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15 May 2007 : Column 194WH—continued

I shall not get distracted—tempted though I am—by the entertainment that we have just had from the hon. Member for Castle Point (Bob Spink); perhaps others will have time to refer to that. The hon. Member for Enfield, Southgate set the national scene ably, so I intend to concentrate on the situation in Bedfordshire, where some of the most valuable work on the treatment, awareness and prevention of alcohol abuse is carried out by the non-statutory body Alcohol Services for the Community, a charity that was set up in 1979 as a treatment and prevention organisation. It started in Luton, but it has expanded to cover the whole of Bedfordshire, including Bedford and, indeed, Kempton, which is in the constituency that I represent.
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Under the umbrella of ASC, there are four services. First, there is a preview prevention service, which seeks to raise knowledge and understanding of alcohol through the media, community events and groups, and which provides training and resources. Secondly, ASC delivers a licensees’ course to help them to prepare for the national certificate for licensees exam. Thirdly, the James Kingham project, which is based in Luton and Bedford, is a rehabilitation service that supports people and families who want to resolve an alcohol-related problem. It also operates an outreach service throughout the community, helps to build self-esteem and encourages people to retrain and re-skill.

The fourth project, which is aimed at young people and children, is called prevention, understanding, knowledge and education—better known as PUKE. It is linked to the James Kingham project, and mainly through schools, it provides an outreach information and support service to young people and children throughout Bedfordshire. Some have a drink problem themselves, but many live in households where adults and parents have a drink problem.

Over the years following the creation of ASC, the resources, including the number of staff and, therefore, the range of activities, initiatives and innovations, have grown. Within the Luton unitary council area, Luton borough council has consistently supported the project, but unfortunately, the situation in the rest of the county of Bedfordshire, including Bedford, has been very different.

A few years ago, the James Kingham project employed five full-time-equivalent staff in Bedford, and from Bedford, 6.5 full-time-equivalent PUKE workers. Owing to funding reductions, the numbers have gone down to 2.5 full-time-equivalent staff in Bedford, and 2.5 full-time-equivalent PUKE workers. However, the work load has increased both in Luton, where the borough council has maintained the funding, and in Bedford.

The work load has increased at a price, of course, because one cannot get something for nothing. The price has been a considerable reduction in the essential one-to-one work in Bedford and wider Bedfordshire, and an increase in group work. Many more volunteers are being employed—if I can use the word “employed”—in Bedford and wider Bedfordshire. The volunteers do a good job, and I am not criticising them, because they are well trained. However, there is a difference between the likelihood of volunteers and the likelihood of paid staff remaining in such activity. Therefore, things are changing, but not necessarily for the better.

The second cost that is being borne owing to reductions in funding is that waiting lists have been introduced by ASC in Bedford and Bedfordshire. That is absolutely the last thing that somebody who feels ready to face up to their problem or to work with members of their family with a problem needs to hear. People screw up the courage to ask for help, but are then told to come back in six months. That is a worrying development, but that is what ASC has had to do.

Despite those pressures, I congratulate ASC on handling 1,100 referrals to the James Kingham project last year, 900 of whom have gone on to the active list—not everybody maintains their wish to be helped.
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The PUKE project has engaged 6,000 young people in Bedfordshire, 150 of whom have received much more intensive help. Therefore, despite the increasing pressure, good work is still being done.

The hon. Member for Enfield, Southgate made the point, which I now want to make, too, that there seems to be a serious mismatch between the resources directed at tackling drugs and those dealing with alcohol abuse. The boost in Government funding through the Home Office for drug treatment and prevention in Bedfordshire and nationally has been very impressive indeed. I understand that the increase in resources for drug treatment in Bedfordshire was around 18 per cent. in 2005-06 and 56 per cent. in 2006-07, although those might in fact be national figures, so perhaps my hon. Friend the Minister could clarify that. However, at the same time as those considerable increases in resources for drug treatment, ASC’s budget for the last financial year was cut by 5 per cent. That is a clear mismatch, and ASC still does not know what its funding situation will be in the current financial year.

