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Our debate started with the Chairman of the Health Committee giving us a run-down of the figures, and it may be timely to remind ourselves of a few of the particularly striking ones. In 1947, we drank 3.5 litres of alcohol per head in this country; now, the figure is well over 9.5 litres. The British Medical Association believes that we have some of the heaviest levels of alcohol consumption in Europe; if that were causing us no harm, there would be no problem. A 2009 survey found that young people are drinking twice as much as they did in 1990, and that a third of men and a fifth of women are drinking 21 units per week.
Alcohol policy has always been difficult for the Government to deal with. The hon. Member for Wyre Forest (Dr. Taylor) took us back probably as far as I have ever heard any Member take us in describing how deeply ingrained alcohol is not only in our British culture but in causing the problems that we now see. It is accepted in a way that other mind-altering drugs are not, and successive Governments have had to strike a difficult balance, encouraging people to drink responsibly while not punishing the responsible drinker. I do not believe we have got that balance right, and there is a heavy cost to that failure.
The president of the Royal College of Physicians estimates that there are 30,000 to 40,000 deaths a year because of alcohol, and liver cirrhosis increased more than fivefold between 1970 and 2006. The number of under-18s hospitalised for alcohol misuse has increased by nearly 40 per cent. since 2002-03, to more than 12,000 in 2007-08, and the number of adults hospitalised increased by 80 per cent. to nearly 200,000 in the same period.
We have a big problem, and any doctor will tell us that it is causing them serious concern. It has a huge impact on the NHS, and it is estimated that alcohol misuse costs the NHS about £2.5 billion every year. At a time when we are looking to get the most out of the NHS, getting to grips with alcohol abuse will not only save lives and prevent illness but save millions of pounds that we can reinvest in improving services.
The link between alcohol and crime is well established. According to the British crime survey of 2008-09, the victims of nearly half of all violent crimes believe the offender to have been under the influence of alcohol. That is a staggering figure. Alcohol misuse has an impact on countless family breakdowns, mental health illness, poor sexual health and even obesity-it is the cornerstone of poor public health in the UK. For every person who is drinking too much and suffering harm, I can guarantee that four or five family members or friends around them will be suffering as a result of their excessive drinking.
There are clearly many options open to Governments for how best to tackle alcohol abuse, and one that the Health Committee has recommended is minimum pricing. The report highlights evidence showing that a rise in the price of alcohol is the most effective way of reducing consumption. We have known about the link between price and consumption for years, but of course there are powerful lobbying groups that are keen to say that minimum pricing will not reduce alcohol intake. We can consider our own anecdotal evidence. When I was younger, my parents would have an occasional whisky in the evening and having a bottle of wine was a rare treat. They could not afford to have one often, but now I
might go home and have a couple of glasses of wine because it is a great deal cheaper.
Both the Government and Opposition Members want to increase the price of alcohol, because we believe it will have an impact. The question, as hon. Members have said, is what is the most effective way of doing that. We must consider what we need in place to get the outcomes that we want. We believe in a targeted approach via an increase in duty on problem drinks-alcopops and super-strength beers-and a ban on the sale of alcohol below cost price. Similar approaches have succeeded in reducing the consumption of problem drinks in Australia and Germany, and Alcohol Concern has stated:
"Strong cider, strong beer and alcopops are some of the most irresponsibly priced and problematic alcoholic drinks available in Britain. Measures of this kind would be a positive step towards making them much less attractive to teenagers. It may also encourage production of low alcohol products, increasing consumer choice for responsible drinkers."
In support of an increase in duty rather than minimum pricing, I shall quote the Health Committee's report. It states:
"The main case for higher sales duties rather than minimum prices is that minimum prices would lead to higher profits for producers and vendors of alcohol, assuming that any fall in sales would be more than offset by the increase in revenue from each unit. In contrast, a rise in duty would avoid this, producing not additional profits but extra money for the Exchequer. A rise in taxes can also be justified, as we found in Scotland, on the basis of recovering the costs imposed by alcohol...the duty on alcohol currently raises far less."
I have mentioned other potential advantages of increasing sales duties, one being that it would allow us to target stronger drinks. Minimum pricing is regressive in that the capital made by increasing the price of alcohol will go straight to the supermarkets and shops that sell the alcohol. Instead, why not tax the alcohol so that the profits of any increase can, as the report says, go back to the Government to help to balance the books or-in an ideal world-for reinvestment in alcohol prevention and treatment?
The debate on minimum pricing might in any case be entirely immaterial, owing to a recent ruling from the European Court of Justice. Will the Minister clarify this? The court decided that minimum pricing legislation on cigarettes in France, Austria and Ireland infringed European law. According to the European Commission, that legislation
"undermines the freedom of manufacturers and importers to determine the maximum retail selling prices of their products and, correspondingly, free competition."
I see no reason why alcohol would be treated differently from cigarettes, so I fear that the Government are behind the curve, which is not a new problem. As the Health Committee report states,
"the response of...Governments"
"from the non-existent to the ineffectual."
