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The noble Lord, Lord Roberts, told us some shocking figures from Wales and drew our attention to the importance of availability, as did almost all other noble Lords. The noble Baroness, Lady Coussins, warned us of the irresponsible use of statistics; hence I will use them here with trepidation. In fact, now that she has spoken, I will cut out most of them from my speech. But while she has been upbeat about movement being in the right direction compared with statistics from some years ago, I hope she will agree that, for persistent drinkers among children, the figures are not promising. We need to do a huge amount of work there. That is the angle on which I will concentrate my own few remarks in this debate.

The Government’s own research acknowledges how intractable the problem is. While there has been a drop in the overall number of children drinking—and the Government are to be congratulated on that—we know that the problem is getting worse with a persistent hard core. According to the latest NHS report, from early September, looking at secondary school pupils in 2006, almost 21 per cent of 11 to 15 year-olds are drinking more than 10 units a week. Of the children who drank in the last week, boys drank 12.3 units and girls drank 10.4.

We know that changing habits and lifestyles is an uphill task in public policy, but we also know that we have good experience in that area. If we take smoking as an analogy, as the noble Lord, Lord Roberts, briefly did to, it has taken several decades to arrive at the situation where almost everyone, including smokers, is aware of the damage caused to their health and the health of others. We have engaged in public health information campaigns, the science has been definitive and its message has been clearly understood. It is no longer acceptable to expect to smoke in social situations in other people’s houses.

We may need to undertake a similar effort with regard to alcohol. I suspect, though, that this will be rather harder because of the prevalence of drinking that is embedded in our culture. Gone are the days when people had a drink on high days and celebrations. Woolworths, for example, has recently been able to market champagne at £5 a bottle along with a range of mix-and-match sweets. It is sending out a clear message that champagne is not for high days but for every day. When that message comes from a national retailer that admits that its customers are mainly young people under 18, it is doubly worrying.

Leaving aside drink retailers, though, the point I am making is that Britain and some other Anglo-Saxon societies seem to see alcohol as an essential component of leisure and pleasure. Whether it is a quick drink in the pub or wine bar on the way home from work or being curled up on the sofa watching a football game, the indispensable element appears now to be beer or wine. That is clear from the Government’s own research, which shows that the problem of alcohol abuse in Britain is deeply rooted and has manifold repercussions in its social costs.

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Culture can change over time, however. I will focus on three areas we need to address. First, it is clear that children and young people have easiest access to alcohol in the home. Better parenting is the remedy proposed for a range of social issues, but would it not be better for the alcohol awareness campaign vis- -vis children also to be directed to parents? My suggestion here is that many parents may not be aware of the extent to which alcohol harms vital organs and children’s development and growth in these crucial years. Have the Government commissioned any research into the level of knowledge adults have about the physiological impact on children’s health of alcohol consumption?

I know, anecdotally, as the parent of a child in that group, that the social acceptability of children’s drinking is an issue on which parents need much greater clarity. The middle classes in Britain have long harboured the view that Continentals are much more liberal about children drinking, and that if only we emulated the so-called Continental lifestyles and allowed our children to drink, they would grow up to be responsible drinkers.

The reality, of course, is that levels of drinking, in adults as well as children, in many countries on the Continent are significantly lower than in Britain. We nevertheless have examples—I am sure that other parents can testify to this—where one goes to lunch or a family party at a weekend and an 11 year-old is allowed a bottle of beer or glass of wine. I have seen it on many occasions. While there are many social problems where the Government are not best placed to bring about social change, this is perhaps an area where there is a role for them to make certain kinds of behaviour unacceptable. Just as smacking children is now socially unacceptable, so, likewise, should we make it socially unacceptable for children to drink with our approval and in our presence.

We know that self-declaration is deceptive as a measure of consumption of alcohol; it is about as deceptive as it was with smoking. The Government’s strategy paper states that that is because people may not be aware of the amount they consume, as information about units consumed is not easy to translate into real amounts consumed. Perhaps we need to acknowledge that a parallel labelling system might bring clarity to the debate. An example could be to label bottles of wine and beer more clearly to state the health implications of drinking two, three or six glasses of a given drink. In other words, we need a harder-hitting, clearer message.

