Health Committee - The Government's Alcohol StrategyWritten evidence from Crime Reduction Initiatives (GAS 20)


CRI is a health and social care charity that works with individuals, families and communities across England and Wales who are affected by alcohol, drugs, crime, homelessness, domestic abuse, and antisocial behaviour. Our projects, delivered in communities and prisons, encourage and empower people to take control of their lives and motivate them to find solutions to their problems.

Executive Summary

Aspects of the Government’s Alcohol Strategy are positive. However, it is too focused on policies like minimum pricing, and it is undermined by its failure to expand alcohol treatment provision.

CRI is also concerned that the Alcohol Strategy is weighted disproportionately to issues of youth drinking and the associated links to crime and disorder, while giving little attention to the wider public health issues associated with widespread alcohol misuse. Notably, the Government should give more attention to problematic alcohol misuse amongst the workforce, which has a significant negative economic impact and would be best addressed by a health lead approach involving employers at every stage.

Central to CRI’s response to this inquiry is the firm belief that the only effective method of stopping individuals from misusing alcohol is high quality early intervention and treatment. Therefore, it is essential that government retains financial and political support for education and treatment services, and that it constantly strives to integrate these services with the criminal justice, health, and education systems.


1. Establishing who is responsible within Government for alcohol policy in general, policy coordination across Whitehall and the extent to which the Department of Health should take a leading role

1.1. The Department of Health should take the lead on issues related to alcohol policy, ensuring a focus on treatment and intervention. The Ministry of Justice and the Home Office also have roles to play, but only when there is an overt criminality or antisocial behaviour link.

1.2. The involvement of different departments at Whitehall level can work well, so long as there is effective coordination and communication. For example, Drug Intervention Programmes were devised by the Home Office but they are successfully commissioned alongside drug treatment services.

1.3. The real issue that effects the implementation of any alcohol strategy is integration at a local level, to ensure that local recovery services are providing a full range of interventions that effectively address the complex needs of individuals. It is incredibly important that, for example, local services for alcohol treatment/intervention and antisocial behaviour are commissioned together, but it matters less which departments the money for those services comes from.

1.4. Local integration between alcohol and antisocial behaviour services is all the more important since it has been estimated that issues related to drugs and alcohol cause up to 50% of crime, and DirectGov has shown that in 2007–8 more than a million crimes involved alcohol in some way.

2. Coordination of policy across the UK with the devolved administrations, and the impact of pursuing different approaches to alcohol

2.1. A degree of flexibility in the delivery of alcohol services allows for innovation, and there are strong arguments to suggest that slightly different approaches to alcohol might work in different areas.

2.2. However, in a context where administrations are devolved, and also across different Local Authorities, it is vital that certain standards and expectations are maintained. Commissioning frameworks, compliance standards and expectations must remain consistent from the top level to the local level.

2.3. The upcoming transfer of responsibilities to Public Health England will see funding for alcohol treatment pooled with other public health funding streams, and CRI has concerns about the security of funding for alcohol treatment services under this new structure. With the ringfence being removed, alcohol services will have to compete with 16 other public health priorities. This could see alcohol treatment cut in favour of other services, and could potentially be affected by local political motives.

2.4. Therefore, while there should be some room for local prioritisation, there must be nationally defined firm guidance on the minimum expectations of investment in locally available alcohol treatment and recovery services, in order to avoid creating a postcode lottery, and to avoid the potential for worsening public health and crime.

3. The role of the alcohol industry in addressing alcohol-related health problems, including the Responsibility Deal, Drinkaware and the role of the Portman Group

3.1. External pressure would have far more of an impact on the alcohol industry than self regulation. That said, the alcohol industry has a role to play. CRI would like to see industry bodies like the Portman Group investing in education and treatment provision.

4. The evidence base for, and economic impact of, introducing a fixed price per unit of alcohol of 40p, including the impacts on moderate and harmful drinkers; evidence/arguments for setting a different unit price; the legal complexities of introducing fixed pricing

4.1. Minimum pricing alone would not be an effective strategy for reducing alcohol consumption, as CRI has seen that the most harmful drinkers among its service users would not be deterred by a higher price of alcohol; they would sacrifice food, clothing, and rent payments to be able to maintain their alcohol consumption.

