Rev. Martin Smyth (Belfast, South): I appreciate the opportunity of speaking first in this debate. The wide representation here from different political parties shows the tremendous interest in the subject of alcohol abuse. I realise that the ten-minute rule Bill introduced yesterday by the hon. and learned Member for Dudley, North (Ross Cranston) focuses on England and Wales, but with my background in Northern Ireland, I share the concerns of English and Welsh Members about the problems faced by their constituents and in the country at large as a result of alcohol abuse.
An early-day motion also expresses our concern about the difficulties that alcohol brings to so many; it affects young people, hospital provision, social care and criminal activities, as well as the multitude of accidents on the roads. I shall draw attention to some of the important issues and others will follow.
Our debate arises out of a growing concern about the impact of alcohol abuse from its health aspects right through to the public order consequences, as illustrated by the role of alcohol in the increasing number of attacks on hospital workers and health professionals. This subject is equally relevant to Northern Ireland as to England and Wales. My own constituency houses the Golden Mile, the centre of entertainment. I know how much extra law and order activity is necessary in that area with its large number of bars and clubs; it has drink-related problems every weekend.
Some say that alcohol is not really a problem, but I wonder if they live in the real world. Statistics show that at every level of health care, an increasing number of deaths are directly and indirectly associated with alcohol abuse. Historically, we have tended to blur the impact of alcohol abuse. We used to say that the problem was epitomised in the well-known Glasgow song, "But what's the matter wi' Glasgow/ For it's goin' roun' and roun'!". Nothing is the matter with the drunk in that song; Glasgow is the problem. That is the difficulty with alcohol.
I recall a statistic from years back that suggested that one in 12 people who drank alcohol could end up as alcoholics. To illustrate that level of doubt, I was once asked whether I would go on a plane if one in 10 of the seats were likely to fall out. That is an apt illustration of the concern arising out of recent tragic accidents.
The English statistics quite closely match those reported by the chief medical officer in Northern Ireland, Dr. Campbell, in March this year, according to which 800 people a year die either directly or indirectly through alcohol abuse. Dr. Campbell showed that 150 people die directly from alcohol misuse while another 650 die through disease or injuries related to drink.
According to figures released in August 2001 concerning 15 to 16-year-olds from 71 secondary schools, two thirds of the boys and girls said that they had consumed alcohol in the previous 30 days. Approximately half said that they had been drunk in that period. That tallies with the statistics and information from England and Wales, where children aged 11 to 15 were consuming twice as much alcohol in 2000 as in 1990. More than a quarter of 11 to 16-year-olds27 per cent.drink alcohol at least once a month, compared to 23 per cent. in 2000. Drinking is more common in older adolescents, with almost a third of 15 to 16-year-olds drinking at least once a week.
As people develop the habit of drinking, so they tend to imbibe more as they get older. That has a growing impact on industry, our social structure and homes. Those involved with social care reckon that 920,000 children live in homes that are affected by alcohol abuse. We are concerned about the welfare of children, who are our most precious heritage as a nation. There is a demand that, within our structures of carein health and in society at largesomething more positive be done for that group.
When we speak of under-age drinking, which can be characterised by binge drinking rather than the odd glass, it must be said that some of our finest talent has failed to reach its maximum potential because of alcohol abuse. That is particularly evident in Northern Ireland with those sports personalities whom we have exported to Great Britain. I am sure that we can think of other people who began well, but because of alcohol abuse did not finish so well. That is a tragic example to give people. I appeal to those personalities in our society to set a better standard and example, so that young people who look on them as role models will have better models to follow and will not suffer from alcohol abuse as others have.
I remember a young friend, who tragically was murdered by the IRA, saying that he liked to take a glass of wine before he spoke because it helped to relax him. I understood what he was saying and do not criticise that at all. However, many young folk who have begun on that road have found alcohol to be a cruel and demanding master rather than a help.
We must provide assistance early to prevent young people from becoming trapped in a spiral of alcohol abuse. Everyone in society must play their part in fighting the problem, starting with under-age drinking. From personalities and leaders to those who serve alcohol, everyone must be aware that they are setting an example that young people follow.
When we examine this situation, people ask, "What can we do about it?" I welcome the helpful work that has been done in our hospitals, but at times we might need other institutes or alcohol or drug clinics to take a greater lead. An example in my constituency was the Shaftesbury Square hospital, an old hospital that became a unit for the treatment of those with alcohol problems. With the financial entrenchment in our health service, some argued that it should be brought into the mainstream in Belfast City hospital, which has a fine unitthe Windsor unitdealing with people with other problems, too.
Mrs. Marion Roe (Broxbourne): I am delighted that we are having this debate this morning because, as vice-chairman of the all-party group on alcohol misuse, I have raised the matter in the Chamber myself. Does the hon. Gentleman agree that many voluntary organisations are also involved in trying to deal with the problems of alcohol misuse, such as that in Hertfordshire where an alcohol advisory group, manned by volunteers, does a fantastic job? Does he also agree that the funding that is available for these groups is always uncertain? Is it not important that these people are given some sort of security to carry out their work at a very reasonable cost, rather than being a burden on government funding. Their work is much appreciated, not just in Hertfordshire, but in a wider area, as they provide examples for others.
Rev. Martin Smyth : I appreciate the hon. Lady's intervention. I was about to say that the Shaftesbury Square unit was kept open because it was so needed. I share her position completely. I am aware of the voluntary bodies, which do a lot of work. The tragedy is that even the Government admit in their statistics that it is difficult to say how much money is being used in health care to deal with alcohol misuse. Through funding voluntary groups at the moment, we do far more project funding than core funding, and core funding is vital for consistent work. On the other hand, I should have thought that any Government aware of what was happening in society would realise that projects need to be funded to give continuity of care to those who need it.
