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During the summer months there has been a great deal of negotiation and I am enormously grateful to my honourable friend John Hayes and to the Minister, Bill Rammell, for their determination in seeking a solution. I thank also the noble Baroness, Lady Sharp of Guildford, for her unwavering support and the noble Lord, Lord Dearing, for his useful clarification. This is government working at their best.
We have the highest regard for our colleges and for the dedicated staff who work in them. They are ready, willing and able to step up to the plate to play their part in delivering the skills that we desperately need to prosper in this highly competitive century. We wish to see them thrive, and I join my honourable friend John Hayes in saying that we believe passionately in the independence of colleges and we would not wish to see any more interference or meddling in their affairs than is absolutely necessary.
In an ideal world, we would not have transferred any further powers to the Learning and Skills Council, but by ensuring that it will be unable to intervene without the approval of the Secretary of State, the Government have recognised the need for accountability, should these draconian powers be used. This amendment will go some way in reassuring colleges and addressing their legitimate concerns. For that I am most grateful.
Baroness Sharp of Guildford: My Lords, I echo the words of the noble Baroness, Lady Morris of Bolton, and say how pleased we are that, as a result of a series of negotiations during the Recess and recently, these amendments have come forward. They meet many of our concerns about the sweeping powers of intervention originally proposed in the Bill and the Government have come a very long way. We indicated that we were not fully happy with the initial proposals that they put to us in July. We felt that there was need for further assurances on the accountability issue. On that front, we are now as fully satisfied as we can be with these amendments moved by the Government.
The LSC must now give notice to the Secretary of State before it exercises its power of intervention. It is somewhat unfortunate that it is at the moment
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We are extremely glad that the LSC will say in its annual report how it has used its powers of intervention, if it has done so, and that the annual report will be laid before both Houses of Parliament so that scrutiny can take place. The Secretary of State has given a written assurance that, if he receives notice from the LSC that it proposes to intervene, he will personally write to local Members of Parliament, which means that there is also accountability through the local MPs.
The Minister was slightly economical with his quotation from Mr John Hayes, who indeed said in the other place:
“Taken together, the amendments and the further written assurance of the Minister represent a significant change of direction”.
However, the Minister jumped what he went on to say:
“They mean, in effect, that the LSC will be unable to intervene without the approval of the Secretary of State”.—[Official Report, Commons, 11/10/07; col. 515.]
We started by saying that we could see little reason why the powers needed to be handed over to the Learning and Skills Council, as the Secretary of State’s residual power of intervention was already in the Act. We have, after considerable consideration, ended up with a situation that is de facto very much the same. We are pleased about that, although whether it was necessary to go round the houses in this way is a little uncertain.
I pay tribute to the way in which these compromises have been reached. Again, I quote what Mr John Hayes said in the other place:
“The House is at its best when Bills are improved by careful scrutiny and when the Opposition are listened to”.—[Official Report, Commons, 11/10/07; col. 514.]
Perhaps he overestimates the role of the other place, as it seems to me that it was in this House that much of the effective scrutiny took place. Certainly, the changes that were made derived from the power of this House, when it considers government proposals to be unwise, to make the Government think again.
I pay tribute to Members on all Benches for their achievements in improving the Bill and making it a much more sensible and viable measure. I am thinking not just of the role played by the two opposition Benches, although I particularly welcome the spirit of co-operation in which we have worked with the noble Baroness, Lady Morris of Bolton; I should also mention, as the Minister did, the important role played by the Cross-Benchers, in particular the noble
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I pay particular tribute to my noble friend Lady Walmsley, who is not here with us today, as she is speaking in distant Wales on behalf of the Lord Speaker. She took the Bill with me through Committee and took it alone through Report and Third Reading while I was away on an extended trip.
Finally, I pay tribute to the two Ministers with whom we have dealt, the noble Lords, Lord Adonis and Lord Triesman. Both are listening Ministers who are prepared to respond when they recognise that the issues raised have substance. I am very grateful to them. I think that we have a better Bill as a result.
