Alcohol Strategy (EUC Report)
(8 years, 10 months ago)
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Baroness Prashar
That the Grand Committee takes note of the Report from the European Union Committee, A New EU Alcohol Strategy? (8th Report, Session 2014–15, HL Paper 123).
Baroness Prashar (CB)
My Lords, I move this Motion as chairman of the European Union Sub-Committee on Home Affairs, Health and Education, which prepared the report to which this Motion relates. Before I get into the substance, I thank the current and former members of the committee, the former clerk to the committee, Michael Collon, and its policy analyst, Lena Donner, for their assistance with the preparation of the report.
As your Lordships all know, alcohol is a major contributor to loss of life and to the burden of disease in Europe. Harmful and hazardous, alcohol use is associated with a wide range of physical, psychological and social harms. The costs to individuals, communities and society are widely recognised. Europe has the highest per capita alcohol consumption of any region in the world. In 2004, the World Health Organization estimated that in the European Union, 11.8% of deaths of people aged 15 to 64 had causes attributable to alcohol. Alcohol also causes harm to others, through drink-driving or domestic violence, while heavy drinking can cause harm to unborn children. To address these problems, in 2006 the European Commission adopted an EU strategy to support member states in reducing alcohol-related harm. This strategy had five priorities: to protect young people, children and unborn children; to reduce deaths and injuries from alcohol-related road accidents; to reduce alcohol-related harm among adults; to increase education and awareness; and to develop and maintain a common evidence base. This strategy expired in 2012 and so far, it has not been renewed.
The sub-committee on home affairs, with its joint responsibility for health and crime, undertook an inquiry which started in July 2014 and was completed in March 2015. Our aim was to assess the 2006 to 2012 alcohol strategy and in part to determine whether there was any value in further EU action in this area. We took evidence from academics, medical professions, non-governmental organisations and industry representatives. Not surprisingly, the evidence was highly polarised and there was no meeting of minds between the public sector professionals and the alcohol industry. But in assessing the first strategy, it was clear that it is difficult to attribute outcomes accurately to any one policy measure or strategy. This difficulty was compounded by the complexity of the cultural, economic and social differences across member states. Furthermore, we found that there was a lack of research indicators, standardised data collection systems and evaluation mechanisms. The strategy has notably failed in achieving one of its key priorities: to develop a common evidence base.
Another fundamental problem was that the EU has only limited competence in health and that the strategy concentrated on matters where the EU could do no more than encourage action by other member states. It ignored a number of areas where it has competence to take action—for example, on EU alcohol taxation regimes or EU rules on food labelling.
Our witnesses said that there should be further action at EU level and that this should take the form of a new strategy. The public health lobby favoured much more action to combat alcohol abuse, although much of it is outside the competence of the EU. Manufacturers, retailers and advertisers of alcoholic drinks nearly all favour the continuation of the same strategy, but our conclusion was that action is worth formulating at the EU level only to the extent that it supplements and supports what member states do independently.
There is in fact considerable scope for action at EU level that is within the competence of the EU. Our conclusion was that action should not be confined to policies dealing specifically with alcohol misuse, though there should be what is called a “health in all policies” approach in related areas such as food labelling, cross-border marketing and taxation. This would bring greater coherence across EU policy areas while respecting the competence of member states in health matters. We also concluded that action is more effective if targeted at specific populations. Accordingly, EU-level measures should be flexible enough to allow members to adapt them to the national context.
The EU alcohol taxation regime is illogical. While beer is taxed based on its alcohol content, wines and ciders may be taxed only according to the volume of the finished product. This prevents member states imposing duty in accordance with alcohol strength, thereby reflecting the public health risk associated with the product.
Minimum unit pricing, as we all know, is a highly controversial topic and views on it are sharply divided. In spite of the commitment to bring forward such a measure in 2012, the Government have so far only introduced a ban on selling drinks below the cost price —that is, they may not be sold at a loss to the retailer. The Scottish Parliament, by contrast, passed an Act in 2012 to set an absolute minimum price of 50p per unit of alcohol. However, this law was not brought into force because it was challenged in the Court of Justice of the European Union, and in December 2015 the court gave a preliminary ruling that such a measure would be unlawful. Part of the court’s reasoning was that the minimum unit pricing objective of protecting health and life could effectively be achieved through taxation. This neglects the point that the aim of the measure was to target those with the most serious alcohol addictions, and that taxation cannot be easily imposed because of the rigidity of the EU tax structure to which I have referred.