The evidence may suggest that minimum pricing is the answer, but it might not be possible because of that ECJ ruling.
There is no doubt that we need radically to change how we view alcohol and that we need to attack on several fronts. On price, licensing and education, we need attitudinal change and, crucially, overarching, funded public health programmes delivered through ring-fenced
public health boards, to which the Conservatives are committed. We need not only to utilise current legislation, but a tougher licensing regime that will give local authorities and the police much stronger powers over licensing, including the ability to remove licences from, or to refuse to grant them to, any premises that are causing problems.
The hon. Member for Luton, North mentioned what the Health Committee report says about the Licensing Act 2003. It states:
"The worst fears of the Act's critics were not realised, but neither was the DCMS's naive aspiration of establishing cafe society: violence and disorder have remained at similar levels, although they have tended to take place later at night. The principle of establishing democratic control of licensing was not realised: the regulations governing licensing gave the licensing authorities and local communities too little control over either issuing or revoking licences, as ACPO indicated. KPMG examined the alcohol industry's voluntary code and found it had failed."
Mr. Stewart Jackson: My hon. Friend touches on an important point. The regulations governing licensing consultation under the 2003 Act are very prescriptive for local councillors and Members of Parliament, as I have found. She is also right to talk about the product pricing within individual establishments. We still have offers such as "Men pay, women drink free," and "Drink as much as you like for £4.99," which is not acceptable. We need to take rigorous action using the existing legislation.
Anne Milton: I thank my hon. Friend for his intervention. He is right, and any Member of Parliament who has a night-time economy in their constituency will know that we are not really getting to grips with that continuing issue. It is a complex problem. This debate, especially towards the end, has focused on price and reducing consumption, but it is naive to think that it is that simple. As we know from smoking, changing people's attitudes takes a long time and one's approach has to be very targeted.
I shall give hon. Members more of an idea of what a Conservative Government would do. We would ban retailers from selling alcohol below cost price. We want also local councils and the police to have a much clearer right of veto over new licence applications and the ability to amend existing licence applications. We want to remove the presumption in favour of granting licensing applications and to give councils the power to control the development or expansion of licensed premises that have a negative impact on local residents. We also want to give the police stronger powers over applications and give clearer guidance to the courts about when an appeal against a council decision can be allowed. We would give councils the power to remove licences from individuals and premises that are breaking the law. Importantly, we would also allow elected representatives and community representatives-ward councillors, school governors and residents associations-to make representations or objections to a licensing application and to initiate a review of a problematic venue. Licensing authorities need the explicit power to control the closing time and licensed capacity of premises by changing the relevant statutory guidance, and we also want to introduce a simple mechanism to allow local councils to make
licensed premises that open late at night contribute to the additional cost of policing and cleaning up those areas, which is significant in some places. We also want to see tougher penalties for licensees who break the law.
Mr. McGovern: Does the hon. Lady agree that the laws are already in place, certainly in Scotland, to address the problem and we do not need new laws? A publican or a member of bar staff should not serve someone who has obviously had too much to drink. People also have to be 18 before they can go into a pub or supermarket and buy drink.
Incidentally, the hon. Member for Shipley (Philip Davies) said earlier, if I understood him correctly, that he is a teetotaller and was shocked to see sex in films when he was 18. When I was 18, I was looking for sex in films.
Anne Milton: The hon. Gentleman is right that one of the problems is that we have a lot of legislation that is not used or enforced. We do however need to change the Licensing Act 2003. One of the most important changes would be to allow more say by local residents. At the moment, we have a mismatch between the night-time economy, and licensees who are not responsible, and local residents. In some areas, the licensees are very responsible-I do not want to tar everyone with the same brush-but we need more democratic accountability on this issue.
This is a massive issue in terms of its impact on health and in its complexity. The danger with a debate such as this is that anyone who is watching or who reads the report in Hansard tomorrow will think that we have not addressed huge chunks of it. We have not touched in detail on the issues for people with mental health problems who have a dual diagnosis with alcohol and/or drug abuse. We have not touched on the issue of alcohol-related violence towards children, to which the Committee refers in the report. There is a considerable amount of domestic violence towards children, women and, indeed, men that is associated with alcohol.
We have not touched upon the need to improve our children's education. There is a lot of talk about children's physical health, obesity, sport in schools and making children less obese, but there is not a great deal of talk about children's mental and emotional health and well-being. We have not talked about the need to improve young people's self-esteem and raise their confidence. Why do they go out on the town and fill their throats, stomachs and heads with alcohol? It is about self-esteem and how they view themselves. We need to ensure that young people grow up with a strong sense of themselves, and with the high self-esteem, confidence and skills necessary to make good decisions about themselves and their health. They have to deal with complex issues, and they need the help, support and education to give them the skills to make those complex decisions.
That is particularly hard because one of the joys of being a young person-I am not old enough yet to have forgotten-is the wonderful immortality that one feels. That same point is made in discussions on sexual health. I listen to health professionals saying, "Young people need to be more responsible", but young people love being irresponsible! It is hard to make young people behave responsibly when, to some extent, they are revelling in that sense of growing freedom and irresponsibility.
