Alcohol Consumption Guidelines

– in Westminster Hall at 4:56 pm on 28th June 2016.

Alert me about debates like this

Photo of Byron Davies Byron Davies Conservative, Gower 4:56 pm, 28th June 2016

I beg to move,

That this House
has considered guidelines on alcohol consumption.

It is a pleasure to serve under your chairmanship, Sir Alan. I am delighted to have secured this topical and timely debate following the conclusion of the public consultation on the proposed new guidelines on alcohol consumption. Given the scale of public interest and levels of public and industry concern about this important issue, I am pleased to see so many colleagues here this afternoon from across the House to support the debate.

I want to be clear from the outset. I recognise the necessity for sensible and effective guidelines to help consumers—our constituents—to make better informed decisions about the amount of alcohol they consume. Ministers were right to ask the chief medical officer to carry out a review of the guidelines, and it is important that the guidance reflects the most up-to-date scientific evidence that is available across the world and that that is properly communicated to consumers.

I declare an interest as a member of the all-party beer group—unashamedly, given that 30 million adults across the UK drink beer each year and 15 million of us visit the pub each week. But I also know that this issue is a matter of concern for anyone who enjoys a drink and wants to drink responsibly.

We have made great strides in this country in promoting responsible enjoyment of alcohol through a partnership approach with industry. That achieves much more than a draconian approach to taxation or heavy-handed regulation. As a Conservative, I want to treat adults as adults and let them have the freedom to make informed choices about how they live, what they eat and drink and how they enjoy their lives. As a responsible Conservative, I also know that industry has a role to play in promoting responsibility through advertising campaigns, voluntary labelling initiatives and provision of consumer information. We have achieved a great deal, successfully reducing alcohol harm for more than 15 years.

The Office for National Statistics confirms that binge drinking has fallen by 25% since 2007. According to Public Health England, alcohol-related and alcohol-specific deaths have fallen since 2008 by 7% and 4% respectively. The Office for National Statistics confirms that alcohol-related violent crime has fallen by 40% since 2007. The number of children drinking alcohol has fallen by more than 50% since 2003 and is currently at the lowest rate on record. According to Public Health England, under-18 hospital admissions due to alcohol have fallen by 41% in the past six years.

Photo of John Howell John Howell Conservative, Henley

The statistics that my hon. Friend has produced are absolutely fascinating. Of course, in the popular press, the one place that is singled out for its continuation of the old culture of drinking is the Palace of Westminster. Does he have a view on what role we should play in setting an example and does he agree that over the past few years the Houses of Parliament have been behaving absolutely immaculately?

Photo of Byron Davies Byron Davies Conservative, Gower

I thank my hon. Friend for that intervention. I can only quote my own example, which is one of extreme caution with alcohol, but it has been thoroughly enjoyable at times in the 12 months since I have been here. Of course, we should not be complacent.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich

I commend my hon. Friend for securing this debate. Does he recognise that we have to be wary of some of the statistics on alcohol-related admissions and alcohol-related morbidity and mortality data? Often, data on admissions to mental health hospitals are poorly collected. Indeed, now that public health services are divorced from the NHS and run by local authorities in England, we must be careful in assuming there is a downward trend. In fact, there is still a real problem with the overlap between mental health conditions and alcoholism.

Photo of Byron Davies Byron Davies Conservative, Gower

I am grateful for that intervention. I accept that we have to be very careful on that issue.

We should not be complacent. It is essential that public health advice keeps pace with advances in scientific understanding. Crucially, the communication of any guidance from the state must be seen to be above reproach and carry the confidence of industry and the public alike. However, I felt this debate was needed because I and several other hon. Members are concerned that the process by which the chief medical officer reaches their conclusion is flawed and has, in some ways, been hijacked by a group of campaigners with a clear anti-alcohol, total abstinence agenda.

Views are strongly held on this subject, which divides scientific opinion and the medical community. I recognise that that puts the CMO in a difficult position in making judgments about risk and in communicating sensible guidelines to consumers. We are bombarded with health advice from all quarters in this 24-hour social media age, and it is vital that anything published in an official capacity as advice from the Government’s chief medical officer is properly scrutinised and beyond reproach. I argue that the process that has been adopted, the clear conflicts of interest of the panel of so-called experts deployed to deliberate on these matters and the biased presentation of the findings have left a crisis of confidence in the new CMO guidelines among consumers, the media and industry. The Minister needs to address that in her response to the public consultation.

Let me deal with those points in turn. First, on the process adopted to undertake this review, the Department of Health guidance for expert group members states clearly:

“It is important to avoid any impression that expert group members are being influenced or appearing to be influenced by their private interests in the exercise of their public duties. All members therefore must declare any personal or business interests relevant to the work of the expert groups which may or may not be perceived by a reasonable member of the public to influence their judgment.”

Members of the guidelines development group set up to advise the CMO have been active policy advocates during the time in which the guidelines have been developed. Thanks to the investigative journalism of Sean O’Neill, chief reporter at The Times, it has come to light that an academic who played a key role in drawing up the controversial new safe drinking limits, Professor Gerard Hastings, did not even declare his links to the Institute of Alcohol Studies, a registered charity that receives most of its income from the Alliance House Foundation, which states that its aim is spreading the principle of total abstinence from alcoholic drinks. That is not quite putting Dracula in charge of a blood bank, but it is not far off.

Policy advocates such as Professor Hastings have taken strident campaigning positions. Many have a temperance or total abstinence axe to grind. They are clearly not neutral or, I argue, objective in their assessment of the costs and benefits of alcohol consumption. Indeed, the chief medical officer for England, when giving evidence to the House of Commons Science and Technology Committee on the proposed new alcohol guidelines, admitted that the experts

“found remarkably little evidence about the impact of guidelines, but we did not do them to have direct impact so much as to inform people and provide the basis for those conversations and for any campaigns that, for instance, Public Health England and others might run in the future.”