There is a need for greater co-operation within society between the various agencies. I speak not only of the voluntary bodies, but of the police, health workers and social services. An interesting experiment has developed in my constituency and is going on in other parts of north Belfastthe "get home safe" campaign. It is a perfect example of the police, council, university and licensees working in partnership. I do not know how far the situation has developed here but some publicans in Northern Ireland have been ahead of the Government. I have long argued for the introduction of an ID card for 16-year-olds, which would be available right across society. Civil libertarians are not too happy, although the Americans do not seem to have problems with it.
Publicans in Northern Ireland have begun to issue their own cards so that they are not caught out by someone looking much older than they are. That is an old excuse. There is a place for such co-operation to develop. We can then provide the services from the beginning, backing up families and especially women who may be involved in secret drinking because of pressures at home. We must get a clearer message across that the law dealt with the serving, not the selling, of alcohol to under-age people. That has been glossed over time and time again.
The time has come for the Government to give a stronger lead, and not only in funding. Tragically, that may start with taking money away from front-line services to provide greater security to health professionals in the accident and emergency departments of our hospitals, where staff are attacked regularly by people who have been drinking. The Government can also stretch across society to help the young and old. I often wonder whether there could be more dramatic advertisements to penetrate the conscience of men and women, young and old, to warn them that their own stupidity is grieving them, harming industry and costing the nation billions of pounds. The tax that the Chancellor draws from the alcohol industry hardly meets the costs of caring for those who abuse themselves and others through the misuse of alcohol.
Ross Cranston (Dudley, North): I congratulate the hon. Member for Belfast, South (Rev. Martin Smyth) on starting the debate. I also thank those present, and all those who were not able to attend the debate, for their support for my ten-minute Bill, which I introduced yesterday. I apologise on behalf of my hon. Friend the Member for Luton, North (Mr. Hopkins), the chairman of the all-party alcohol misuse group, who could not be here this morning. He has a pressing constituency engagement. The hon. Member for Colchester (Bob Russell) wanted to attend the debate, but also had a pressing engagement. I also want to highlight the work done by the charity Alcohol Concern, which has been a trailblazer in drawing attention to the problem of alcohol abuse, and has produced several practical solutions to the problem.
Mr. Gareth R. Thomas (Harrow, West): I apologise to my hon. and learned Friend for intervening so early. I endorse his praise for Alcohol Concern, as I was lucky enough to have a two-day secondment with the organisation through the voluntary sector's equivalent of the Industry and Parliament Trust. In advocating a national strategy to tackle alcohol misuse, Alcohol Concern has consistently referred to the high incidencemore than 80 per cent. at timesof people admitted to accident and emergency departments with alcohol in their bloodstreams.
Ross Cranston : That is certainly the case. My hon. Friend has drawn attention to the impact of alcohol abuse on health. I want to draw attention to the impact on the criminal justice system. My right hon. Friend the Home Secretary recently highlighted the involvement of alcohol in youth offending. I want to expand on that. The victims of alcohol-related crime are most noticeable in three categories: first, violent crimes in public places; secondly, individuals killed or injured through drink-driving offences; and, thirdly, family members who are subjected to violence or abuse in the home. I came across the first category when sitting as a recorder. At my level, I tend to get cases of Friday or Saturday night fights. Sometimes, they are simply affrays, but often the cases are much more serious; I have tried cases involving serious glassings, in which the victims were scarred as a result of fights fuelled by alcohol. I shall return to the link between alcohol-induced aggression and violent crime in a moment. In Dudley, in my constituency, the
I mentioned three categories, but there are other aspects of criminal behaviour associated with alcohol. Recently, Stephen Wooler, the chief inspector of the Crown Prosecution Service, published an excellent joint thematic report with Her Majesty's inspectorate of constabulary on rape, which validates the work of the chief inspectorI was associated with the establishment of the officeand Stephen Wooler and his team are to be congratulated on their work.
Ann Deehan published a report for the Home Office in 1999 entitled "Alcohol and Crime: Taking Stock". She collected statistics that suggested that alcohol misuse contributes to an estimated 40 per cent. of violent crime, 78 per cent. of assaults and 88 per cent. of criminal damage cases. Other studies underline the association between alcohol and criminality.
It is important, however, not to think that there is a direct causal link; researchers caution against the assumption that because there is a correlation, there is direct causation. Other factors must be considered, for example, personality traits. Alcohol consumption by stressed individuals can predispose them to violence and individuals' defence mechanism for dealing with anxiety and so on may be lowered by alcohol. There is not necessarily a direct, causative link. Ann Deehan's study states:
The centre for health economics in York advanced another aspect of measuring the impact of alcohol misuse on the criminal justice system. It tried to measure the cost involved and came up with an estimate, in 1994, that the social cost of criminal activities was approximately £55 million. The House of Commons Library gave me useful figures that build on that estimate. Although it is a guesstimate, it suggests that we are dealing with a serious problem.
Alcohol Concern, to which my hon. Friend the Member for Harrow, West (Mr. Thomas) and I referred, suggested several ways in which we can address the problem, one of which it calls "designing out drink disorder". The strategy includes national standards on managing the environment in and around drinking locations, toughened glass requirementsas I mentioned, one often comes across tragic incidents of glassingenhancing the role of public transport in preventing alcohol-related disorder, and diversionary options.
There are therefore several practical ways of addressing the violent offending in the first category, and the drink driving in the second category. I am disappointed that we still have the 80 mg limit in this country. I am sure that we could do more to promote responsible drinking by conducting national public health campaigns. The campaign against driving when one is tired has had an impact, and I am sure that a similar campaign to promote responsible drinking would do the same.
