themselves, but many live in households where adults and parents have a drink problem.

Over the years following the creation of ASC, the resources, including the number of staff and, therefore, the range of activities, initiatives and innovations, have grown. Within the Luton unitary council area, Luton borough council has consistently supported the project, but unfortunately, the situation in the rest of the county of Bedfordshire, including Bedford, has been very different.

A few years ago, the James Kingham project employed five full-time-equivalent staff in Bedford, and from Bedford, 6.5 full-time-equivalent PUKE workers. Owing to funding reductions, the numbers have gone down to 2.5 full-time-equivalent staff in Bedford, and 2.5 full-time-equivalent PUKE workers. However, the work load has increased both in Luton, where the borough council has maintained the funding, and in Bedford.

The work load has increased at a price, of course, because one cannot get something for nothing. The price has been a considerable reduction in the essential one-to-one work in Bedford and wider Bedfordshire, and an increase in group work. Many more volunteers are being employed—if I can use the word "employed"—in Bedford and wider Bedfordshire. The volunteers do a good job, and I am not criticising them, because they are well trained. However, there is a difference between the likelihood of volunteers and the likelihood of paid staff remaining in such activity. Therefore, things are changing, but not necessarily for the better.

The second cost that is being borne owing to reductions in funding is that waiting lists have been introduced by ASC in Bedford and Bedfordshire. That is absolutely the last thing that somebody who feels ready to face up to their problem or to work with members of their family with a problem needs to hear. People screw up the courage to ask for help, but are then told to come back in six months. That is a worrying development, but that is what ASC has had to do.

Despite those pressures, I congratulate ASC on handling 1,100 referrals to the James Kingham project last year, 900 of whom have gone on to the active list—not everybody maintains their wish to be helped. The PUKE project has engaged 6,000 young people in Bedfordshire, 150 of whom have received much more intensive help. Therefore, despite the increasing pressure, good work is still being done.

The hon. Member for Enfield, Southgate made the point, which I now want to make, too, that there seems to be a serious mismatch between the resources directed at tackling drugs and those dealing with alcohol abuse. The boost in Government funding through the Home Office for drug treatment and prevention in Bedfordshire and nationally has been very impressive indeed. I understand that the increase in resources for drug treatment in Bedfordshire was around 18 per cent. in 2005-06 and 56 per cent. in 2006-07, although those might in fact be national figures, so perhaps my hon. Friend the Minister could clarify that. However, at the same time as those considerable increases in resources for drug treatment, ASC's budget for the last financial year was cut by 5 per cent. That is a clear mismatch, and ASC still does not know what its funding situation will be in the current financial year.

In December 2003, I was privileged to be asked formally to launch the Bedfordshire drug action team, which is based in Bedford. Since then, it has changed its name to the Bedfordshire drug and alcohol action team, which relates to the point that my hon. Friend Mrs. Dean made, although I have a different take on that. From the evidence of what is going on in Bedfordshire, it seems that putting the two issues on an official level playing field and in an equal position of recognition is a good way of proceeding.

The Bedfordshire drug and alcohol action team commissioned a report last autumn on alcohol use and the availability of alcohol treatment services in Bedfordshire. However, despite the official interest in alcohol, which is suggested by having that word in the organisation's title, I have been categorically assured by ASC that senior staff at BDAAT say that it does not fund alcohol services and that its increased resources are entirely directed at drug treatment and prevention. From my detailed local knowledge of the attitude of councillors, it seems that officers are telling councillors in Bedford, at both the county and district level, that BDAAT is dealing with all alcohol matters, as well as all drug matters. That is the message that Bedfordshire primary care trust seems to have been given, too. Therefore, when there are resources, whatever they are, they go to BDAAT, not to the organisation that has such a good track record and is still doing such good work.

There is confusion. The situation is unsatisfactory and should be resolved locally. However, perhaps the Government can intervene and assist, too. The national review of the strategy is an opportunity for that to take place, and could propose clearer advice to PCTs and drug action teams. I ask my hon. Friend the Minister to comment on that, if she has time.

Alcohol abuse is a serious problem. It is a national issue, and it is not good enough to leave it to be dealt with primarily by the voluntary sector. The Government are understandably reluctant to impose targets. Whenever they do, they are pilloried, sometimes by the same people who might ask them to impose targets for alcohol. However, there will need to be a stronger lead and a clearer message. Alcohol-induced harm to individuals and society is on a far greater scale than that caused by illegal drugs. Massive resources have been allocated to drug treatment and prevention, but more people die from, and are harmed by, alcohol misuse. I therefore ask the Minister to respond to the proposal that more of the revenue collected from the sale of alcohol be invested in the prevention and treatment of alcohol-related harm.

