Monday, September 18, 2006

Failure of the Government's 'Alcohol Harm Reduction Strategy'

From Lord Avebury P0615091

Tel 020-7274 4617

September 14, 2006

Dear Tony,

Thank you for your letter of September 7 about the Government’s approach to alcohol misuse. You don’t mention my letter to the Home Secretary of June 25, in which I asked him about his plans for compulsory rehabilitation of drinkers who commit violent crimes, reported in The Observer of June 25, and I enclose a copy for ease of reference. It would be much appreciated if I could have an answer, particularly as the targeted screening and brief interventions, and the possible dedicated referrals for offenders you now refer to in your current letter would increase the demand for alcohol rehabilitation services.

The Government had made no additional funding available to the NHS for this purpose under the Alcohol Harm Reduction Strategy, and the £15 million extra you now say is available to Primary Care Trusts from 2007/08 on top of the present £217 million, a mere 6.9%, would represent a trivial increase in real terms after taking into account wage inflation. How much of the £15 million do you estimate is required for the targeted screening and brief interventions, or is there some other money for that purpose? What are the ‘new initiatives to help people who are damaging their health through alcohol abuse’, and do you really think £3.2 million is a sum proportionate to the cost of misuse to society? Is any of the £15 million or the £3.2 million going to be earmarked for services to prisoners, a high proportion of whom are serving sentences for crimes that are connected with alcohol misuse?

On the taxation of alcohol, you repeat the mantra that the Government does not regard this, by itself, as an adequate way to deal with alcohol abuse. Nobody has ever suggested that taxation should be the only means of dealing with the problem, but I certainly challenge your ex cathedra assertion that other instruments such as social legislation and self-regulation are more effective. What evidence do you have for that statement? If the aim is to reduce consumption – and this paragraph of your letter now appears to accept this objective – the social legislation required might have to be quite drastic, as in Finland, for example, and I suggest it would be far more difficult to persuade the British electorate to accept Scandinavian-type restrictions on alcohol, than to apply the price mechanism which they have been used to in previous years.

The Advisory Council on the Misuse of Drugs has now weighed in with a recommendation that it would be irresponsible to reject. They show that alcohol consumption rose by 20% between 1998 and 2002, from 9.7 to 11.7 litres of pure alcohol per person per year [Pathways to Problems, para 2.26], while among young people aged 16-19, the proportion of males drinking over 50 units a week increased by 80% between 1992 and 2002, and of females, the increase was 400% {para 2.29]. The ACMD say that ‘there is very strong evidence that increasing the price of alcohol reduces consumption overall and may have a disproportionately large effect on consumption by young people’. They recommend that the Government should seriously consider progressively raising the excise duty on alcohol, and this has to mean that it should be raised by an amount sufficient to make alcohol expenditure form a higher proportion of people’s average disposable incomes. What is your answer to their evidence-based proposal?

I am interested to learn that DH officials have participated in working groups preparing the European Union Alcohol Strategy which is to be published next month, but what policies have we been recommending to our EU partners? Will you please lodge copies of the papers we have presented at these working groups in the Library of the House of Lords?

In my letter of July 1, I drew attention to the evidence in the IC Report that the alcohol problem is worse in some other EU member states than in Britain, and suggested that European policy should be to align duties on alcohol upwards throughout Europe. May I please have your comments on that proposal?

From the statistics available to the ACMD, the Government’s Alcohol Harm Reduction Strategy has not achieved the long term aim of reducing the harms caused by alcohol, and as you know perfectly well, ACPO has said that it is far too early to say whether the extension to the licensing hours has had a positive or negative impact on crime and disorder. It is therefore quite unjustifiable for you to couple the reductions in alcohol-related violent crime figures with the Licensing Act, as you do in your final paragraph. Please take heed of the admonition by Chris Allison, ACPO lead on Licensing, in the Press Release, Reference 109/06 of August 2, 2006, ‘ACPO LINE ON THE LICENSING ACT’, that ‘it will be at least a year before we can measure the true impact of the Act, and stop making any claims until you have the evidence.

I did ask the Home Secretary, in my letter of August 2, copy also attached for the web reference of the site where the parameters to be used in the assessment of five areas in which extensions of hours had been granted, and five other control areas in which the hours are unchanged, are being recorded, and I repeat this request.

You say that it would not be practicable to replicate the detailed analysis of the Cabinet Office’s Interim Analytical Report on an annual basis, as I suggested (not for the first time) in my letter of August 2, copy also attached. On what other basis do you suggest that the public might assess the overall success of your Alcohol Harm Reduction Strategy? Rather than focusing entirely on binge drinking, on which, I reiterate, the ACPO jury is out, lets take the Information Centre for Health and Social Care’s statistics on hospital admissions where there was either a primary or a secondary diagnosis of selected alcohol-related disease as a representative index of alcohol-related harm, referred to in my letter of July 1, but on which you make no comment. [, Statistics on alcohol, 2006, the Information Centre, June 30, 2006, Table 5.2, p 51] This figure increased from 88.6 thousand in 2000/01 to 126.3 thousand in 2004/05, an increase of 44.25%, and if the cost of alcohol harm went up by that amount since the Interim Analytical Report, it would now have reached £28.5 billion. The outcome of your Government’s so-called Alcohol Harm Reduction Strategy would be an increase in the level of harm costing the nation £8.5 billion. I am sure you will have arguments to show that hospital admissions cannot be taken as an index of alcohol harm, but if that is your case, you have an obligation to construct a representative index that will allow the public to judge the success or failure of your policies. Please do so.

Tony McNulty Esq MP,
Home Ofice,
2 Marsham Street,
London SW1P 4DF

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