In December 2003, I was privileged to be asked formally to launch the Bedfordshire drug action team, which is based in Bedford. Since then, it has changed its name to the Bedfordshire drug and alcohol action team, which relates to the point that my hon. Friend the Member for Burton (Mrs. Dean) made, although I have a different take on that. From the evidence of what is going on in Bedfordshire, it seems that putting the two issues on an official level playing field and in an equal position of recognition is a good way of proceeding.

The Bedfordshire drug and alcohol action team commissioned a report last autumn on alcohol use and the availability of alcohol treatment services in Bedfordshire. However, despite the official interest in alcohol, which is suggested by having that word in the organisation’s title, I have been categorically assured by ASC that senior staff at BDAAT say that it does not fund alcohol services and that its increased resources are entirely directed at drug treatment and prevention. From my detailed local knowledge of the attitude of councillors, it seems that officers are telling councillors in Bedford, at both the county and district level, that BDAAT is dealing with all alcohol matters, as well as all drug matters. That is the message that Bedfordshire primary care trust seems to have been given, too. Therefore, when there are resources, whatever they are, they go to BDAAT, not to the organisation that has such a good track record and is still doing such good work.

There is confusion. The situation is unsatisfactory and should be resolved locally. However, perhaps the Government can intervene and assist, too. The national review of the strategy is an opportunity for that to take place, and could propose clearer advice to PCTs and drug action teams. I ask my hon. Friend the Minister to comment on that, if she has time.

Alcohol abuse is a serious problem. It is a national issue, and it is not good enough to leave it to be dealt with primarily by the voluntary sector. The Government are understandably reluctant to impose targets. Whenever they do, they are pilloried, sometimes by the same people who might ask them to impose targets for alcohol. However, there will need to
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be a stronger lead and a clearer message. Alcohol-induced harm to individuals and society is on a far greater scale than that caused by illegal drugs. Massive resources have been allocated to drug treatment and prevention, but more people die from, and are harmed by, alcohol misuse. I therefore ask the Minister to respond to the proposal that more of the revenue collected from the sale of alcohol be invested in the prevention and treatment of alcohol-related harm.

Mr. Bill Olner (in the Chair): Order. Will the hon. Gentleman bring his remarks to a conclusion now, please?

Patrick Hall: Certainly, Mr. Olner. In fact, you will have heard from the way I was speaking that I was seeking to convey the message that I was indeed bringing my comments to an early conclusion.

We need the balanced picture that alcohol can be pleasurable, and even preventive in health terms, and has been part of our culture for centuries. However, part of that balance is to admit that there is a serious problem that cannot be ignored, and that must not play second fiddle to acknowledging the serious problems associated with illegal drugs. We look to the Government to strike the right balance through the review promised this year. In doing that, I hope that the problems faced in Bedfordshire will be resolved, but also that we achieve a much better balance, which will help us all in this country.

10.26 am

Sandra Gidley (Romsey) (LD): I congratulate the hon. Member for Enfield, Southgate (Mr. Burrowes) on securing this debate. The problem of alcohol abuse has had a raised profile recently, which is a good thing, although I still believe that it is not discussed enough, so I thank him for successfully raising it today.

As a relatively fresh MP a few years ago, I made a round of visits to police stations. I would ask the local police officers what their biggest problem was. I was also quite interested in the drugs problems, because they were high profile at the time. This was probably not a politically correct comment to make, but the police would invariably say in informal feedback, “Drugs? No problem. In fact, we quite like them when they’ve been smoking spliffs, because they’re quite mellow and they don’t cause that much harm”—let us put aside the longer-term harm of drugs for a moment. “Alcohol’s the real problem we have to deal with, but nobody’s doing anything about it”. Seven years on, it is difficult to see what has been done to address those problems practically, because they have got much worse.

