Alcohol Strategy
The Alcohol Harm Reduction Strategy for England was finally
published on 15th March 2004. Joy that the Strategy, eagerly awaited
since 1998 was finally appearing soon gave way to dismay when it became
obvious that the wait had not been worthwhile. As expected, the Strategy
focuses strongly, - some argue disproportionately – on youthful `binge
drinking’.
Launching the Strategy, Public health minister Melanie Johnson said:
“The measures in this strategy will help us tackle problems at
source - for example, around 70 per cent of weekend accident and
emergency admissions are alcohol-related. This document is an important
contribution to the government’s wider debate on public health -
Choosing Health? - that will lead to a white paper later this year. We
will further develop the approach to alcohol treatment and support
services as part of the consultation on this white paper.”
Hazel Blears, minister for crime reduction, policing and community safety said:
“We have consulted widely on this strategy and identified that
a lot of good practice already exists. In many areas the police, local
councils and the drinks industry are working together to combat underage
drinking, antisocial behaviour and drink-fuelled violence. Our strategy
will widen this approach so that people are more aware of the dangers
of excessive drinking, that advertising doesn’t promote irresponsible
drinking, and violent behaviour in our city centres is reduced.”
Predictably, immediate reactions to the Strategy were mixed but generally guarded.
The BMA’s Head of Science and Ethics, Dr Vivienne Nathanson said:
“It is very good news that the Government is taking the issue
of alcohol abuse seriously. What we need now is concrete action to
tackle the crisis. The BMA would like to see clear warnings and
labelling on alcohol products as well as a ban on alcohol advertising.
“It is a tragedy”, she continued, “that doctors are starting
to see serious liver disease in young people because of alcohol. It is
also very expensive for the NHS. Young people must be made aware that
having fun does not have to mean getting drunk three or four times a
week. Alcohol is a poison. Too much in one go can be lethal, too much
week after week kills you more slowly.”
Professor Ian Gilmore of the Royal College of Physicians also gave a less than wholehearted response.
“I am pleased the strategy has been published,” Professor
Gilmore said, “but there is some disappointment that it appears to be
much stronger on issues of law and order than on health.”
Professor Gilmore also criticised the report’s emphasis on further research rather than action.
“The report talks about audits and pilots but we believe there
is already more than enough evidence for action. It is stronger on
cleaning up the streets than on preventing physical harm.”
Eric Appleby, chief executive of Alcohol Concern said that
ministers deserved praise for tackling an issue that had proved too hot
to handle for past governments, and he also welcomed the review of
alcohol advertising and the promise of targeted campaigns. “But”, he
continued, “we must boost treatment and counselling services for people
experiencing drink problems now. The recent Commission on Alcohol
Services said these services needed urgent help to cope. We also expect
the drinks trade to live up to their obligations on drinks promotions.”
Lord Adebowale, chief executive of social care charity Turning Point:
“We welcome measures around education, preventative work and
requirements on the drinks industry. But these are just part of the
puzzle, and the biggest piece is missing; tackling the lack of treatment
services for the 3.8 million people who are dependent drinkers. The
document gives little hope of speedier, effective treatment for people
with alcohol dependence, and is small comfort for the families of the 13
people who will die today, as every day, as a direct result of alcohol
misuse.”
Others were even less generous in their appraisal. Professor
Christine Godfrey, one of the country’s leading health economists and
who was an adviser to the Strategy Unit which prepared the analysis on
which the Strategy is supposedly based, described it as a huge
disappointment and little more than a sop to the alcohol industry.
It was hardly surprising therefore that industry bodies
welcomed the Strategy rather more enthusiastically than did the alcohol
abuse agencies. Sources connected to the alcohol industry confirmed to
Alert that the industry’s main reaction was one of relief that it had
got away so lightly, particularly as it emerged that the Home Secretary
had been pressing for far tougher measures than any to be found in the
Strategy. However, the possibility that tougher measures will be
introduced at some point in the future cannot be entirely discounted.
