measure progress regularly against clearly defined indicators.
We have reached the point of taking stock. What are those clearly defined indicators and how has the strategy measured up to them? We understand from those who have been consulted, briefly, that there has been some effort to inquire widely as to how the first alcohol harm reduction strategy has gone. As we have heard from others today, in no way has that taken the form of a consultation. That is remarkable as Ministers come to set up the second part of the alcohol harm reduction strategy, which we expect to be launched next month. As my hon. Friend the Member for Enfield, Southgate pointed out, it is timely to review what has gone right and what has gone wrong in order to inform phase 2 of the strategy. It is worrying that it has not been more obvious that that process is under way.
It would be interesting to know whether the Minister intends to publish any sort of review to inform and educate the rest of us. It would be nice if that were the case, but so far we have seen no evidence of it. Back in 2004, the alcohol harm reduction strategy called for a national audit of the demand for alcohol treatment services and their provision. I have not seen that, and it would be interesting to know where it is. The alcohol harm reduction strategy called for, among other things, greater use of exclusion orders to ban the troublesome, more fixed penalty fines, work with licensees to ensure better enforcement of under-age drinking rules and the licensing of door supervisors by March 2004. I do not make any comment about the relative value of any of that, but it would be interesting to know where the Minister has reached.
Effective treatment requires that...appropriate treatment is available.
I would have thought that that was fairly obvious, but clearly it is not, as the strategys call for an audit of treatment facilities ought to have shown us. We know from providersI have mentioned Clouds housethat primary care trusts are reluctant commissioners of services that mainly fall outwith the NHS. Other hon. Members have discussed that this morning. I know from alcoholics who have been to see me in my advice surgery that they have problems accessing residential treatment in particular.
Three times as many people die from alcohol as die from drugs, yet the National Treatment Agency for Substance Misuse focuses almost exclusively on drugs. Drug action teams, according to the strategy, were to be encouraged to become drug and alcohol action teams by the second quarter of 2004. To what extent has that happened? We know that £946 a head is spent on those who are dependent on drugs, but only £197 on people who have problems with alcohol abuse. Why does alcohol appear to be the poor relation, despite the fact that in public health terms it is clearly the more important issue?
The Food Standards Agency is exercised about identifying foods that are high in fat, sugar and salt, but alcohol seems to be the elephant in the room. The proper identification of units surely eclipses complex nutrient profiling, on which the FSA appears to be focused completely. I hope that the Minister will tell us how she will update information on units better to inform the public, who appear to have a lamentable understanding of what a unit actually is.
The first alcohol harm reduction strategy stated that the experience in the US was that there was no significant change in drinking behaviour as a result of labelling alcohol. Is that still the Governments position? Despite the lack of evidence, we were told in 2004 that the UK permanent representative to the EU, no less, would thrash out a compulsory labelling scheme for alcohol. Has he done so? Does it involve the rather crude pregnant woman logo that I believe that the French are keen to put on their bottles of alcohol? If anything similar is contemplated in the UK, it is important for the Minister to establish the evidence base that she will use to require such an initiative.
There is a link between the cost of alcohol and consumption, but the Chancellor has resisted putting up the price of alcohol dramatically, presumably because he is worried about smuggling, among other things. Has the Minister given any thought to the British Medical Associations suggestion that alcohol content should be taxed rather than the product? Presumably that would apply rather more to wines and beers than to spirits. Does the Minister think that it might be used as a lever to cut alcohol content?
As the Minister takes stock at the end of the first alcohol harm reduction strategy, perhaps she will agree that given the fact that ill health and lawlessness attributable to alcohol have worsened since its start, much needs to be done. I hope that the second alcohol harm reduction strategy will be a great deal more successful than the first.
The Minister of State, Department of Health (Caroline Flint): I am sure that the hon. Member for Westbury (Dr. Murrison) will forgive me if I prioritise the questions of the hon. Member for Enfield, Southgate (Mr. Burrowes), who secured the debate, and other colleagues on the Back Benches. The hon. Member for Westbury probably gets more than his fair share of opportunities to ask questions of the Front Bench.