One member of the behavioural expert group, Dr Theresa Marteau, writing in the British Medical Journal, went further and stated that the new guidelines are

“unlikely to have a direct impact on drinking…but they may shift public discourse on alcohol and the policies that can reduce our consumption.”

Minutes from the guidelines development group meeting of 8 April 2015 state:

“It would be important to bear in mind that, while guidelines might have limited influence on behaviour, they could be influential as a basis for Government policies”.

There we have it. Never mind what consumers think about being told by the chief medical officer to think of cancer every time they hold a glass of wine or pour a can of beer, or that, as someone drinking a pint of beer a day, they are drinking more than they should. The not so well hidden agenda of the temperance activists is to influence Government policy to drive down alcohol consumption across the board. Wales has a strong Methodist and temperance tradition, which I respect, but I take issue with organisations such as the Institute of Alcohol Studies, which is funded directly by the temperance movement, helping to produce biased reports that are then given undue influence over the Government’s alcohol policy.

Having raised my concerns with the process adopted in undertaking the review, which I believe may have prejudiced the outcome and has certainly rendered the process lacking in credibility with consumers and the industry, I turn to the presentation of the review’s findings and, in particular, to the assertion that there is no safe level of alcohol consumption, the lowering of the recommended weekly levels for men in line with those for women, and the communication of risk. I believe that that assertion is at the heart of the flawed nature of the proposed guidelines and it is, in some respects, clearly deliberate on the part of campaigners. If the Government accept that there is no safe level of consumption, it becomes much easier to argue for more restrictions on alcohol availability,

Photo of Graham Stringer Graham Stringer Labour, Blackley and Broughton

I agree with the points the hon. Gentleman is making, specifically and generally. Does he agree that, not just on these guidelines but right across the board, Governments of all political colours have made a mistake in involving campaign groups and pretending that they are scientific experts? It is not just on alcohol, but in all sorts of other areas.

Photo of Byron Davies Byron Davies Conservative, Gower

I could not have put it better myself. I thank the hon. Gentleman for that intervention.

As I said, it becomes much easier to argue for more restrictions on alcohol availability, higher taxation of all alcohol regardless of strength, and more alarmist public health advertising to frighten people away from drinking. I am not a medic, but I have been around long enough to understand the old adages of “a little bit of what you fancy does you good” and “all things in moderation”—including international science. Indeed, looking into this further, I have discovered decades of evidence that shows the protective effects of low, moderate drinking.

Photo of Patricia Gibson Patricia Gibson Scottish National Party, North Ayrshire and Arran

Does the hon. Gentleman agree that new, revised alcohol guidelines will not of themselves necessarily change or reduce drinking, but they will increase awareness of potential harm? That is surely a good thing.

Photo of Byron Davies Byron Davies Conservative, Gower

I am not quite clear on the hon. Lady’s point. I genuinely believe that this is a kind of social engineering, which I totally disagree with. A recent survey commissioned by the Campaign for Real Ale showed that a majority of GPs disagreed with the new advice and believes that drinking alcohol in moderation can be part of a healthy lifestyle.

Photo of James Davies James Davies Conservative, Vale of Clwyd

I congratulate my hon. Friend on securing this debate. As a GP, I can confirm the current lack of faith in the validity of the guidelines. Many feel, for instance, that the social benefits of moderate alcohol intake have not been given sufficient weight. Does he agree that, if they are to be observed, it is vital that guidelines are trusted?

Photo of Byron Davies Byron Davies Conservative, Gower

That is the crux of the matter—my hon. Friend makes a very valuable point, which I am delighted that he, as a practising GP, has made.

Photo of Diane Abbott Diane Abbott Shadow Secretary of State for Health

The hon. Gentleman talks about the alcohol guidelines as social engineering, when they are actually designed to bear down on the health harms from alcohol consumption. How can he call it social engineering when the Government are trying to ensure that our fellow citizens are healthier and live longer?

Photo of Alan Meale Alan Meale Labour, Mansfield

Order. Before the hon. Gentleman resumes, it pains me to do so but I have to point out that it is not in order for the Front Bench spokesperson to participate in questioning. Ms Abbott will get time to sum up for the Opposition at the end.

Photo of Byron Davies Byron Davies Conservative, Gower

I am grateful for that guidance, Sir Alan. The proposed new guidelines do not reflect the full international evidence base on alcohol and health, and actively downplay decades of epidemiological evidence that shows the protective effects of low to moderate drinking against cardiovascular disease, stroke, type 2 diabetes and cognitive—

Photo of Byron Davies Byron Davies Conservative, Gower

If the right hon. Gentleman will forgive me, I really need to move on.

To quote a no less august body than the Harvard T.H. Chan School of Public Health in the United States:

“More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk.”

The US Government’s National Institute on Alcohol Abuse and Alcoholism supports that position.

One crucial point is not scientific, but about responsibility. I am a proud Conservative. Therefore, like most sensible people, I believe that, by and large, people can make their own decisions about their lives. I am not advocating that people go out and smoke 100 cigarettes, drink heavily, eat mountains of butter or consume mounds of sugar. However, if people want to enjoy the company of their friends with a fine pint of British beer that has been brewed using British ingredients following a fine art that has been honed carefully over our history, who are we to stop them? The medical advice I have listed remains clear indeed.

