(1 year, 9 months ago)
Lords ChamberMy Lords, I apologise for having to be virtual this week. I thank the noble Baroness, Lady Thornton, for this debate, with a very special “thank you”.
I am a member of the All-Party Group on Coronavirus. On several occasions we have taken evidence on long Covid. On the last occasion, three ladies gave us evidence—a doctor, a teacher, and a train driver. All would like to be working, but it was impossible. Long Covid had struck them so badly that they were unable to leave their houses and fatigue and brain fog had taken over their lives. One of the ladies said, “We are the forgotten”. I said, “No, you are not forgotten”. That is why my “thank you” to the noble Baroness, Lady Thornton, for having this debate, is so special.
Recently, I met a doctor at a BMA dinner who is doing research on long Covid in Birmingham. I asked him how he found long Covid, and he wrote to me, stating:
“I have been reflecting on the challenges I am facing in both my roles as a clinician and researcher in long Covid. One of the biggest issues for me personally is the definition of long Covid. It is necessarily broad, given that we do not fully understand it, but it includes such a heterogenous group of patients that the diagnosis has limited use for patients. As a result, it is also very difficult to design studies to understand it better. Funding for specific research to address this would benefit the community greatly.
Pragmatically, my experience of the long Covid services has been good, though I should emphasise I only have experience with one centre, and I am fully aware that across the country services are patchy. We have been fortunate locally to have rehabilitation experts who have joined the team and made a positive contribution”.
Services are patchy across the country in respect of so many health issues. People living in rural areas should not be forgotten, as the right reverend Prelate the Bishop of Exeter said. The key messages from the APPG on coronavirus are that long Covid is having and will continue to have a significant impact on both the UK’s health and economy, that Covid-19 must be recognised as an occupational disease, that a compensation scheme must be put in place for key workers living with long Covid, and that a comprehensive long Covid care system must be established to tackle the significant burden that it will continue to place on the NHS.
Long Covid impacts significantly on the UK population and will continue to do so, including on the UK workforce in both public and private sectors. Many of those living with the acute health challenges presented by long Covid were initially infected as a result of work they did during the pandemic on the front line—caring for patients, educating children and continuing to provide vital transport services—yet support from employers and indeed the state is hugely variable.
The APPG has heard of long Covid’s devastating impact on children. Long Covid can have a significant impact on children’s education as a result of lost learning, and the level of support offered by schools to pupils and to parents of pupils living with long Covid is extremely variable. The APPG has heard that
“children experience a wide range of Long Covid symptoms, and that these symptoms can differ from those displayed in adults”,
yet there remains little research into treatment or specific care pathways for children. Without such research, long Covid will continue to impact the health and education of those children living with it.
There should be government guidance on long Covid across the country for GPs, employers, private and public services and the public at large. Some GP surgeries do not want to be involved, but patients only want to know where to go for help.
I am just about to finish. They need directions—not to feel forgotten and not worth advising. Does the Minister agree?
We need compassion at this difficult time across the country. We need to solve the mystery of why some people develop long Covid and others recover without complications, and to take any similarities into consideration.
(4 years, 5 months ago)
Lords ChamberThe noble Lord is entirely right in his analysis that getting the social and economic package right is imperative for delivering the social behaviour response to the virus. It is completely understood by the Government that, to get people to abide by the kinds of provisions and recommendations coming from the CMO, there has to be a whole-person solution, and that includes figuring out the money. We understand that and are working on it. We have already altered some of the provisions for statutory sick pay so that people can claim after one day instead of four, which is an important change. We are negotiating with the Treasury, the DWP and other parties on making further changes.
My Lords, Swansea University today announced its first case of Covid-19. Given that students travel from all other countries to universities—perhaps in greater numbers than to some sporting events—what particular advice will the Government give to universities?