Lord Dearing: My Lords, I congratulate all three Front Benches on finding a resolution to the problem in Clause 56. It is very reassuring when we have consensus on an education matter of such difficulty. I thank the Minister for his clarification of the word “management”. I accept that and, fully reassured, I wish the Bill well.
On Question, Motion agreed to.
Alcohol Harm Reduction Strategy
12.09 pm
asked Her Majesty’s Government what consultations they are holding in connection with the revision of their alcohol harm reduction strategy.
The noble Lord said: My Lords, when we debated the first government alcohol harm reduction strategy in May 2004, I said that it had little hope of making a real impact on England’s most dangerous habit, and I am sorry to say that that forecast has been disastrously confirmed. Alcohol harm has steadily increased over the years and is continuing to increase. It is no wonder that Ministers refuse to update the estimate of September 2003, which put the amount of the damage at £20 billion a year. From the figures that I have studied, I believe that £22 billion would be a more accurate figure now—an increase of 10 per cent since the Government published their preliminary strategy in 2003.
The number of deaths per head of the population from causes linked to alcohol consumption has increased every year since 2001 by 4 per cent for men and 3 per cent for women. Every man dying from an alcohol-related cause loses 20 years of his life and every woman 15. Hospital admissions for adults where there is either a primary or secondary diagnosis of selected alcohol-related diseases increased by 61.3 per cent between 2001-02 and 2005-06. These figures may be an underestimate; the North West Public Health Observatory is about to publish a wider picture of hospital admissions to include, for instance, accidents, fall injuries and certain types of cancer which may be related to alcohol consumption. Reported alcohol consumption by children aged 11 to 13 almost doubled between 2001 and 2006, so there is far worse to come.
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The evidence on alcohol-related attendances at A&E departments is inconclusive, but anyone who has had a serious accident on a Saturday night will know that it is mayhem there over the weekend. A survey of 191 A&E departments found recently that only 2 per cent of them used a formal screening tool to identify hazardous drinkers, and none routinely measured blood alcohol levels. That study, done by St. Thomas’s Hospital, showed that any statistics on the number of alcohol-related attendances at A&E departments must be treated with caution, including the Home Office’s evaluation of data from five A&E departments, which is due by the end of the year. The objective of that survey is to assess the effects of the Licensing Act, but as well as variations in identification and recording methodologies, major police operations were aimed at ensuring that the Act was effective, which would distort the figures immediately after it came into force. It will be necessary to take a much longer-term view, based on common procedures, which I hope will be adopted for classifying attendances as alcohol-related.
I am not dealing with the Licensing Act today; there will be an opportunity to do so when the evaluation is published, looking also at ambulance call-outs and crimes of violence in the five selected areas. But for what it is worth, the Metropolitan Police collect regular statistics on crimes of violence. These show that between 1 o’clock and 4 o’clock in the morning in selected areas of Greater London, there was an increase of 53 per cent in the 12 months following the Act coming into force. However, that must be seen in the context of an equally staggering increase of 53 per cent in the previous 12 months.
As before, the main problem is that the Government discarded the possibility of using price and availability to reduce consumption in both the original strategy and the revised document, Safe. Sensible. Social. It ought to have been entitled “Dangerous. Foolish. Anti-social”, because those are the main characteristics of English drinking. There is to be a review of the evidence on the relationship between price, promotion and harm, on which there are abundant data already. The end product to be considered, if necessary, is regulatory change, directed, presumably, at special offers and promotions rather than pricing in general. The Chief Medical Officer, Sir Liam Donaldson, has called for the tax on alcohol to be increased as a deterrent to excessive drinking. I understand that the Conservatives want a “treatment tax” on alcohol. However, with no direct attack on consumption by adults, the Government rely on people knowing the “sensible drinking” guidelines and the personal risks associated with drinking above those levels. People have very little idea of what the units mean or what is meant by hazardous or harmful drinking, and still less of the possible long-term consequences for their life expectancy and health. Reduction of consumption by under-age drinkers is listed as an objective, but the Government apparently believe that this can be done by providing young people and their parents with,
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- “authoritative, accessible guidance about what is and what is not safe and sensible”.—[Official Report, Commons, 5/6/07; col. 10WS.]
