Health: Alcohol Abuse

Lord Brooke of Alverthorpe Excerpts

Tuesday 21st January 2020 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty's Government what plans they have to produce an effective strategy for dealing with alcohol abuse in 2020.

[The Minister of State, Home Office (Baroness Williams of Trafford) (Con)]

My Lords, we are working to reduce alcohol-related harms with the NHS long-term plan, the prevention Green Paper, support for children of alcohol-dependent parents and action to tackle alcohol-related violent crime. Together, this work constitutes an effective package to address alcohol abuse. We are not planning a stand-alone strategy.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful for the reply but not its content. It is very disappointing. Last year the Government were moved to produce a strategy on drugs, which hopefully will be effective. However, the problems with drugs are minimal compared to the problems with alcohol. Does the Minister recall that in 2011, the coalition Government produced a widely welcomed strategy on alcohol? It fell apart in 2015, primarily because the Government could not carry the drinks industry with them. We had a responsible deal which proved to be irresponsible. Are we not going to face the same problems again? Unless the Government bring the threads together to produce a strategy with real teeth, nothing will change.

[Baroness Williams of Trafford]

We now have in place a wide-ranging approach that negates the need for a separate, stand-alone alcohol strategy. We have announced a new addictions strategy and will roll out the electronic monitoring of alcohol abstinence requirements for those whose offending is fuelled by alcohol.

Passport (Fees) Regulations 2018

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd March 2018 Lords Chamber

[Baroness Williams of Trafford]

My Lords, I do not think it is a question of knowing the answer or not. I make the point that the noble Lords, Lord Kennedy and Lord Stoneham, were present in Committee last Thursday when we discussed this. We will have plenty of opportunity to discuss where the passports are printed. This is simply about fees. I repeat the points that I made to my noble friend and the noble Lord.

[Lord Brooke of Alverthorpe (Lab)]

Will the noble Baroness say when the opportunity to discuss that will be?

[Baroness Williams of Trafford]

My Lords, as noble Lords will know, when things are discussed in this House is entirely a matter for Members.

Gender Equality: Pay

Lord Brooke of Alverthorpe Excerpts

Wednesday 21st March 2018 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, where does the Minister suggest that we look for the next steps and action to be taken in those areas where equal pay still does not exist? Returning to our backyard, the public service—she just mentioned local government—is it not true that there are still significant elements of unequal pay within the Civil Service, the public service and local government? This is an area where we have control. What do the Government intend to do there?

[Baroness Williams of Trafford]

I am almost certain that most local authorities will have settled equal pay claims with their employees—mine certainly did. On what more is there to do on equal pay, if women think that they are not being paid the same as men for the same job, they are perfectly entitled to—and should—bring claims forward.

Finance (No. 2) Bill

Lord Brooke of Alverthorpe Excerpts

2nd reading (Hansard): House of Lords & 3rd reading (Hansard): House of Lords & Committee: 1st sitting (Hansard): House of Lords & Report stage (Hansard): House of Lords
Thursday 8th March 2018 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, could it be perhaps that noble Lords wish to speak in the next debate, which they see as more important?

[Lord Bates]

That is one possible explanation, but your Lordships have always been assiduous in their attention to matters such as the Finance (No. 2) Bill before us.

Let me try to address some of the points that were raised. The first point was on the argument about growth. We were the joint fastest-growing major economy just as recently as 2016. Of course, there has been a level of uncertainty as a result of the British people’s decision to exit the European Union; that is understandable and most people would recognise it. However, I do not see 1.7% as being a miserable or pathetic rate of growth, or that other OECD competitors with rates of 1.9%, 2% and 2.9% are experiencing extraordinary rates of growth. We entered into this cycle of growth out of the recession of 2008-09, much earlier than others. Therefore, we are at a different stage of growth. But to be able to say that we have grown for 20 consecutive quarters—five years of growth—and that manufacturing has grown for eight consecutive months, which is the longest continuous streak for 30 years, is surely reason for a degree of optimism.