Curtis Ellison is professor of medicine and public health at Boston University School of Medicine, and director of the International Scientific Forum on Alcohol Research. He says:

“Statements suggesting abstinence is better than light drinking in terms of health and mortality are erroneous and do not reflect current scientific literature, with well-conducted studies showing that mortality is lower for light-to-moderate drinkers than for lifetime abstainers.”

As a nation, we have always believed in the fundamental good sense of the British people and, although my confidence was shaken by last week’s events, we have allowed people to decide what is best for their own lives. The pub is a crucial part of the social and cultural fabric of the UK. There are few things that are as crucial a part of our identity and history as the casual, relaxed pub culture that Britain has enjoyed over hundreds of years. Indeed, the importance of the pub—casual and social drinking—to people’s mental and physical wellbeing is marked.

The Oxford University and CAMRA-instigated report, “Friends on Tap” acknowledges the benefits of pubs to wellbeing. By telling people there is no safe level of drinking, we could be denying millions the positive social effects of going to the pub and the positive effects on the community. The results from the pub surveys suggest that people who go to small community pubs have more close friends and feel that their communities are better integrated. Indeed, small community pubs are now vital in supporting community services.

Pub is The Hub has supported many pubs across the length and breadth of the UK to stay open, become community owned and offer vital services. The services on offer include internet lessons and provisions, restaurants, post offices and shops. The pubs have been transformed into a social hub and are providing services that are vital to communities’ very survival. I fear that alarmist advice threatens not only pubs but the threads with which our communities are weaved together.

To further support my case, the findings of Oxford University suggest that pubs in general, and local community pubs in particular, may have unseen social benefits. Pubs provide us with a venue in which we can serendipitously meet new and, in many cases, like-minded people. They offer an opportunity to broaden our network of acquaintances, which has advantages. There is a potential to translate acquaintances into new friendships and to widen our contact with a greater diversity of cultural groups by bringing us into contact with people from other walks of life and other cultures, whom one might never otherwise meet.

Pubs allow us to engage in conversation with, and get to know better, other members of our local communities. By extension, they allow us to mix, meet a wider range of community members, and interact with a greater diversity of social classes and cultures than would otherwise be the case if our social world was confined to work and home.

Closer to home and on the benefits of moderate alcohol consumption, Dr Richard Harding was a member of the Government’s 1995 inter-departmental working group on sensible drinking. In written evidence submitted to the Science and Technology Committee in 2012, he outlined the changes in available evidence since 1995, including the strengthening of the evidence base around the range of health benefits of moderate alcohol consumption. He said that the key findings are:

“Clear evidence that the frequency of drinking is as important as, or even more important than, the amount of alcohol consumed. All epidemiological studies show that the more frequent drinkers, including daily drinkers, have lower risks for many diseases than do individuals reporting less frequent drinking… Firmer evidence for the protective effect of moderate alcohol consumption for coronary heart disease, as well as further clarification of the mechanisms for the protective effect…Evidence for an approximately 30% reduction in risk for type 2 diabetes for moderate drinkers…Evidence that moderate drinkers have less osteoporosis and a lower risk of fractures in the elderly compared to abstainers…Evidence that light to moderate drinking is associated with a significantly reduced risk of dementia in older people…Increasing evidence that moderate drinking should be considered as an important constituent of a ‘healthy lifestyle’”.

Dr Alexander Jones of the University College London Institute of Cardiovascular Science says:

“There have been a couple of studies which showed that if they were randomised to either just eating a Mediterranean diet or eating a Mediterranean diet and drinking a glass of red wine a night, that those who drank a glass of red wine a night had better cardiac function over time.”

That international consensus is rejected at a stroke by the CMO’s proposed new guidelines in favour of a “no safe limits” narrative. The statement of no safe levels sends out confusing and contradictory messages to consumers and will serve only to generate public mistrust in the health service.

David Shaw, senior researcher at the Institute for Biomedical Ethics at the University of Basel says that

“the ‘no amount is safe’ message undermines the new recommended limit for men and the retention of the limit for women. Why should people attempt to adhere to the new limits rather than the old ones if they are also being told that the new recommended levels are not safe? Giving such a mixed message further increases the likelihood that the guidelines will not be taken seriously.”

Dr Augusto Di Castelnuovo, professor of statistics and epidemiology at the Institute for Cancer Research in Italy says:

“The new recommendation that there is no ‘safe’ alcohol limit is misleading: low to moderate consumption up to one-two units a day in women, up to two-three in men of any type of alcohol—with the possible exception of spirits—significantly reduces the risk of cardiovascular disease. Moderate drinking is associated with a modest excess risk of oral and pharyngeal, oesoph”—

I will forget that word—

“and breast cancers. But the balance between these two different effects is in favour of drinking in moderation.”

As well as concerns about the language of “no safe level”, considerable concern has been expressed about the communication to consumers of the level of risk associated with alcohol consumption. It is really important that we put risks in context so that consumers can make informed choices.

Ignorance of the international evidence has been heavily criticised by the Royal Statistical Society. In the key points in its response to the consultation, it states:

“We are concerned that, in their recent communications about alcohol guidelines, the Department of Health did not properly reflect the statistical evidence provided to the Expert Guideline Group, and this could lead to both a loss of reputation and reduced public trust in future health guidance…We are concerned that scepticism concerning the guideline process might apply to future pronouncements concerning arguably much greater health risks associated with inactivity, poor diet and obesity that, unlike alcohol consumption, are increasing problems. Once public trust has been lost, it is extremely difficult to win back, and you will have lost a key tool in managing future behavioural change.”

Those key points are on not just alcohol consumption but how we will view future medical advice from the Department of Health. The public must have confidence in our great institutions and be of the belief that they are serious and sober in their analysis while also realistic about people’s life choices and lifestyles.