Photo of Bill Olner Bill Olner Labour, Nuneaton

Order. Will the hon. Gentleman bring his remarks to a conclusion now, please?

Photo of Patrick Hall Patrick Hall Labour, Bedford

Certainly, Mr. Olner. In fact, you will have heard from the way I was speaking that I was seeking to convey the message that I was indeed bringing my comments to an early conclusion.

We need the balanced picture that alcohol can be pleasurable, and even preventive in health terms, and has been part of our culture for centuries. However, part of that balance is to admit that there is a serious problem that cannot be ignored, and that must not play second fiddle to acknowledging the serious problems associated with illegal drugs. We look to the Government to strike the right balance through the review promised this year. In doing that, I hope that the problems faced in Bedfordshire will be resolved, but also that we achieve a much better balance, which will help us all in this country.

Photo of Sandra Gidley Sandra Gidley Shadow Minister, Health 10:26 am, 15th May 2007

I congratulate Mr. Burrowes on securing this debate. The problem of alcohol abuse has had a raised profile recently, which is a good thing, although I still believe that it is not discussed enough, so I thank him for successfully raising it today.

As a relatively fresh MP a few years ago, I made a round of visits to police stations. I would ask the local police officers what their biggest problem was. I was also quite interested in the drugs problems, because they were high profile at the time. This was probably not a politically correct comment to make, but the police would invariably say in informal feedback, "Drugs? No problem. In fact, we quite like them when they've been smoking spliffs, because they're quite mellow and they don't cause that much harm"—let us put aside the longer-term harm of drugs for a moment. "Alcohol's the real problem we have to deal with, but nobody's doing anything about it". Seven years on, it is difficult to see what has been done to address those problems practically, because they have got much worse.

Hon. Members have mentioned that there is a problem in recognising alcohol abuse, and also highlighted the fact that the availability of treatment varies. "A Glass Half Empty?" by Alcohol Concern calculated that £400 million had been spent on 18,390 drugs service users, which is equivalent to just over £21,000 a head, but that only £217 million had been spent on the 1.1 million people who are dependent drinkers, which is equivalent to about £197 a head. There is clearly a great disparity in how the different problems are funded and perceived.

I know from talking to my local drug and alcohol treatment centre that it feels that it has a relatively large amount of funding for drugs, but that it struggles to find adequate funding to treat alcohol problems. It is only because more and more people are coming through with joint problems that the centre can tackle some of the problems, such as the long waiting list. Figures show that an average of only about one in 18 people who need treatment for alcohol abuse can receive it. The regional disparities are even starker; in the north-east of England, only one in 102 people requiring access to such treatment can receive it. If people who have an incident that prompts a desire to tackle their alcohol problem cannot get help there and then, things become difficult. The necessity of waiting weeks or months to access services is one of the urgent problems that needs to be tackled.

I am surprised that little mention has been made in this debate of Alcoholics Anonymous, which provides a very useful service, although the style may not be for everyone. Last year, I was invited to attend an open AA local meeting, which I found illuminating. I was particularly struck that some people with an alcohol problem had been attending Alcoholics Anonymous for 15 or 20 years. They felt that it was important to keep the link and realised that they were no better, if you like, than the tramp in the gutter with a bottle of cheap plonk.

Bob Spink highlighted the problems in respect of children. Recent surveys have all pretty much confirmed that alcohol consumption among children is increasing. There are mixed reports about whether allowing children to consume alcohol at home eases or worsens the problem. We are probably taking too broad and simplistic a view of the issue. As was hinted at in an earlier intervention, there is a range of parental attitudes towards alcohol. Some parents introduce it in a controlled setting and supervise their children's exposure to it. However, I remember being absolutely horrified when I watched a programme called "Wife Swap"—one has to de-stress somehow—in which a couple were knowingly giving their quite young children quite large amounts of alcohol. The parents thought it fine if their children, totally unsupervised, drank large amounts at parties. So there is a range of parents, and they can have completely different attitudes to alcohol. We have to take that into account when we analyse such surveys.