Under the Crime and Disorder Act 1998, the local crime partnership in my constituency of Dudley has included alcohol in its strategy. The Home Office does not require that, but the partnership has made alcohol misuse and its reduction one of its four key aims. I hope that other community safety partnerships can do the same. I pay tribute to the dedication of what was the Dudley Priority Health NHS trust for putting alcohol at the centre of its agenda, and I pay special tribute to the work of Richard Rogerson.
As a result of the strategy, there are several innovative programmes in Dudley, including a pilot for an arrest referral scheme. Under the scheme, arrest referral workers based in the custody suites of the main police stations have access to cells, and the custody sergeant informs the arrested person of the scheme. If that person volunteers to go on a limited programme, they are confronted with the results of alcohol abuse. It is too early for an evaluative study of the programme, but it appears that people are referring themselves to it and to other longer programmes.
In the long run, including alcohol abuse in the strategy will have a beneficial effect. However, this is not universal; it is not a requirement that a crime and disorder partnership includes alcohol in its auditing and planning process. I hope that as a result of my ten-minute Bill, all local crime partnerships will take alcohol seriously.
I hope that as a result of this debate, the messages will go out that the problems associated with excessive alcohol consumption are as great as or even greater than those associated with illegal drugs and that much more needs to be done.
Mr. David Amess (Southend, West): I congratulate the hon. Member for Belfast, South (Rev. Martin Smyth) on giving us the opportunity to debate such an important issue. Cynics might say, "Fancy having a debate on alcohol abuse in the House of Commons." All I would say to that is that I think we are greatly maligned.
I pay tribute to the hon. and learned Member for Dudley, North (Ross Cranston), who did the House a great service yesterday by introducing his ten-minute Bill. I hope that, when the Minister responds to the debate, we shall hear that that Bill is to become law in some sense. We would be well advised to listen carefully to what the hon. and learned Gentleman says. As a recorder, he sees what happens in the courts as a result of alcohol abuse. If the public regard Members of Parliament increasingly cynically as not being responsible legislators, we would be foolish not to take action.
Why do people drink? I suppose that they drink to relax, to drown their sorrows because they have some private problem or as a result of habit. In my experience, drinking too much has two effects: first, it makes people very happy and ultimately very sillymy goodness, what a bore it is to be in the company of someone who is very silly and a little too happy; and, secondly, it makes people violent, which is a very serious matter. All Members of Parliament can see the results of such violence, especially among young people, and I am sure that the hon. and learned Member for Dudley, North can testify to that. We have all seen at football matches the result of youngsters drinking too much. Thank goodness, that is now being dealt with.
I went to the House of Commons Library, which I regard as the purveyor of truth so far as statistics are concerned. Its statistics on drinking are truly shocking. On hazardous drinking, men are more likely than women to have scores in the hazardous rangethe score is 35 per cent. of men and 15.5 per cent. of women. Hazardous drinking patterns tend to decline with age. Nearly 42 per cent. of 16 to 24-year-olds scored more than eight, but only 12 per cent. of those aged 65 to 74 were in the same category. However, I am ashamed to say that a greater proportion of men than women drink at a dangerous level, even with advancing years.
My second set of figures is for dependence. Again, dependence is more marked in men. Some 11 per cent. of men were in higher categories, whereas fewer than 3 per cent. of women met higher dependency criteria. High dependence levels, too, are associated with younger people.
The third set of statistics that I got from the Library concern alcohol consumption among pupils, to which the hon. Member for Belfast, South referred. Overall, mean alcohol consumption for pupils aged 11 to 15 doubled from 0.8 units in 1990 to 1.6 units in 1998. That is a huge increase and, frankly, we are barking mad to free up the licensing laws in this country. For those aged 15, consumption rose from 2.1 units to 4.4 units in the same period. Historically, consumption by boys has led, by a considerable margin, that by girls.
The final statistics relate to deaths. There is a clear increase in deaths from alcohol-dependent syndrome. Some 144 deaths were recorded in 1998, but by 1999 the figure had more than doubled to 325. Again, male deaths were much higher than those for ladies. The number of deaths from chronic liver disease or cirrhosis is considerably higher, registering at 4,718 in 1999.
Those figures are shocking, and Members of Parliament should be able to do something. I have a briefing from Alcohol Concern, to which I am grateful. It does magnificent work, and worries that services are shrinking in number, that most services have static or declining funding and that they face rising levels of client need. It advised me that the present funding sources are not secure, alcohol care services are patchy, and that there is a postcode lottery of availability and a huge range in quality.
There is a haemorrhage of skilled staff for drug agencies. It is wonderful that people help such agencies, but it is worrying that they are leaving the area of alcohol abuse. The Government have given greater funding priority to expansion in the drugs services sector, and the area of alcohol is losing out as a result because other organisations offer better paid training, accreditation and qualifications. Alcohol Concern has advised me that there are high levels of unmet need, especially for early intervention and preventive services. That is shown by the high number of alcohol-related admissions to accident and emergency units. I spent some time in an A and E unit and saw the nonsense from drunks that staff must put up with.
The Government have not published their long-awaited alcohol strategy, which was promised four years ago. Nor have they suggested that alcohol health care and alcohol public health targets are priorities. I believe that primary care trusts are unwilling to invest heavily until they receive a firm steer from Government. Primary care trusts can shift from block to spot purchasing on a case-by-case basis, and buy services for shorter periodsthat will not help the overall situation. Local authorities are not prioritising alcohol issues in their community strategies, local public service agreements or crime reduction strategiesagain, due to the lack of pressure from Government.