One cannot avoid, as many noble Lords have mentioned, the relationship between price, availability and consumption. We know from a recent campaign to stamp down on sales of alcohol to under-age drinkers that 22 pubs and off-licences face fines of up to £10,000 and three-month bans after being caught repeatedly serving under-age teenagers. A further 224 licensed premises were caught twice during the sting operation. That enforcement campaign ran 10 weeks and found, according to the accompanying press release, that “only” 15 percent of pubs and shops were prepared to sell alcohol to teenagers. I would argue that 15 per cent is way too high. If a short campaign

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resulted in those figures, the problem may be more severe during seasons when drink consumption rises across the board.

We therefore welcome the Government’s commitment to a review. As the noble Baroness, Lady Finlay of Llandaff, reminded us, the evidence exists in spades; now we need to act on it. There may also be a case for greater consultation with parents and communities on their preferences for availability of alcohol. Last year, Massachusetts held a referendum at the time of local elections on whether to extend the availability of alcohol in retail outlets on Sundays. After vibrant campaigning on both sides of the debate, the public were much better informed and voted a resounding “no”. Perhaps the lesson here is that simply supplying information is not enough and that we need to engage people in decisions about the kind of society that they want. I suspect that that engagement will show, as polls have done, that people are concerned but perhaps impotent in terms of voice. We need to take this campaign forward in many different ways.

1.09 pm

Earl Howe: My Lords, the noble Lord, Lord Avebury, has brought us to a subject that is not only of critical importance for public health but also, in view of this week’s press coverage, extremely topical. For that, the House will be grateful, and I congratulate him on a cogent and powerful speech.

As with so many public health issues, including obesity, drug-use and teenage pregnancy, we are dealing here with a societal problem which any government acting alone cannot hope to cure. However, government can do a lot. My worry during the past few years is that the growing problem of alcohol abuse has not sufficiently occupied Ministers’ in-trays or red boxes. Of course, the Minister will point to various worthy-sounding initiatives, but as with obesity, we will fight a losing battle unless focused and concerted efforts are made to change public attitudes and patterns of behaviour. As it is, the odds are stacked decidedly against any quick fix. In the past 15 years, children’s alcohol consumption has doubled. In the past five years alone, consumption across the board has gone up by 15 per cent, which is a continuation of an upward curve that started 50 years ago, only much steeper. People are starting to drink at a much younger age, with nearly one-quarter of young people aged between 11 and 15 regularly drinking up to 10 units a week. Perhaps the most shocking statistic of the lot is that one in 10 primary school children regularly drinks alcohol.

The cost of all this—to the health service, the criminal justice system and to people’s lives—is enormous. The noble Baroness, Lady Finlay, and the noble Lord, Lord Roberts, brought that home very graphically. My personal view is that we have reached a point where, without very major initiatives at national level, these trends are only going to get worse. What might those initiatives look like? The Government’s alcohol harm reduction strategy, which was published three and a half years ago, contained some good ideas, such as providing better information to consumers about the

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dangers of alcohol abuse and clamping down on irresponsible sales promotions. However, if you talk to doctors who practise in this field, they will say that the strategy was not nearly ambitious enough. The principal target of the harm minimisation strategy was binge drinking, which, although worthy of being a target, was by no means the only important one. There was no explicit ambition in the strategy actually to bring down the overall level of alcohol-related harm, let alone any timescale for trying to do so. When it was published, Professor Drummond of the National Treatment Agency for Substance Misuse rather brutally remarked that,

Perhaps that was a little harsh but certainly it reflected his frustration that the strategy failed to get to grips with alcohol misuse as well as the underlying causes of it.

Unfortunately, as with the Government’s policy on cannabis, the message on alcohol has sometimes been mixed. The alcohol harm reduction strategy of 2004 followed hard on the heels of the relaxation of the licensing laws. The Government strongly defended that relaxation at the time, saying in effect that it was unfair to criticise Ministers for giving the man in the street what he wanted. But if ever there was a case for piloting something, that was surely it. In fact, my own party said exactly that at the time. As it was, we were plunged straight into a giant national experiment, the results of which are still being evaluated. Whatever the findings are—and no doubt the Minister will be able to tell us how the Department of Health views them so far—the messages sent out by the growth of superpubs and longer drinking hours are surely the wrong ones. You have only to read history, not least the history of the l8th century and the arrival of cheap gin, to realise that the introduction of the licensing laws was no accident. It is a good thing that the Government are now looking again at the 2003 Act and, if they decide, on the evidence, to reverse it, we on these Benches will support them.