Speaking for public consumption, Rob Hayward, chief executive of the British Beer & Pub Association said:
“The government has laid down a challenge to the industry to
promote responsible drinking. We are determined to build on good
practice that exists. At the heart of this strategy is recognition that
90 per cent of the population enjoy alcohol as part of their social
lives without harm, but we recognise the need for action to tackle a
minority who misuse alcohol and cause anti-social behaviour. This
strategy is a key cornerstone in that campaign.”
Jean Coussins, chief executive of the alcohol industry’s Portman Group said:
“There are serious and growing problems of alcohol misuse and
the industry must continue to play its part in tackling these. I am
pleased that the government has recognised that it can build on the good
practice already in place amongst leading companies within the
industry. The industry must do even more to deliver against the tough
targets set out in the strategy, or face government action.”
The frequent references to a crackdown on binge drinking in the
media at the time of the announcement of the Alcohol Harm Reduction
Strategy was either the result of cynical spin or lazy journalism. The
only real crackdown was on the Home Secretary who wanted measures which
other ministers had already ruled out during the passage through
Parliament of the Licensing Act 2003 – a measure which many believe will
in itself exacerbate the problems of binge drinking.
The day before the launch of the Strategy, the Sunday Times
reported that in a private letter sent on February 6, Home Secretary
David Blunkett warned the Prime Minister that the “situation at night in
our town and city centres raises serious concerns about the control of
alcohol-related crime and disorder”.
The newspaper reported that research commissioned by the Home
Office had uncovered a sharp rise in violent assaults linked to drink
and a significant increase in people being attacked by drunken
strangers. Moreover, a senior Home Office official was quoted as saying
that it was now “more or less impossible” for the police to enforce the
law in city centres. Leaked minutes of a meeting record Leigh Lewis, a
permanent secretary at the Home Office, saying that alcohol-related
violence was no longer confined to the larger city centres but was now
evident in smaller towns. He also explained that it now started earlier
in the week. The meeting was told the surge in violent crime followed
the alcohol industry changing its approach to marketing with
“irresponsible sales promotions”.
The consequences for the police were disclosed at a meeting on February 9, chaired by Ellie Roy, director of crime reduction.
Roy warned: “The high number of licensed premises in city
centres makes it more or less impossible for the police to effectively
enforce the licensing laws, especially given their other crime and
terrorism priorities.”
Those who followed the passage through Parliament of the new
Licensing Act will recall that such arguments were put forward by
various opposition spokesmen and were repeatedly dismissed by Government
ministers, particularly the principal Government spokesman in the House
of Lords, Baroness Blackstone. In one notable exchange with Lord
Avebury who had asked her to comment on the statistics of violent crime
in areas with a concentration of late night drinking establishments,
Baroness Blackstone explained: “All my training as a social scientist
would lead me to be extremely cautious about making such a deduction.
There are many causes of violent crime and you cannot necessarily assume
that because there is a late night entertainment culture, and the
drinking associated with it, that is the cause of violent crime.”
Baroness Blackstone’s expertise as a social scientist was
perhaps less evident in her reply to Lord Avebury than was her
obligation to follow the official line, however implausible, of the
Department of Culture, Media and Sport, a Department which appears to
believe that its responsibilities to the public weal are best discharged
by acting as the agent of the alcohol industry lobby which has been
campaigning for de-regulation of the liquor licensing system.
The Sunday Times reported that Mr Blunkett wants to see:
- Powers to fix the prices of alcoholic drinks in city centres to help to curb excessive drinking.
- A compulsory annual levy on pubs and clubs of an average £10,000 a year each to pay for up to 30,000 extra police officers.
- Local councils to be instructed to refuse all new licences
to premises unless the applicants can prove that they will not increase
antisocial behaviour.
The newspaper suggested that these measures were blocked by
the Treasury, the Department for Culture, Media and Sport and the Prime
Minister as being anti-business. However, their most significant feature
is that they are explicitly ruled out by the Department of Culture,
Media and Sport’s new Licensing Act.