Following this judgment, I understand that the Ministers of the Scottish and Irish Governments have said they are committed to bringing about minimum unit pricing measures. What steps are the UK Government taking to investigate the implications of that judgment? Will they follow the example set by Scotland in pursuing minimum unit pricing measures? Does this judgment have implications for the UK’s existing ban on sale below cost price?
On the other hand, I am encouraged to see that the Commission has undertaken a public consultation on the law concerning the marketing of alcohol. The labelling of alcoholic beverages, however, remains a concern. We recommended that the Government should press the Commission to propose amendments to the food labelling regulations to include information on strength and calorie content, guidance on safe drinking, and to warn of the dangers of drinking during pregnancy. So far, I have seen no evidence that the Government have done so. The regulations are already sufficiently flexible to allow member states to impose such rules domestically, and France has done so. The Government have responded, saying they are concerned about the additional burdens this would place on businesses. Given that labelling is already required, it is difficult to see that that burden would be great.
We also need further cross-border research on alcohol and its effects, and what works. A more strategic approach is needed in the selection of topics for research and how it is commissioned.
Having published our report in March 2014, we granted the Government a two-month extension to the standard two-month deadline to respond to our recommendations. Even with that leeway, however, the Government took almost six months to respond and this debate has taken almost a year to be scheduled.
We recommended that action on specific topics should be taken at EU level. Whether or not this is called a strategy is irrelevant. Since the publication of our report, civil society and member states have called for the renewal of the strategy and the Council, in particular, has called on the Commission to do so by the end of 2016. So far, however, the Commission has not brought forward a new strategy to combat alcohol-related harm or taken any significant action in this area.
In their response the Government said they were broadly supportive of our recommendations, but it was less than clear what precise steps they have taken to encourage the Commission to bring forward further EU action in line with our recommendations. What steps have the Government taken, and what steps are they taking, to bring this about?
While the Commission and the Government were pondering at excessive length their responses to our report, it was receiving a welcome from the Latvian Ministry of Health. Last April, during the Latvian presidency, an informal council was held in Riga and the discussion paper put before the council summarised and endorsed the conclusions of our report. This is a welcome example of the attention that foreign countries give to the reports of this House. I beg to move.
Lord Brooke of Alverthorpe (Lab)
My Lords, I am grateful to the noble Baroness, Lady Prashar, and her committee for the report they have produced. Again, it was of a high standard and matched what one expects of House of Lords scrutiny committees. Like her, I regret that it has taken so long to obtain a debate on it; that it has taken six months for the Government to reply; and that it is still taking the Commission an extraordinarily long time to make up its mind whether it wants to renew with a further strategy—or whatever we might care to call it.
It is a pity that this debate is not being held in the Chamber and that we are pushed away to one side, which reflects, to a degree, the phrases used in the report. There is a degree of apathy about this issue at Commission level—and we are discussing this in a secondary Chamber rather than the main one—even though so many people are dying and suffering as a consequence of alcohol misuse. Not enough attention is given to it.
As the noble Baroness mentioned and as the report says, after tobacco and high blood pressure, alcohol is the third leading risk factor for deaths and disease in Europe. As she also mentioned, Europe leads the world in the volume of alcohol consumed.
On the 2006-12 strategy, I share the committee’s view that a review similar to the original one would be of little value even if minor amendments were made to it. I also share the committee’s view that if there is to be a further strategy, or whatever one might call it, it must be far more radical than we have witnessed so far. I share, too, the committee’s view that it should not be focused only in the health DG—although that is very important—and that we need to look at the way it interacts with other DGs in Europe. As the noble Baroness said, it should deal with drink-driving, which is very important. Labelling is dealt with under an entirely different DG. Minimum unit pricing is also dealt with elsewhere, as is taxation.
I note that in the Government’s response, they share the view that there is a requirement to read across and not just focus on one department. However, I am happy to see ever greater emphasis being placed on the health aspects and consequences that arise from abuse of alcohol. I am pleased that we have a health Minister here today to listen to our views. Given the problems he faces with the NHS, particularly the current financial difficulties, and given that alcohol is a contributory factor to those difficulties, he brings a sympathetic ear—I hope—to the representations many of us are making. Therefore, I agree with and support most of the recommendations that the noble Baroness and the committee have made. Initially, I disagreed with her view on minimum unit pricing. Having read the document, I know that the committee recommends that we should find out what is happening in Scotland, monitor it and then decide whether we should move forward on that issue.