Binge drinking among children is on the increase, and that is a concern. The European school survey project on alcohol and other drugs found that drinking levels among 15 to 16-year-olds in the UK were at 27 per cent., exceeded only by two other countries in Europe. Ireland tops the poll at 32 per cent. Clearly, there is a problem. Recently, I tabled a parliamentary question about end-stage liver disease among the under-18s. I did not expect any sort of answer at all, and some people were pleased that only three under-18s had been diagnosed with the problem. However, given the lead-up time to developing end-stage liver disease, the figure means that children are drinking large amounts at a younger and younger age. A bulge in the figures indicates such a shift and indicates the growing problem, which is not being tackled.

Obviously, the problem will impact on the health service, but there are other impacts too. My hon. Friend Mr. Foster asked for figures on alcohol-related accident and emergency admissions since 1997. In 1997-98, there were 75,863 such admissions; by 2005-06, that had almost doubled to 148,477. Earlier, we heard evidence that when such people access A and E, they can be abusive and a threat to our NHS staff. That is another aspect of the problem that we cannot afford to ignore. There is also a large alcohol-related component in domestic violence figures; about half of domestic violence incidents are fuelled by alcohol.

Another health-related link is with teenage pregnancy and it should not be ignored. In 2002, when I was one of its members, the Health Committee wrote a report on sexual health. We invited young people to talk to us and they were clear that the pressures of drink—or the pressure to drink—added to the problem of the pressure to indulge in sexual activity. The two are not unrelated. Alcohol Concern's "A Glass Half Empty?" points out that evidence suggests a strong link between alcohol consumption and the neglect of contraceptive use during sexual intercourse among the young. However, that issue was completely ignored by the alcohol strategy. It would be helpful if the Minister said whether anything was planned to tackle the issue.

Mrs. Dean claimed that things had not worsened under the new licensing hours. However, there is no evidence that matters have improved either. Recorded alcohol-related crime between 11 pm and 2 am has not decreased as a result of extended opening hours. However, I—and many other hon. Members as well, I suspect—have probably had an increase in our postbags as a result of those hours. People now go home from the pub during a longer time span, in which minor criminal damage—silly things, such as damage to cars and property, that are a real irritant to people—can take place. Having spent my teenage years on the continent, I always felt that introducing those hours would be a good thing. However, that is not necessarily the case.

In my last couple of minutes, I should like to talk about advertising.

Photo of Bill Olner Bill Olner Labour, Nuneaton

Order. I hope that the hon. Lady will make it only a minute; the Conservative spokesman must speak and the Minister needs to reply.

Photo of Sandra Gidley Sandra Gidley Shadow Minister, Health

I take your point, Mr. Olner.

I am fairly sure that it is too late for a sensible-drinking message, because there are confusing and conflicting messages about alcohol—those who drink in moderation, for example, live longer than teetotallers. People do not have a strong idea of what moderation is; glasses are bigger and alcohol is stronger. We really need a hard-hitting advertising campaign and to consider a ban on alcohol advertising. The UK budget for alcohol promotion is estimated at £600 million to £800 million, but that for alcohol awareness is £7 million. The figures do not stack up, and all the evidence shows that increased exposure to advertising increases the incidence of drinking among the young and the not-so-young. It would also be helpful if the Minister outlined how that issue will be tackled. Advertising before the watershed is also a big problem that needs to be sorted.

Photo of Andrew Murrison Andrew Murrison Shadow Minister (Health) 10:38 am, 15th May 2007

I congratulate my hon. Friend Mr. Burrowes on securing this debate and on the measured and thoughtful way in which he introduced it. It is about an important subject; alcohol-related deaths went up by 18 per cent. between 2002 and 2005, and that is a worrying statistic. I am sure that the Minister will tell us about the importance that she attaches to the apparently deteriorating position in respect of illness and lawlessness related to alcohol, and what she intends to do about it as part of phase 2 of the alcohol harm reduction strategy for England, or AHRSE.

According to that strategy, alcohol abuse costs £20 billion a year. I am afraid that we tend to dismiss such statistics: £1 billion, £20 billion—what's the difference? The sum is massive, however, and it impacts on all our public services as it is money lost to them. It is extraordinary that such a relatively trivial sum should have been spent on alcohol harm reduction, given the enormous figures, in cold economic terms, that alcohol abuse causes.