Hon. Members have mentioned that there is a problem in recognising alcohol abuse, and also highlighted the fact that the availability of treatment varies. “A Glass Half Empty?” by Alcohol Concern calculated that £400 million had been spent on 18,390 drugs service users, which is equivalent to just over £21,000 a head, but that only £217 million had been spent on the 1.1 million people who are dependent drinkers, which is equivalent to about £197 a head.
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There is clearly a great disparity in how the different problems are funded and perceived.

I know from talking to my local drug and alcohol treatment centre that it feels that it has a relatively large amount of funding for drugs, but that it struggles to find adequate funding to treat alcohol problems. It is only because more and more people are coming through with joint problems that the centre can tackle some of the problems, such as the long waiting list. Figures show that an average of only about one in 18 people who need treatment for alcohol abuse can receive it. The regional disparities are even starker; in the north-east of England, only one in 102 people requiring access to such treatment can receive it. If people who have an incident that prompts a desire to tackle their alcohol problem cannot get help there and then, things become difficult. The necessity of waiting weeks or months to access services is one of the urgent problems that needs to be tackled.

I am surprised that little mention has been made in this debate of Alcoholics Anonymous, which provides a very useful service, although the style may not be for everyone. Last year, I was invited to attend an open AA local meeting, which I found illuminating. I was particularly struck that some people with an alcohol problem had been attending Alcoholics Anonymous for 15 or 20 years. They felt that it was important to keep the link and realised that they were no better, if you like, than the tramp in the gutter with a bottle of cheap plonk.

The hon. Member for Castle Point (Bob Spink) highlighted the problems in respect of children. Recent surveys have all pretty much confirmed that alcohol consumption among children is increasing. There are mixed reports about whether allowing children to consume alcohol at home eases or worsens the problem. We are probably taking too broad and simplistic a view of the issue. As was hinted at in an earlier intervention, there is a range of parental attitudes towards alcohol. Some parents introduce it in a controlled setting and supervise their children’s exposure to it. However, I remember being absolutely horrified when I watched a programme called “Wife Swap”—one has to de-stress somehow—in which a couple were knowingly giving their quite young children quite large amounts of alcohol. The parents thought it fine if their children, totally unsupervised, drank large amounts at parties. So there is a range of parents, and they can have completely different attitudes to alcohol. We have to take that into account when we analyse such surveys.

Binge drinking among children is on the increase, and that is a concern. The European school survey project on alcohol and other drugs found that drinking levels among 15 to 16-year-olds in the UK were at 27 per cent., exceeded only by two other countries in Europe. Ireland tops the poll at 32 per cent. Clearly, there is a problem. Recently, I tabled a parliamentary question about end-stage liver disease among the under-18s. I did not expect any sort of answer at all, and some people were pleased that only three under-18s had been diagnosed with the problem. However, given the lead-up time to developing end-stage liver disease, the figure means that children are drinking large amounts at a younger and younger
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age. A bulge in the figures indicates such a shift and indicates the growing problem, which is not being tackled.

Obviously, the problem will impact on the health service, but there are other impacts too. My hon. Friend the Member for Bath (Mr. Foster) asked for figures on alcohol-related accident and emergency admissions since 1997. In 1997-98, there were 75,863 such admissions; by 2005-06, that had almost doubled to 148,477. Earlier, we heard evidence that when such people access A and E, they can be abusive and a threat to our NHS staff. That is another aspect of the problem that we cannot afford to ignore. There is also a large alcohol-related component in domestic violence figures; about half of domestic violence incidents are fuelled by alcohol.

Another health-related link is with teenage pregnancy and it should not be ignored. In 2002, when I was one of its members, the Health Committee wrote a report on sexual health. We invited young people to talk to us and they were clear that the pressures of drink—or the pressure to drink—added to the problem of the pressure to indulge in sexual activity. The two are not unrelated. Alcohol Concern’s “A Glass Half Empty?” points out that evidence suggests a strong link between alcohol consumption and the neglect of contraceptive use during sexual intercourse among the young. However, that issue was completely ignored by the alcohol strategy. It would be helpful if the Minister said whether anything was planned to tackle the issue.