The noble Baroness, Lady Kramer, asked about NHS funding. The Budget provided an extra £6.3 billion of new funding for the NHS, and we are committed to increasing the NHS budget by a minimum of £8 billon in real terms over the next five years. This is a significant first step towards that. The NHS is seeing over 2.9 million more A&E patients every year compared to 2010 and treating 57,000 more people every year for cancer, giving the UK its highest ever cancer survival rate. The noble Baroness asked whether we would have a hypothecated tax for health. Of course, we have such a tax in the sense that 20% of NIC receipts go directly towards the National Health Service.

On the point about housing provisions not bringing about changes, if the measure on stamp duty were taken alone, that might well be true, but it will help a million first-time buyers. Surely that has to be welcomed. In the wider context, the fact that employment is at almost record levels, with 3 million more people earning a salary than in 2010, must also be helpful for the housing market, because it means they have a salary with which potentially to buy. But that is not enough, and it is why we said that stamp duty was one element of that. Another element was to go towards our aspiration of building 300,000 new homes each year.

Let me turn to investment—I think the noble Baroness said that business investment had “fallen off a cliff”. Again, that might be overstating it a little. Business investment contracted by 2.6% in the year to the EU referendum, but grew by 2.5% in the year since. The OBR forecast is for business investment to grow by 2.5% in 2017 and 2.3% in 2018-19, which is a different approach. A key element of that was extra funding of £31 million for the productivity investment fund. That will make a significant contribution, as will businesses investing in themselves, which is the most successful form of business investment. The corporation tax rate has fallen from 28% to 19%, which means that small, medium-sized and large businesses have more money to invest in their own businesses and their own futures.

The noble Lord, Lord Davies, referred to the equality briefing. It was under this Government that we became one the first countries to introduce gender pay gap reporting. The gender pay gap for full-time employees is at a record low. Building on this, the Budget announced steps to boost female enterprise and innovative trials to support women returning to work. The number of women in work is at a record high of 15 million, an increase of 1.4 million since 2010, of which 80% were full-time. The gender pay gap for full-time employees is at a record low of 9.1%.

There are reasons to recognise that we need to be prepared to strengthen the economy to make more it competitive internationally so that we make a success of Brexit for Britain. The people who do that will be the workers and businesses of this country. This Bill strengthens measures to help them by reducing their taxes, increasing incentives to invest—especially in knowledge-intensive industries—and helping young people to achieve their aspiration of getting on to the housing ladder. These are all reasons why I am happy to commend this Bill to the House.

International Women’s Day: Progress on Global Gender Equality

Lord Brooke of Alverthorpe Excerpts

Thursday 8th March 2018 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the noble Baroness, Lady Williams, for giving us the opportunity for this debate today. I express my gratitude to her, to women in general and to some particular women too. I start, rather like the noble Baroness, Lady Browning, with an expression of gratitude to my mother. Had she been alive, she would have been 113 this week. She bore three sons within three years, went 12 years more and then, without any planning, I turned up in the middle of the war. My father was away; she had three young teenage boys and she was working as a weaver. We had very little money and a very poor background; we were born into a society where there was very limited public education at the time. There was no health service: it was six years before the National Health Service came into being. There were many slums around us, and generally life was quite different to what we have come to experience latterly.

I was born into a world where we worried about the quality of our leadership. It was a world that was led by men: Hitler, Stalin and Mussolini. The Chinese were preparing for a revolution led by men. We were all at war fighting each other. With male domination, what do men do best? They cannot resist fighting each other for power. There were few women around in political leadership anywhere in the world. There were a few in the Commons and none in the Lords: there were no life peerages then, only hereditaries, who were all male. I have been here for 20 years, and I look back and see the changes that have taken place not only in my lifetime, but in the 20 years since I have been in the Lords. There have been dramatic changes, particularly in the advancement of women and their opportunities here. I have served solely as a Back-Bencher, but I have served primarily under women leaders on both sides of the House. It is a remarkable tribute to the progress that we have made.