I am firmly of the opinion that there is now a body of evidence which indicates that we should move to a minimum unit price. The Prime Minister said in 2012 that we needed to have minimum unit pricing. I hold consistently to that view, and believe there is now even more evidence that we should move to a minimum unit price and not wait to see what happens in Scotland. Like the noble Baroness, I look forward with interest to the Minister’s remarks on that issue. However, I am of the view that we should move fairly quickly on MUP, especially given the major problems arising from obesity, diabetes and excess sugar consumption. Alcohol is a contributory factor given its sugar content, but many people are totally unaware of that. Fresh initiatives are required in these fields. I look forward to seeing what the Government bring forward in their policy on obesity. I hope that it will not be limited simply to children but will recognise that there is a serious problem across the whole population. I hope they will address that and not focus solely on children.
I particularly support and commend Recommendation 6 in paragraph 117, that,
“Future EU action … should not be confined”—
solely to health policy, as I said—
“but should take a ‘health in all policies’ approach”,
right across the board. In looking at the government response, I hope I am right in thinking that they share that view. I hope that the UK Government will not only support that practice being put in place in Brussels, but will start to practise that themselves in the UK, where they have total control.
The responsibility deal, legitimately, has the simple aim of reducing the volume of alcohol that is consumed. However, in March 2015, the Chancellor’s Budget not only froze alcohol duties but went further and reduced them on certain spirits. Indeed, yesterday I had a letter from an organisation representing breweries which said, “We’re having a party. Would you like to come and join us?”. For three years running we have had no change in duties on alcohol. So there we have it—the Chancellor is cutting the price of alcohol. I would like the Minister to confirm that the price of alcohol in the UK at the moment, especially given the strength of sterling, is probably the lowest it has been for about four or five years. I also draw to his attention that, following further inquiries on the Budget, I discovered that the Treasury itself—it is not represented here today—stated that the Chancellor’s actions would increase the volume of alcohol consumed in this country. So on the one hand we have the Chancellor increasing the amount of alcohol being consumed, and on the other we have the responsibility deal seeking to reduce it.
I then asked the Treasury whether it had consulted the Department of Health on this before it decided to change the rates of duty. Given that health is the second biggest area of expenditure the Chancellor deals with in the Budget, it seems a bit strange that I then discovered that he had never consulted the department about the cost effects on the health service. I tried to table a Question to ask how many people would have died as a result of the Chancellor’s action, but our clerks decided that that was a little beyond the pale and I did not manage to do so. Therefore, I suggest to the Minister that when we are looking at Europe we should start to practise a little bit more clearly and openly what we suggest they should be doing.
I would like the Minister to say what he feels about the Chancellor’s actions on limiting the growth in duty, and whether he believes that that will lead to a diminution in the number of people who die or suffer ill health as a consequence. Alternatively, I would like him to state where we stand on the future of the responsibility deal. The drinks industry and distributors are all very much in favour of the responsibility deal continuing, but of course, in the UK we have the division between the producers and the health industry which I believe the noble Baroness encountered when the committee did its report. There is a clear division between the health lobby and what has been happening with the drinks industry.
The effectiveness of some of the bodies established under the 2006 to 2012 strategy is questionable. The drinks industry wants the forum to continue, yet in the mean time a lot of the health organisations have withdrawn from it. Where do the Government stand on the forum: do they believe it has a worthwhile future, and if so, how do we make it much more effective? We need to practise at home what we preach; let us try to make sure that Europe introduces a long-term, meaningful strategy.
Will the Government return to MUP following the recommendations that keep coming from Public Health England, which says that MUP is desperately needed to address the issue fundamentally? Are the Government seriously looking at all the available evidence, and are they prepared to revisit the topic, which was regrettably set aside in 2014? MUP is fundamental to a change in attitudes. Happily, younger people are drinking less—quite a change has taken place there—and against that background, no doubt, many people say that we do not need many further changes. However, a close examination of what is happening shows that A&E and hospital admissions have increased by about 3% a year since 2012. Even though younger people are drinking less, older people still present at hospital needing attention, which costs the health service phenomenal amounts of money. Therefore, we have a major continuing problem in spite of the good news about young people.
I hope that the Minister will be able to say that the Government are considering drawing up a strategy for the UK, as well as pressing for one in Europe. The last one was drawn up by the coalition and, so far as I am aware, no such strategy currently exists. We have issues with obesity, I would like to know where we stand on the strategy for and approach to alcohol.
Lord Maclennan of Rogart (LD)
I, too, welcome the report by the sub-committee of the European Union Committee; it has made very powerful points, many of which the Government have accepted but not yet implemented. The damage done by drinking alcohol is enormous. Many alcohol-related deaths and chronic illnesses occur as a result. Hospital occupations are greatly enhanced by alcoholism. It affects crime, and violent crime in particular, and it can also affect businesses when people absent themselves because of having drunk too much.
