APPENDIX 19
Memorandum from The Scottish Council on
Alcohol
TAXATION
Excise duty income from alcohol to the UK was
£5,967 billion in 1998-99, and £6,426 billion in 1999-00.
These figures do not include vat. Between 1998-99 and 1999-2000
increase in duty was 10 per cent, on spirits, on beer was 4 per
cent and on wine was 12 per cent. Over the same period increase
in consumption of spirits was 10 per cent on beer was 0.1 per
cent, and in wine was 17 per cent, and to date we know that the
fasted rate of increase in consumption is in the purchase of wines
in the UK. Therefore, over that two year period taxation and consumption
have increased, and this pattern would appear to challenge the
assumption that increased taxation has a direct and immediate
impact on consumption. (Source of data: SLRA Statistical Handbook)
It is arguable, however, that cost and price
are effective mechanisms for tackling problems associated with
alcohol misuse.
The following issues need to be considered;
— While there is every reason to consider
that price is a determinant of consumption, it could also be argued
that for those with alcohol related problems price is only one
of a number of determinants.
— Questions of affordability, disposable
income and desired impact of the alcoholic beverage also impact
on consumer choice.
— Increasing the price of alcohol simply
increases the relative cost burden on lower income groups, without
necessarily impacting on alcohol misuse.
— As evidenced in the context of tobacco,
it is possible that taxation thresholds will be reduced which
may be a consequence increase in the level of trafficking.
— With the illicit-sale of alcohol
comes a reduction in the ability to exercise control over preferred
drinking environments.
— Were alcohol to significantly increase
in price, there is every likelihood that those with alcohol related
problems, in families would tend to drink at home, as well as
spend a greater proportion of their income on alcohol, with a
concomitant negative impact on family life.
Regulation of alcohol consumption solely through
price mechanisms is extremely complex. It is argued that patterns
of consumption are regulated by individual expectation, social
pressures, availability of choices, disposable income, brand preference,
marketing processes, media profile, and for those with alcohol
related problems, the maximum volume of alcohol which can be available
at the lowest cost. The SCA would argue that people with alcohol
related problems differentiate by cost, quantity, impact of their
purchases, and disposable income, and will adjust their purchasing
behaviour accordingly. Therefore, as a means of tackling alcohol
misuse, attempting to use market forces may not be as effective
as presumed.
REVENUE/COST
TO THE
NHS
Revenue income from alcohol is estimated to
be around £6 billion.
The estimated cost of hospital treatment in
Scotland for alcohol related illnesses and accidents is £180
million, the annual costs to the Scottish Ambulance Service is
£21 million, 1:7 of acute admissions to hospital are related
to the misuse of alcohol, and around 50 per cent of seriously
injured patients admitted via Accident and Emergency had an alcohol
related injury. These figures are likely to be under-estimates
because often alcohol is the underlying cause, which is not always
recorded.
The actual level of funding for services relating
to alcohol misuse is unclear because of the complex inter-relationship
between alcohol related problems and forms of service delivery.
In particular, spend on the broader social problems related to
alcohol misuse is not as yet adequately recorded. This issue is
being addressed by the Scottish Advisory Committee on Alcohol
Misuse.
The SCA would argue that greater attention needs
to be paid to the social costs and consequences of alcohol misuse,
and that funding needs to be targeted at that area.
It would be helpful to have an audit of spending
on alcohol issues across the breadth of issues and services, which
provide for those with alcohol related problems. This would allow
the identification of where money was spent and enable a best
value form of analysis. Currently SACAM is preparing an audit
of services, which should provide effective baseline information
on current service levels.
The SCA would argue that new money should be
targeted to priorities such as:
SOCIAL INCLUSION
AND SOCIAL
JUSTICE
— One of the seven most common and
important causes of social exclusion is the misuse of alcohol
(DGV reference European Commission).
— The stress of poverty can lead to
over-drinking, whilst over-drinking can cause poverty, ill health
and long term unemployment.
— One in three people seeking help
for their drinking problems is unemployed (SCA Statistics 1999)
10,000 people per day receiving help for their drinking problems
(UK).
— One in every three Local Council
on Alcohol Service Users is unemployed or receiving incapacity
benefit (SCA Statistics 1999).
Children and families
The devastating impact of a drinking parent
or parents on children and young people is largely hidden and
unrecorded:
— Heavy drinking is a common factor
in family break-up.
— Children living with a drinker have
higher levels of behavioural difficulty, school related problems
and emotional disturbance, than other children.
— Children living with a drinker have
higher levels of dysfunction, than children whose parents have
other mental or physical problems.
— Many or most children living with
a drinker suffer from psychological and physical abuse and are
often badly neglected (Barbar, 1994 Simpson, 1993 Children of
problem drinkers Zeitlin 1994).
— At least 85,000 children in Scotland
are living with a problem drinker.
CRIMINAL JUSTICE
Crime and violence
— Between 60 and 70 per cent of men
who assault their partners do so under the influence of alcohol.
— Alcohol is a factor in a third of
all child abuse cases.
— The assailant or victim has been
drinking in 65 per cent of murders and 75 per cent of stabbings
— The annual cost of drink related
traffic crime is £50 million (Measures for Measures).