However, the elephant in the room here is not the licensing laws but, as a number of noble Lords have said, something rather more far-reaching: the price of alcohol. Alcohol is more than 50 per cent cheaper than it was in 1980—and this at a time when people’s disposable incomes have increased very considerably. I appreciate the arguments against imposing large tax hikes on alcohol. One of them is that we cannot find ourselves severely out of step with other EU member states; another is the adverse effect on our drinks industry. But it would be helpful to hear from the Minister exactly why the Government resist the notion, if indeed they do, that significant price rises on alcoholic drinks, perhaps introduced over a period, would not be beneficial to the nation. The Government’s review of their alcohol strategy was published in June and in it there is a pledge to look at the extent to which low prices and advertisements increase the amount that we drink. Perhaps the Minister could tell us the timescale for doing this.

A lot of people believe that more can usefully be done to reduce children’s exposure to alcohol advertising. We already have restrictions on television

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during the hours when young people are most likely to be watching, but I wonder whether the Minister is aware of the finding by Alcohol Concern that TV advertisements for alcohol increase dramatically between 3 pm and 5 pm, which is the precise time when children return from school. Are the Government looking at that finding?

The other main prongs of the Safe, Sensible, Social action plan are tougher enforcement of the existing law on sales and drunken behaviour and campaigns to promote sensible drinking. It is not particularly profitable in a health debate to spend time on law and order policy, although I wonder whether the policy will be matched by the necessary resources. I should be interested to hear from the Minister a little more about the public information campaigns that are planned.

The report focuses a lot of its attention on,

In view of the findings published this week by the North West Public Health Observatory, I take it that the spotlight is now not only on teenage binge drinkers but on middle-class social drinkers. The two are linked, because the evidence is that peer pressure and parental example are the most significant drivers of drinking among young people. Among adults especially, one issue has to be looked at; the level of general public awareness of government health warnings. While a majority of people have heard of the guidelines, a significant proportion of those people say that they do not know what the guidelines are. There is ignorance on another level as well. If you ask people what a unit of alcohol looks like, the chances are that they will give you the wrong answer. A 125 ml glass of wine contains approximately one and a half units. However, a glass of wine that you pour at home is probably going to be larger and may be much more than one and a half units, particularly if it has a stronger alcohol content. If the messages to the public continue to be expressed in terms of units, at the very least those messages have to become more sophisticated.

The Safe, Sensible, Social document is, I fear, an admission on the part of Ministers that their previous initiatives on alcohol abuse have failed. I do not think that any of us can stress enough how important it is for this one to succeed. People point to illicit drugs as the cause of much crime; which is absolutely true. But the evidence is that alcohol abuse underlies much drug-taking, teenage pregnancy, school truancy, crime and the growth in sexually-transmitted diseases. Alcohol abuse is truly at the heart of many of our society’s ills. Only a serious and concerted public health campaign, sustained over a long period, can hope to reverse the very worrying trends of recent years. That campaign is now well overdue.

1.18 pm

Baroness Royall of Blaisdon: My Lords, I, too, congratulate the noble Lord, Lord Avebury, on securing this important and timely debate. I am grateful for his expertise and for the close interest that he takes in the Government’s efforts to tackle the

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harms that are associated with alcohol misuse. I also thank him for his clear exposition of the challenges that we face; the demands on all of our services and the blight on so many people’s lives, which are unnecessary. He is right that alcohol can be an addiction. I very much like his suggestion that lunches hosted by public bodies should be alcohol-free and that that should be an example for the rest of society. I will take that back.

I also warm to the suggestion made by the noble Baroness, Lady Finlay, that if you have the car keys you have a soft drink, but I am told by my colleagues at the Department for Transport that the department will keep the blood alcohol consumption limit under review, and there are no plans to change that at present. But it does not harm us or stop us from saying, “If you have the keys, please take a soft drink”.

Too many people are drinking above sensible levels and are unaware of the harm that they may be causing to themselves. This week’s publication of the local alcohol profiles for England provides clear evidence of the problems we face. The hazardous drinking of the middle classes hit the headlines, but the problems are much deeper. The important work undertaken by the North West Public Health Observatory was commissioned by the Government to enable public health directors to identify action that needs to be taken in their areas to tackle the impact of harmful drinking. The figures are disturbing, but the fact that we commissioned this study shows that we do not seek to hide the data and statistics.

