Alcohol Abuse

Baroness Berridge Excerpts

Thursday 30th March 2017 Grand Committee

[Baroness Berridge (Con)]

My Lords, I thank the noble Lord, Lord Brooke, for his persistence in keeping the matter of alcohol abuse on the parliamentary and government agenda.

Evidence and reports abound on this matter. Public Health England did a thorough evidence review in 2016, the Government’s alcohol strategy was issued in 2012 and there are numerous reports detailing the cost to the NHS, which has been outlined as £3.5 billion a year. Last year there was an excellent report by the APPG on Alcohol Harm called The Frontline Battle about the huge burden on the emergency services caused by alcohol misuse. However, there is precious little mention in these reports—or, therefore, praise or policy from Her Majesty’s Government in this regard—of how alcohol and its use varies in religious and ethnic minority communities, the Joseph Rowntree Foundation report in July 2010, Ethnicity and Alcohol: A Review of the UK Literature, being a notable exception.

What is known is that in many ethnic minority communities the rates of abstinence are higher. According to the Public Health England evidence review that I have mentioned, 15% of white women, 38% of black women and 74% of British Asian women abstain completely. There are many reasons for this, including the physiological. According to the Berkeley university well-being project, it is very common in people from Chinese, Japanese and Korean backgrounds to have difficulty digesting alcohol because of a genetic variant that impairs the production of an enzyme that helps to metabolise alcohol in the liver. Within religious communities such as the Latter-day Saints, Muslims, the Salvation Army and Methodists, and for many within the black Pentecostal churches, refraining from alcohol is advocated, which may explain the lower levels of alcohol consumption in the British black and black Caribbean communities.

While the main government messaging needs to remain around drinking sensibly as this is the majority activity, the lack of commendation by the NHS and government Ministers of religious and ethnic minority communities, particularly Muslims, who refrain is remiss. Having taken part in the parliamentary police service scheme and been out on a Friday night on Shaftesbury Avenue, it is not people in obvious religious attire such as Muslim women or Salvation Army leaders that you see literally in the gutters and then appearing at A&E—a fact that is just not mentioned. These religious and ethnic minority communities are indeed ahead of the curve as they are in tune with the rising number of young adults, the millennials, who drink in moderation or do not drink at all.

Studies have shown that where there are young adults in a college setting with a significant number from a black or minority ethnic community, overall the young people in that group drink less. It has an effect of good peer pressure within the group. Yet the lack of evidence is serious as without it there are none of the bespoke policies needed to help those in these communities who drink. There is evidence that when such people drink they do so at higher levels, hidden away and facing barriers to accessing the help they need from the NHS. Also, if you drink without the enzyme to break down alcohol there are greater health risks and a higher incidence of hypertension. I have not seen any awareness of this within the NHS.

A national piece of work, looking at the evidence and policies in Yorkshire mill towns, city centres such as Birmingham, Chinatown and boroughs such as Lambeth is well overdue. It would show how much ethnic minorities save the National Health Service but also any deficiencies so that people could then access services they need. Perhaps religious leaders could also help bring down the barriers for communities when they need to access other professional services.

Mental Health and NHS Performance Update

Baroness Berridge Excerpts

Monday 9th January 2017 Lords Chamber

[Lord O'Shaughnessy]

I thank the noble Baroness for her question. She is absolutely right: millions of people across the country care for a relative who has some care need, be it a spouse, somebody at retirement age or a child with mental health problems. I do not have the specific details to answer her question; I shall write to her with those details—but through the social care reforms being delivered by local authorities and the reforms going forward through the five-year forward view in community health, there is more focus on that ground-level support, in a way that is much more difficult to do from Whitehall. So we are seeing through the early drafts of the STPs—one of the new bits of jargon that I have had to learn—ideas for how to provide family support that goes beyond the statutory support that is available through the benefits system or the community health system.

[Baroness Berridge (Con)]

My Lords, I welcome my noble friend to his new role and welcome particularly his comments on the parity in practice, as well as in law, of mental and physical health. I welcome the Government’s commitment of money and the Green Paper on young people’s mental health. Can my noble friend please comment on whether there will be a focus on the disparities of outcomes that persist for many in the black and minority ethnic community, who are often diagnosed late, are more likely to be detained for their condition and overall suffer poorer outcomes as a result in mental health? Could some focus be given to these issues of disparity?

[Lord O'Shaughnessy]

I thank my noble friend for her warm welcome. I take that point very seriously. Clearly, parity of esteem is no good unless it is applicable to everybody who is suffering from a particular illness. I am not fully aware of the details of the nature of the disparity with black and minority ethnic families but, if there is a problem, making sure that we fulfil this ambitious and I hope welcome strategy is going to make sure that we can lift performance of those services for people in minority ethnic groups.

HIV Diagnosis: Clinical Guidance

Baroness Berridge Excerpts

Thursday 1st December 2016 Lords Chamber

[Baroness Berridge (Con)]

My Lords, one of the largest groups within the population who have got this disease through heterosexual transmission is the British black African community—men and women. There are 30,000 cases there. As of last year, estimated undiagnosed cases were increasing within this population. Can my noble friend the Minister please outline what initiatives are specifically aimed at raising awareness and avoiding the late presentation prevalent among that community? In particular, as many in that community are members of faith institutions, what is being done to engage them in raising awareness?

[Lord Prior of Brampton]

The black African community, male and female, is a group especially vulnerable to HIV, as identified in the work done by NICE. It is a part of the population where special efforts must be made to increase early testing. The work done by the Terrence Higgins Trust in the MARPs programme has also identified that community as extremely important. I think we will see greater targeting of the about 13,000 people in the population who are living with undiagnosed HIV.

Health: Black and Minority Ethnic Psychiatric Patients

Baroness Berridge Excerpts

Monday 29th February 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Baroness makes a very important point and that is why the Prime Minister has asked David Lammy to conduct an inquiry into this precise issue. In his recent report, the noble Lord, Lord Crisp, recommended that there should be a patients and carers race equality standard. The Five Year Forward View for Mental Health, produced recently by Paul Farmer, recommended an equalities champion. I hope that we will be able to do both those things in the near future.

[Baroness Berridge (Con)]

My Lords, the Minister of State, Alistair Burt, said earlier this month that he would be meeting a wide range of stakeholders to look at BME groups and their unequal access to mental health services. Will the Minister confirm that those stakeholders will include faith community leaders? Black and minority ethnic people are also disproportionately members of faith communities. If those leaders could be trained in recognising the early signs of mental illness, perhaps more people would be referred earlier to the mental health services that they need.

[Lord Prior of Brampton]

My Lords, I will certainly have a word with Alistair Burt, the Minister of State for Health, who is having the meeting to which the noble Baroness referred. I will bring her comments to his attention.