Community safety
— A survey of Probation Officers found
that nearly 30 per cent of their clients and 58 per cent of remand
and sentenced prisoners had severe alcohol problems (NAPO 1994).
— In 41 per cent of contact crime,
including assault and mugging, the offender had been drinking.
(Home Office 1996).
— One in five of all violent crimes
takes place in and around licensed premises (Safer Scotland Campaign).
PRICING POLICIES
AND SOFT
DRINKS
Prices of soft drinks in pubs
This issue has been raised with the Office of
Fair Trading (OFT), who have decided not to conduct an investigation
into the price of soft drinks in pubs. The OFT believe pubs operate
in a competitive market and that OFT powers under competitive
legislation cannot be used to address public health measures.
The Department of Trade and Industry conducted
a survey on the price of soft drinks in pubs and found that 70
per cent of pubs were not displaying prices adequately. It also
found that the difference between what was paid by consumers in
off licenses and supermarkets compared to what they paid in pubs,
was considerably greater for soft drinks than for beer and lager.
The Price Marketing (Food and Drink) Order 1979 is now being reviewed
in light of this lack of price transparency to see how it can
be improved and updated to ensure that consumers get clear information
to enable them to price compare.
The SCA argues that the prohibitive cost of
soft drinks and bottled waters in places where alcohol is purchased
mitigates against other initiatives which are targeted at sensible
and safe drinking. For example in those places where "nominated
driver schemes" exist, efforts are made to reduce the costs
of non-alcoholic drinks. Were this pricing practice to become
more widespread, it is likely this would encourage the spread
of these initiatives.
Of major concern is the spread of irresponsible
promotion of alcohol, such as cheap drink initiatives, drinking
games, and fixed price promotions. Such practices encourage binge
drinking with resultant community safety and health issues. There
is a strong view expressed in Scotland that the review of licensing
law should address this issue.
HEALTH
Mortality
The number of alcohol deaths* is increasing
each year as follows:
1996 - 964; 1997 - 1021; 1998 - 1075; 1999
-- 1149
Hospital admissions
Alcohol related hospital admissions place a
significant burden on the NHS with one in seven of acute hospital
admissions being related to the misuse of alcohol. (Canning 1999)
Around half of seriously injured patients admitted
via A & E and needing to stay in hospital had an alcohol related
injury (Dyehous 1995)
Community
Estimated number of patients with severe drinking
problems seen monthly by GP's in the Greater Glasgow Health Board
area is 4,700.
Excessive and binge drinking
In the Greater Glasgow Area alone 30,000 males
and 3,000 females are drinking more than twice the recommended
limit eg this is in excess of 42 units of alcohol per week for
males and more than 28 units of alcohol for females.
Scotland has a cultural norm of binge drinking,
particularly excessive heavy drinking on Friday and Saturday nights.
This may be considered as socialising/good time etc, but binge
drinking carries its own health risks, different from heavy regular
drinking. For example, a review of statistics conducted by the
Scottish NHS, argue that an excess of deaths from coronary heart
disease occurred on Mondays, amongst people, including those under
50 with no previous hospital admission for CHD, is partly attributable
to weekend binge drinking.
Ths Scottish definition of a "good time"
too often relates to that of being drunk.
Large numbers of intoxicated persons place an
enormous strain on resources particularly the police and accident
and emergency services.
Alcohol is a significant factor in:
— 80 per cent of road traffic accidents
involving pedestrians between the hours of 10.00pm and 4.00am
— 66 per cent of fire fatalities for
men
— 46 per cent of fire fatalities for
women
(All in a Night's Work, The Scottish Office
1993).
Sexual Health & Teenage Pregnancy
Alcohol is a significant risk factor in relation
to sexual health and unplanned pregnancy.
Britain has the worst record on teenage pregnancies
in Europe. In its report on teenage pregnancy, the Social Exclusion
Unit highlights the importance of alcohol in teenage sex, pointing
to research that shows that after drinking alcohol one in seven,
16 to 24 year olds have had unsafe sex. (Social Exclusion Unit
1999a)
A recent report on the drinking patterns of
young people indicated that within Europe, Britain is at the top
of the league for alcohol, tobacco and illicit drugs consumption.
These statistics should inform policy makers that a high priority
should be given to resource initiatives which tackle these problems.
CONCLUSION
The SCA manages the Servers Intervention Programme
which is a training programme aimed at licensees, servers, and
bar staff. This programme aims to establish minimum standards
around the sale of alcohol underpinning licensing law. The service
has developed into a partnership between the voluntary sector,
the trade, the industry, the legal profession, and licensing professionals.
There is a determination amongst the partners to create a safer,
pleasanter and more responsible environment for the consumption
of alcohol through this programme, and many of the issues on which
you have requested a response are currently under discussion in
this context.
Evidence from this approach, and from the Drinkwise
campaign which is also managed by The SCA confirms that no one
approach to the problems of alcohol misuse is more effective than
another. However, by engaging in partnership with parties interested
in promoting the sensible drinking approach, coupled with a spectrum
of approaches targeted at issues associated with alcohol misuse
are more likely to have a positive impact on the population's
drinking behaviour.
The Scottish Council on Alcohol
February 2001
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