(7 years, 10 months ago)
Commons ChamberIt is a great pleasure to participate in this incredibly important debate. I congratulate my hon. Friends the Members for Eddisbury (Antoinette Sandbach) and for Colchester (Will Quince) on securing it and thank them for the outstanding work they have undertaken on this issue through the all-party group on baby loss. I also thank the other hon. Members who have participated in that group. I pay tribute to the hon. Members for Lewisham, Deptford (Vicky Foxcroft) and for North Ayrshire and Arran (Patricia Gibson) and my hon. Friend the Member for Banbury (Victoria Prentis) for their brave speeches.
I have known my hon. Friend the Member for Eddisbury for quite some time. We are friends and were Members of the National Assembly for Wales together. Indeed, we used to sit next to each other in the Assembly, and I witnessed at first hand the terrible devastation she faced when going through the loss of her baby. It is testimony to her courage and resolve that, despite her tragic loss, she is highlighting once again this issue that has affected some of us who are here today. It takes bravery to tackle the silence and stigma that used to exist around baby loss. She was instrumental in tackling it as an Assembly Member, and she has been instrumental in bringing this issue to the national stage and raising awareness for the tens of thousands of families who need help and support. I pay tribute to the outstanding work that she does.
In November 2015, the Secretary of State for Health launched the national ambition to reduce the rate of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or soon after birth by 50% by 2030, along with the short-term aim of achieving a 20% reduction during this Parliament—by 2020. That was, no doubt, in large part due to the extraordinary work that my hon. Friends the Members for Eddisbury and for Colchester are doing.
In 2014, there were 3,245 stillbirths and 2,689 infant deaths in England and Wales. The death of a baby is one of the most traumatic events for a mother and father to go through and to deal with the aftermath of. The care that families receive afterwards is vital in helping them to cope in the long term with the loss of their child. That is why I am so pleased that this issue is being raised by my hon. Friends. Awareness is the key to reducing stillbirths and infant mortality, and to tackling the stigma surrounding the issue.
There can be no greater grief than that caused by the loss of a child. It causes psychological conditions that can last years and even a lifetime. The loss never truly leaves you, but how we care for families and individuals can make a huge difference to the future lives of those who live with such tragedy.
I have been through it myself. My wife and I have a wonderful son, but we also lost a child in the 1980s, when there was certainly a stigma around the issue—you just could not talk about it; it was taboo. It was almost an embarrassment to bring it up in public. We could not discuss the grief and sadness that we felt, and we did not have help to deal with what was one of the most traumatic experiences of our lives. It is a devastating experience. I am pleased to say that my son, who is now 34, and his lovely wife Natalie have presented us with a grandchild.
Having children is one of the most marvellous and truly happy experiences for a couple, and something we cherish. Yet, in a moment, we can go from one of the happiest, life-changing experiences to one of the most devastating. When you lose a child, you lose something for which you and your loved one have built a life for and around. You looked forward to going to sports at school, graduations and marriages, and in an instant that cherished future, that child and that happiness are cruelly taken away. I well remember that when we experienced that loss, there was no way to talk about it and all those feelings had to be bottled up. That never does and never can help the grieving process. We, too, were given medical advice to keep trying. I am afraid that that was not quite good enough at the time.
That brings me to the crucial point that, as with many mental health issues, we must communicate to everyone that talking about problems is always a sign of strength and never one of weakness. It is vital that we have the very best care, counselling and services for mothers who have experienced this agonising loss. They must be treated with kindness, sensitivity and respect in the hospital afterwards. It is also crucial that we support fathers who, while being strong for the mother and focusing on her needs, also have to bear the terrible loss.
As I have said, my family have experienced this at first hand. There is a great feeling of powerlessness and anguish when you see your wife, girlfriend or partner rushed into hospital and then into theatre, with no idea of the issue or the outcome, when all you are trying to do is to start your own family. In an instant, the whole world, your family and your life spiral out of your control. You are a bystander to your fate and future, with no power to help your loved ones.
We must therefore ensure that the national health service provides counselling and advice, coupled with statutory leave, so that parents have the best professional support. With that in mind, I wholeheartedly support the efforts of my hon. Friend the Member for Colchester through the Parental Bereavement Leave (Statutory Entitlement) Bill. It is fundamental to guarantee that parents will have some time to grieve for their loss. To ensure that that opportunity is given, it needs to be on a statutory footing.