First, I congratulate the hon. Member for Enfield, Southgate on securing the debate. It is timely, because we are reviewing the alcohol harm reduction strategy for England that was published in 2004. Although we have not carried out a formal consultation as part of that process, I can assure hon. Members that we have had a series of detailed discussions that have informed our thoughts and views on how to take the strategy
forward. Those discussions have included stakeholders from health, non-governmental organisations, the police, young peoples services and industry.
Once the strategy is published, there will be further opportunities to consult on different aspects of it. It is a cross-Government approach to tackling the multi-faceted problems of some for whom drinking has become a problem in their daily lives to varying degrees, but it is also for the majority who keep within the sensible drinking limits but for whom excessive drinking spills over into their lives. That might be because they want to go for an enjoyable night out without having to face the prospect of disorder in their communities or, as we have heard, because of matters such as domestic violence in which alcohol plays a part. Hon. Members have commented on the difficulties for children living in homes where alcohol is a common feature and contributes to a lack of support for them. There will be on ongoing discussion, and we will look for opportunities to consult on the various aspects of it.
We are determined to reduce the harm caused by alcohol misuse, and without being at all complacent I think that we have made some progress. It is becoming clear that the mechanisms that the Government have put in place since 2004 are becoming established and beginning, in spite of comments made today, to have a positive effect in tackling the range of harm that results from alcohol misuse. Most of the commitments in the Governments strategy have been deliveredon under-age sales of alcohol and on violent crime and offences involving alcohol, which have fallen. That is not to say that we should be satisfied by where we are, but the indications are that such offences have fallen.
I pay due respect to those in local communities who are enforcing operations on under-age sales, which have been extremely successful. The partnership involved has been very good. I visited two small supermarket outlets, which I shall not name, and in both asked about alcohol sales. Both those supermarkets were on a final warning after two operations in which, I am afraid, they had been found wanting. In the staff room there was information up for all staff to further get across the point that they really had to take responsibility for checking on age. Schemes such as those mentioned by my hon. Friend the Member for Burton (Mrs. Dean) are, I am sure, common to many other hon. Members constituencies and tackle under-age drink sales. That is vital if we are to change some of the worst aspects of where drink is provided in our communities and the consequences of that.
We need to challenge the belief that drunkenness and antisocial behaviour are an accepted part of English drinking culture. There is sometimes a perception that it is our drinking culture, but the reality is that a minority indulge in such a way. Most people drink within the Governments sensible drinking guidelines or exceed them only occasionally. Even among 18 to 24-year-olds, the group most often associated with drunkenness, more than two-thirds of young men and three-quarters of young women drink within the guidelines. Of those who drink at levels above them, only a quarter become involved in antisocial behaviour or disorder.
The renewed strategy needs to build on what has been achieved and where we are now, and set out how
to embed the strategy furtherit is not about starting afreshand take it forward. Total recorded alcohol consumption in the UK is estimated to have doubled between 1960 and 2002, which is a trend over a long period. That is important in dealing with the cases of cirrhosis of the liver that appear in our hospitals, and I agree with the hon. Member for Romsey (Sandra Gidley) that we need to consider future health and what we can do to prepare for the number of people who might still have problems with cirrhosis of the liver or other health conditions linked to alcohol. We must look further down the road at how we can stem that flow in the future, but consumption has doubled in 40 years.
The average weekly consumption of alcohol increased from 5.3 units in 1990 to 10.4 units in 2000, and it has since remained at about that level. That decade was significant in that respect. Heavy drinking remains high, but levels have decreased significantly among men and there are indicationsI use that word carefully; we cannot be complacentthat it may have peaked among 16 to 24-year-old women. It is too early to say whether that represents the start of a consistent downward trend in consumption levels, but it is at least helpful for an informed debate.