I regret that the Commission has not implemented a new alcohol policy after the 2006-12 one. It needs to apply its mind to this issue, which should be discrete from other matters. Although I accept that taxation and trade are necessary elements, the need for a specific alcohol-related policy is considerable. Possible approaches include addressing the affordability and availability of alcohol. The British Medical Association has put forward a very strong recommendation that I hope the Government will consider. It has advocated restricting the promotion of alcohol. That is particularly necessary for young people, who can be influenced by alcohol advertisements on television, which make drinking alcohol seem absolutely normal and do not discourage it.
We need greater evidence on the effect of excessive alcohol drinking in the European Union as well as in this country. The Government are awaiting the outcome of the reduction in the amount of alcohol that is acceptable when driving in Scotland. The indications are that the number of accidents in Scotland has already reduced by almost 1,000 per annum, which is significant. Drink-driving is one of the most unacceptable manifestations of alcohol drinking. In one year, 10,000 people are killed in the European Union due to excessive alcohol drinking. We must accept that this issue is clearly subject to the European Union, because our drivers and citizens living on the continent are subject to this risk. I hope the Government acknowledge that.
It is particularly to be deplored that the Commission rejected the recommendations of the European Parliament and Council of Ministers for a new alcohol strategy. We need to develop this policy independently of the industry, because our interests—citizens’ interests—are not the same as those of the industry itself. We need more evidence and science on the effects. I hope the Government will take on board what the committee advocates and that they will accept the need for co-ordinated action, because different taxation and duty rules across the Union could damage this country.
We also need to understand that this is a continent-wide problem, and that WHO examinations of it should be aligned with those of the EU. I hope the Government will tell us today what they propose to do about the new alcohol strategy. The Scottish initiative of a limit of 50 milligrams per 100 millilitres might bring considerable benefits; indeed, I think it already has. We would, however, be very interested to hear what the UK Government have in mind.
Baroness Murphy (CB)
My Lords, about a week ago I looked at the list and thought that, well, there are so few of us going to speak in this debate that maybe we should all pack up and go down the pub instead. We have, however, improved our numbers respectably.
As a doctor and a psychiatrist I have, of course, witnessed the ravages of alcohol many times, and I know well its destructive force. Drinking, however, is a pleasure that I greatly enjoy. I can get my endorphins instantly from a glass of wine, which I cannot by going down the pub for at least an hour. Also, I think that most of us in this House, like most of the population of Britain, enjoy a drink; it adds to the conviviality and calm of public gatherings.
I feel that I ought to mention, because it is no longer in the register, that I was for many years a part-owner of a gin distillery, and, in the 1990s, a director of a brewery. I still have some emotional, but not financial, connections with that brewery. I know, therefore, that some members of the alcohol industry realise that it is in its best interest to reduce the associated long-term harm; otherwise they will be subjected, eventually, to what is happening to the tobacco industry, which they are not daft enough not to have seen. The UK has been more effective than any other EU country in reducing tobacco consumption; it has been a great success. If we are to reduce the harm that alcohol does, we need to learn a great deal about that; but we must learn the best of what we know on the evidence, which means having a very diverse strategy. That includes such matters as the noble Lord, Lord Maclennan of Rogart, has mentioned, and the Private Member’s Bill of the noble Lord, Lord Brooke of Alvethorpe, which aims to reduce drivers’ alcohol consumption. A mixed strategy is required to reduce harm overall.
The European Observatory on Health Systems and Policies published a wonderful review in 2013, in which Currie and Gilmore looked at how tobacco reduction strategies were structured in all EU countries. The most effective ones were those with diverse approaches across all elements, as has already been mentioned. It is not only a health strategy. It includes warnings, pricing, taxation and opportunities for treatment and for people across the board to think about what they are consuming.
I congratulate the noble Baroness, Lady Prashar, on her committee’s tackling the way the EU set about its work on an alcohol strategy. It made a mistake that we have often seen made by august bodies such as the WHO and the UN on other matters. They are very good at telling others what to do about strategies, and far less good at thinking about what they themselves can do as a priority. Her committee has issued an excellent report on what the EU should be doing. It is a disgrace that it does not have a strategy to which we can all subscribe, and which makes best sense of what it and individual states can do.
What the EU can do is important and may not be so upsetting to the alcohol industry. Alcohol duty is structured in a barmy way at the moment. As noble Lords know, the problem is that alcohol strength—the quantity of neat alcohol in a drink—which is the driver of harm, is not taxed proportionate to the amount in the drink. Under current EU legislation, you can do it for beer or spirits but not for wine or cider. Have your Lordships ever asked yourselves why supermarket ciders are so darn strong—up to 8% or 9%? It is because they are not taxed in the same way.