We have worked so hard as a nation, with industry and Government working hand in hand to reduce serious problem drinking. Do not misunderstand me: I know there is some way to go on this matter and I am fully supportive of the efforts to curb problem drinking and tackle its health effects, but we must not remove industry from this process and we cannot let serious medical advice be tainted by alarmist and prescriptive guidelines that threaten to undermine the whole process we have embarked on.

Let me turn to the new CMO 14-unit weekly prescription for men and women, which would effectively make 2.5 million more of our male constituents problem drinkers overnight, classed as increasing risk from low risk by virtue of the fact that they might drink more than one pint a night in the pub. Immediately following this announcement, we saw The Guardian’s front page article asserting that as we now have in excess of 10.5 million people “drinking harmfully”, further regulatory interventions were needed. That was backed up by members of the Guidelines Development Group, including the chief executive of the Institute of Alcohol Studies. Job done—they moved the goalposts and scored straight away. But the established international precedent in 30 countries worldwide is that men and women are set different guidelines reflecting differences in alcohol metabolism due to body size and weight as well as the lower body water content and higher body fat content of women. Aside from the UK, there are only five other countries that recommend the same guidelines for men and women: Australia, the Netherlands, Albania, Guyana and Grenada.

Dr Erik Skovenborg from the Scandinavian Medical Alcohol Board and board member at the European Foundation for Alcohol Research said:

“I am surprised to see the same limits for weekly alcohol consumption for men and women, in spite of the well-established greater susceptibility of women. The danger is that the new guidelines will give women the false impression they are on a par with men in their ability to tolerate alcohol.”

The CMO told the Science and Technology Committee that the guidelines were primarily informed by new evidence on alcohol and cancer:

“the science has moved on...we know a lot more about the impact of alcohol on the development of cancer and on the risk of cancer”, yet guidelines for women have remained the same, while guidelines for men have been reduced based on modelling of acute harms such as accidents and injuries. I simply cannot concur that that is sound medical advice on a number of levels.

Those of us who favour a partnership approach to these matters are very concerned that this triple lock—of proceeding with the language of “no safe level” in the face of international evidence to the contrary, of promoting the notion that men and women have equal tolerance levels to alcohol and of Britain needing to have the most stringent alcohol guidelines in the world, despite the positive recent developments in tackling alcohol harm—is a triple whammy that threatens to undermine the significant recent progress we have made, with industry and Government working together to tackle alcohol harm.

Sitting suspended for Divisions in the House.

On resuming—

Photo of Byron Davies Byron Davies Conservative, Gower 5:50 pm, 28th June 2016

I had about 20 seconds left when the Division bell rang, so I will bring my speech to a close by saying that a triple whammy threatens to undermine the significant recent progress made by the industry and the Government working together to address alcohol harm. The triple whammy also threatens to do significant harm to our communities. We cannot afford to threaten the key bonds and relationships that tie many local communities, particularly rural ones, together.

I fear that this advice will take us down a dangerous path. As we have heard, the advice is not medically sound, and it is certainly not in the best interests of these vital community assets. I call on the Minister to act. Unless she rejects the “no safe level” narrative, the new alcohol guidelines will lack credibility, carry no authority with consumers and potentially cause the industry to rethink its voluntary commitments, all of which will be retrograde steps. I am sure that that is not her intention, as she has worked tirelessly on this issue.

Several hon. Members:


Photo of Alan Meale Alan Meale Labour, Mansfield

I have a few guidelines for Members before we continue. We have overrun quite a bit, and we are now scheduled to conclude at 6.27 pm. It is normal practice to give a couple of minutes to the mover at the end to wind up, with the Minister getting 10 minutes and the two Opposition spokespeople five minutes each, which takes us to 6 o’clock. We do not have much time left for Back Benchers, but there is sufficient time for Members to get their message across.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Health), Shadow DUP Spokesperson (Transport), Shadow DUP Spokesperson (Equality) 5:51 pm, 28th June 2016

I congratulate Byron Davies on securing this debate. I am conscious of the shortness of time, but I will try to bring some balance to the debate. I have great respect for the Minister, but we have to consider the guidelines. The guidelines are based on the recommendations of the advisory group, which asked the Sheffield alcohol research group to publish a report, and they are very clear: men and women should not regularly drink more than 14 units a week and, if they drink as much as 14 units, it should be spread evenly over three or four days. The Royal College of Nursing, Cancer Research UK and the National Institute for Health and Care Excellence support the guidelines. There is a clear link between alcohol and cancer. Those are the medical facts on which the Minister will respond.

The Campaign for Real Ale has raised many concerns, and it alleges that there is overwhelming evidence that moderate alcohol consumption can be part of a healthy lifestyle. The hon. Gentleman made that point clearly in his introduction. It is about balance and people knowing their limits. He also mentioned promoting social wellbeing, and for many people modest alcohol consumption in pubs enables us to build friendships and create a sense of community.

The industry was thought to be dying, with literally dozens of pubs closing each week, but pubs have now become vital community facilities that bring local people together. Pubs have increasingly diversified to provide much-needed services such as village shops, post offices and even housing for defibrillators. We have seen a beer revolution, and there is no constituency anywhere in the United Kingdom that does not have its own local beers and local gins. Alcohol sales are worth some £40 billion, which does not factor in the associated income from activities and events involving alcohol. Wines and spirits directly and indirectly support 512,000 jobs, 69% of which are directly dependent on the industry’s stability and success.

The issue of problem drinking has to be addressed. The industry points to the fact that most people in this country are moderate drinkers. Research shows that 60% of alcohol sales are made either to those who are risking their health or to harmful drinkers who are doing themselves potentially lethal damage. More than 1 million hospital admissions a year are related to alcohol—double the number 10 years ago.