Four years ago, the Government announced that they would publish a strategy; two years ago, they said that they would implement the strategy in 2004. There is still no strategy, and if the Government do not act now, more services will close and the remaining ones will be of a preventive nature, which is not the whole answer. The lack of availability in rural areas will worsen, as will the fragile position of specialist services for people from black and Asian communities. Finally, the bills for the taxpayer will show up elsewhere in public services, such as in acute and chronic health care.
Much must be done. Given that the House has approved the extra £6 billion that the Government announced they are investing in the health servicethe Minister had the pleasure of listening to my rant on the Budget yesterdayI hope that the comments of the hon. Member for Belfast, South and the hon. and learned Member for Dudley, North will not only be heard but acted on.
Mr. Peter Atkinson (in the Chair): Order. Before I call the hon. Member for Stroud (Mr. Drew), I say to hon. Members who hope to catch my eye that we anticipate starting the winding-up speeches at 10.30, and the three Members who wish to contribute should bear in mind that that will give them about seven minutes each.
I welcome the debate secured by the hon. Member for Belfast, South (Rev. Martin Smyth). It comes on the back of the ten-minute Bill of my hon. and learned Friend the Member for Dudley, North (Ross Cranston). Both of those are important matters in their own right. The House of Commons is at its best when it addresses an issue such as alcohol. People might say that that has little to do with real politics, but one has only to be on the streets on a Friday to see that, for many people, that is what life is about. They are involved with alcohol, fearful of it or trying to control it, and we must do something about that.
My plea to my hon. Friend the Minister is nothing new because a number of us involved with the all-party group, which is excellent, have been calling for some time for the publication of a strategy. It is time for the Government to put their money where their mouth is. Now they have got the money, perhaps they should try to solidify their policies and come up with a degree of consistency, which seems to be the biggest problem across the board with the provision of alcohol services.
Given that nobody else has done this, I shall start with a little anecdote, because Members of Parliament all have anecdotes about people who have been to see them in their surgeries. About two years ago, a lady came to see me to talk about watching her partner die as a result of alcohol-related illness. She has written a play, which is in the public domain, about that, but for obvious reasons I shall not mention her or him by name. He was a musical performer, and alcohol became part of his performance. The sad thing was that his very close friends accepted the fact that, more often than not, he was really drunk on stage, and they bought him drinks to get him going. That was seen to be part of his lifestyle, and his friends responded to it. With the benefit of hindsight, many of them will think sadly about their roles. I do not seek to ascribe blame, but people should think about the fun person, the one who drinks too much, because it may not be as harmless as it first appears.
The second problem was the oblivious nature of the medical services to what was a cry for help. Although some help was available, the medical services appeared to believe that, because the problem was alcohol related, it could be coped with and was not as serious as it appearedthe man eventually died from something related to cirrhosis. Nevertheless, he lost his life and I am sure that there are other such cases to which hon. Members can refer.
I know that some hon. Members would passionately disagreehopefully not violentlywith this, but alcohol can tell us something about the problems of either decriminalising or legalising drugs. People claim that that is one way to overcome the problems of crime and hiding addiction. They think that by waving a magic wand, things will become dramatically better. Alcohol teaches us that when a legal substance is abused, one has just the same problems of criminal behaviour and medical incapability as when an illegal substance is abused. I urge caution on those who see simple solutions as being the way forward on drugs.
We know that alcohol is a growing problem, and we all worry about young people drinking alcopops and strong alcohol. Producers must take a degree of responsibility, whether or not that is through the Portland Group, to make sure that we really grapple with the problem. My main argument is that we must take the matter seriously. We need a strategy in place. A lot of good work is taking place on the ground; in Gloucestershire, we have a very good drug action team, under Colin Hassall. The Gloucestershire drugs and alcohol service does a lot of commissioning, and those organisations work closely together. We also have some rehabilitation centres, such as Nelson house in my constituency. It is an abstinence-based centre run by a Christian organisation, which I have visited on several occasions, and it takes in people who need to end their addiction to drugs and alcohol.
One problem that I would ask my hon. Friend to bear in mind, which is not his responsibility but is linked to the issue, is that when people move away for rehabilitation it is often a signal that they need to start a new life. The last thing that they want is to be forced back whence they came. That puts pressure on places that have such centres to house and support individuals. That is where we need joined-up policy. It should not be just a medical model; it should be associated with a social model, which includes housing of individuals. If a single man in his 50s is trying to rebuild his life, we should not put him through expensive rehabilitation provision and then tell him that there is no housing for him because he is not a priority. Although the new homelessness legislation can make such people priorities, that was not the case until comparatively recently. They have no family, are not elderly, and if they are to be pushed back to where they came from, the whole process is a waste of time financially, let alone for the individual. However, that also means that such people could end up in the streets in the area that they have come to, which is totally unacceptable.
There are social as well as medical arguments, and there is an individual aspect to responsibility. One of the problems with alcohol is that everyone can handle it until they cannot. I hope that, through educationpartly because we have now begun to improve drugs educationwe can show people directly the effects that drugs have and what they do to people's lives. We must do the same with alcohol, which affects many young people morethey probably already drink. That needs to be done in our schools.
Andrew Selous (South-West Bedfordshire): I too would like to congratulate my hon. Friend the Member for Belfast, South (Rev. Martin Smyth) on initiating the debate. May I give my apologies in advance, Mr. Atkinson, if I am not here for the wind-ups as my Select Committee starts shortly? I apologise to my hon. Friend and the Minister for that.
