Alcohol Harm

Patricia Gibson Excerpts

Tuesday 17th March 2020 Westminster Hall

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am pleased to be participating in this debate. I begin by paying tribute to the hon. Member for Congleton (Fiona Bruce) for giving us a very thoughtful and comprehensive opening to the debate. I begin also by saying that people have mentioned the effect of being isolated at home because of the coronavirus and that it is worth bearing in mind, as we go through this crisis, that drinking alcohol lowers the body’s immunity.

We have heard a lot today about the damage of alcohol over-consumption. The cost to our families, our communities and ourselves is almost incalculable. It cannot be counted in pounds and pence, although very often we are forced to do that, for practical reasons. Alcohol abuse leads people to lose their homes, families and jobs. There is a cost in hospital admissions, perhaps on numerous occasions, and people may even end up encountering the criminal justice system. Victims of alcohol abuse become economically inactive. They often become absent parents. The damage to mental health and physical and emotional wellbeing is profound.

I remember standing in this Chamber a couple of years ago to speak on alcohol abuse. A number of us involved in that debate were willing to admit that we came from homes with an alcoholic parent. My father was by all accounts an alcoholic, although I never knew him, as he died when I was 15 months old—he was very much helped on his way by alcohol. The damage to my family was not insignificant. My husband’s father was also an alcoholic and died because of the demon drink. These stories are not unusual; in fact, they are far too common. Almost every person we meet has a family member or knows someone who is an alcoholic. That is very sad, but it is a fact of life. However, that does not mean that we cannot turn things around. It does not mean there are not measures that we can take and, in Scotland’s case, have already taken to combat this problem. There is no silver bullet, but much can be done to mitigate the harmful grip that alcohol has on our communities. In the round, a number of measures can be taken.

In Scotland, 686 hospital admissions and 22 deaths every week are due to alcohol. In 2018, the figure for alcohol-specific deaths was 1,136. In 2018-19, there were 35,685 alcohol-related hospital admissions in general acute hospitals. Worryingly, hospital admissions are still more than four times higher than the level seen in the 1980s. Clearly, in Scotland, we could not simply shrug our shoulders and tolerate that. We tried to turn the situation around. I am pleased that the SNP Government chose to use the powers at their disposal to tackle the level of alcohol harm suffered by our communities, at great cost to those communities, on every single measure.

The hon. Member for Congleton pointed out the need for England to have a revised or updated alcohol strategy, and she is correct to say so, as the current one is out of date. Indeed, the Scottish Government updated their own alcohol strategy in 2018.

I could stand here today and talk about the fact that the Scottish Government have invested almost £800 million to tackle alcohol harm and drug use since 2008 and will allocate a further £95 million next year to reduce the harms caused by alcohol and drugs. I could mention—indeed, I have already alluded to—the Scottish Government’s alcohol framework setting out 20 actions that build on existing measures to change Scotland’s relationship with alcohol. I could even mention the legislation introduced by the Scottish Government to ban irresponsible alcohol promotions, such as the multi-buy discounts in supermarkets.

[Jim Shannon]

Will the hon. Lady give way?

[Patricia Gibson]

I am worried about time, so I will press on, if that is okay.

That legislation was associated with a 2.6% reduction in consumption in the 12-month period following its introduction from October 2011. The hon. Member for Henley (John Howell) might be interested to know that in 2014 Scotland reduced the legal alcohol limit for drivers from 80 mg to 50 mg in every 100 ml of blood. That reduction has not been made in the rest of the UK, which, apart from Scotland, currently has the joint highest levels in Europe that are permitted for driving. I could mention a whole range of measures—

[Ian Paisley (in the Chair)]

The hon. Lady has another six minutes. She does not need to feel that she is rushed.

[Patricia Gibson]

Okay. I will give way briefly.

[Jim Shannon]

I compliment the hon. Lady and particularly the Scottish Parliament on what they are doing. The hon. Lady has outlined a blueprint for the whole of the United Kingdom of Great Britain and Northern Ireland. We should all take note of it and let it be our blueprint for Northern Ireland, Wales and England.

[Patricia Gibson]

I thank the hon. Gentleman for his comments. As I will go on to say, there is no room for complacency in any part of the United Kingdom. There are things that work that every part of the United Kingdom should implement, and the UK should continue to review them to see how the measures can be improved.