The UK has an alcohol problem, but as with many policy areas, striking a balance, while incredibly difficult, is essential. We cannot harm those who want to enjoy a drink—not to the point that they end up in A&E—but at the same time it is right to warn people of the perils of excessive drinking. The solution lies in education from as early an age as possible. We still have teen drinking; despite existing education and awareness campaigns, the reality is that teen drinking continues. People need to be made aware why they need to watch what they drink, rather than simply being told to do so.

I will conclude, because I am very conscious that other Members want to speak. Recommendations seem to be continually ignored by all age groups, which is regrettable. To see real change—the change we want—there needs to be more awareness, and that awareness needs to be created in a positive manner, so that drinkers manage their own intake because they want to and not because they are being coerced into doing so.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton 5:55 pm, 28th June 2016

It is a great pleasure to serve under your chairmanship, Sir Alan, and to address the issues raised by my hon. Friend Byron Davies. They are hugely important issues and he got into the detail of them.

I am also pleased to take part in a debate with the Minister, because she has worked really constructively with the industry during her time in office. The work that she has done in lowering the alcohol by volume in drinks, as a result of working closely with the industry, has taken a billion units out of consumption. That shows that constructive working can have a huge impact on the nation’s health and the nation’s drinking habits.

I should declare an interest as the chairman of the all-party group on beer, and colleagues should see my entry in the Register of Members’ Financial Interests; I am also the patron of a drug and alcohol rehabilitation centre in my constituency. I want to see a healthy drinks industry and a healthy population, and those two things are not mutually exclusive.

In Government, we used to have something called “the nudge unit”, to try to persuade people and help them to make the right choices. However, we are seeing “Project Fear” in this approach and we saw in the referendum that that approach simply does not work. At a stroke, we have made 2.5 million people problem drinkers. Let me tell the tale of my auntie, Irene. She died at the age of 88. Before she died, she used to enjoy a bottle of Mackeson Stout every evening. According to these guidelines, she was a problem drinker. That is what we have done. These guidelines are so against the grain of the way that people live their lives that we risk people ignoring them and ignoring other advice, and going on regardless, so that the guidelines become absolutely pointless.

For instance, Sir Alan, you will be surprised to know that according to these guidelines the Minister can drink exactly the same amount of alcohol as my right hon. Friend Sir Eric Pickles. I have never been drinking with the Minister, but that does not seem to make any sense at all. Size, and the way in which men and women absorb alcohol at different rates—none of that is being taken into consideration.

It is interesting that in a written answer to my hon. Friend Tim Loughton the Minister said that, although we have specific guidelines on calorie intake for men and for women—that guidance is differentiated—we do not have them for the intake of alcohol. That just shows that there is absolutely no sense in the way this guidance is being proposed.

My hon. Friend the Member for Gower referred to the concerns that exist about the way this report was drawn up and about the organisations that took part in the research, including those involved in the temperance movement. I am also concerned that in a written answer to my hon. Friend the Minister wrote that

“The National Institute for Health Research has awarded funding to The University of Sheffield… to evaluate the new drinking guidelines.”

That is a case of people marking their own homework, and we should all be very concerned about that. There are real concerns about the rigour with which this information has been compiled and we risk people turning off and not taking any notice, which could damage the health of the nation.

I realise that other Members wish to speak and that time is pressing. I appreciate the efforts that the Minister has made to work with the drinks industry, but this guidance came as a bolt from the blue. The industry knew nothing about it. There was no consultation. Nobody from the alcohol industry was involved in peer-reviewing the evidence, so I hope that we will reconsider. I realise that it is an independent report, but I urge the Minister to reconsider the validity of the evidence, because it just does not stack up.

Photo of Alan Meale Alan Meale Labour, Mansfield

Before I call the last two speakers, I should inform you that, as I said before, we will have to start the winding-up speeches at five minutes past 6, so if you can, please share the time remaining.

Photo of Patricia Gibson Patricia Gibson Scottish National Party, North Ayrshire and Arran 6:00 pm, 28th June 2016

I will be as brief as possible, Sir Alan. I thank Byron Davies for securing this debate. The main point that I want to make is that this entire debate must be viewed in the context that we across the United Kingdom have a problematic relationship with alcohol. We know that the new guidelines will not automatically change how people drink or their relationship with alcohol, but if they do anything at all to raise awareness of the risk of harm and the newly discovered and developing link between cancer and alcohol intake, I for one think that that is a good thing.

In the Scottish Government, we are considering minimum pricing for alcohol as one tool in a whole host of tools to redefine our relationship with alcohol, but to call a revision of the guidelines for consumption “social engineering” is a step too far. I do not think that over-the-top comments are helpful in this debate. I speak as somebody who has a great affection for a glass of wine at the end of the evening. We all want the same thing; we want people to enjoy moderate, healthy drinking. We do not want to demonise alcohol. Most people do not have a problematic relationship with alcohol, but we cannot ignore the fact that it is a blight on too many families and communities. If we can raise awareness of risk and harm and educate the public, not dictate to them, so that they can make informed choices, I genuinely cannot understand why anybody would have a problem with that. I will conclude my remarks on that note.

Photo of Mike Wood Mike Wood Conservative, Dudley South 6:02 pm, 28th June 2016

We as Members should question the credibility of alcohol advice, but our primary role is surely to consider the wisdom and effectiveness of such guidance from a public policy viewpoint. The guidelines fail to acknowledge the decades of research demonstrating that moderate alcohol consumption is compatible with a healthy lifestyle. Multiple studies since the 1970s show that light to moderate alcohol drinkers have a lower mortality rate than non-drinkers or heavy drinkers. When plotted on a graph, the relationship between moderate consumption and total mortality appears as a J-shaped curve, demonstrating the benefits of light to moderate alcohol consumption compared with both abstinence and heavy drinking.