We have some great individual women here. On our side, we have already mentioned the late departed Muriel Turner, who used to sit where my noble friend Lady Donaghy is now. She was always there. Noble Lords will all recall with great affection two others who are missing today: my noble friend Lady Farrington of Ribbleton, who is unwell, and my noble friend Lady Gould, who, without any doubt, would have been speaking today. She did so much in the Labour Party for women and has done so much in this House since she came in. I am sure we would all like to send our regards to them and best wishes for their recovery from ill health.

My background is in the trade union movement which, again, is very much a male domain. I was the general secretary in a civil service trade union, which had 60% women members and only 40% men, but it was primarily run by men: the leadership, the executive council and all the important positions were, in the main, held by men. In trying to effect changes, we consulted the noble Baroness, Lady Fritchie, a Cross-Bencher who is not in her place today. She played a very important role in public appointments, trying to get gender balance in this country. She helped our union to try to get changes that would advance the interests of women. We did it mainly by a quota system. That was not particularly popular in certain quarters, and it is still not particularly popular in some areas where people say, “No, we will do it solely on the basis of our talent; we do not want any places reserved”. The situation was reflected in the contribution from the noble Baroness, Lady Anelay, who told us how quotas have been working in Albania and how they were the only way women there could advance. I believe the problem is the class system. In particular, quotas are strongly opposed by middle-class women, but the working-class sees them as an opportunity, so they should not be ruled out. Our use in the Labour Party of women-only appointment lists is a form of quota system that has produced wonderful results; it should be looked at by other parties. There are parties that have not yet been able to produce a female leader. I hope it will not be long before we have a female leader of the Labour Party. We should look at our structures to ensure that women can continue to rise to the highest places in our organisation.

In business, again, big changes are needed; some changes have been effected. I pay tribute to the noble Lord, Lord Davies of Abersoch, who has worked very hard by using the second system that is available and open to us: targets. He has gone for a 25% target for women on the boards of FTSE companies, and a good deal of progress has been made there. So we have quotas and targets.

I also like the concept of mentoring, which was mentioned earlier. I am speaking today primarily because I now have, through the good offices of the Royal College of Psychiatry, a woman doctor working with me. She has spent the last six months with me, working on mental health. She has taken me into new areas that I needed to explore that are good for me and my development, and she has taken me back to some of the issues I looked at when I worked on equality with women. She said, “You should speak in this debate this coming Thursday and persuade some of your male colleagues to speak as well”. As the noble Baroness, Lady Flather, said earlier, women will not achieve these changes alone; they need to get men on board with them, to persuade men of a sympathetic mind to stand up with them, and then you will find that you have a majority. Through a majority, we can effect the changes we need.

We still need changes in the NHS: 77% of its employees are women, but the majority of senior leadership posts fall to men. We look at the BBC—we all know what is happening there. Women are a major factor in the BBC, but are not holding as many of the posts as they should. The Armed Forces are the next area in the eyes of the British public. We listened to debates recently about whether the Armed Forces should permit part-time working. God Almighty! We are still debating issues like that—we need to change it.

I will also mention the Queen, who is outstanding. Think of the three monarchs of this country who you believe have made the greatest contribution. To my mind, it is the two Elizabeths and Victoria. When I think about the males, I recall all of them for the worst of reasons. Therefore, there is an argument to be made about the way in which the hereditary system can also produce important changes.

There is still a lot of work to be done. Primarily, we see changes taking place that we are not keeping abreast of. New international companies and communications organisations are being run primarily by men who are not accountable; women are just not on the scene. We had a change at the United Nations, but why did we not have a woman in charge of the United Nations for the first time ever? This is the kind of issue on which women—all of us—should press for change to increase the movement towards greater equality.