However, alcohol abuse, as we have heard graphically this morning, costs our nation dear in many ways. It causes ill-health, such as cirrhosis of the liver, and we heard that about 4,700 deaths are recorded annually due to that. It can also contribute to cancers and heart disease. Injuries are caused through alcohol abuse. Alcohol-related crime is of great concern to the wider community. Road accidents are caused, as is economic loss. Most significantly, alcohol abuse can lead to domestic violence, unemployment, homelessnessoften people lose their homes because they cannot maintain their jobsand family breakdown. How many wives have lost husbands through alcohol abuse? How many children are cheated of a parent because alcohol has driven them out of the family home?
We also heard this morning that there are about 920,000 children in homes where alcohol abuse is a feature as far as their parents are concerned. Alcohol Concern has estimated that adding all those costs together, the total cost to our nation is about £10 billion. I hope that the Minister might factor in some sort of cost-benefit analysis detailing what the Government spend on the problem so that we can examine the benefits as we reduce the cost of alcohol abuse.
Alcohol is an addictive drug. We know from "The Health of the Nation" report produced by the previous Government in 1992 that targets were set to decrease alcohol abuse. Sadly, they not being achieved. Indeed, the figures are going in the wrong direction in respect of those targets. There has been an increase in the number of women and young men drinking over sensible alcohol limits. In addition to those with a heavy alcohol dependency, about 20 per cent. of the population regularly drink more than sensible amounts. Most worryingly, there has been an increase in the frequency of children drinking and the amount that they drink. We have heard statistics on that.
Some 10 Government Departments are involved in an alcohol strategy. There is a real case for one senior Minister to give a lead co-ordination to the Government's efforts and be the focal point for action in that area. The good news on alcohol abuse is that we know that social attitudes can be changed. Attitudes to drink driving are a prime example. It used to be more or less socially acceptable to drink and drive but, thank goodness, it no longer is. That should give us hope.
We must have a more balanced approach to the advertising of alcohol in the media. We see lifestyle advertising on our television screens that portrays association with certain drinks as very attractive, bringing friends and entry to a golden lifestyle. We need much more balance there. It seems curious that there are such severe restrictions on tobacco advertising but very limited ones on the advertising of alcohol. That needs to be examined.
On public education, we must redouble our efforts in schools. We need more role models who are advocates of a low-alcohol or no-alcohol lifestyle, or who can tell young people about the effects of alcohol abuse and
On licensing, Alcohol Concern has proposed that there should be a licence related to both the premises and the individual licenseea dual-licensing mandate. That should be heeded. A study on the sale of alcohol to young persons commissioned by psychologists from the universities of Wales, Leeds and Reading in conjunction with Thames Valley police, which is on the website of the Institute of Alcohol Studies, found that in September 2000 there was very easy availability of alcohol to young people. The figures are deeply worrying. At the age of 16, 88 per cent. of girls and 77 per cent. of boys were able to purchase alcohol. Even at the age of 13, 41.6 per cent. of girls were able to purchase alcohol, although the figure was somewhat lower for boys.
We must redouble our efforts in terms of the penalties that licensees face for selling alcohol to underage people in off-licenses and licensed premises. The current penalties seem not to be viewed as a disincentive to do that. In only 12 per cent. of cases was a demand made for an identity card from those young people. I want to emphasise the success of the voluntary citizen's card scheme, which has had an effect in some cases. In counties where there is a partnership agreement with secondary schools, there is good take-up. In Surrey, about 4,133 young people have that card, whereas in my county, Bedfordshire, which does not have that partnership agreement with schools, there are only 730 cardholders. There are strong arguments for encouraging such partnership schemes. We need much tougher action to ensure that licensees of premises do not get away with selling alcohol to underage drinkers.
Mr. Russell Brown (Dumfries): I congratulate the hon. Member for Belfast, South (Rev. Martin Smyth) on securing the debate and my hon. and learned Friend the Member for Dudley, North (Ross Cranston) on introducing his private Member's Bill yesterday. In introducing that, he made the point that alcohol care services throughout the country are under severe pressure, as we heard again this morning. Regrettably, that service provision is shrinking, and the unfortunate position of a lottery of availability and the range and quality of the services provided in many areas are matters of deep concern.
The issue of drugs and illegal substances is at the forefront of the minds of communities throughout the UK. We heard this morning and yesterday about that. Alcohol Concern has described the haemorrhage of skilled staff, who are moving away from working with people with alcohol problems to work for drug agencies, which are being given greater priority.
We must ask how serious the problem is, how seriously we as politicians take it and how seriously it is taken in our communities and by GPs. The frightening statistics from Alcohol Concern show that about one in four adults drinks to excess. Those are the figures for England, but I believe that they are mirrored throughout the UK. If those figures are correct, I am sure that we all know of a household that contains someone who drinks to excess.
Some time ago, I read about how people were paid. Weekly pay for industrial workers was an important issue. Several years ago, there was a step change from people being paid on a Friday to their being paid on a Thursday. The figures suddenly began to stack up to show that people were beginning to miss work on a Friday, too. When people have money, they do what is regarded as socially acceptable, and go out to drink.
Problems are created in the home, including physical violence. Those of us who have had contact with women's aid projects find the figures frightening. It is also upsetting for children. We sometimes witness the terrible cycle whereby children trapped in such circumstances themselves turn to alcohol. We all know of stories about children as young as eight, nine or 10 drinking. As time progresses, they move to secondary school and do not attend it because they themselves have ended up in the downward spiral.
There are also law and order problems and the associated extreme violence, on Friday and Saturday evenings in particular. People have been scarred for life when someone has used a bottle or a glass. Some responsibility lies at the door of licensees. Almost 10 years ago, I was on holiday and witnessed a young man in a bar to which my wife and I had gone for a meal. He could barely stand, but the licensee was still prepared to sell him alcohol. I asked, "Don't you think that this young man has had too much?" He brushed it aside and had nothing to do with me. Half an hour later, that young man collapsed across a table and spoiled the evening for a family that had been sitting there. I remember the look that I got from the barman, but it was too late.
