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10.14 pm
The Minister of State, Department of Health (Caroline Flint): I congratulate my hon. Friend the Member for Plymouth, Devonport (Alison Seabeck) both on securing this debate and on the support that she received from the hon. Member for South-West Devon (Mr. Streeter) and my hon. Friend the Member for Plymouth, Sutton (Linda Gilroy).
The misuse of alcohol, not just in the past few years but over a steady period of time, should give us all cause for concern, and I wish to explain how we are trying to tackle that difficult problem, which presents a range of challenges, including the need to prevent the problem and improve people’s understanding of the dangers of alcohol misuse. We have focused on the need to increase awareness of the strength of drinks on the market, compared with their strength some years ago. We must improve people’s understanding of information on the units of alcohol in different drinks, but that task is made more complex by the fact that wine, beer and alcopops each have a different alcohol content.
When providing treatment, we must weigh the needs of chronic alcohol dependants against the needs of people who need a different service, because their excessive drinking may become hazardous over a long period. It is a challenge both nationally and locally to identify the way in which we can best deal with that group—more commonly known as binge drinkers. To take up the point made by the hon. Member for South-West Devon, people are not aware of the dangers 10 years down the line of their over-indulgence, even if it only takes place on a Friday and Saturday night every week, and we must attend to that.
I should like to talk about the problems in Plymouth before I make some general points about our national strategy. I am concerned about the problems that have affected the Harbour alcohol service in Plymouth, which I visited a couple of years ago. I was pleased that with the support of the drug and alcohol team, the project was trying to find constructive ways to provide both drug and alcohol services because, like services in many other parts of the country, it has become increasingly aware of the connection between the two substance addictions. Having met people with a substance addiction, I know that a number of individuals addicted to class A drugs are addicted to alcohol, too. The pooled treatment therefore allows for the treatment and support of people with those different addictions. Dual diagnosis can help to identify mental health problems and alcohol abuse, and we have published good practice guidance on services for individuals with co-existing mental health and substance misuse problems, aimed at people who commission and provide mental health and substance misuse services to help them understand how the problems are connected.
I share the commitment of my hon. Friend the Member for Plymouth, Devonport to improving the provision and quality of services in Plymouth and elsewhere, and we must try to understand the problems faced by the Harbour project if we are to do so. I am pleased that the Plymouth drug and alcohol action team, which oversees the planning and commissioning arrangements for both drug and alcohol services in the city, is leading the development of an alcohol harm reduction strategy for Plymouth. We conducted our own audit of alcohol treatment and, in some cases, there was good news on treatment services, particularly for chronic alcohol dependants. Around the country, the picture was patchy, but the audit allowed us to consider how we could contribute to strengthening commissioning in this area. I understand that the work
in Plymouth will lead to an integrated alcohol commission strategy, linking investment in health, social care and criminal justice, to tackle some of the concerns that have been raised this evening.
Alcohol treatment in Plymouth is predominantly centred around Harbour, an active partnership between the NHS, social services and the non-statutory sector, and it has carried out some important and beneficial work for the people of Plymouth. I understand that the team at Harbour has reduced dramatically the previous waiting list for those with alcohol problems, working closely and meaningfully with different sectors to achieve this reduction, and they are to be congratulated on that.
As the PCT and others are exploring how a more strategic approach to the delivery of services for those with alcohol problems will be developed for the future, it is clearly rather early for me to suggest what form that should take. But I am sure that Harbour’s contribution will be taken into account as will where that might fit in a future service providing stronger commissioning and stronger identification of the problems. That takes me back to my point about the issues that affect chronic alcohol dependence compared with those for whom drinking is becoming perhaps not even unsafe, but a ritual that can lead to some particular medical problems, such as liver damage and a host of others, as has been outlined. I understand that Harbour is also considering steps to improve its own financial arrangements, and that is to be welcomed.
The Government have sought to assist local areas in the commissioning of these vital services, which I hope will be seen as supportive of the review in Plymouth. In 2005 we published the alcohol needs assessment research project and, as I said, that provided the first ever comprehensive picture of alcohol-related needs and the availability of treatment, which before that mapping exercise had been anecdotal. We are now much clearer about the level of demand for alcohol treatment services and the task and challenge facing us. We know, for example, that £217 million is invested in alcohol treatment, with 63,000 people receiving treatment for alcohol-related disorders. However, we also know that the level of provision varies widely, with some areas being able to provide services for those that need them, but others having much lower levels of provision when compared with local needs.