I would not presume to argue with the chief medical officer’s opinion that any alcohol is damaging, but I do not believe that as a matter of public policy, an abstinence approach is either wise or effective. We recognise that recommending abstinence is a counterproductive policy in tackling teenage pregnancies, yet we are asked to imagine that saying that there is no safe amount of alcohol is an effective way of tackling alcohol abuse. The previous unit limit might have been an arbitrary figure, but it was a realistic target for most people and helped reinforce the message that alcohol needs to be kept to light and moderate levels. The guidelines threaten that.

As well as significant evidence about physical health, there is growing evidence about the benefits of moderate alcohol consumption in a safe and social environment for mental health. In particular, a recent study commissioned by the Campaign for Real Ale from Oxford University found that people who regularly visit a community-type pub tend to have more close friends on whom they can call for support, and that they are happier, healthier and more trusting of others. A moderate amount of alcohol improves wellbeing and some social skills, just as it has been shown to improve other cognitive abilities and health.

Any future guidance must, of course, be cautious, but it should also recognise the protective effects of moderate alcohol consumption. I also advocate withdrawing the advice that there is no safe level of alcohol consumption so that we can concentrate on the social and medical benefits of limiting alcohol consumption to moderate levels.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Cities) 6:04 pm, 28th June 2016

It is a pleasure to be able to speak in this debate. I congratulate Byron Davies on securing it.

This debate has highlighted the fact that statistics can be used to prove just about anything. It is important that people out there have confidence in the statistics and the guidance that they are given, and I am concerned that the Royal Statistical Society seems to have a bit of a worry about the guidance that has been put forward—particularly on the issue to do with intake for women and men. There is evidence to suggest that women’s and men’s bodies absorb alcohol slightly differently, and that really ought to be acknowledged so that each individual gets the best advice possible.

Andrew Griffiths talked about the differences between people. My brother is 6 feet 4 inches and his girlfriend is about 5 feet 2 inches, and there are obviously stark differences between them. Having said that, unless people are going to have a personalised alcohol prescription, it is quite difficult to be specific. We have to have general guidelines that give people an idea of what they can expect. People have to know their limits, as Jim Shannon said. He also said that 60% of alcohol sales are to problem drinkers, which is an issue that we have had in Glasgow and the west of Scotland. As my hon. Friend Patricia Gibson said, alcohol consumption significantly blights families.

Organisations such as the Glasgow Council on Alcohol, through their community work, seek to get people talking about the impact that alcohol has on communities. As the Glasgow Centre for Population Health has found, inequality has a significant effect. In Glasgow, the most deprived communities have five times more of a problem with alcohol than the least deprived communities.

Alcohol guidelines are not just about pubs, as the hon. Member for Gower seemed to be suggesting. I very much support the real ale industry, and CAMRA does really good work and has transformed the way people look at alcohol—they go for quality rather than quantity in some cases—but the fact remains that many people, particularly in deprived communities, are not going to a nice, cosy real ale pub; they are going to the local shop on the high street and buying large volumes of alcohol, which will do them significant damage.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I agree with much of what the hon. Lady is saying. Does she share my concern about telling people that alcohol can cause them to misjudge risky situations, cause accidents and cause them to lose self-control, and giving them advice about drinking alcohol before going up a ladder? That is not the kind of advice about alcohol that people expect, and the risk is that the general public will have no confidence in the guidelines.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Cities)

We need to be aware of the impact of alcohol generally. John Howell spoke earlier about alcohol in the House of Commons, which is still a concern for me. I was at an event earlier celebrating tennis—a nice, healthy activity—and there was booze. I could get a drink at lunchtime. I do not think that is acceptable. The House of Commons should consider whether it is appropriate for people to have a drink with their lunch at events that take place during a working day. I am not convinced that it is.

The Scottish Government have a framework for action on alcohol. We pursued the Alcohol (Minimum Pricing) (Scotland) Act 2012, which, due to the alcohol industry, has been bogged down in a legal dispute. Importantly, it is about trying to cut down the number of people buying large volumes of alcohol. We are trying to change that behaviour and get people to think about how their drinking is affecting their health.

Evidence that organisations such as the Glasgow Centre for Population Health have looked at suggests that we need a change in attitude. There are people who are damaging their health severely every day. This is not about an auntie who drinks a wee drink before she goes to bed or anything like that. It is about people who are drinking more than they should and drinking in unhealthy ways, which has an impact on their health and their ability to go about their business safely.

I saw a study from the Glasgow Centre for Population Health a few years ago that suggested that, in the most deprived areas of Glasgow, people who drink quite a lot end up in hospital more than people who drink an equivalent amount in better-off areas, because their lifestyles and the things around them do not keep them safe. Someone in a well-off area might be having a bottle of wine every night, whereas someone in a poorer area having something else is far more likely to come to harm. There are serious considerations not only about public health but about how we think about alcohol in general, and about the guidelines that are put in place to get people to think about how much they are drinking and what they can do to reduce their intake, be healthy and happy and have a good role in their families and communities.

Photo of Diane Abbott Diane Abbott Shadow Secretary of State for Health 6:10 pm, 28th June 2016

I congratulate Byron Davies on securing this very important debate. The most important thing to stress is that this is not a moral issue—hon. Members have talked about abstinence and so on—nor is it about pubs, many of which are reinventing themselves by serving food and providing craft beer. I welcome the social haven provided by pubs. This is about the health of the nation, and it is interesting that Members have skirted around the health issues. That is why we have guidelines; it is not because the chief medical officer wants to stop people having fun. At the end of the day, any Government must have care and concern for the health of the population, and particularly of young people.