The hon. Member for Belfast, South made a point about sportsmen wasting their lives. There is no greater example of a life and talent wasted than the Belfast boy himself, George Best. I have taken part in sport over the years, although perhaps hon. Members would not think so to see me now. I played amateur football. I have seen youngsters in their early teens being taken on board by local clubs, but, again, talent and potential were wasted, because they were mixing with older teenagers and those in their 20s, and drinking was the thing to do after a game. They were influenced so easily. They were wasting their talent and ending up on the scrapheap.
I should like to give an example of the roles of general practitioners and their attitudes. Two years ago, a lady came to me desperately worried. Her husband was a professional gentleman seeking help. I encouraged her to go to her GP with her husband to talk the issue through. Assistance was given. However, I was horrified some four or five months later to find that the same GP had turned away a woman and her son when they were seeking assistance. GPs may help professionals, but there is a belief that those who come from less well-off
I tabled a question for my right hon. Friend the Secretary of State for Health on the use of laser treatment. There is a business in my area that offers laser therapy for smoking cessation. The figures stack up to show that laser therapy has a 46 per cent. success rate, whereas nicotine patches have only a 20 per cent. success rate. We need to consider treatments available for smoking cessation. The laser treatment also works for alcohol, and for those like me who have a craving for chocolate on occasion. No study on such therapy has been carried out in my area. The lady who runs the centre told me that she took on board four professional people who desperately wanted to stop drinking. She had a 100 per cent. success rate with the treatment and back-up service that she was able to offer them. However, four people do not make a widespread study. The therapy can work, and we must consider that.
We need a multi-agency approach involving police, educational and social services, licensing authorities and the health service. Resources have dwindled in recent years, as has been pointed out by Alcohol Concern. That must be reversed. After last week's announcement by my right hon. Friend the Chancellor of the Exchequer of additional funding for the health service, I hope that some of that money will go back to assisting people and families who desperately need help.
Dr. Evan Harris (Oxford, West and Abingdon): We owe a debt of gratitude to the hon. Member for Belfast, South (Rev. Martin Smyth) for securing the debate, just as we have in the past owed debts to the hon. Members for Broxbourne (Mrs. Roe) and for Wirral, South (Mr. Chapman), and my hon. Friend the Member for Southwark, North and Bermondsey (Simon Hughes). They have all raised the matter in recent years in Adjournment debates, presumably in order to get some responsenot just words but actionfrom the Government. Most recently, a commendable ten-minute Bill was introduced yesterday by the hon. and learned Member for Dudley, North (Ross Cranston).
The Government have failed to produce the strategy that was promised four years ago. It is hard to run away from that fact, because when it is recognised that a strategy is required but it is not produced on time, there is a suspension of action. It allows people to say, "Well, there's a strategy coming. We'd better not make plans and provisions because they may all be overturned by the publication of the strategy."
The Government must do better on public health issues. Exactly the same problem occurred with the sexual health strategy, which was promised and postponed four times. After three years, it finally emerged and even then was not complete in terms of the public education campaign.
Multiple problems are associated with drinking. A culture of binge drinking is emerging, especially among young women. Antisocial behaviour is often the result, which causes fear among local residents who are exposed to such behaviour as well as damage to property. Older people often live in fear of younger people who are drunk and rowdy.
The hon. Member for Southend, West (Mr. Amess) mentioned the numbers of people suffering cirrhosis and the severe illness suffered by those with chronic alcohol addiction. The end-stage liver failure that results requires a liver transplant, and not enough livers are available. Patients under treatment for liver failure continue to drink because of their addiction and make multiple admissions to hospital, as I remember when I worked on a liver ward a few years ago.
Emotional as well as physical violence is associated with alcohol. The result is family arguments and sometimes rape, as the hon. and learned Member for Dudley, North mentioned, especially in cases when the attacker is known to the victim.
Clearly, there are opportunities to make widespread savings through investment, although they may not be immediately obvious within the budget in which the investment is taking place. Greater investment in services would obviously improve matters, socially and financially, and the Government should be making calculations across budgets.
The lack of youth provision is another factor. Young people gather together, often grabbing cheap bottles of strong cider or lager to drink in shopping centres and on street corners because of a lack of youth provision. There is insufficient time to talk about the problems facing the youth service, but as everything else is prioritised and local authorities have inadequate resources, it is often non-statutory or discretionary provisionthose things that people are not forced to do even though they see a need for themthat suffers.
The Government have, in a sense, accepted the problem of priorities as a reason for why their strategy has not emerged. In an Adjournment debate on 31 October last year, the Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears), said:
That is the problem: over-prioritisation in some sectors without recognitionexcept in that paragraphthat that necessarily means deprioritising others. When certain issues are chosen for political reasons, the less glamorous Cinderella services are often deprioritised.
The Government's view of alcohol differs from their view of drugs. We know that alcohol causes far more problems than cannabis. It is not a simple matter, but opposing outright any decriminalisation of cannabis while failing to tackle alcohol problems is bizarre. We recognise the lack of an evidence base for assessing the best strategies for prevention. The Government should have invested in that by now.
We have heard helpful contributions from all hon. Members who have spoken and I am sorry that I do not have time to respond to them all in detail. The hon. Member for South-West Bedfordshire (Andrew Selous) argued that people who are far too young are still buying alcohol. We license premises to sell alcohol, so why can we not improve enforcement? I am not opposed to more sting operations; the fear of being caught will affect the attitude and approach of licensees.
