Alcohol Harm

Justin Madders Excerpts

Tuesday 17th March 2020 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Paisley, and I congratulate the hon. Member for Congleton (Fiona Bruce) on having secured this debate. It is always a pleasure to hear from a fellow Cheshire MP, and she introduced the subject extremely well. She was right to say that this is an extraordinary time, but when we hopefully get through the current crisis, the issue of alcohol harm will still need to be tackled. She was also right to say that as we face this crisis, there is an increased risk that long periods of self-isolation will lead to excessive drinking. I know there is tremendous pressure on the Department at the moment, but I hope that important point will be considered. The hon. Lady has also described the importance of integrating the loneliness and social prescribing agenda into alcohol support strategies.

We also heard from the hon. Member for East Lothian (Kenny MacAskill), who brought his own experience to bear on this matter. He was clear that affordability, availability and advertising are the key ways in which to tackle this issue, and that education on its own is not enough; he was also right to identify off-sales as a trend that needs looking at. The hon. Member for Henley (John Howell) made some interesting points about drink-drive limits and also raised the issue of drinking before conception—before the period of pregnancy—which we do not talk enough about at the moment. As always, we heard from the hon. Member for Strangford (Jim Shannon), who discussed in detail the history of his eating habits, raising an important point about moderation and controlling temptation that can be applied equally to this area. He also clearly highlighted the social difficulties caused by excessive alcohol consumption.

We also heard from my hon. Friend the Member for Blaydon (Liz Twist), who spoke mainly about minimum unit pricing. She talked about the benefits that the University of Sheffield’s study demonstrated such pricing could create, and made the interesting point that 48% of publicans support minimum unit pricing, which we do not always appreciate. She was also right that a holistic approach needs to be taken to alcohol harm, which is a point that most Members touched on to some extent.

Every year, thousands of people die because of alcohol consumption and many more people are harmed. This is an issue that goes beyond the individual and affects the whole of society, including their family and their whole community. The statistics we have heard this morning are shocking, and I make no apologies for repeating some of them, because they are worth repeating. Alcohol is the leading risk factor for death for 15 to 49-year-olds in England, and eight people die every day due to alcohol. Alcohol-related hospital admissions are at a record high, having risen by 44% over the past decade. In 2018, there were 1.1 million admissions to hospital related to alcohol use. Every day, 33 people are diagnosed with one of seven types of alcohol-related cancer, and liver disease is a major and increasing cause of death. It causes about 2% of all deaths in the UK every year, having increased by a shocking 400% since 1970.

Those numbers come at a high cost. Alcohol costs NHS England £3.5 billion annually, and 25% of A&E workers’ time is spent dealing with alcohol-related incidents. It is also reckoned to cost the economy £1.2 billion to £1.4 billion annually. In total, over 10 million in the UK consume more than the recommended levels of alcohol.

As we heard, 2 million people have an alcohol-dependent parent; at least 200,000 children live with at least one alcohol-dependent adult. According to the Children’s Society, parental alcohol abuse damages the lives of 700,000 teenagers across the UK. More than 4,000 children a year contact Childline with concerns about their parents’ alcohol use—it is the most common reason for children to call about their parents. We know from previous debates about the adverse childhood experiences of growing up with a parent with alcohol or substance misuse, which can have lasting, and sometimes devastating, impacts on children. We hear about them having to fend for themselves, when they have no option but to take on as best they can the adult responsibilities foisted upon them.

Children themselves may get into a similar spiral. One in three diagnosed mental health conditions in adults is known to directly relate to adverse childhood experiences. The World Health Organisation outlines a cycle of violence, because alcohol and substance misuse impacts on children’s lives, with a devastating impact on their adulthood.

My hon. Friend the Member for Leicester South (Jonathan Ashworth) has campaigned passionately on these issues; he is clear that alcohol addiction is a public health issue and is strongly linked to health inequalities in England. The rate of alcohol-specific deaths is more than double in the most deprived areas compared with the least. Tackling alcohol harm is a key route to increase the health of our nation, to reduce health inequalities and to reduce pressure on our public services. That means investment in those services, focus on prevention and challenging the wider circumstances and social determinants of ill health, including addiction. We struggle with that at the moment, because alcohol services continue to be cut because of public health spending reductions of around £700 million, including addiction services cut by £162 million. That has an impact; we heard from my hon. Friend the Member for Blaydon that local authorities still do not know their public health allocation for next year, despite it coming into force in two weeks’ time.

We must fund alcohol treatment services fully; the hon. Member for Congleton highlighted that 88% of those who need services in Cheshire East are not getting that support. Unless we take this issue seriously, that figure will not improve.

I want to say a few words about workforce. Whenever we talk about health issues, there are always workforce implications. The number of training posts in addiction psychiatry has decreased by 60% since 2006. In 2017, the Royal College of Psychiatrists census found that the NHS had 20% fewer consultant addiction psychiatrist posts than four years previously. Obviously, that has an impact on frontline staff, and there is less one-to-one client contact, which is vital. We must improve co-ordination and partnership working with mental health services. Too many people who experience addiction problems also experience mental health conditions such as depression, anxiety or schizophrenia. Yet just one in four people with a diagnosed mental health problem in substance treatment also receives mental health treatment. We have talked many times about the need for mental health to get parity of esteem.

The Government’s alcohol strategy in 2012 devoted just two paragraphs to recognising the link between co-morbidities of alcohol problems and mental health. That simply is not good enough. Dual diagnosis must be the expectation, not the exception. Just as we need to do more to improve recovery and addiction services, we need to be bolder on prevention and population health interventions. We have a proud record on bringing down smoking rates, because we have taken decisive action. We need to do the same with alcohol abuse; it must be at the heart of the prevention agenda.

There are three areas that should be included—transparency on alcohol labelling, pricing, and prevention and marketing. Unfortunately, there is not time to go through all those in much detail, but I know that the Government committed to a new prevention Green Paper and updated alcohol strategy. While I appreciate that the Department has huge pressures on it at the moment, it would be helpful if the Minister gave us an indication of when we might expect to see that, if she is able to, because that will be the key to making progress on those issues in the future.