The areas in which women have the greatest influence on our lives at the moment are culture and religion. It is difficult to talk about these subjects here, but they have a massive influence on everyone’s lives, particularly with regard to women and equality. We look at where the religions started and who led them; who sustained them, in the main? Take the Church of England and the battle it has had over women bishops. But in many respects, it is women who keep the Church of England going and who do the hard work. That applies in so many other religions. We need changes within the religions and opportunities for greater equality, one way or another. We all need to work together for that—men and women together. Alone we will do nothing, but together we can achieve much.

Sterling: Euro Exchange Rate

Lord Brooke of Alverthorpe Excerpts

Monday 9th October 2017 Lords Chamber

[Lord Bates]

I acknowledge the noble Lord’s great professional experience in economics, but I am saying something slightly different. I am not saying that we do not pay attention to that and do not watch it at all; I am saying that the way in which it has been configured, through successive Governments, is such that this is a matter for the Monetary Policy Committee of the Bank of England to respond to. Where inflation rises above 3%—its target is 2%—it has to respond. Where it sees matters which are causing concern, it can choose to cut interest rates—as it did after the referendum, to historically low levels of 0.25%. We are not saying that we do not have any policy; we are saying that we have a core set of policies which the Government are responsible for and we are acting on them.

[Lord Brooke of Alverthorpe (Lab)]

Will the Minister explain to the House why we have been downrated?

[Lord Bates]

If someone wants a historical lesson on the accuracy of the ratings agencies in making predictions, the events of 2008-09 might raise some question as to what they were doing then. We are talking about a downgrade of one notch. That reflects some concerns that they have about the transition period as we exit the European Union. They are perfectly entitled to say that. We are saying that we have a clear plan as to how we want that exit to happen, we want it to happen as soon as possible and we believe that the prospects for this country thereafter are very positive indeed.

Public Sector Pay Cap

Lord Brooke of Alverthorpe Excerpts

Wednesday 5th July 2017 Lords Chamber

[Lord Bates]

Not for the first time, I am happy to stand corrected by my noble friend Lord Tebbit.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I will return to the Minister’s point about productivity. I have raised questions previously about the extent to which public servants are being encouraged to work and change their productivity and to find ways in which they might be rewarded. Can the Minister say whether any instructions are being sent to the pay review boards about this, to search for better productivity? There may be an opportunity for more money to be paid to public servants if productivity can be linked to their performance, and this may be a way out of the impasse we find ourselves in.

[Lord Bates]

We look at that constantly. When I was at the Home Office we looked at that with regard to the police, as reducing bureaucracy improves practices and efficiency within the police force. We were able to maintain levels of front-line policing while at the same time we saw crime falling to record lows. So all these things can be looked at and improved.

Air Pollution

Lord Brooke of Alverthorpe Excerpts

Monday 3rd November 2014 Lords Chamber

[Baroness Northover]

My noble friend makes a very good proposal. I am sure that he will have seen the report today which, in terms of tackling climate change, puts a great deal of emphasis on planting trees.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, the Mayor of London abandoned plans to introduce congestion charging in west London. Did that help to reduce air pollution or cause more trouble?

Travel to School: Rural Areas

Lord Brooke of Alverthorpe Excerpts

Wednesday 26th February 2014 Lords Chamber

[Baroness Northover]

My Lords, it is clearly very important that young people attend college or school and we recognise that it can indeed be very costly for them to travel, especially in rural areas. Local authorities set out annually the arrangements for transport in their area. Typically, that is for young people to pay an annual fee—a fixed amount. I have a number of details of what is provided. It can be especially good value for those who live in rural areas and for particularly disadvantaged young people, as I mentioned, there is the bursary fund.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, is the noble Baroness aware that there are similar problems in cities, particularly for the young unemployed, who often have great difficulties finding the money to get to interviews that they have been required to attend to ensure they get their benefits? Given there is a possibility that benefits may be withdrawn from those over 18, is it not time to have a complete review of the way in which assistance with travel to work, to interviews, to college or to schools is given? There are many people in the country who are in receipt of benefits—I am thinking of people such as myself—who, quite frankly, do not need assistance with travel on public transport. We could have a fairer or more equitable distribution of the money, particularly for those who are unemployed or going to school or college.