The alcohol harm reduction strategy has, I am afraid, been characterised by something of a lack of direction and rather indistinct leadership from the start. The Minister without Portfolio, Hazel Blears, set it up when she was in the Department of Health, and she appeared to take it with her when she was translated to the Home Office. Of course, cross-cutting and interdepartmental work is important with such initiatives, but they need ownership and it is not clear where that has been during the strategy's short history. In short, no one appears to have been in charge for much of the time.

The Prime Minister's strategy unit's website, which comes complete with typing errors, tells us that the first alcohol harm reduction strategy aimed to

"tackle alcohol-related disorder in town and city centres".

Clearly, it failed to do so. It aimed to

"improve treatment and support for people with alcohol problems".

I represent East Knoyle, and the Minister will know that in East Knoyle are the premises of Clouds, a charity that deals with alcohol problems and has recently been reformed as Action on Addiction. I doubt whether those at Clouds feel that things have improved over the past three or four years.

The strategy unit tells us that the strategy aimed to

"clamp down on irresponsible promotions by the industry".

We have heard today about how there may be shortcomings in that respect, and I would be particularly interested to hear what the Minister feels about supermarkets' attitudes to that. The strategy aimed to provide

"better information to consumers about the dangers of alcohol misuse".

Baroness Andrews spoke about that in 2004 in connection with foetal alcohol syndrome, and said that she would work with the industry on labelling. Not much has transpired since then. Will the Minister update us on where she is with that?

In March 2004, the alcohol harm reduction strategy said that Government would "take stock" in 2007, and that they would

"measure progress regularly against clearly defined indicators".

We have reached the point of taking stock. What are those clearly defined indicators and how has the strategy measured up to them? We understand from those who have been consulted, briefly, that there has been some effort to inquire widely as to how the first alcohol harm reduction strategy has gone. As we have heard from others today, in no way has that taken the form of a consultation. That is remarkable as Ministers come to set up the second part of the alcohol harm reduction strategy, which we expect to be launched next month. As my hon. Friend the Member for Enfield, Southgate pointed out, it is timely to review what has gone right and what has gone wrong in order to inform phase 2 of the strategy. It is worrying that it has not been more obvious that that process is under way.

It would be interesting to know whether the Minister intends to publish any sort of review to inform and educate the rest of us. It would be nice if that were the case, but so far we have seen no evidence of it. Back in 2004, the alcohol harm reduction strategy called for a national audit of the demand for alcohol treatment services and their provision. I have not seen that, and it would be interesting to know where it is. The alcohol harm reduction strategy called for, among other things, greater use of exclusion orders to ban the troublesome, more fixed penalty fines, work with licensees to ensure better enforcement of under-age drinking rules and the licensing of door supervisors by March 2004. I do not make any comment about the relative value of any of that, but it would be interesting to know where the Minister has reached.

The alcohol harm reduction strategy states somewhat tautologically:

"Effective treatment requires that...appropriate treatment is available".

I would have thought that that was fairly obvious, but clearly it is not, as the strategy's call for an audit of treatment facilities ought to have shown us. We know from providers—I have mentioned Clouds house—that primary care trusts are reluctant commissioners of services that mainly fall outwith the NHS. Other hon. Members have discussed that this morning. I know from alcoholics who have been to see me in my advice surgery that they have problems accessing residential treatment in particular.

Three times as many people die from alcohol as die from drugs, yet the National Treatment Agency for Substance Misuse focuses almost exclusively on drugs. Drug action teams, according to the strategy, were to be encouraged to become drug and alcohol action teams by the second quarter of 2004. To what extent has that happened? We know that £946 a head is spent on those who are dependent on drugs, but only £197 on people who have problems with alcohol abuse. Why does alcohol appear to be the poor relation, despite the fact that in public health terms it is clearly the more important issue?

The Food Standards Agency is exercised about identifying foods that are high in fat, sugar and salt, but alcohol seems to be the elephant in the room. The proper identification of units surely eclipses complex nutrient profiling, on which the FSA appears to be focused completely. I hope that the Minister will tell us how she will update information on units better to inform the public, who appear to have a lamentable understanding of what a unit actually is.

The first alcohol harm reduction strategy stated that the experience in the US was that there was no significant change in drinking behaviour as a result of labelling alcohol. Is that still the Government's position? Despite the lack of evidence, we were told in 2004 that the UK permanent representative to the EU, no less, would thrash out a compulsory labelling scheme for alcohol. Has he done so? Does it involve the rather crude pregnant woman logo that I believe that the French are keen to put on their bottles of alcohol? If anything similar is contemplated in the UK, it is important for the Minister to establish the evidence base that she will use to require such an initiative.

