Alcohol Abuse

Baroness Walmsley Excerpts

Thursday 30th March 2017 Grand Committee

[Baroness Walmsley (LD)]

I, too, congratulate the noble Lord, Lord Brooke of Alverthorpe, on securing this important debate. Last January, I chaired a seminar run by the All-Party Parliamentary Health Group on developing a long-term strategy to reduce the harm from alcohol consumption. We heard from several eminent contributors whom I shall mention as I go along. We started with Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance, who described the burden of alcohol harm. He told us that, statistically, alcohol is the number one risk factor for premature death in the UK today. The BMA tells us that 60 different medical conditions are caused by alcohol abuse, and are therefore preventable. Sir Ian Gilmore said that 70% of presentations at A&E on a Friday or Saturday night, and about 20% of all hospital admissions, are related to alcohol. Interestingly, mental and behavioural disorders due to alcohol use account for almost 20% of those admissions, so we know that we are talking about mental, as well as physical, diseases. We know what the diseases are; several noble Lords have referred to them today. In addition to those physiological diseases, of course, accidents are caused by alcohol use, and there are a lot of hospital admissions because of those, as well.

Sir Ian was followed by Dr Mirza, an emergency medicine consult from West Middlesex University Hospital. He began by shocking us all with four real-life but typical situations that had taken place in his department over the past month. They included drunken patients attacking staff or police officers, running rampant and breaking thousands of pounds- worth of hospital equipment, requiring to be restrained and taking up hours of time of the staff, meaning that other sick patients were not treated for hours. The disruptive effect on the department was enormous, he said, and added additional strain to an already overstretched A&E department.

What does all this cost the nation? The Government themselves estimate that it costs £3.5 billion a year to the NHS, £11 billion a year on criminal justice and £7.3 billion in lost production, a total of £21 billion a year. What could the NHS and social care do with that money?

In addition to these costs and the burden of disease, there are costs for children and families. My daughter-in-law is currently writing a PhD thesis about the scale of domestic violence following excess alcohol consumption after major sporting events. Dr Mirza pointed out that there are many children living with one or more parents with an alcohol-related problem, resulting in mental and emotional strain and poor academic attainment for the child.

What are the options for reducing these harms? First of all, we have to ensure that young people are educated in their PSHE lessons about the harm that alcohol can do. We heard from Professor Yvonne Kelly, Professor of Lifecourse Epidemiology at University College London, that, of those adults who drink, 80% to 90% of them start in the second decade of life. Pleasingly, as someone has said, there has been a fall in the number of underage drinkers in the past 25 years, and I put that down to education. However, she told us that the amount being drunk by each underage drinker shows no sign of falling, so these are the people we need to target. A number of options were suggested to us, including those affecting price, labelling, marketing, advertising, availability, low-alcohol options, help with behaviours, et cetera. Many of these have excellent evidence of effectiveness, according to the academics.

I have a number of questions for the Minister. Has he done an impact assessment of the reduction in alcohol abuse services following the cuts to public health budgets? Is he aware that this money is well spent? For every £1 spent on alcohol treatment, £5 of public money can be saved. We know that a five-minute chat from a health professional can have a major effect on a person’s drinking habits, yet GPs do not have time to do this in a 10-minute appointment. Will the Minister publish imminently the Government’s new alcohol strategy, and will he consider including in it minimum unit pricing to tackle products such as white cider, which I was staggered to discover costs only 15p per unit of alcohol and is used mainly by very problematic drinkers? Will he ask the Chancellor to increase the general cost of alcoholic drinks? Given what the noble Lord, Lord Brooke, said, what can he do to reduce the comparative cost of low or zero-alcohol products? Will he issue guidance to local authorities which authorise licences to ensure that health is a factor in licensing decisions, so that they understand the effect of long opening hours and high density of premises selling alcohol? Alcohol action areas have already proved the effectiveness of reducing density and hours.

Will the Minister also look at what can be learned from the policies on tobacco? I agree with the noble Lord, Lord Brooke of Alverthorpe, about labelling. Labelling of tobacco products showing the health damage they can do could easily be replicated with alcohol. Alcoholic products should not only show the calories and units of alcohol they contain but also have a reminder of the Chief Medical Officer’s advice about maximum weekly consumption and alcohol free days. Perhaps we can do that after Brexit.

There is evidence that increased exposure to alcohol increases the chances of children drinking, so will the Minister also include in the policy a ban on advertising of alcoholic products before the watershed? Will he also consider banning alcohol sponsorship of sports events for the same reason? The health and economic benefits of all these actions would be immense.