The hon. Member for Burton (Mrs. Dean) claimed that things had not worsened under the new licensing hours. However, there is no evidence that matters have improved either. Recorded alcohol-related crime between 11 pm and 2 am has not decreased as a result of extended opening hours. However, I—and many other hon. Members as well, I suspect—have probably had an increase in our postbags as a result of those hours. People now go home from the pub during a longer time span, in which minor criminal damage—silly things, such as damage to cars and property, that are a real irritant to people—can take place. Having spent my teenage years on the continent, I always felt that introducing those hours would be a good thing. However, that is not necessarily the case.

In my last couple of minutes, I should like to talk about advertising.

Mr. Bill Olner (in the Chair): Order. I hope that the hon. Lady will make it only a minute; the Conservative spokesman must speak and the Minister needs to reply.

Sandra Gidley: I take your point, Mr. Olner.

I am fairly sure that it is too late for a sensible-drinking message, because there are confusing and conflicting messages about alcohol—those who drink in moderation, for example, live longer than teetotallers. People do not have a strong idea of what moderation is; glasses are bigger and alcohol is stronger. We really need a hard-hitting advertising campaign and to consider a ban on alcohol advertising. The UK budget for alcohol promotion is estimated at £600 million to £800 million, but that for alcohol awareness is £7 million. The figures do not stack up, and all the evidence shows that increased exposure to advertising increases the incidence of drinking among
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the young and the not-so-young. It would also be helpful if the Minister outlined how that issue will be tackled. Advertising before the watershed is also a big problem that needs to be sorted.

10.38 am

Dr. Andrew Murrison (Westbury) (Con): I congratulate my hon. Friend the Member for Enfield, Southgate (Mr. Burrowes) on securing this debate and on the measured and thoughtful way in which he introduced it. It is about an important subject; alcohol-related deaths went up by 18 per cent. between 2002 and 2005, and that is a worrying statistic. I am sure that the Minister will tell us about the importance that she attaches to the apparently deteriorating position in respect of illness and lawlessness related to alcohol, and what she intends to do about it as part of phase 2 of the alcohol harm reduction strategy for England, or AHRSE.

According to that strategy, alcohol abuse costs £20 billion a year. I am afraid that we tend to dismiss such statistics: £1 billion, £20 billion—what’s the difference? The sum is massive, however, and it impacts on all our public services as it is money lost to them. It is extraordinary that such a relatively trivial sum should have been spent on alcohol harm reduction, given the enormous figures, in cold economic terms, that alcohol abuse causes.

The alcohol harm reduction strategy has, I am afraid, been characterised by something of a lack of direction and rather indistinct leadership from the start. The Minister without Portfolio, the right hon. Member for Salford (Hazel Blears), set it up when she was in the Department of Health, and she appeared to take it with her when she was translated to the Home Office. Of course, cross-cutting and interdepartmental work is important with such initiatives, but they need ownership and it is not clear where that has been during the strategy’s short history. In short, no one appears to have been in charge for much of the time.

The Prime Minister’s strategy unit’s website, which comes complete with typing errors, tells us that the first alcohol harm reduction strategy aimed to

Clearly, it failed to do so. It aimed to

I represent East Knoyle, and the Minister will know that in East Knoyle are the premises of Clouds, a charity that deals with alcohol problems and has recently been reformed as Action on Addiction. I doubt whether those at Clouds feel that things have improved over the past three or four years.

The strategy unit tells us that the strategy aimed to

We have heard today about how there may be shortcomings in that respect, and I would be particularly interested to hear what the Minister feels about supermarkets’ attitudes to that. The strategy aimed to provide

Baroness Andrews spoke about that in 2004 in connection with foetal alcohol syndrome, and said that
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she would work with the industry on labelling. Not much has transpired since then. Will the Minister update us on where she is with that?

In March 2004, the alcohol harm reduction strategy said that Government would “take stock” in 2007, and that they would

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