Supporting local commissioners and partnerships in addressing those variations is a priority for the Department. At Alcohol Concern’s conference in November last year, I was pleased to be able to announce the publication of guidance for developing a local programme of improvement for alcohol misuse. I hope that those working in this area in Plymouth will find that useful. It provides detail on the evidence of alcohol harm to individuals, families and communities, and our ideas and aspirations for identifying the problem and improving health.
The guidance also presents some very clear economic arguments for action. That is important when PCTs and local authorities, perhaps through the local strategic partnerships but also local area agreements, are thinking about how this fits in the context of the wider needs of the community in terms of regeneration and the economy, but also the social cost of doing nothing.
Every £1 spent on alcohol treatment would save £5 on wider public sector costs. My hon. Friend the Member for Plymouth, Devonport referred to the issues around time spent in hospitals and bed days due to admission for a wider range of chronic conditions, including diabetes, heart disease, cancer, hypertension, and, of course, cirrhosis of the liver, all of which can be linked to alcohol. I am sure that each of us here this evening could add many more examples of where alcohol is part of a bigger problem in our communities.
We have also set out in the guidance some practical steps for local health organisations, local authorities and others seeking to work with the NHS to tackle alcohol misuse. We are providing practical guidance to improve screening and brief interventions for those who are drinking at hazardous and harmful levels, but do not necessarily see it as a problem that requires treatment in the traditional sense of that word. In doing that, we can assess local need, identify the local service gaps and examine the partnerships between primary care trusts, local authorities, accident and emergency departments and others in delivering some of the screening and brief interventions in a way that is, I believe, good value for money.
A database, developed with the North West Public Health Observatory, was made available in December 2005. It will help regions determine local levels of misuse and identify gaps in treatment. Later this week, I will launch “Models of Care for Alcohol Misusers”, which the Department commissioned from the National Treatment Agency for Substance Misuse. It sets out a framework for commissioning and providing intervention and treatment for adults who are affected by alcohol misuse. It sets out how we can strengthen the arguments for commissioning and the success of commissioning in what is purchased and tendered for by organisations that believe that they can play a part in providing services.
My hon. Friend the Member for Plymouth, Sutton made a point about prevention. We are working closely with the Home Office on a joint campaign to promote responsible drinking among young people through clearer and better targeted information. That is planned for later this year. We are also working with the alcoholic drinks industry and non-industry stakeholders such as the British Liver Trust on promoting more responsible drinking and preventing alcohol misuse.
In answer to a point made by the hon. Member for South-West Devon, I have asked a group of industry representatives to work with Department officials to consider sensible drinking messages. The position is not the same as that on cigarettes but it might be helpful to explore sensible drinking messages and clearer unit information on the products and at the point of sale. Of course, alcohol should be included when schools deal with substance misuse, alongside
illegal drugs, cigarettes, prescription drugs and glue. Part of dealing with the problem is understanding the way in which alcohol misuse has changed, and promoting a better understanding among young people of the dangers that they present to themselves.
The balance of funding between drugs and alcohol is difficult to achieve. Separate funding in the NHS is given only to drug expenditure because it was believed to be a poor relation in NHS priorities. That expenditure is supported by Home Office investment. That is not to say that we have not been able, more recently, to take stock of what is happening with alcohol and ascertain where we can achieve better connectivity between the different forms of substance misuse and the different levels and perceptions of misuse. We need to pay attention to that.
Linda Gilroy: My hon. Friend mentioned schools. We have an active students union in Plymouth. It had a good campaign to help with the problem of spiked drinks. Will she also try to engage student unions in her work?
Caroline Flint: That is a good idea. We have engaged student unions on several matters, including sexual health. Involving student unions as one of the partners is well worth exploring in areas where there is a large student population.
A message that we want to try to convey to young people is that one of the consequences of consuming too much alcohol is the danger in which one puts oneself, whether one is a man or a woman. Sometimes the more traditional health messages do not cut any ice with a young person who cannot imagine what it is like to be 30. Talking about personal risk of, for example, getting involved in fights or being sexually assaulted, has a resonance with young people. We do not want to scare people, but we should talk about such things and how to protect oneself in the best way possible.
I hope that I have identified some of the ways in which we are exploring how we can strengthen services and identify the gaps for which funding could be sourced for better use. We are considering piloting some of the brief interventions, for example, in identifying appropriate treatment, especially for binge drinkers. Perhaps treatment is the wrong word and engagement is preferable initially, so that people feel that they can talk about the matter and how it affects them.
My hon. Friend the Member for Plymouth, Sutton also mentioned town centres—
The motion having been made at Ten o’clock, and the debate having continued for half an hour, Mr. Speaker adjourned the House without Question put, pursuant to the Standing Order.
Adjourned at half-past Ten o’clock.
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