I agree with the hon. Member for Dumfries (Mr. Brown) that serious questions remain about whether GPs have the time or interest to deal with alcohol as a health issue, particularly among non-professionals. Individual cases must be brought to the attention of the authorities. We return to the problem of the absence of a proper strategy and the resulting blight. A lack of priority will mean defunding the Cinderella services, as people leave for the glory areas that are well funded. That is sad for those who work and face such pressure in those services, as well as for the victims.
Tim Loughton (East Worthing and Shoreham): I, too, pay tribute to the hon. Member for Belfast, South (Rev. Martin Smyth) for sharing with us his experiences in Northern Ireland, which are similar to those of Members in other constituencies throughout the UK. I also pay tribute to the hon. and learned Member for Dudley, North (Ross Cranston) for presenting a timely ten-minute Bill yesterday. I add my thanks to Alcohol Concern for its work and the material that it contributed to many Members' speeches today.
Alcohol abuse is a bigger problem than many other health-related issues that we regularly debate in this Chamber. It seems, however, to merit rather less attention and urgency from the Government. Problems are not limited to health. As hon. Members have explained, alcohol has implications for crime, the yob culture, road traffic accidents, family break-ups, domestic violence and the environment. It affects the quality of life of many people whose peace is disturbed late at night by drunks coming out of pubs. It has public order consequences, effects on employment and business through absenteeism, and its impact on impressionable young people is particularly harmful. For today's debate, however, it is viewed as a health problem.
I saw many of the consequences of drinking problems as a member of the Wandsworth alcohol group when I was a representative on the Wandsworth community health council. I saw the health impact on heavy drinkers and their families. I would not like anyone to have to go through those experiences. As constituency MPs, we have all seen them at first hand. As the hon. Member for Stroud (Mr. Drew) rightly said, all the problems that I have listed are the stuff of real politics and it is up to politicians to address them head-on.
We have heard many statistics today. According to Alcohol Concern, alcohol misuse costs the NHS at least £3 billion a year, and a further £3 billion cost to society arises from sickness and absenteeism at work, premature deaths, accidents and alcohol-related crime. One in six people attending A and E departments does so for alcohol-related injuries or problems, and that rises to eight out of 10 at peak times. I witnessed it at first hand when I spent a night in an A and E department in Whitechapel. Fortunately, it was a relatively quiet night. A young woman came into A and E and within minutes collapsed in the waiting room. She was rushed to "resus" and within a matter of seconds, 15 health professionals were around her bed: the consultant, the registrars and the nurses. She had a series of X-rays in a deeply comatose state, and a magnetic resonance imaging scan. Everything that could possibly be done for her was done.
Intensive health care was given to that woman. Fortunately, no one else required attention at the time. It turned out, when the blood sample came back half an hour later, that her blood alcohol level was in excess of 360 mg per 100 ml of blood, compared with the safe-to-drive level of 80 mg. She was highly intoxicated, unnecessarily. The cost to the NHS in that A and E department was enormous, but the potential cost of the lack of treatment that would have been available for other emergencies was unforgivable.
Those are the consequences of irresponsible drinking that we see night in night out in casualty departments around the country. The effects on the family are considerable. As my hon. Friend the Member for South-West Bedfordshire (Andrew Selous) said, an estimated 920,000 children live in a home where one or both parents misuse alcohol, and 23 per cent of child neglect cases identified by telephone calls involve parental alcohol misuse. As the hon. and learned Member for Dudley, North pointed out, the implications for crime are enormous too.
The Parliamentary Under-Secretary for Health, the hon. Member for Salford (Ms Blears), admitted that the Government's targets for the original timescale had been ambitious. The Government are talking about implementing a national strategy for tackling alcohol misuse, but not until 2004. The consultation for that strategy, we are told, will draw in contributions from the
The absence of the long-awaited Government strategy on alcohol is causing planning blight locally, too. A hot issue in my constituency is the proliferation of wine bars that are open until late at night. One wine bar in Worthing recently won permission to stay open until midnight every night of the week, against the wishes of local people, the council and the police. Fortunately, Worthing council has set aside £40,000 to fight that decision and to give people who live in the centre of Worthing some peace and quiet late at night, because their lives are being ruined by people coming out of wine bars drunk and unruly. That is unfair to all concerned.
The Government do not even know how much money goes on tackling alcohol abuse now. When the hon. Member for Twickenham (Dr. Cable) asked how much central Government funding was specifically allocated for preventive and curative work in relation to drug, alcohol and tobacco dependency, the former Under-Secretary, the hon. Member for Birmingham, Edgbaston (Ms Stuart), replied:
She went on to give details of all the money being spent on drug misuse, such as £59 million on a special allocation to health authorities, £25 million additional funding in relation to drug misuse, and £7.5 million for preventive activity. A lot of money was allocated to smoking, yet there was only
I do not say that drugs and tobacco problems do not need the attention, but alcohol abuse does not receive a fair slice of the cake, although it is a deeply important and increasingly worrying problem.
As my hon. Friend the Member for Broxbourne (Mrs. Roe) has highlighted in Adjournment debates that she has initiated, another problem is that existing funding arrangements are coming to an end as health and welfare services move towards the new primary care trust arrangements that are designed to meet central targets and priorities. The lack of priority given to alcohol services and the dominance of the drugs agenda are destabilising services. Indeed, we have heard about the haemorrhaging of skilled staff as they move to deal with drugs rather than alcohol cases.
The effect on young people is getting worse all the time. Among 16 to 24-year-olds, 37 per cent. of men and 23 per cent. of women regularly drink twice the recommended safe levels of alcohol. Cirrhosis of the liver now kills 1,600 women a year, compared with 1,200 seven years ago. It kills more women than cervical cancer, yet how much do we hear, quite rightly, about cervical smears and all the attention and resources that go into that problem? We could also talk about teenage binge drinking.