It is understood that the Home Secretary fought to delay the
introduction of the Licensing Act. However, a week after the Alcohol
Strategy appeared, the Government published the guidance on the Act,
completing the next major stage in bringing it into life. (see page 20)
Commenting to Alcohol Alert on the Sunday Times allegations,
Lord Avebury, one of the main protagonists in the licensing bill
debates, recalled the apparent impossibility of convincing Government
Ministers that there was any connection at all between the growth in the
number of premises licensed for late night drinking and the increasing
problems of crime and disorder, said: “While there is joy at any sinner
who repenteth, I’m afraid it’s too late. There is no possibility of
another Licensing Act being introduced before the last one has even come
into force .”
24-hour drinking ‘will fuel crime’
Allowing pubs and clubs to open all hours could lead to a rise
in violent crime, disorder and nuisance, according to a report produced
by the Metropolitan Police. The report, the Preliminary Assessment Of
The Impact Of The Licensing Act 2003 On The Metropolitan Police Service,
produced by the Clubs and Vice Operational Command Unit, flatly
contradicts the claims made by the Department of Culture, Media and
Sport for the new Licensing Act.
The Police report forecasts more drink-driving because of the
lack of public transport late at night, a boom in illegal cabs and taxi
touts, a growth in street vendors operating in the black economy and
greater disturbance to residents.
Varied closing hours, it says, will encourage people to go out
later and force the police to patrol trouble spots throughout the
night.
However, while the Home Office is emphasising the need to
contain excessive drinking, the Department for Culture, Media and Sport
is pressing ahead with its plans for 24 hour licensing.
The Met’s report is concerned with London, especially the West
End, but police chiefs across the country are thought to share its
misgivings about the Licensing Act 2003.
The report says: “The Government’s assertion that closing time
and binge drinking are linked is valid, but closing time is not the
only causal factor.”
It predicts a rise in pub crawls through the night.
“A further complication will be that, with premises remaining
open longer, transient drinking will take place. This will increase the
numbers of persons on the street.
“Whilst it is accepted that staggered closing may induce a
gradual drift away from premises, it is unlikely to reduce the numbers
that use premises. The flashpoints that traditionally occur between 11pm
and 5am may be reduced in intensity but occur with increased
frequency.”
With more drunks on the streets for longer, the police fear a
rise in fights, rape, robberies, domestic violence and assaults on
officers.
The report cites the experience of several European cities,
including Dublin where flexible hours were introduced four years ago.
It says: “With the drinking culture that is firmly entrenched
in the country, the relaxations in permitted hours will for the
foreseeable future fuel this culture.”
David Davis, the shadow home secretary, said the Government
should ensure that existing laws against under-age drinking are properly
enforced before extending the opportunity for bingeing.
The Strategy
The Strategy, which appeared after its six years
gestation to have co-operation with the alcohol industry at its heart,
consists mainly of promises to encourage more use of existing controls
combined with promises to keep the situation under review. There will,
for example, be a review of the ‘sensible drinking’ message. There will
be a review of the issue of alcohol advertising, and a review of
treatment needs and services. The drink driving figures are also to be
kept under review, but neither in relation to drink driving nor anything
else is there a promise to introduce any of the measures that the large
and growing international research evidence suggests can be expected to
make a real difference.
The polices rejected by the Government include those related
to taxation and physical availability, both of which are shown by the
body of research evidence to be the most effective. Of course, the
Government’s own Licensing Act produces the contrary effect as far as
availability is concerned. One of the absurdities of the whole process
which Alert has repeatedly pointed out was the order of events: the
Licensing Act preceding the Strategy and in so doing greatly limiting
its options, given the presumed imperative of not making the Government
look foolish. The table below, reproduced from the recently published
Alcohol: no ordinary commodity (reviewed on page 22), the work of the
leading international experts in the field, indicates the range of
effectiveness of the various alcohol policies. It should be noted that
another top scorer for effectiveness is the range of drink driving
measures which the Government has signally failed to bring in, despite
its promises in opposition. It is also striking that the very measures
proposed most enthusiastically in the Strategy are shown to be of little
or no effect.