It is dangerous and naive nonsense to think that that will be effective. Some 5.9 million people exceed the recommended guidelines, so merely giving adults the information does not work and there is even less chance that it will have any effect on children’s behaviour. But much more could be done to get at people suffering from alcohol harm at what Professor Robin Touquet calls the “teachable moment”.
I welcome, as far as it goes, the decision to pilot studies in nine A&E departments, 24 GP practices and 24 criminal justice sites to identify those who drink harmful quantities and refer them to a nurse or social worker for advice. But the pilots will not be reported until May 2009, and then there will no doubt be further delays before deciding on the preferred model. We know already that brief interventions could result in 250,000 men and 67,500 women reducing their consumption from hazardous and harmful to low risk and that, for an investment of £24 million, the NHS could save £40 million over five years. The Department of Health has provided PCTs with a mere £15 million to spend on their local arrangements for commissioning and delivering alcohol interventions, but the money is not ring-fenced and there is nothing to stop them using it to reduce their deficits, as many have already done. Resources should be provided now to enable PCTs and police authorities to launch brief interventions on a much wider scale, with the option of making the continuation of the funding after 2009 conditional on adjusting the local programmes to conform to whatever models are found to be most effective.
However, there must also be a national programme for training the workers who will deliver the brief interventions, and there must be a budget for residential places for those who need longer-term treatment. The London Borough of Lambeth, where I live, for example, says that residential places for young people cost £4,000 a week, for which it has a nil budget.
I hope that, in all the advice models tested, those who drink harmful quantities will be invited to consider an alcohol-free lifestyle. The Government say that 10 per cent of the English population do not drink at all and, instead of insisting that so-called “sensible drinking” is the model for everyone, they should recognise that for some people it is an addiction as dangerous as heroin and that many others could be healthier and happier if they stopped drinking altogether. Alcoholics Anonymous welcomes referrals from professionals in the health and criminal justice systems, and the service that it provides should be recognised and encouraged.
There is to be a new programme to help local partnerships and communities to tackle alcohol-related crime and disorder, yet the Home Office’s young people’s substance misuse partnership grant is 10 per cent less in the current year than it was in 2006-07, and the cuts, euphemistically described as,
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in the Home Office letter to drug and alcohol action teams, are excused on the grounds that they follow several years of increased funding. The £15 million for PCTs, mentioned earlier, is meant to cover services to prisons, for which responsibility was transferred to them in April this year. I gather that none of the extra money has gone to Brixton, in the London Borough of Lambeth, and I wonder whether any other prisons have got any of it.
On drink-driving, RoSPA’s recommendations for a reduction in the blood-alcohol limit and random testing have been ignored, although 20 people are killed and 220 seriously injured in alcohol-related road accidents every week—well over a third of the total, which remains stubbornly above 30,000 a year. RoSPA also advises staff who drive in the course of their work not to drink at lunchtime. I suggested to the Prime Minister when he took office that alcohol should not be served at lunchtime events hosted by public authorities, and particularly by government departments, which would set an example that other employers could then be advised to follow. I am sorry to say that he did not reply.
Those examples show that we have a very long way to go before there is an effective strategy for combating alcohol harm, and I hope that this debate will prod the Government towards policies that will eradicate a drinking culture that is poisoning this generation and leading to a catastrophe in the future as appalling in its effects as climate change or terrorism. We need national leadership, not more cross-ministerial and departmental groups.
12.21 pm
Baroness Finlay of Llandaff: My Lords, I am grateful to the noble Lord, Lord Avebury, for tabling the Question. It is a very important topic facing our society, and causes more and more distress, not less and less.
I hope that the Government will consult the professionals who deal day in day out with the outcome of problem drinking as well as consulting those who are looking into the underlying causes of the binge and dangerous drinking epidemics that we are now in. Our city centres are given over to alcohol-fuelled revelry on Friday and Saturday nights—many cities have closed their centres to traffic because the police can control the crowds more easily and try to minimise the accident risk. What do we know is happening? At peak times, as has been said, up to 70 per cent of admissions to accident and emergency units are related to alcohol consumption. It is true that Professor Touquet’s Paddington alcohol test is incredibly useful because it builds on that teachable moment, but it is also a sad fact that there are not adequate numbers of alcohol counsellors to then deal with the problems identified.