Alcohol-related illness or injury accounts for 180,000 hospital admissions per year and, in 2005, more than 4,000 people in England and Wales died from alcoholic liver disease. These are matters of deep concern. Since 1979, alcohol-related deaths have more than doubled for men over 35, with more people dying at a younger age. Then there is the third-party damage, graphically illustrated by the noble Baroness, Lady Finlay. Against this backdrop, the Government launched in June their renewed alcohol strategy, Safe, Sensible. Social:The Next Steps in the National Alcohol Strategy. In the main, the strategy reflects that of the Government’s first ever national strategy to tackle alcohol misuse in England, published in 2004. In the run-up to its publication, it was the subject of an extensive consultation exercise eliciting more than 300 responses.

Safe, Sensible, Social builds on and refines the 2004 strategy, rather than heading off in a new direction. It does not mean that the previous strategy was not successful; we are building on its success. Although we did not feel it necessary to repeat the earlier consultation, we worked closely with around 80 stakeholders and representatives of key stakeholders from the medical profession, the alcohol industry and NGOs in developing our proposals.

Noble Lords, including the noble Viscount, Lord Falkland, mentioned specific problems related to young people and alcohol—the peer pressure and the dreadful consequences of alcohol abuse. That is why

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the strategy will focus largely on young people, and stakeholders broadly share our analysis of progress since 2004. They support our proposals to focus activity on three groups most at risk—binge drinkers aged 18 to 24, young people under 18 who drink alcohol, and harmful drinkers, including middle-class drinkers whose drinking is damaging their health, often without their realising it—while challenging the social acceptability of drunkenness and driving which causes harm.

To help young people and their parents make informed decisions about drinking, the Government will provide authoritative, accessible guidance about what is and is not safe to drink. We have announced that we will convene a panel of experts, including paediatricians and psychologists to examine the effects of alcohol on the developing child.

When there are new proposals, the Government have published a commitment to consult in more detail with a wide range of organisations on how best to implement them. These consultations will take place in 2008, when a number of reviews that we have commissioned will have reported their findings. In the mean time, the Government are keen to ensure the continued engagement and support of both industry and non-industry stakeholders. Therefore, the Department of Health and the Home Office are convening an alcohol corporate social responsibility group, comprising departmental representatives, the Office of Fair Trading and the Advertising Standards Authority, as well as representatives from the on-trade and off-trade and public health bodies. The group will provide the key mechanism for securing stakeholder support to ensure that we make progress on strategy actions.

The noble Lord, Lord Avebury, and many other noble Lords raised the issue of price and availability. The Government recognise that many people are concerned that the practice of “deep discounting” could encourage customers to purchase more alcohol than they would otherwise do, which could lead to harmful drinking.

The noble Earl, Lord Howe, asked why the Government resist a stepped increase in tax on alcohol. Tax is a matter for the Chancellor, with decisions taken every year at the time of the Budget. The Government have announced that they are commissioning an independent review of the relationship between alcohol policy and harm. This crucial review will seek to establish, through a systematic review of the evidence, how and in what circumstances price—including discounting, advertising and other forms of promotion—drives consumption of alcohol and all forms of alcohol-related harm. The Government will use the review’s findings, which they intend to publish in July 2008, to assess whether particular types of discounting, linked to purchasing of bigger quantities, and promotional activities contribute to alcohol-related harm. They will, if necessary, consider the need for regulatory change in the future, following public consultation.

In November 2005, the alcohol industry launched its Social Responsibility Standards document, a landmark set of principles and standards that are

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intended to underpin responsible production and sale of alcohol. There are now many examples of industry good practice. What is less clear, though, is how widely these standards have been implemented across industry, how visible they are to the public and whether they go far enough in protecting those at most risk, such as young people. Safe, Sensible, Social therefore includes a commitment by the Home Office to review the effectiveness of the alcoholic drinks industry’s Social Responsibility Standards in contributing to a reduction in alcohol harm in England and, following public consultation, to consider the need for regulatory change in the future, if necessary.

Noble Lords are correct to point out that current advertising in our cinemas portrays alcohol as being cool and attractive, whereas we know that it is not. The Advertising Standards Authority is assessing the extent to which implementation of the code has reduced the appeal of alcohol advertising to under-18s. We look forward to seeing the results of the review later this year.

The noble Lord, Lord Roberts, mentioned the role of schools. In England, education about alcohol is part of the national curriculum. Perhaps either the contents or the way in which they are taught need to be improved, but parents also have a responsibility, as many noble Lords have pointed out. As the mother of three young people, I know just how difficult it is, even as a responsible parent, to inculcate these values into young people. I certainly note the points made about catching people at certain points of their vulnerability and the need for counsellors to deal with them at this stage. I will take those points back to the department.

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