All the measures that have been taken, on their own merits and collectively, represent real action and commitment to dealing with the scourge of alcohol on our communities. Many of them were set out by my hon. Friend the Member for East Lothian (Kenny MacAskill), who has significant insight into the issue from his role as Cabinet Secretary for Justice in the Scottish Government. There has been broad agreement today that minimum unit pricing for alcohol is the single most significant action that can be taken to tackle alcohol harm, as we have seen in Scotland, but it is not a silver bullet. Nothing is, and nothing ever will be. As my hon. Friend the Member for East Lothian reminded us, it is part of a package of measures and must be seen in that context. I urge the Minister to emulate that measure in England in order to benefit the communities that many Members in this Chamber represent.

When it comes to the strongest drinks on the market, in England we can buy cider for 18p, lager for 23p, vodka for 36p and wine for 38p—I am talking about units, not bottles. Minimum unit pricing was introduced in 2018 in Scotland. Shamefully, the policy was delayed for several years as the alcohol industry dragged it through every court it could find to stop it or delay its implementation for as long as possible. Studies indicated that there would be around 121 fewer deaths a year as a result, and there would be a fall in hospital admissions of just over 2,000 a year by the end of year 20 of the policy.

It gives me no pleasure to say that the initiative sadly met more blocks during its passage through the Scottish Parliament, as opposition parties opposed it purely on the basis that nothing the SNP Government introduced could ever be supported. Although that is the usual response to any SNP policy in the Scottish Parliament, eventually the Tories abandoned their absurd opposition. Labour, however, simply could not bring itself to do so because it was an SNP initiative. The Labour party argued and argued against it and grew more ridiculous with every word. In the end, unable to support it even in the face of overwhelming evidence that it would be a key weapon in the battle against alcohol harm, Labour contented itself with abstaining on the issue. I know that many Labour MPs from other parts of the UK looked on at their Labour colleagues with bewilderment at what was going on—not for the first time, and probably not for the last. Willingness to put narrow party politics before public health is one of several reasons why the Labour party in Scotland is completely adrift. Some issues go far beyond party political lines.

The evaluation of the first year of alcohol minimum pricing has been very promising. As the first country in the world to introduce such a measure, we saw off-trade sales per adult in Scotland fall by 3.6% in the first year after implementation. In the same period in England, there was a rise of 3.2%. There was an 18.6% fall in off-trade cider sales per adult in Scotland in the year following minimum pricing, and an 8.2% rise in sales in England and Wales. There is still more to do, and there can be absolutely no complacency.

A 50p per unit price provides a proportionate response to tackle higher-risk alcohol use. We know there is a proven link between consumption and harm, and that minimum unit pricing is the most effective and efficient way to tackle the cheap, high-strength alcohol that causes so much harm. Going back to the comments made by my hon. Friend the Member for East Lothian, the World Health Organisation said that tobacco education was not, and could not be, as effective as regulation and Government action. We need to remember that when we seek to tackle alcohol harm.

People in Scotland still buy 9% more alcohol per head than those in England and Wales, but that gap is closing because of growing sales of alcohol in England and Wales last year. A 50p minimum unit price is no longer sufficient, because after it was brought in in 2012, the implementation of the policy was delayed by court action for years after the 50p level was set. It is time to explore raising that unit price to 60p, because it has to be set at a level where it is effective; it is not there for some kind of virtue signalling. A 60p minimum unit price seems reasonable to me.

I urge the Minister to carefully examine the action that has been taken in Scotland to tackle alcohol harm. It is a basic economic fact that if the price goes up, consumption goes down, and if the price goes down, consumption goes up; it is not rocket science. There are no silver bullets for tackling this issue, but there is some good practice in Scotland. Scotland, as well as England, has to build on what we already know and what we are already doing. I urge the Minister to emulate this practice for the good of the families and the communities who live with this scourge every day, and who need action.

--- Later in debate ---

[Helen Whately]

As I said, I fully appreciate and respect my hon. Friend for the huge amount of work that she does to urge us to recognise the harmful effects alcohol can have.

We know that alcohol misuse can have an impact on hospital care and demand. It contributes to a wide range of conditions including cardiovascular disease, cancer and liver disease, as well as accidents, violence and self-harm. Some 12% to 15% of A&E attendances are alcohol-related, and alcohol is a causal factor in the patient’s diagnosis for more than 1.1 million hospital admissions every year. We absolutely take my hon. Friend’s concerns seriously.