There is a link between the cost of alcohol and consumption, but the Chancellor has resisted putting up the price of alcohol dramatically, presumably because he is worried about smuggling, among other things. Has the Minister given any thought to the British Medical Association's suggestion that alcohol content should be taxed rather than the product? Presumably that would apply rather more to wines and beers than to spirits. Does the Minister think that it might be used as a lever to cut alcohol content?

Photo of Bill Olner Bill Olner Labour, Nuneaton

Order. Will the hon. Gentleman wind up?

Photo of Andrew Murrison Andrew Murrison Shadow Minister (Health)

I will wind up with much pleasure. The Minister has a lot to answer for and I shall certainly leave her time to do that.

As the Minister takes stock at the end of the first alcohol harm reduction strategy, perhaps she will agree that given the fact that ill health and lawlessness attributable to alcohol have worsened since its start, much needs to be done. I hope that the second alcohol harm reduction strategy will be a great deal more successful than the first.

Photo of Caroline Flint Caroline Flint Minister of State (Department of Health) (Public Health) 10:48 am, 15th May 2007

I am sure that Dr. Murrison will forgive me if I prioritise the questions of Mr. Burrowes, who secured the debate, and other colleagues on the Back Benches. The hon. Member for Westbury probably gets more than his fair share of opportunities to ask questions of the Front Bench.

First, I congratulate the hon. Member for Enfield, Southgate on securing the debate. It is timely, because we are reviewing the alcohol harm reduction strategy for England that was published in 2004. Although we have not carried out a formal consultation as part of that process, I can assure hon. Members that we have had a series of detailed discussions that have informed our thoughts and views on how to take the strategy forward. Those discussions have included stakeholders from health, non-governmental organisations, the police, young people's services and industry.

Once the strategy is published, there will be further opportunities to consult on different aspects of it. It is a cross-Government approach to tackling the multi-faceted problems of some for whom drinking has become a problem in their daily lives to varying degrees, but it is also for the majority who keep within the sensible drinking limits but for whom excessive drinking spills over into their lives. That might be because they want to go for an enjoyable night out without having to face the prospect of disorder in their communities or, as we have heard, because of matters such as domestic violence in which alcohol plays a part. Hon. Members have commented on the difficulties for children living in homes where alcohol is a common feature and contributes to a lack of support for them. There will be on ongoing discussion, and we will look for opportunities to consult on the various aspects of it.

We are determined to reduce the harm caused by alcohol misuse, and without being at all complacent I think that we have made some progress. It is becoming clear that the mechanisms that the Government have put in place since 2004 are becoming established and beginning, in spite of comments made today, to have a positive effect in tackling the range of harm that results from alcohol misuse. Most of the commitments in the Government's strategy have been delivered—on under-age sales of alcohol and on violent crime and offences involving alcohol, which have fallen. That is not to say that we should be satisfied by where we are, but the indications are that such offences have fallen.

I pay due respect to those in local communities who are enforcing operations on under-age sales, which have been extremely successful. The partnership involved has been very good. I visited two small supermarket outlets, which I shall not name, and in both asked about alcohol sales. Both those supermarkets were on a final warning after two operations in which, I am afraid, they had been found wanting. In the staff room there was information up for all staff to further get across the point that they really had to take responsibility for checking on age. Schemes such as those mentioned by my hon. Friend Mrs. Dean are, I am sure, common to many other hon. Members' constituencies and tackle under-age drink sales. That is vital if we are to change some of the worst aspects of where drink is provided in our communities and the consequences of that.

We need to challenge the belief that drunkenness and antisocial behaviour are an accepted part of English drinking culture. There is sometimes a perception that it is our drinking culture, but the reality is that a minority indulge in such a way. Most people drink within the Government's sensible drinking guidelines or exceed them only occasionally. Even among 18 to 24-year-olds, the group most often associated with drunkenness, more than two-thirds of young men and three-quarters of young women drink within the guidelines. Of those who drink at levels above them, only a quarter become involved in antisocial behaviour or disorder.