Finally, I am pleased that the Department of Health has conducted a survey to map the bereavement provision in England to build up a picture of current provision and identify where the gaps are. It is crucial to highlight areas of good practice and understand the challenges that services face. It is also crucial that the Government are increasing the number of midwives, and I hope that that leads to an increase in the number of midwives who have specialist training in bereavement. That should be a lesson to all our devolved Governments.
A Sands report found that fewer than half of doctors and midwives had had mandatory training in care for after the death of a baby. It is vital that staff are trained in caring for the psychological and physical needs of families, and in counselling them when needed. I hope that the Government commit to going even further in improving mandatory training and in supporting the need for statutory leave for families to grieve for the loss of the most cherished thing in our lives—a child.
(7 years, 10 months ago)
Commons ChamberFor many people, drinking alcohol is part of their normal social lives, and we are perfectly clear that these guidelines are advisory. They are in place to help people make informed decisions about how they drink and decide whether they want to take fewer risks with their drinking. They are not designed to label everyone who drinks as a problem drinker or to prevent everyone who wants to drink from drinking, but I point out to the hon. Gentleman that Rochdale has more than double the number of admissions to hospital where alcohol is a factor than the best authorities in England.
Following on from that answer, will the Minister reassure the House that public health guidance given to consumers of alcohol is realistic and will not undermine responsible drinking campaigns, penalise responsible drinkers or damage the vital role that pubs play in our communities?
As I have said, these guidelines are simply intended to be advisory. They are intended to give the best possible information and advice and to put all the evidence in one place so that people can make the best possible decisions with their drinking.
(8 years, 2 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
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.
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?
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.
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.
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,
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.
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.
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.
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.
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?
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.
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?
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. The hon. Member for Hackney North and Stoke Newington (Ms Abbott) will get time to sum up for the Opposition at the end.
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—
Will the hon. Gentleman give way?
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.
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.
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—
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.
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.
(9 years, 2 months ago)
Commons ChamberThe shadow Minister should know that we in this country perform best of all countries that measure A&E, and that is the only way that we can judge this. The trouble is that by talking down that remarkable fact, all we do is denigrate the work of the people who deliver that every day.
I move on to the financial performance of the NHS, the second point that the shadow Minister raised, which lies at the heart of his motion. Let me set the financial context. [Interruption.] While Opposition Members are giggling, they might like to remember that they went into the last election not willing to commit to the NHS’s own plan for the next five years. Only one major party pledged to give the NHS the funding that it requested for the next five years: the Conservative party. The history on delivery is clear: we are talking about an additional £12.9 billion of cash in the last five years; a contribution of £2 billion this financial year, and a further £8 billion to fulfil the five-year plan. That is the financial background to this debate—a background that the Opposition refused to match at the last election. Money on its own does not get to the root of the problem, which I am afraid is not recognised in the motion, namely the relationship between quality, standards and money.
Does the Minister agree that it would probably do the shadow Minister and other Opposition Front Benchers a great deal of good to move down to Wales, where there has been an 8% cut in the budget? Wales has not met A&E targets since 2008.
It is a real delight to respond to my hon. Friend. It is a good thing for the shadow Minister and those living in England that they do not have to endure the experiences of people in Wales, which have, I am afraid, been inflicted on them by the appalling management of the Labour Government there, who chose not to invest in the NHS in the way that we did, in a time of constrained budgets across the public sector. I have to say to the shadow Minister that by concentrating on money—he cannot match the Conservative party’s commitments on that anyway—he misses the points around quality and safety, which are conjoined with money. If we go back to the Mid Staffordshire NHS Foundation Trust—[Interruption.] Opposition Members may groan, but they may wish to reflect on why Stafford hospital went wrong. It was within budget and was hitting its targets, yet at the same time it was killing people. Until that simple fact is remembered, and until we put quality and patient care first, we will not get the efficiency, as regards either care or money, that I am sure Members on both sides of the House wish to see.