Much more needs to be said, but we also need much more Government action. What progress is being made with the alcohol strategy and exactly how high a priority is it for the Government? In the proposals for a national alcohol strategy in a 1999 paper, we were told about a high-profile ministerial lead. However, as my hon. Friend the Member for South-West Bedfordshire mentioned, it is still fragmented across 10 Departments. What work have local authorities done and what progress has been made with the voluntary citizen card and other schemes?
It is about time that the Government put their money where their mouth has been for too long and we saw serious action in many sectors of society to ensure that proper attention is given to a problem that is getting worse. The Government appear not to treat it as a priority.
The Minister of State, Department of Health (Mr. John Hutton) : I congratulate all hon. Members who have spoken on the quality and succinctness of their comments. We are all concerned about the issues that have been raised. Whether we draw on experiences in our own families or our constituency work, there cannot be one hon. Member who is not aware of the seriousness of alcohol misuse. I congratulate in particular the hon. Member for Belfast, South (Rev. Martin Smyth) on giving us an opportunity to discuss these issues.
We heard a great deal about the statistics associated with alcohol misuse. Indeed, I think that all hon. Members who spoke used them. However, I hope that they will forgive me if I do not parade another list of statistics before them, because the danger with that form of presentation is that we lose sight of what is happening.
We are talking about people rather than numbers, and by any calculation the statistics paint a particularly grim picture. It is not only of wasted life opportunities, although I guess that that is our principal concern; the effect of alcohol misuse on society as a whole and on crime in particular goes much wider and deeper than that. Many hon. Members spoke about the wider connotations and the wider background to today's discussion. Alcohol misuse has a profound effect, not only in terms of wrecked lives, but on the quality of family life and on crime.
In particular, the hon. Member for East Worthing and Shoreham (Tim Loughton) spoke about the effect on the national health service. He has been fortunate in seeing some of the excellent work that is done in our accident and emergency departments day in, day out.
There is a clear effect on the NHS. I am sure that we have all seen drunk people attending A and E departments in our constituencies who are violent and abuse not only the staffpublic servants who are there to help patientsbut other patients. That is completely unacceptable.
As the hon. Gentleman will know, the Government have taken a number of measures to try to improve the safety and security of patients and staff in those departments. That will continue to be an important issue for us. I think that the hon. Gentleman ended his remarks by calling on the Government to set new national targets and to devote more resources to alcohol services. I was struck by the inconsistency of his approach. In the Chamber, he and his hon. Friends spent most of their time saying that we had too many national targets, but yesterday they voted against extra resources for the NHS. The hon. Gentleman needs a new script if his arguments are to carry more weight.
I am sorry that the hon. Member for South-West Bedfordshire (Andrew Selous) is not present, as he made several very good points; two, especially, struck a chord with me. He expressed his concerns about the licensing laws, although he may have misunderstood some of the proposals that were floated. I shall draw his remarks to the attention of my right hon. Friend the Secretary of State for Culture, Media and Sport.
The hon. Gentleman and the Member for East Worthing and Shoreham made a good point about the need for consistency throughout government in considering the structures in place to deal with these issues. At least 10 Government Departments are involved in tackling alcohol misuse. It is not only an issue for the NHS, although it brings an expertise to bear on the problem. My Department will reflect on the suggestions made by the hon. Gentleman and other hon. Members about how better to co-ordinate our work on those issues throughout government.
My hon. Friend the Member for Stroud (Mr. Drew) made a good speech, as he always does on these issues. My hon. Friend the Member for Dumfries (Mr. Brown) rightly drew attention to resources, which I accept is the most important matter, and to consistency. My hon. Friend and others referred to the post-code lottery in respect of alcohol services, which is unacceptable. The national strategy will have to address that matter, and the issue of consistency, and I shall say something about it in a moment. About £95 million is spent in the NHS on issues related to alcohol treatment and services, which is a substantial investment. We have been asked to devote more resources to it, and that will be considered when allocations to health services are made later this year and beyond, as we move to a longer-term financial planning framework for the NHS. When we
My hon. and learned Friend the Member for Dudley, North (Ross Cranston) made a good speech drawing upon his experience as a recorder, which was of great benefit to the debate. I pay tribute to him for his impressive record of service and for his excellent work on these issues when he was Solicitor-General.
Several hon. Members mentioned the Government's commitment to a strategy. "Where is it?" was their question. I reconfirm what my hon. Friend the Under-Secretary said: we remain committed to implementing the national strategy on alcohol misuse by 2004. We need a wide-ranging partnership to build that effective strategy, and that is what we have been working to achieve. I understand that the hon. Member for East Worthing and Shoreham fell into temptation in asking where was the strategy and why we do not have one; a little bit of humility might be in order for Conservative Members. We all have painful memories of the experience, but the hon. Gentleman and his hon. Friends were running the country for 18 years. Unless I missed it, I do not remember a Conservative health Minister making a commitment to a national strategy. Now they want the strategy, and we are committed to it.
As many hon. Members have said, it is not only an issue for the Department of Health; other Departments are involved and there are wide-ranging and more general issues to be considered. The strategy must be based on two key pillars: prevention and effective treatment. We have been doing, and will continue to do, various work, including focusing on education and ensuring that young people in particular are properly educated about the risks of alcohol misuse. I hope that the hon. Member for Belfast, South will at least be pleased to know that, over the past three years in England, we have put another £29.5 million into education on substance misuse, which includes alcohol. I apologise to the hon. Gentleman that I do not have the figures for Northern Ireland.