[Baroness Northover]

We keep this whole area under close review. New guidance has just been issued to local authorities so that they work out with enormous care what is required in their area and assess the needs that the noble Lord has pointed to. He obviously points to an important area.

Health and Social Care Bill

Lord Brooke of Alverthorpe Excerpts

Wednesday 16th November 2011 Lords Chamber

[Lord Wigley]

My Lords, I rise with some trepidation as this Bill applies to England only, although there are some consequential effects on Wales. As I was speaking in Grand Committee on the Welfare Reform Bill upstairs a moment ago on initiatives in Wales which should be copied in England, I hope that initiatives in this area will be copied by the National Assembly for Wales and I very much hope that the spirit of the amendments, some of which I have my name alongside, can be taken on board by the Government, even if the wording is not perfect.

I welcome the address made by the noble Baroness, Lady Finlay, in opening this debate and pay tribute to the work that she has undertaken in this context, which is recognised all round. I come from a generation in Wales where we used to have to smuggle ourselves out to the pubs because of the general ban on alcohol that used to exist. In previous generations, understandably and rightly, there had been a clamping down on alcohol use in Wales. My parents’ generation referred to whisky, for example, as medicine and very rarely used it. In fact, the pledge was a general feature of society there. My generation was responsible for a movement in another direction. The pendulum swung and is still swinging in that direction and it is time to start it swinging back.

I have no doubt at all that alcohol is one of the greatest problems that we have in our society today. I say that not as a teetotaller although I restrict myself two months of the year to not touching the stuff because it is so important that we have self-discipline as well as discipline that may come from the statute book. But in terms of violence, the break-up of families, poor performance at work—one remembers David Lloyd George’s initiatives in the First World War to try and clamp down on alcohol because of the effect on the war effort—criminality, injuries and the pressure on accident and emergency departments in hospitals, and the social disruption that arises from it, we can see the effect all around. The effect seems to be hitting people younger and younger. Children at the ages of 11, 12 and 13 are showing the effects of alcohol. That cannot be acceptable.

I realise that in an area of social responsibility such as this it is sometimes difficult to legislate. However, there must be pressure to turn the tide in another direction. Amendment 202 refers to establishing a duty to reduce alcohol harm. Amendment 328 covers the assessment of alcohol damage in local communities. Amendment 329 would provide appropriate places for representatives of alcohol services. These modest steps, taken together, would add up to a message that would come across. I implore the Minister, even if he cannot accept the amendments, to accept the thrust of the argument that lies behind them, because we have to do something about this great scourge of our society today.

[Lord Brooke of Alverthorpe]

My Lords, I hope that the noble Earl will accept these amendments. In many respects they are very modest. I have grave doubts about the extent to which we will be able to influence the course of events in this arena with the changes that we have before us. I am grateful to him for responding in his long letter of 20 October to all of us who raised a variety of questions at Second Reading. He endeavoured to address some of the topics that I had raised on alcohol, labelling, licensing and so on. However, I still believe that ultimately the major issues on alcohol policy will need to be addressed at the centre.

One can do nothing about the cost of alcohol at local level. It must be done centrally. That is being addressed—but inadequately. The marketing of alcohol is something over which local authorities and well-being boards will have no control whatever. The drinks industry is increasingly marketing on the internet and targeting youngsters, particularly in the social networking sphere. I heard recently that one-third of young girls aged 13 to 16 surveyed in Essex are suffering blackouts from excessive drinking. If they continue to drink like that, they will not be ill immediately—they will have good fun and games—but within 10 years, when they get to their late 20s, they will have real problems. What will health and well-being boards be able to do about that? I have been pestering the noble Earl on the labelling issue for quite some time. Nothing can be done about that at local level.

There is one issue that we could have done something about at local level, but we missed our chance. The noble Lord, Lord Clement-Jones, will recall that when we debated the Police and Social Responsibility Bill, we addressed the freedom that people now have to issue licences on a much more liberal basis than used to be the case—we now have a proliferation of off-licences everywhere—but were unable to effect any changes that would have given local authorities greater powers to limit the way in which licences are granted locally. Again, nothing can be done by health and well-being boards.