In 2000, between 15,000 and 22,000 deaths in England and Wales were related to alcohol misuse. Since 2003 the number of alcohol-related deaths has slowed and flattened out. I use those figures not to over-hype that as a sign of success, but something seems to be happening. I am not suggesting that it is all down to the Government; maybe it is because of greater awareness or maybe the headlines in our papers are beginning to make people take stock of their drinking and the impact that it has.
Through the strategy we undertook the first national assessment of the need and availability of alcohol treatment, which was published in November 2005. We allocated £3.2 million last October to establish three major identification and brief advice trailblazer trials, which are taking place on 57 sites, to identify and support harmful drinkers. That initiative is important because it is about trying to address people who are not defined as chronic alcohol dependants but whose drinking is regularly proving hazardous to their health and could result down the road in severe health conditions for them to face up to.
We are trying to examine the matter differentlymaybe in accident and emergency settings or maybe in other environments such as a local police station if someone has been picked up for antisocial behaviourto engage with a persons drinking and its relationship to why they have turned up there. They might have turned up at A and E because they have fallen over and cracked their head open and require stitches, or at a police station because of disorder. I know that they are examining the matter in Enfield and are in discussion with their trust about staffing in the A and E department to support such work. I congratulate them on that.
The hon. Member for Enfield, Southgate, my hon. Friend the Member for Bedford (Patrick Hall), and the hon. Members for Romsey and for Westbury talked about drugs and why they are given such a priority compared with alcohol. We could have a whole debate about that, but I have a few comments. Action on
alcohol is at a much earlier stage than that on drugs. It is also, as I think we all agree, a complex issue in that it is not of itself illegal. The drugs strategy was combined with dealing with illegal drugs and their link to crime. Unlike tobacco consumption, low alcohol consumption may be beneficial for health for certain population groups, and moderate consumption is not harmful. Alcohol therefore poses a different range of problems and issues to be resolved.
The alcohol harm reduction strategy for England was the first comprehensive Government-wide strategy to establish different ways to approach this complex issue. We may compare that with drugs, for which the Government have had a strategy in place since 1998 and for which there were predecessor strategies before that under other Governments. We are now encouraging drug and alcohol action teams, and many people involved in drug addiction through illicit drugs, a number of whom I have met, also have alcohol problems. There is an opportunity for dual diagnosis and dual treatment to go hand-in-hand.
I say to my hon. Friend the Member for Bedford that there is an opportunity to use the young peoples grant to address both alcohol and drugs. I am happy to talk to him about the situation in Bedford and why that might not be happening in his area. We work with the NTA and discuss such issues regularly, and we are considering how we can improve the situation. I hope that I shall not be corrected on this by officials, but I understand that if an area has met its targets on drug treatment numbers there is flexibility to use resources for alcohol services.
Of course, a number of our providers are both alcohol and drug treatment providers and will have benefited, for example, from the capital funding that we have provided for those services. Many of them are in the voluntary sector, such as Clouds, which was mentioned. I was happy to go to the launch yesterday of the merger of Clouds, Action on Addiction and The Chemical Dependency Centre. Quite cleverly they are going to use the same nameAction on Addiction.
We are absolutely serious about focusing on the area in question. I commend the comments of my hon. Friend the Member for Burton about how we can work with the industry. We cannot work with the illegal drug industry, but we can work with the alcohol industry in different ways to tackle irresponsible retailing. I have heard the points made about on-trade/off-trade promotions. We are examining advertising, and the authorities are going to review the code that they tightened up only a short while ago to see whether it is working. We are also working on labelling, and through self-regulation that is one way in which we have made some progress.
Ian Lucas (Wrexham) (Lab): It is a pleasure to appear under your care and control this morning, Mr. Olner, and to have the company of such a star-studded cast of Members of Parliament, in particular my hon. Friend the Minister for Higher Education and Lifelong Learning, with whom I had the pleasure of working for a considerable period. We still speak intimately as well as publicly.