As part of our NHS long term plan, alcohol care teams are being introduced in hospitals with the highest number of alcohol-related admissions. It has been shown that those teams significantly reduce avoidable bed days and re-admissions. The seven-days per week service at Royal Bolton Hospital saved 2,000 bed days in its first year, and modelling suggests that alcohol care teams in every non-specialist acute hospital will save 254,000 bed days and 78,000 admissions per year by their third year of operation.

Thanks to the personal testimony and campaigning by hon. Members present and by others who were unable to attend, the Government have invested £6 million to improve outcomes for children with alcohol-dependent parents. That funding includes £4.5 million for nine local areas to test innovative ways of working and to join up systems to support children and families—promising results are emerging in those areas. We have also allocated £1.5 million to voluntary sector organisations to build resources and capacity at national level, including helpline and contact-centre support through the National Association for Children of Alcoholics. We are also investing £6 million through a capital fund to enable local authorities to improve services and facilities for people with alcohol problems.

We continue to educate the public, ensuring that people are aware of the health risks of alcohol through local and national programmes, such as Public Health England’s One You campaign. The alcohol risk assessment in the NHS health check is used to inform a discussion on reducing the individual’s risk. New guidance encourages referral for liver investigation, where risk is identified. In addition, there is a commissioning for quality and innovation—CQUIN—scheme to incentivise increased cirrhosis and fibrosis tests for alcohol-dependent patients.

My hon. Friend also mentioned labelling. We have worked with industry to communicate the UK chief medical officer’s low risk drinking guidelines on the labelling of alcohol products. The Portman Group and others in the industry have made a commitment that labels will reflect the guidelines and we are closely monitoring progress.

We have also made a commitment in the prevention Green Paper to work with industry to deliver a significant increase in the availability of alcohol-free and low-alcohol products by 2025. A roundtable is being organised to take this work forward. Encouragingly, sales of no or low-alcohol beer are up 30% since 2016 and “nolo” alcohol is set to be one of the driving trends of 2020, although I am sure trends are being reviewed in the light of the pandemic.

Public Health England supports local authorities in their work of needs assessment and commissioning alcohol and drug prevention and treatment services by providing advice, guidance and data. PHE is developing UK-wide clinical guidelines for alcohol treatment. That work will promote good practice and improve the quality of service provision, resulting in better outcomes for patients.

We know that alcohol-exposed pregnancies present a significant public health problem across the country. Foetal alcohol spectrum disorder can have a major impact on the early years development of children and their life chances. There is great work under way at local levels to tackle this. For example, the Greater Manchester health and social care partnership recently launched its #DRYMESTER campaign to raise awareness of drinking alcohol when pregnant. NICE are currently consulting on a draft quality standard on FASD. The voluntary sector also plays a vital role here. As part of the children of alcohol-dependent parents funding programme, over £500,000 is being made available to support work on FASD.

Finally, the good news from the budget is that £46 million in funding is being provided to improve support to individuals experiencing multiple complex needs. That includes tackling homelessness, reoffending and substance abuse, including alcohol misuse. In addition, as part of our rough sleepers programme, there is £262 million of new funding for substance misuse treatment services. When fully deployed, that is expected to help more than 11,000 rough sleepers a year. It will enable people to move off the streets and support them to maintain a tenancy for the long term. The funding complements £237 million announced by the Prime Minister for accommodation for rough sleepers, and a further £144 million for associated support services.

Several hon. Members raised minimum unit pricing, particularly the hon. Member for North Ayrshire and Arran (Patricia Gibson), who drew on her experience in Scotland. There are no plans to implement minimum unit pricing in England at present, but the Government continue to monitor the evidence as it emerges from Scotland and Wales.

Several hon. Members talked about the Government’s alcohol addiction strategy. As announced in November, we are undertaking a UK-wide cross-Government addiction strategy. Plans on the contents of the strategy are being developed and we will have more to say on this shortly.

[Patricia Gibson]

I listened carefully when the Minister said that the Government currently have no plans to implement minimum unit pricing. In the light of that, and given the funding and investment she talks about that will deal with the consequences of alcohol addiction, does she agree that tackling the consequences is less effective than tackling the problem at source? Cider and some of the highest content alcohol is on sale in shops in England for less than a bottle of water or a pint of milk. Does she agree that making alcohol a little bit more expensive could have an impact?

[Helen Whately]

I thank the hon. Lady for her contribution and I take her point. It is important that we continue to look at the evidence and that is the approach we will follow. I thank everyone here today for their contributions to this important debate and for having this conversation.