The defects in the existing taxation legislation produce these distortions in alcohol pricing. It makes a huge difference. New world wines are now 15%—a slug of Cabernet from New Zealand or South Africa will knock you over. If there was a proportionate alcohol taxation on volume, lighter wines would be encouraged and we would consume far more of the lower-alcohol wines. The same is true of beer. Scandinavian countries, which have taken the point on board, produce many very popular low-alcohol beers. We should press the EU in this area. The industry would be agreeable on this point.
I wholeheartedly agree that rules on food labelling are crucial, particularly for women. I gave up drinking for four months last year because I was on a diet. It was difficult. Two large glasses of white wine, my favourite tipple, are the equivalent of a large plate of French fries. How many women know that? The noble Lord, Lord Patel, is muttering about how many chips I eat. It is crucial that we have proper alcohol labelling. It would help women in particular, but also concentrate the minds of men.
We need to suppress demand in the areas where it is the greatest in order to reduce the culture of drunkenness. We have a culture in this country which is quite different from much of Europe, in that people go out to get smashed. They buy cheap offers at the supermarket and “preload” before they go out—and then get further smashed in the pub. It is encouraging that alcohol consumption is dropping among a proportion of younger people in this country, although that may well be because the population’s structure and demographics are changing. It may be that the attitude to alcohol of native-born, white British, Scots and East Anglians—for example, Norfolk folk—is not changing a great deal. Perhaps we are seeing that in London, with a different sort of population.
We therefore need effective pricing policies for supermarkets, effective taxation and effective warnings. Warning women about consuming large amounts of alcohol during pregnancy is crucial; we should at least get that on the bottles. These are the things that my noble friend Lady Prashar’s committee recommended, and which we should ask of the EU because only the EU can do it. We should say to the EU, “Please, rethink this”, because the industry would, I believe, be agreeable. I am not suggesting for one moment that we do not need to tackle the alcohol industry, but there are ways through the pricing and taxation problem that would be more agreeable to the industry if they were part of an overall strategy. We should press the Government strongly to ask the EU to look again at what could really work. I look forward to hearing what the Minister has to say about what we can do to urge the EU to tackle this problem.
Lord Patel (CB)
My Lords, I will be brief, because much of what could be said has already been said. I was going to say that the only thing left that has not been covered is how occasional or moderate alcohol drinking is quite satisfying, but my noble friend Lady Murphy even covered that—she did not leave it for me. I agree that we should thank the EU committee and my noble friend Lady Prashar for presenting this report. It is a well-produced report that makes all the points and highlights the lack of a co-ordinated alcohol strategy in the EU and the United Kingdom. We have a piecemeal approach, and it would be nice to develop a co-ordinated strategy.
Let me deal briefly with one or two of the committee’s recommendations and the Government’s response. First, I agree with my noble friend Lady Murphy about pricing. Why is pricing not based on strength of alcohol? That would mean that those who enjoy alcohol could drink lower-strength alcohol, which would be more popular. It is higher-strength alcohol that is largely responsible for the behaviour we see from those who drink too much. So I would support that and I would be interested to hear the Minister’s response.
I know that bottles are labelled saying that alcohol can be harmful during pregnancy, but that does not go far enough. In my clinical practice I have always advocated giving up drinking during pregnancy, or even before if you intend to become pregnant. The labelling should be much stronger.
I was interested in Recommendation 11, on marketing. The Government’s response seems rather a fudge. It states:
“This work will lead to a new draft of the Directive by June 2016. The revised Directive will need to be transposed into UK law”.
It would be nice to know the Government’s view on marketing, rather than their saying they will wait until the EU produces something. The Government must surely have a view on marketing.
Recommendation 12 says that,
“the Government should press the Commission to propose amendments to the Food Labelling Regulation”.
My noble friend Lady Murphy referred to the calorific content of some drinks and how that may affect nutrition. The Government seemed to be quite strong on this, saying that we should have labelling related to nutritional and calorific values, but in their response they seem to have weakened. I may have misread their response, but it would be nice to know which strategy is correct.
I will finish there as most of the other points have already been made in great detail by other speakers.