The principal initiative contained in the Strategy is a three-
part voluntary social responsibility scheme for alcohol retailers. This
seems to consist mainly of agreements to behave as any reasonable
person would expect them to be behaving anyway. The three parts are:
Promotion of good practices in product development, branding,
advertising and packaging. This will cover aspects such as observing the
existing advertising codes and not targeting under-age drinkers.
A donation to an independent fund
This is an innovation. A fund will be set up with
contributions from the industry which will be used to fund local and
national level projects designed to tackle alcohol-related harm.
Promotion of Good practice down the supply chain
As far as implementation of the Strategy is concerned, there
is to be no alcohol czar. For all the understandable mockery which
greets the proliferation of czars, the failure to appoint one in this
case sends out the strong message that the alcohol problem is nowhere
near as important as that posed by illicit drugs. Instead of a czar, the
two junior Ministers, one from the Home Office, the other from the
Department of Health will assume joint responsibility for delivery of
the Strategy in what looks to be a low key version of the short-lived
Inter-departmental Committee on Alcohol Misuse set up by the
Conservative government in 1988. There is also to be an external
stakeholder group to bring an outside perspective and serve as a
sounding board for initiatives. All the indications are that this too
will be dominated by the alcohol industry.
The lack of significant content of the Strategy is hardly a
surprise in view of the biased editing of the Interim Analysis produced
by the Strategy Unit. As reported in Alert (Issue 3, 2003), research
findings suggesting policy choices at variance with those favoured by
the alcohol industry were removed from an earlier draft of the Analysis.
Prompted by these earlier goings on, the Academy of Medical
Sciences convened its own group under Professor Sir Michael Marmot to
`put the alcohol back into alcohol policy’ by examining the importance
of the overall national consumption of alcohol. In a report published
prior to the launch of the Government’s Strategy, the Academy concluded
that “The scientific evidence indicates that, for the health of the
public, action is required to reduce the consumption of alcohol at a
population level.”
If the Academy entertained the hope that a careful examination
and presentation of the relevant evidence would influence the
Government it was mistaken. While the Strategy concedes that national
consumption is rising and that if present trends continue, England will
be one of heaviest drinking nations in Europe within the next ten years,
it then proceeds to ignore completely the implications of that fact for
the level of harm and what needs to be done to reduce it. Instead,
beginning in the Prime Minister’s foreword, the Strategy prefers to
promote the myth of the two populations – the great majority of sensible
drinkers who never have any problems, and the small minority of deviant
drinkers who cause all of the problems. Predictably, the Strategy also
emphasises how moderate drinking is good for health, and how very good
indeed the alcohol industry is for the nation’s economy.
This latter claim is of particular interest as it directly
contradicts the Strategy Unit’s analysis on which the Strategy is
supposedly based..
An early paragraph of the Strategy reads:
“While it is outside the scope of this report to quantify the
economic benefits in detail, alcohol plays a key role within the leisure
and tourist industry. It accounts for a substantial section of the UK
economy: the value of the alcoholic drinks market is more than £30bn per
annum and it is estimated that around one million jobs are linked to
it.”
However, the Strategy Unit report ‘Alcohol Misuse: How much
does it cost?’ devotes a section to explaining why the output, income
and employment generated by the alcohol industry should not be
represented as benefits the community receives from the production of
alcohol. This is because the claim rests on the false assumptions that
in the hypothetical absence of alcohol, the money spent on it by
consumers would not be used in any form of expenditure on any other
products or services and, likewise, that the resources used in producing
alcohol products and services would have no alternative uses. The point
made by the Strategy Unit was that neither of these assumptions is
true, and the other uses to which the expenditure and the resources
would in reality be put could provide similar benefits but without the
burden of costs that the alcohol market inflicts on the wider society.
The Strategy
Better education and communication
The strategy includes a series of measures aimed at
achieving a long term change in attitudes to irresponsible drinking and
behaviour, including:
- making the “sensible drinking” message easier to understand and apply;
- targeting messages at those most at risk, including binge- and chronic drinkers
- providing better information for consumers, both on products and at the point of sale;
- providing alcohol education in schools that can change attitudes and behaviour;
- providing more support and advice for employers; and
- reviewing the code of practice for TV advertising to ensure
that it does not target young drinkers or glamorise irresponsible
behaviour.