Let us spell it out: alcohol is one of the most well established causes of cancer. It increases the risk of mouth, throat, voice box, food pipe, breast, liver and bowel cancers. It astonishes me that Members who I suspect know those things are still standing in this Chamber criticising Government attempts to bear down on alcohol consumption.

This is about not just the scientifically proven contribution of alcohol consumption to ill health, but its contribution to social disorder. In 2014, the University of Bath estimated that the annual cost of binge drinking was about £4.6 billion. That includes A&E attendances, road accidents, alcohol-related arrests and the number of policemen involved. If someone goes into any A&E department almost anywhere in England or Scotland on a Saturday night, they will see disproportionate numbers of people who are there because of alcohol abuse. It astonishes me that hon. Members show no concern about the billions that that is costing our health service, or about the life chances and quality of life of people who engage in binge drinking. Of course, the abuse of alcohol is also very closely related to domestic violence. If Members are not concerned about the link to cancer and ill health, or about what alcohol is costing our health service, or about social disorder or domestic violence, I wonder what it will take.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

Can the hon. Lady tell me of just one sentence today in which any Member has said that they are not concerned about the effects on health, or about domestic violence or alcoholism? This is a ridiculous speech—I realise that she is new in her position, but I suggest that in future she does a little more research before she comes to the Chamber.

Photo of Diane Abbott Diane Abbott Shadow Secretary of State for Health

I have to advise the hon. Gentleman that I was a spokesperson on public health for three years for the Labour party. Not only did I do research on the health issues around alcohol, but I visited other countries—notably Scandinavian countries—to see what they had done. My point is that if hon. Members are willing to come here without spelling out the issues that I am describing, it must suggest to anybody listening to or reading the debate that they put them below the interests of the pub trade.

Photo of Patricia Gibson Patricia Gibson Scottish National Party, North Ayrshire and Arran

Does the hon. Lady agree that as well as health issues, social disorder and domestic violence, there is a huge impact on the economy from lost productivity and work days caused by people phoning in sick because they had too much to drink the night before?

Photo of Diane Abbott Diane Abbott Shadow Secretary of State for Health

I thank the hon. Lady for that. We can only look at the guidelines in the context of the social harm of alcohol abuse, and the guidelines are designed to bear down on alcohol abuse. It is too early to say how effective they are, but the principle of the Government acting to bear down on the social harms and costs of alcohol abuse must be correct. Like some other Members, I have visited hospital wards that have to deal with people whose health has been ruined by binge drinking. If hon. Members had seen what I have seen—

Photo of Diane Abbott Diane Abbott Shadow Secretary of State for Health

I am afraid I have to complete my remarks. If some hon. Members really understood the social harms and costs to the nation of alcohol abuse, they could not have made the speeches they made this afternoon.

I welcome the guidelines. It will take time to decide whether they are exactly right and what their effects are, but we need a holistic strategy on alcohol abuse. When I was public health spokesperson for my party, I believed in a minimum price for alcohol. There is more that we can do on classroom-based education, but I have no doubt that the thinking behind the alcohol guidelines is correct. I also have no doubt that as Members of Parliament with a responsibility to our communities, we should do everything we can to bear down on problem drinking.

Photo of Jane Ellison Jane Ellison The Parliamentary Under-Secretary of State for Health 6:16 pm, 28th June 2016

I thank colleagues for bearing with our rather interrupted debate. I am fairly confident that I will not have time to discuss all the issues in my response, but as some colleagues are aware, my door is always open, and I have a proposal towards the end of my speech for how we might continue the discussion.

First, I congratulate my hon. Friend Byron Davies on securing this debate and on opening it so authoritatively. We are all aware of the impact of alcohol misuse, which was well summed up by the shadow Minister, who is knowledgeable about that. She reminded us of some of the pressure it puts on our vital public services. It is right that we give this issue our attention.

I know that people have asked why we need new guidelines when alcohol consumption is falling. My hon. Friend, in introducing the debate, talked about some of the areas in which we have had welcome improvements in the statistics. The majority of people drink alcohol in an entirely responsible way. In 2014, 59%—just over 25 million adults—drank within the new guidelines, so it is important to stress that quite a lot of people drink that amount or less at the moment.

As a Government who believe in informed and empowered consumers, we have a responsibility to provide clear information to help people make informed choices about their drinking. The guidelines are not about preventing those who want to enjoy a drink from doing so. Goodness knows, as a passionate remainer, I can certainly say that guidelines of all sorts have been suspended in my household for the past week or so. This is about ensuring that people get common-sense advice and practical information, and some of that will be about things like taking days off from drinking. There is an appetite for that; we know that from the research we have done with people.

The new low-risk drinking guidelines are the means by which the four UK chief medical officers, working together, provide the public with the latest and most up-to-date information about the health risks of different levels and patterns of drinking. Let me clarify at the outset, in case I run out of time, what the guidelines are not. Nobody has said that more than 14 units is considered harmful or problem drinking. It is just not recommended as low risk. To be clear, there is no public policy on abstinence. The guidelines are not about the rate at which alcohol affects men and women in terms of intoxication, but how it affects their long-term health.

Photo of Jane Ellison Jane Ellison The Parliamentary Under-Secretary of State for Health

If colleagues will forgive me, I have very little time. I will not even have 10 minutes. I will give way, but it means I will not get through my speech.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I have a very simple question. Does the Minister think there is no such thing as safe drinking?