Lord Hunt of Kings Heath (Lab)
My Lords, I, too, congratulate the noble Baroness on the way in which she introduced the report and on the report itself. We have had a very balanced debate. I suppose we are seeking to embrace the enjoyability of alcohol in moderation, alongside a recognition that for many people it causes misery and degradation. To get the policy right will always involve a balance, and one that we do not get right every time. For instance, looking back, the extension to 24-hour licensing was done with the best of intentions. If I recall correctly, it tried to encourage what we thought to be a responsible, continental style of drinking. I am not sure whether it has altogether been successful in that regard.
The report itself is excellent, because it has assembled a great deal of hard evidence about the scale of alcohol use and some of the problems that arise from it. I particularly took the point that not only does Europe have the highest per capita alcohol consumption in the world, but we know that the UK has high consumption itself. We also know, as the committee points out, that there are huge variations in society. The noble Baroness, Lady Murphy, may well be right about the statistics coming through on young people and the reasons for that. We should be cautious about reading too much into that at the moment.
I very much took on board the evidence given to the committee by the Chief Constable of Northamptonshire about the impact of alcohol on domestic abuse. He estimated that alcohol was a factor in a third of all domestic abuse. The Home Office official, Mr Greaves, pointed to the Crime Survey for England and Wales which estimated that in 49% of violent incidents,
“the victim believed the perpetrator to be under the influence of alcohol”.
There is also the more general issue of anti-social behaviour. My honourable friend Jessica Phillips caused a certain degree of controversy a couple of weeks ago, when she compared what happens in Broad Street in Birmingham every Friday night with the very serious incidents in Germany. She has been criticised for that but she is certainly right that Broad Street on a Friday or Saturday night is not a very pleasant place to be, the problem being that it is also where Symphony Hall and the Rep are, so it is difficult to avoid. Frankly, for many people the atmosphere and disorder that come from alcohol are frightening. I know that the Government are seeking to give greater powers and flexibility to local authorities to try to ensure that licensing is more appropriate. However, the Minister will know that local authorities are torn between, in a sense, public order and wanting young people to come and spend money in their cities. That is a conundrum and a very big problem.
We come to the issue of the European strategy. The report from the noble Baroness, Lady Prashar, says that Europe has a limited competence in health. Successive Governments have wanted to keep that competence limited. Certainly, from our point of view that was because we wanted to make sure that changes in European directives and legislation would not impact on the way we run our National Health Service. The current debate about TTIP shows some of the dynamics of concerns about how, say, that potential trade agreement between Europe and North America might impact on the way we run the NHS. I certainly support the continued limited competence in health on the part of the EU, which needs to concern itself with a lot of other issues at the moment.
However, I also take the point made by the committee that there is a case for EU action which can supplement and add value to the activities of national governance. In their response, the Government say that they agree with that. Can the Minister give me any indication that the Government really do sign up to that, so that they will support some European-wide action where that truly can add value to how we want to take forward policy on alcohol in this country?
My noble friend Lord Brooke made some very telling points about the Chancellor of the Exchequer and inconsistencies in his approach to these issues. He might have mentioned the swingeing cutbacks in public health budgets that have taken place at the same time as the decision that the Chancellor announced. I hope that the Minister will say something about taxation and consistency. As regards the strength of cider, 8% or 9% is a shocking figure. We are entitled to ask the Government to look again at the requirement for consistency. I would also like to ask the Minister about minimum pricing. The Government are keeping this under review. Of course, Governments keep everything under review. But I would like to hear a little more about the Government’s current thinking on pricing, because clearly many people think that we should use pricing as a way to reduce consumption.
I would like to come on to the issue of public health. I have been very impressed with the work of Public Health England in the last two or three years. Its work is evidence-based and the body has been forthright. I hope that the Government will continue to listen to Public Health England’s recommendations in this area. Regarding the impact of the reduction in the public health budget to local authorities, to what extent does the Minister think that Public Health England and the Government have a role in that context to chivvy local government to take seriously its responsibilities in the area of alcohol? That is one area where you can see that almost all the services of a local authority can have an impact. You can also see the tensions within a local authority because, on the one hand, encouraging more licensed premises—and encouraging more people to use them—will have a positive impact on its income and jobs; on the other hand, it has all the problems that arise from anti-social behaviour. Therefore, local authorities have a major role to play in public health responsibility. It is not good enough simply to leave it to local authorities. The Government and PHE need to be rather more proactive in encouraging local authorities to treat this seriously and as a priority.