Improving health and treatment services
The strategy proposes a number of measures to improve
early identification and treatment of alcohol problems. These measures
include:
- improved training of staff to increase awareness of likely signs of alcohol misuse;
- piloting schemes to find out whether earlier identification
and treatment of those with alcohol problems can improve health and lead
to longer-term savings;
- carrying out a national audit of the demand for and
provision of alcohol treatment services, to identify any gaps between
demand and provision; and
- better help for the most vulnerable – such as homeless
people, drug addicts, the mentally ill, and young people. They often
have multiple problems and need clear pathways for treatment from a
variety of sources.
Combating alcohol-related crime and disorder
The strategy proposes a series of measures to address
the problems of those town and city centres that are blighted by alcohol
misuse at weekends. These include:
- greater use of exclusion orders to ban those causing trouble from pubs and clubs or entire town centres;
- greater use of the new fixed-penalty fines for anti-social behaviour;
- working with licensees to ensure better enforcement of
existing rules on under-age drinking and serving people who are already
drunk. We will also work in partnership with the industry to reduce
anti-social behaviours – issues to be addressed may include layout of
pubs and availability of seating, managing crime and disorder in city
centres and improved information on safe drinking in pubs; and
- In addition to local initiatives, the Security Industry
Authority (SIA) will begin the licensing of door supervisors with effect
from March 2004.
Working with the alcohol industry
The strategy will build on the good practice of some
existing initiatives (such as the Manchester Citysafe Scheme) and
involve the alcohol industry in new initiatives at both national level
(drinks producers) and at local level (retailers, pubs and clubs).
- At national level, a social responsibility charter for drinks producers, will strongly encourage drinks companies to:
- pledge not to manufacture products irresponsibly – for
example, no products that appeal to under-age drinkers or that encourage
people to drink well over recommended limits;
- ensure that advertising does not promote or condone irresponsible or excessive drinking;
- put the sensible drinking message clearly on bottles alongside information about unit content;
- move to packaging products in safer materials – for example, alternatives to glass bottles; and
- make a financial contribution to a fund that pays for new
schemes to address alcohol misuse at national and local levels, such as
providing information and alternative facilities for young people.
- At local level, there will be new “code of good conduct”
schemes for retailers, pubs and clubs, run locally by a partnership of
the industry, police, and licensing panels, and led by the local
authority. These will ensure that industry works alongside local
communities on issues which really matter such as under-age drinking and
making town centres safer and more welcoming at night.
Participation in these schemes will be voluntary. The success
of the voluntary approach will be reviewed early in the next parliament.
If industry actions are not beginning to make an impact in reducing
harms, Government will assess the case for additional steps, including
possibly legislation.
Making it all happen
Making it happen will be a shared responsibility across
Government. Ministers at the Home Office and the Department of Health
will take the lead. We will measure progress regularly against clearly
defined indicators and will take stock in 2007.
Top of pageViolence at work is a problem for one in two doctors
Half of all doctors in the United Kingdom say that violence
is a problem in the workplace and that alcohol is one of the major
causes.
Violence at work: the experience of UK doctors, a report
published by the British Medical Association, is based on responses to a
survey from a thousand doctors and, in addition to the 50 per cent who
saw violence as a growing problem, it was also found that:
- a third of respondents had experienced some form of violence
in the workplace last year - this was the case for both hospital
doctors and general practitioners;
- amongst hospital doctors those working in Accident &
Emergency and psychiatry were more likely to experience patient
violence;
- amongst doctors who reported some experience of violence,
almost all (95 per cent) had been the victim of verbal abuse in the past
year;
- the main causes of violence were perceived to be alcohol and
other drugs (15.4 per cent), health related/personal problems (27.1 per
cent), dissatisfaction with service provided (25.5 per cent).
How far alcohol was involved in the incidents perceived as
arising from the two other major categories was not recorded. It is, of
course, already well recorded that alcohol related violence and abuse is
particularly experienced by NHS staff in Accident and Emergency
departments.