The renewed strategy needs to build on what has been achieved and where we are now, and set out how to embed the strategy further—it is not about starting afresh—and take it forward. Total recorded alcohol consumption in the UK is estimated to have doubled between 1960 and 2002, which is a trend over a long period. That is important in dealing with the cases of cirrhosis of the liver that appear in our hospitals, and I agree with Sandra Gidley that we need to consider future health and what we can do to prepare for the number of people who might still have problems with cirrhosis of the liver or other health conditions linked to alcohol. We must look further down the road at how we can stem that flow in the future, but consumption has doubled in 40 years.

The average weekly consumption of alcohol increased from 5.3 units in 1990 to 10.4 units in 2000, and it has since remained at about that level. That decade was significant in that respect. Heavy drinking remains high, but levels have decreased significantly among men and there are indications—I use that word carefully; we cannot be complacent—that it may have peaked among 16 to 24-year-old women. It is too early to say whether that represents the start of a consistent downward trend in consumption levels, but it is at least helpful for an informed debate.

In 2000, between 15,000 and 22,000 deaths in England and Wales were related to alcohol misuse. Since 2003 the number of alcohol-related deaths has slowed and flattened out. I use those figures not to over-hype that as a sign of success, but something seems to be happening. I am not suggesting that it is all down to the Government; maybe it is because of greater awareness or maybe the headlines in our papers are beginning to make people take stock of their drinking and the impact that it has.

Through the strategy we undertook the first national assessment of the need and availability of alcohol treatment, which was published in November 2005. We allocated £3.2 million last October to establish three major identification and brief advice trailblazer trials, which are taking place on 57 sites, to identify and support harmful drinkers. That initiative is important because it is about trying to address people who are not defined as chronic alcohol dependants but whose drinking is regularly proving hazardous to their health and could result down the road in severe health conditions for them to face up to.

We are trying to examine the matter differently—maybe in accident and emergency settings or maybe in other environments such as a local police station if someone has been picked up for antisocial behaviour—to engage with a person's drinking and its relationship to why they have turned up there. They might have turned up at A and E because they have fallen over and cracked their head open and require stitches, or at a police station because of disorder. I know that they are examining the matter in Enfield and are in discussion with their trust about staffing in the A and E department to support such work. I congratulate them on that.

Patrick Hall, and the hon. Members for Romsey and for Westbury talked about drugs and why they are given such a priority compared with alcohol. We could have a whole debate about that, but I have a few comments. Action on alcohol is at a much earlier stage than that on drugs. It is also, as I think we all agree, a complex issue in that it is not of itself illegal. The drugs strategy was combined with dealing with illegal drugs and their link to crime. Unlike tobacco consumption, low alcohol consumption may be beneficial for health for certain population groups, and moderate consumption is not harmful. Alcohol therefore poses a different range of problems and issues to be resolved.

The alcohol harm reduction strategy for England was the first comprehensive Government-wide strategy to establish different ways to approach this complex issue. We may compare that with drugs, for which the Government have had a strategy in place since 1998 and for which there were predecessor strategies before that under other Governments. We are now encouraging drug and alcohol action teams, and many people involved in drug addiction through illicit drugs, a number of whom I have met, also have alcohol problems. There is an opportunity for dual diagnosis and dual treatment to go hand-in-hand.

I say to my hon. Friend the Member for Bedford that there is an opportunity to use the young people's grant to address both alcohol and drugs. I am happy to talk to him about the situation in Bedford and why that might not be happening in his area. We work with the NTA and discuss such issues regularly, and we are considering how we can improve the situation. I hope that I shall not be corrected on this by officials, but I understand that if an area has met its targets on drug treatment numbers there is flexibility to use resources for alcohol services.

Of course, a number of our providers are both alcohol and drug treatment providers and will have benefited, for example, from the capital funding that we have provided for those services. Many of them are in the voluntary sector, such as Clouds, which was mentioned. I was happy to go to the launch yesterday of the merger of Clouds, Action on Addiction and The Chemical Dependency Centre. Quite cleverly they are going to use the same name—Action on Addiction.

We are absolutely serious about focusing on the area in question. I commend the comments of my hon. Friend the Member for Burton about how we can work with the industry. We cannot work with the illegal drug industry, but we can work with the alcohol industry in different ways to tackle irresponsible retailing. I have heard the points made about on-trade/off-trade promotions. We are examining advertising, and the authorities are going to review the code that they tightened up only a short while ago to see whether it is working. We are also working on labelling, and through self-regulation that is one way in which we have made some progress.