Finally, I come back to the point raised by the noble Baroness, Lady Murphy. Recently, we saw the publication of advisory alcohol limits. I do not think that this is an easy issue. However, does the Minister think it advisable to publish limits that are so low that just about everybody will simply disregard them? I am sure that Ministers had debates with the Chief Medical Officer about this. I am not being critical but what will be the eventual outcome? Clearly, there is an element in the public health movement which wants to move to a no-alcohol position—not perhaps prohibition because we have all seen the consequences of that—and is itching to go down the route of eventually saying, “No, you should not drink alcohol at all”. I understand that and am sympathetic to the public health movement, but there is a terrible danger that if you say to young men that the limit is 14 units—that is, four or five drinks a week—it will just be laughed at and disregarded. I am not sure whether nudge policy comes to mind. However, this does not seem to me very nudgy; rather, it seems very nanny. As part of taking forward a general strategy on alcohol, perhaps the Government need to think again about the psychology of alcohol and what really would influence behaviour.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)
My Lords, I also thank the noble Baroness, Lady Prashar, and her committee for the report. It has stimulated a very interesting, balanced and well-informed debate today. We have probably not got time to do justice to all the issues raised. I would suggest that we might meet for a drink afterwards but that would probably not be appropriate in the circumstances.
We are all aware of the impact of alcohol misuse. I was interested in the reflections of the noble Lord, Lord Hunt, on getting the balance right between trying to achieve something—but not doing so in such a blunt way that it will have unintended consequences—and deciding that it is not possible so we will not even try to do it. The way in which successive Governments have tackled the problem of tobacco over a very long period shows that you have to win the argument with the public. We are a long way from winning this argument with the public. Although not everyone likes a drink, most of us do, and so the argument is more difficult than it was with tobacco. On the other hand, the argument is even more difficult with obesity. That is the most difficult argument of all to win. We need to get the balance right.
The noble Baroness was right to raise the issue of the comments of the Chief Medical Officer. The image where every time you take a glass of wine you think of cancer has stuck with me, although it was-directed at women. The noble Lord, Lord Hunt, is shaking his head. However, it has at least raised the issue, even if it has spoiled a glass of wine. We all know that the misuse of alcohol can be hugely damaging and not only from a health point of view. As has been said, misuse of alcohol can lead to domestic abuse, violent crime and the like.
On strategy, the 2012 strategy is extant and we will soon be publishing our life chances strategy and the new crime prevention strategy, which will include a separate chapter on alcohol. We may not be coming up with a specific new alcohol strategy but alcohol is very much part of our approach to a number of different issues. It is good that we are giving our attention to this. Perhaps it would have been better to debate this in the main Chamber but we are dealing with it here.
It is worth prefacing what I am going to say by reminding the Committee that most people drink in an entirely responsibly way. We do not want to penalise people who drink responsibly unnecessarily just because a small minority do not. I was slightly worried by the comment of the noble Baroness, Lady Murphy, about Norfolk. I did not know that we had a particular problem with Norfolk. If we do, perhaps it is in the Brancaster golf club or somewhere like that. I do not know where that problem is.
I want to highlight the UK Government’s position on some of the key areas of our response to the report of the House of Lords committee. Overall, we welcome the report and broadly agree with its recommendations. In particular, we fully agree with the committee that action is worth formulating at an EU level only to the extent that it supplements and supports what member states can do independently. That is important. It is what we do here that is of primary importance. I agree with the comments of the noble Baroness, Lady Prashar, that anything we do at EU level must also be flexible because every country is different—the culture in Norwich is different from that in Rome—and anything we do should reflect that.
The UK Government continue to support the view that member states should drive alcohol policy but that the Commission should complement this by sharing best practice, by providing a common evidence base— which the noble Baroness felt the EU had singularly failed to do—and by dealing with issues that member states cannot deal with on their own.
It is worth mentioning taxation in this context. The UK Government believe that alcohol duties should be directly proportional to alcohol content. This falls into the “bleeding obvious” territory. However, this is a European Union issue but the UK Government will be putting what pressure they can at that level to try to get proportionality into the way that we tax alcohol.
The UK Government are keeping minimum unit pricing under review. I am afraid that I cannot go beyond that. We are monitoring closely what is happening in Scotland with the Scotch Whisky Association. I can do no more than say that we will keep it under consideration. It is a serious issue and anyone formulating a policy on alcohol would be foolish not to keep it under consideration. Whether they decide to do so is another matter. However, it is like a sugar tax land we should keep it under careful consideration.
On marketing, the Government are committed to working with industry to address concerns over irresponsible promotions. We believe that material in the Committee of Advertising Practice’s UK Code of Broadcast Advertising relating to the advertising and marketing of alcohol products is exceptionally robust. For example, it may not be featured in any medium where more than 25% of the audience is under 18. However, if new evidence emerges that clearly highlights major problems within the existing codes, the Advertising Standards Authority has a duty to revisit them and take appropriate action.