Photo of Jane Ellison Jane Ellison The Parliamentary Under-Secretary of State for Health

I will come on to deal with some of the issues, but I will also make a suggestion for how we take this discussion forward. The issue outlined was about the extent to which alcohol affects people. The second part of the consultation, to which a response has not yet been published—I will come on to talk about that—is about how we express and communicate the new guidelines. That is slightly different from the science that sits behind them. I want to try to pull those two things apart. Clearly we have a job of communication to do, because we want to be helpful to the public.

Perhaps it would be useful to remind Members how we arrived at this review. It was not Ministers who asked the chief medical officers to do it but Parliament. The previous guidelines came out in 1995, and in 2012 the Science and Technology Committee recommended that they should be reviewed because they had not been for so long. It is fair to say that there are a lot of places around the world where such guidelines have not been looked at for a long time, so the evidence base is not as up to date as it could be. There was a lot of parliamentary interest, especially in the previous Parliament, in guidelines—for example, in the harmonisation of the pregnancy guidelines when we had debates about foetal alcohol syndrome.

At the request of the four UK chief medical officers, three independent groups of experts have met since 2013 to look at both the scientific and the behavioural evidence of the health effects of alcohol. Those groups were made up of international experts in the field of epidemiology, public health, liver disease, behavioural science, science communications and evidence-based alcohol policy. None of those people were members of the temperance movement.

To ensure that the guidelines are as practical as possible, after their publication the Government held a public consultation to gather views on their clarity, expression and usefulness. I should clarify something that is important: the Royal Statistical Society supported the evidence review and the conclusions. It was very specific in its challenge about how the Department of Health presented it in the launch. That is exactly why there was then a consultation about how we express and discuss the guidelines. To be clear, though, the RSS did not question the evidence review or its conclusions.

As part of the consultation process, Public Health England has undertaken market research to test understanding and acceptance of the guidelines—just the points that colleagues have asked about. Overall, the results were positive, showing that the language was understood and accepted and the tone appropriately informational. That is the tone we are trying to achieve: informational, not hectoring or nannying. The expert group has now reviewed the consultation responses and market research and has put its final recommendations to the four CMOs for their consideration. We intend to publish the final guidelines and the Government response to the consultation as soon as possible.

We of course recognise that industry has a key role in communicating the new information to consumers, particularly through labelling. I thank my hon. Friend Andrew Griffiths for his remarks. As he knows, as a Back Bencher in the previous Parliament I was an active member of the all-party groups on pubs and beer. I had the honour of being the guest judge of the pale ale category at the Battersea beer festival on more than one occasion. To declare an interest, I am a member of the Campaign for Real Ale. I could not agree more that a well-run pub or bar can be a great way to help people to drink responsibly while maintaining social contact.

Nevertheless, the industry needs to enable those who want to moderate what they drink to do so. It has done some really good work on that. The work with the industry in the previous Parliament on alcohol units was very useful. I always have a further challenge for the industry. One thing we can do to reduce the number of units people consume and to develop that wider choice is to put more emphasis on lower-alcohol products. When I have spoken to them, I have always been very honest with industry spokesmen that greater promotion of lower-alcohol drinks can help people to get into healthier habits. Simple switches can help. I want to put on the record that just by swapping from a pint of beer or lager at 6% strength to a pint at 4% strength, people could cut their units by a third—that is, they could take out 1.1 units. They could still enjoy their pint but cut their alcohol intake by a third.

The chief medical officer had a successful meeting with the Portman Group yesterday, confirming willingness on both sides to continue to work constructively together and to deliver benefits to the public and good information to our constituents. There are reasons for optimism in some of the alcohol statistics, but the shadow Minister is right that there are some significant and often highly concentrated problems. We need to give people the best and most up-to-date advice. We recognise that it is not for the Government to tell adults what to do in their private lives, but we do have a role in enabling the public to make informed decisions about their health based on up-to-date guidelines and the best science.

I am grateful to the chief medical officer, who has confirmed that she is happy to hold a parliamentary drop-in briefing for colleagues to discuss the matter further. It simply is not possible to pick up many of the detailed points that have been made on the various international studies in the time available. For the record, the review scrutinised all the available high-quality evidence and covered the findings of 63 systematic reviews from the evidence worldwide. It was a major undertaking. I think it would be useful for colleagues to be able to come along and discuss some of the studies that have been cited. Some of them are in different countries and some, it must be said, are based on different situations in terms of the nature of the national health service and the health support in those countries. I do not have time to go into that factor, but it is relevant for some of the comparative remarks that were made.

I hope I have reassured colleagues that we want to move forward in a sensible way. We want to give people the best information and we want to communicate it with clarity. Change will not happen overnight, but we want to raise awareness of the health risks, particularly around some of the links, such as between breast cancer and alcohol. We have a vastly better understanding of that than we did in 1995, and that has come through in recent years. It is important that we reflect that and continue to communicate it. I hope we can move forward constructively from here. I will set up the meeting that I offered. I sense from the Chamber that there is an interest in having further constructive dialogue. I leave a couple of minutes to my hon. Friend the Member for Gower to close the debate.

Photo of Byron Davies Byron Davies Conservative, Gower 6:26 pm, 28th June 2016

This has been an interesting debate. I am most grateful to everyone who has taken part. I particularly thank the Minister for her remarks at the end. I just want to mention one thing, which relates to a point that the shadow Minister made. I spent 32 years as a senior Metropolitan police officer, and choosing to blame alcohol for just about everything is quite ridiculous. The issue is about personal responsibility, and the debate is about encouraging moderate and responsible drinking. That is what we are here to discuss. The points have been well made, and I am grateful to everybody, but particularly grateful to the Minister for responding and to you, Sir Alan, for your chairmanship.

Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).