These are major topics and I wonder how much power there will be to change the course of events. These issues all link to related topics such as obesity and diabetes. It is important that we do not delude ourselves into believing that there will be massive changes without a strong drive from the centre. The nudge-nudge approach will not work with the big drinks industry. Neither, as the noble Baroness, Lady Williams, mentioned this morning, will it work in the context of food, with salt, fats and sugar. These are real problems for people and very little change will be effected at local level; it must all be done centrally.

I come back to the amendments before us. They are very modest and I see no reason why they cannot be accepted. In particular, I will look at the endeavour to achieve change at GP level. Many GPs have been very innovative. Initiatives have been offered to them to effect changes and a number of them have taken up the cudgels and worked adventurously to identify the problems at local level in their communities. Many more have not been doing anything like what should have been done. The Government have declined to accept the screening possibility that was mentioned. Again, I hope that they will be prepared to review their position on that.

Overall, I urge the Government not to reject the modest changes here, but to accept the amendments.

[Lord Turnberg]

My Lords, I should like to speak to the amendments in the name of the noble Baroness, Lady Finlay of Llandaff, and others. I do not think that it is necessary for me to reiterate the dangers of excessive alcohol consumption. The damage done by alcohol is obvious to anyone who visits an A&E department on a Friday or Saturday evening—and indeed, now, almost every evening during the week. It is the cause of more than 1 million admissions a year to hospitals—that is, admissions to hospital beds, not to the A&E department. Liver disease is spiralling out of control. All of this has been described very eloquently by the noble Baronesses, Lady Finlay of Llandaff and Lady Hollins, and other noble Lords.

I want to concentrate on the sort of things that we might be doing—in addition to the things suggested, very modestly, in these amendments—with regard to two aspects, prevention and treatment. It is pretty obvious that the system of voluntary pledges with the alcohol industry does not work. It has not yet worked, and does not look like it ever will. The drinks industry is not in the business of reducing alcohol consumption. We cannot suggest that it is. We have tried the voluntary pledges system, and it is obviously not having an impact.

I agree entirely with my noble friend Lord Brooke of Alverthorpe that we need a national strategy. We cannot rely on local authorities alone. In any national strategy, I fear that we have to focus on the price of alcohol. Our history has shown that every time the price of alcohol goes up, the incidence of liver disease and death from liver death goes down. It is the most effective measure. The Government have suggested that we should look at the minimal unit price, which is the price based on VAT and duty, as the minimal level. That is a pretty pathetic level and it does not work. I am reliably informed by Sir Ian Gilmore, who is a guru on the effects on alcohol, that this price measure affects no more than one in 4,000 drinks that are on sale. You have only to go to the supermarket. It is still possible, for example, to get three litres of 7.5 per cent cider—which is the drink of choice of many—for £2.99, and if you are lucky you can get a two-for-one offer, too. Price is critical. It is clear that the Department of Health is not responsible for pricing, duty and so on, but it must put pressure on for a rise in the price. It is not very popular with journalists, and it is even less popular with politicians. Nevertheless, it is an important measure.

I shall talk about treatment. There is no doubt that the best results from treatment come where there is an integrated team approach to patients suffering from the effects of severe alcohol ingestion. That is a team which combines specialist nurses, specialist doctors, primary care doctors and their team in an integrated way. A good example of that service is the one run by Dr Kieran Moriarty in Bolton. It is a very good system. Unfortunately, there are too few of those sorts of arrangements available. We need many more. They work, because you can actually do something with them. You prevent further damage from alcohol by aborting the effects of alcohol very early on. It works.

There is a lot that is needed, and a lot that can be done. We certainly cannot rely on the drinks industry to put up the price. We have to do something nationally. We have to enhance the alcohol services. I hope we can see some action here. I support these amendments as a first step.