A number of noble Lords raised the issue of mandatory labelling. As a result of the responsibility deal, just under 80% of bottles and cans of alcohol were assessed to have the correct health labelling, by which I mean clear unit content, the CMO’s lower-risk drinking guidelines and a warning about drinking when pregnant. I have noticed that the noble Lord, Lord Patel, raised the issue of pregnancy and when we are reviewing our strategy we should consider whether that is enough. The UK also secured a provision to allow voluntary calorie labelling, which some businesses are already using. Supermarkets including Sainsbury’s, Co-op and Waitrose are using voluntary calorie labelling. That is probably as far as we can go at this stage. The possibility of mandating nutritional labelling, including calories and ingredients labelling on alcohol, is still under discussion at EU level. As I say, we are making progress on a voluntary basis in the mean time.
I would like to highlight the other actions that we are taking. As noble Lords have said, sales of alcohol below the level of duty plus VAT were banned in May 2014. We are advised that the minimum unit pricing case does not affect that ban, so I think that it will continue as it is. Later this year, we will publish the new crime prevention strategy, within which alcohol will feature prominently. The noble Lord, Lord Maclennan, raised the issue of drink-driving. We are going to watch what happens in Scotland, where the level is being brought down from 80 milligrams to 50 milligrams—is that per litre of blood?
Lord Brooke of Alverthorpe
It is 50 milligrams to 100 millilitres of blood.
Lord Prior of Brampton
We will see what impact that has: if it is major, we should clearly take it into consideration.
Since April last year, the standard GMS contract has included delivery of an alcohol risk assessment to all patients registering with a new GP. This has the potential to raise awareness of alcohol as a risk factor with a large percentage of the population. The Government are also continuing to work with Public Health England, which is giving a high priority to alcohol issues by working with local authorities. However, we believe it is right that the primary responsibility for drug and alcohol issues should be with local authorities. PHE will support all local authorities and their partners to put in place high-quality interventions to prevent, mitigate and treat effectively alcohol-related health harm. As noble Lords will know, services include local licensing controls and specialist services to support recovery for dependent drinkers.
In 2014-15, the Department of Health commissioned PHE to review the evidence and provide advice on the public health impacts of alcohol. The review of evidence has been completed and is in the process of being written up as they complete a peer review process. It will be available in due course.
The new alcohol guidelines provided by the CMO are currently out for consultation. That will have an important impact on the debate as we go forward, so I hope that noble Lords in this House will contribute to that consultation. The department recognises that in the light of the new guidelines further work will need to be done on labelling and an appropriate transition period will be put in place to ensure industry can change its labelling in a cost-effective way.
The noble Lord, Lord Brooke, raised the issue of duties and the mixed messages that might come from reducing duties. All Governments face this issue. They have to get the balance right between what is good for people and what people want to do in a free and democratic country. It is a difficult balance to strike. I do not think that the Chancellor has been any more or less responsible in this matter than previous Chancellors. One of the joys of living in a democracy is that these issues are balanced for us. In a world that was less free, a ban might be put in place—prohibition or something—but I do not think that many of us would like to live in that kind of society. So this balance between what is good for you and what people like doing is something that we vote for in general elections.
We recognise the contribution that not just individuals but also businesses and our communities can make to help people better understand the risks associated with alcohol. I am sure that this is an issue to which we will return in due course. Change will not happen overnight. I take very much on board what the noble Lord, Lord Hunt, said about how we approach this issue, and that a nudge can sometimes create a barrier to change.
The noble Baroness, Lady Prashar, has made a very important contribution to this debate and we take that very seriously. Any responsible Government would take this very seriously. How we get the right balance in this debate is very important. Part of getting that balance involves the kind of debate we have had this afternoon.
Baroness Prashar
My Lords, I thank the Minister for a very full response. I also thank noble Lords who took part in this debate. In producing the report, we were very conscious of the fact that we did not wish it to be a killjoy report but that we had to take a very balanced and informed approach to the issue. It is very gratifying that all noble Lords who have taken part in this debate have reinforced the recommendations that we made. Therefore, it is encouraging to note that we were obviously moving in the right direction.
I listened carefully to the Minister’s response and wish to highlight two points. On the minimum unit pricing, it would be useful if the Minister would write to me informing me of the implications of the European Union judgment for the UK. On labelling, I know that the Minister mentioned doing this voluntarily, but I still think that it should be mandatory because the voluntary approach is not sufficient. Having said that, we did not have a large quantity of noble Lords speaking in this debate but its quality was very good. I think that all the points have been covered. I again thank all noble Lords and the Minister for his response.