4.2. There is also a significant section of the population—higher net worth individuals, who tend to drink more expensive forms of alcohol—who misuse alcohol but will not be affected by a minimum price.

4.3. However, alongside increased investment in treatment and education a minimum price will have a significant role to play.

5. The impact that current levels of alcohol consumption will have on the public’s health in the longer term

5.1. Current levels of alcohol consumption are a public health time bomb. A binge-drinking culture has shaped harmful drinking habits within an entire generation. Unlike other European countries, people in Britain drink too many units of alcohol in short periods of time.

5.2. However, the Government’s strategy focuses on highly visible problematic drinkers who indulge in antisocial behaviour, when this is not the only form of alcohol misuse.

5.3. There is a wider need to reinforce public health and prevention messages. There is a large sector of society where people drink far more than they should, but would not be affected by the kind of minimum price being proposed, as they already drink more highly priced alcohol.

5.4. Different approaches are required for different sectors of society. Investment in education, intervention and treatment for young people is vital, in order to address problem drinking early on at a stage when addiction tends to be less entrenched, so there are greater opportunities to assist people to get their lives back on track.

5.5. On a wider scale, less visible alcohol misuse—for example, people who regularly drink excessively in their own homes—has a significant impact on the economy through worklessness or working days missed through alcohol related sickness. In order to improve public health, large employers should be encouraged to invest in treatment as part of their health provision.

5.6. The Government should also consider replicating the strong and effective awareness campaigns which were deployed against tobacco harm in the context of alcohol harm.

5.7. In order to most successfully reduce harmful drinking, alcohol misuse must be considered in its wider context. Family relationships, homelessness, unemployment, mental health issues and drug misuse all play a part, and services that address these needs must not be commissioned separately.

6. Any consequential impact on future patterns of service use in the NHS and social care, including plans for greater investment in substance misuse or hepatology services

6.1. Alcohol services are underfunded. Public investment per alcohol drinker is minimal compared to public investment per drug user when the stark reality is that problematic drinking is about twenty times as prevalent as illicit drug use. However, the response should not be to re-direct funds away from drug treatment services toward alcohol treatment services as this would merely dilute the impact of services in fighting both types of addictions.

6.2. In order to generate long term savings for the NHS, there is a need for more funding for both alcohol and drug treatment and intervention services.

6.3. The need for investment in hepatology services could be minimised by investing in prevention work. Investing in education and early intervention would be cost effective and would have a greater impact in terms of public health than investing in crisis intervention.

7. Whether the proposed reforms of the NHS and public health systems will support an integrated approach to future planning of services for people who experience alcohol-related harm

7.1. As outlined in 2.3 and 2.4, CRI is concerned by the fact that Public Health England will see the adult Pooled Treatment Budget combined with other public health funding streams, effectively removing the ringfence for alcohol treatment services and allowing for alcohol agendas to be dropped in some areas. In order to allow for improvements to public health, investment must be maintained in alcohol services.

8. International evidence of the most effective interventions for reducing consumption of alcohol and evidence of any successful programmes to reduce harmful drinking

8.1. Public health interventions such as education and information:

CRI believes that early intervention through public health education and information is absolutely key to reducing alcohol consumption and harmful drinking.

8.2. Reducing the strength of alcoholic beverages:

Some alcoholic products, such as super-strength lagers and ciders, are almost exclusively consumed by problematic drinkers, and therefore reducing the strength could have some impact; however, this would not form a solution, and would only be of any use alongside investment in treatment and intervention. As outlined above, the most problematic drinkers will simply buy more—if necessary, sacrificing food and other necessities—in order to feed their addiction.

8.3. Raising the legal drinking age:

Such a measure is unlikely to have any impact.

8.4. Plain packaging and marketing bans:

As has been seen with cigarettes, restrictions on marketing and widespread public health education can be effective in reducing consumption, and the government should explore the potential impact of a similar approach to alcohol.

May 2012

Prepared 21st July 2012