So we have to be very sophisticated and clever about how we change those attitudes and get young people not to go out on the town and do what all their friends are doing. They need a very sophisticated set of skills, so we need to get this right. Government action will focus on stopping drinking among those who are already drinking too much, but at the same time we must get those public health messages right. If we are serious about improving the nation's public health, we must view reducing alcohol misuse as one of the key drivers of change.
Absolutely no one in the House wants to prevent people from having a good night out or a friendly drink. However, we must ensure that the Government send a clear message to the public about the damaging effects that the abuse of alcohol can have. I am not convinced that minimum pricing is the right approach; we need a targeted approach, including targeted duty. Furthermore, as I have said, it is crucial that funding for public health is ring-fenced and delivered by public health boards, about which my hon. Friend the Member for South Cambridgeshire has talked. Public health boards would work with local authorities, the police and all the other local players, because to improve the public's health, including in terms of alcohol consumption, we also need social and economic change.
4.23 pm
The Minister of State, Department of Health (Gillian Merron): I thank the Chair of the Health Select Committee, my right hon. Friend the Member for Rother Valley (Mr. Barron), and all Committee members for the detailed and thorough inquiry, to which I was pleased to give evidence. We are grateful for the Committee's report. It recognises the scale and complexity of the challenge that we face. We are looking closely at the report and its recommendations and, as my right hon. Friend acknowledged, I have confirmed that we will be responding shortly. I am glad that he has welcomed the tone of my initial comments in public on the report.
I have listened carefully to the varying views and opinions of right hon. and hon. Members. We have had a colourful and extensive debate, and I will attempt to pick out the main themes. First, however, I shall set out the Government's position. We take seriously the harm to health that alcohol may bring, and we have in place a comprehensive and evidence-based plan to tackle that harm, to provide information to make healthy choices easier and to support those who need help through the national health service. Yes, we can improve, yes, we want to continue to do so, and yes, the Committee's report will assist us in doing so.
As today's debate has generally confirmed, there is no one action that we could take to change overnight our culture or the situation in which we find ourselves. Action on alcohol requires close working by industry, community services and Departments across Government. It also requires a careful balance in protecting the rights and the health of individuals and communities.
Recent figures show that we are making a difference on alcohol consumption and awareness. The latest studies suggest that awareness of the units system, the NHS daily guidelines and the health risks is definitely increasing. Figures from the Office for National Statistics indicate that overall consumption might be levelling off. Average weekly alcohol consumption fell from 14.3 units in
2005 to 12.3 units in 2008. However, it is too early to draw any conclusions or comfort from those figures, although given that alcohol use has steadily increased for the past half-century, any indication that changing attitudes to alcohol are translating into lower consumption is nevertheless a welcome sign.
This Government were the first seriously to consider alcohol as a public health issue. We published the first alcohol strategy in 2004, which we updated in 2007, based on three main approaches, the first of which was to inform and educate people about units, the NHS guidance on alcohol, and the health risks of regularly drinking too much. Secondly, the strategy sought to create an environment in which the healthy choice is an easier choice. Thirdly, we sought to deploy the experience, capabilities and professionalism of the NHS to provide treatment and support to those who have lost their health or happiness to alcohol, and also to help to prevent that in the first place.
We have made great strides in educating and informing people, which a number of right hon. and hon. Members have mentioned. Earlier this year we launched the Alcohol Effects campaign, graphically bringing home the truth about the reality of alcohol misuse. Our approach is about working with people to change attitudes, just as we did on seatbelts and smoking. Across Government, our "Know your limits" and "Why let drink decide?" campaigns have gathered significant attention and made the messages about health and the consequences of alcohol real for many adults and young people.
There is evidence that those messages are getting through. According to the ONS, nine in 10 adults are aware that alcohol is measured in units, while three in four have heard of daily limits and half know their personal recommended maximum. Awareness is even higher among those drinking more heavily. On recognition of the units system, I was interested in the support given by the hon. Member for Poole (Mr. Syms), who is no longer in his place. However, I regret that the Conservative policy would be to change the units system and to seek a new awareness of centilitres. That would be misguided, given the progress that we have already made.
We are also taking action to create the right environment around alcohol, which means ensuring that it is possible to choose an alternative. For example, the Government will now introduce a requirement to make free tap water available in bars, pubs and clubs, and to ensure that smaller measures are available, which a number of right hon. and hon. Members have welcomed today. Taking action will mean doing everything that we can to cut out the practices that drive excessive drinking, as we have also heard in this debate. That means, as the Home Secretary recently announced, banning the most irresponsible promotions from next month and enforcing age verification. I was glad to present awards at the Best Bar None evening in Lincoln recently, which celebrated best practice across the city in encouraging responsible drinking when people are out and about.
Customers need to be presented with the key facts when making a choice. We will follow through on the recently launched consultation on labelling by doing whatever is necessary to get industry to co-operate on this important matter.
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