Many of those who attend are not there with trivial injuries, such as falling off the pavement and twisting an ankle. Every year young people fall under Tube trains and die. Many are bright students on a night out. I expect that the Minister will tell us that road deaths are down—they are—but they are still too high. Why do we tolerate 80mg/100ml blood levels
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The catalogue of deaths is huge. Every day 23 people die from alcohol-related causes in England and Wales, which is more than the total number of people dying from MRSA, cancer of the breast and cancer of the cervix put together. Yesterday I was in York and heard of two students who died recently in alcohol-fuelled accidents. One drowned because he fell into the river and the other died from a head injury caused by falling over when drunk. They were young students having just gone up to university with their lives ahead of them. Make no mistake, this is a story repeated time and again across the nation in our cities and universities.
Every weekend young people are beaten up in city centres around the country and left maimed for life. Some do not survive their injuries. The total cost of alcohol misuse to the health service has been estimated at at least £1.7 billion a year. In 2004 in England, 38 per cent of men and 16 per cent of women in the age group 16 to 64 had an alcohol use disorder. That is over a quarter of that population, equivalent to about 8.2 million people.
What has this done to the nation’s economy? The Government’s own data reveal that an annual cost through lost productivity as a result of alcohol misuse is at least £6.4 billion, with up to 17 million working days lost through alcohol-related absence. The research evidence shows that mental functioning in those who have drunk heavily in the preceding 24 hours is seriously impaired, so even those who make it into work are not functioning properly.
It has often been said that drinking alcohol is a matter of personal choice—indeed, it is. The trouble is that the third-party damage caused by alcohol is not a matter of choice. Around half of all violent crimes—1.2 million violent incidents—are linked to alcohol misuse annually. Around a third—360,000—of domestic violence incidents are linked to alcohol misuse. If you are the child who has been hit, or the battered partner, that was not your choice. The cost of crime and anti-social behaviour linked to alcohol misuse is £7.3 billion annually and no one chooses to be the victim of a crime.
One could say that if you are informed and still drink, then you have brought the cirrhosis and other diseases on yourself, but alcohol is an addictive drug and relatively cheap to buy. We know that the amount of alcohol consumed by girls aged between 11 and 13 has increased by 83 per cent in the six years 2000-06 while, for boys, consumption has gone up by 43 per cent during the same period. One million children have alcohol-addicted parents.
Ask youngsters why they binge drink, as I have been doing in preparation for this debate, and they tell you “Peer pressure”: the pressure to be seen to have a good time. Many admit they feel awful, sick and unwell but they feel more miserable if they feel they have no friends. So they go with the crowd, fall to
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It is then a way of life to prove that they are cool and having a good time. They run into debt, they function less well, many get injured or harm others and a few die. Among those who get arrested for criminal damage, 35 per cent of prisoners think they have an alcohol problem and 46 per cent believe that alcohol was a factor driving their offending behaviour.
Advertisers go right up to the line. Look at advertisements for alcohol: they make it look as if it is going to be really fun to down that vodka, those spirits, as if you will somehow feel good. They do not tell you that you are going to feel awful and might harm the people nearest to you.
What are we doing about it? The Government announced a planned £3.2 million on alcohol management initiatives. That figure is not to be sniffed at, but welcomed. We have Professor Drummond’s study on alcohol screening and brief intervention pilots, known as SIPS. However, I hope that the Government are not going to put everything on hold waiting for the results of some of these studies to come through and that they are not going to be used as stalling tactics. The evidence is already there. We know things need to be done, and we know what works. The Paddington alcohol test is a clear example.
The key determinants of alcohol consumption have been identified as price, prevailing social culture and accessibility. The price is too low relative to other costs in our society. The prevailing social culture is that binge drinking is “cool”, that you are somehow a better, more fun person if you go out and get smashed out of your mind on a Friday and Saturday night as a young adult.
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