I am delighted to have the opportunity to speak on the important issue of funding systems for higher education in the United Kingdom, an issue that has been neglected somewhat since our intensive discussions on the subject during the passage of the Higher Education Act 2004. The area that particularly concerns me and which I want to explore is the existence of different funding systems in the UK. I proceed from the premise that education should always broaden the mind, and that individuals from the different member countries of the UK should be encouraged to go to university in other member countries of the UK. The present system is making that more and more difficult.
I am reaching the time of life when my own children are considering going to university. That pleases me greatly but the situation brings pressures and concerns. I recently picked up a rather good edition of The Guardian that included a helpful university guide. An interesting article headed, Want to study in a different part of the UK? What you need to know contained 16 paragraphs setting out the different arrangements that exist for individuals who want to apply to go to universities in different parts of the UK, depending on where they live and where they want to study. That is a real concern for the student. I have a simple approach: I believe that students should apply to study on the course that suits them best as an individual and that will take them the furthest academically and in terms of their future career. At present, financial factors differ depending on where they are from and where they go to university, and that is unfortunate.
I have a strong constituency interest in the matter because I represent a border constituency; Wrexham constituency is on the border with Cheshire. I represent an area of the country, north-east Wales, that has been extremely successful economically in recent years. Indeed, the area that includes west Cheshire and north-east Wales has been one of the most successful in the UK. Recent studies have shown that that geographical area, which is known as the Deeside hub, is one of the areas of the UK with the most intensive economic growth.
There are many multinational companies in the area, including, most famously perhaps, Airbus in Flintshire, General Motors, Sharp UK and JCB, all of which are large multinationals. It is interesting that, until very recently, that area did not have within it a university. I am pleased to say that a couple of years ago university status was secured for what is now the university of Chester, and, at present, the North East Wales Institute of Higher Education in my constituency of Wrexham is going through the arduous process of securing degree-awarding powers.
Yesterday, I attended the launch of NEWIs annual review. I have nothing but praise for the work that is being done by the institutes staff, particularly the principal, Professor Michael Scott, who has taken the institute forward enormously. We hope that there will indeed be a university based in Wrexham within the next year.
NEWI is a particular type of higher education institution. It is entitled to boast that 67 per cent. of its graduates come from households earning less than £17,000 per annum. That is an extremely impressive statistic, and even more impressive is the fact that 91 per cent. of its students are in work within 12 months of graduation.
The institute works hard to engage with powerful companies in the economic area. Along with a further education college, Deeside college in the constituency of my hon. Friend the Member for Alyn and Deeside (Mark Tami), it has developed a foundation degree with Airbus, which is the type of degree that I understand is on the Governments agenda and what we want for delivering higher education throughout life.
The institute takes individuals from non-traditional university backgrounds through education, and provides the education and skills that we all want for our childrenand, indeed, for adults. Many of the students at NEWI are part-time students who secure entry to university, often through their employers and often through an aggressive marketing campaign that the institute runs in the area, which convinces people from non-university backgrounds that university is for them and that it will take them forward.
A problem for the geographical area known as the Deeside hub, which is an integrated area, is that it spans both sides of the England-Wales border. The financial regime for students from Wrexham is completely different from the one for students from, for example, Cheshire, which is literally across a brook some 5 yd wide. That creates enormous complications for the institutions that have to deal with the process. As I said, The Guardian set out in 16 paragraphs the process for any student who wants to attend university in the UK. I believe that there are actually seven different funding systems for UK students.
I have always been concerned about the issue. Indeed, that concern was one of the major reasons why I voted against implementation of the 2004 Act. One of the most unfortunate aspects of the Act, as far as I am concerned, is that it has created a situation in which it is cheaper for Welsh students to attend university in Wales than in England. As a UnionistI do not hesitate to use the termI think that that is extremely unfortunate. I would like a situation where that is not an issue for someone from my constituency who chooses to go to university. The key consideration should be whether the course is right for them academically, not whether it is cheaper to attend a university closer to home.
There are different conditions in England and Wales. There is also the situation of someone from Wales who wishes to study veterinary science but cannot attend a university in Wales because the course is not available in any of the higher education institutions. They would have to go across the border into England, and in that case the funding system for them would be the same as for a student from England.