In a separate survey carried out of all GPs in Northern
Ireland, results were similar to those for the UK-wide survey of doctors
in all specialties.
The BMA makes a number of recommendations to tackle the problem of violence towards doctors:
- Training should be in place for all healthcare staff to
handle potentially violent situations - this could include methods of
restraint, communication, managing aggression and personal safety;
- Doctors and other healthcare staff should be working in
partnership with local police, the relevant agencies and the media to
tackle violence;
- Patients must be made aware of their responsibilities and
acceptable behaviour - they need to know that violence will not be
tolerated;
- It should be compulsory for violent incidents to be recorded. De-briefing or counselling facilities should be offered.
- Substantial differences in the perception of workplace
violence exist amongst hospital doctors according to specialty. For
example, nine out of ten A&E doctors and seven out of ten doctors
working in psychiatry reported violence as a problem in their workplace,
which compares with only around 20% of doctors working in geriatrics.
A quarter of doctors who responded to the survey believed
there had been an increase in workplace violence in the past year. This
is particularly the case for general practitioners.
- "Child protection cases have provoked verbal abuse when
attempting to assess the child. Drunk parents can be hostile,
obstructive and verbally abusive. I have also experienced suggestive
remarks and inappropriate touching. One man pushed me against stair wall
in our clinic."
- "I've been on the receiving end of intimidating and abusive
comments and behaviour especially relating to perceived poor practice
(e.g. unable to cure cancer etc)."
- "When people are frustrated after waiting for a service, or
the service does not meet their expectation, it is only human nature to
be angry. Add to this a few pints of intoxicating liquid and what else
do you expect?"
- "Two youths intoxicated with alcohol demanded "viagra", on
refusal to prescribe they verbally abused me shouting racist, sexist
remarks, which were intimidating and humiliating to me."
Top of pageAlert opinion
Sarah Webb
The UK is signed up to the WHO European Charter on
Alcohol which states: “All people have the right to a family, community
and working life protected from accidents, violence and other negative
consequences of alcohol consumption.” They omitted to say “so long as it
doesn’t interfere with business.”
In March it was business as usual. The government finally
published an Alcohol Harm Reduction Strategy. The following week it
published the Guidance to be given in regard to the operation of the new
Licensing Act, the one that allows pubs to open 24 hours a day, 7 days a
week. The Strategy, six years in the making, reads more like a Plan for
Protecting Alcohol Sales. The Licensing Act is of course a plan for
increasing them.
A draft interim version of the Strategy started out looking
quite promising. However, it was just a bit too heavy on truth – such as
the fact that price and availability are the prime levers that
influence consumption, and that overall consumption has to be reduced if
harm is to be reduced. The crucial evidence vanished from that first
draft, and now the facts about alcohol are mixed in with so much spin
that the liquor is hardly detectable – just like an alcopop.
So the message is – keep drinking! Booze sales must not drop
because the Treasury needs the money and the influential alcohol
industry must not be hindered. In any case, it’s good for you. Tony
Blair predictably gave us the Portman Group’s line. This Group is the
industry’s public relations mouthpiece, and it has been doing an
excellent job. Alcohol is quite safe - unless it is misused of course.
The government spouts convenient Portman Group propaganda
while ignoring any genuine evidence which might confirm the
uncomfortable truth - that alcohol is a drug which needs careful
control. A typical example of Portmanspeak was their assertion that
lowering the drink-drive limit would lead to drinking drivers becoming
more dangerous than they are already: “I must be well over the limit so I
might as well have another…” George Orwell would have been proud.
The Portman Group is currently headed by Jean Coussins, an old
chum of the Minister of Culture responsible for doubling drinking time
from 12 to 24 hours a day. Tessa Jowell should stroll around towns like
Bath at night (see Alert issue 2, 2002) to see what just three extra hours of alcohol availability can do.
Dealing with drunks or ‘binge drinkers’ is costly, messy,
occasionally dangerous, and takes up valuable police time. If it is
possible to stop them getting drunk in the first place then prevention
has to be the more cost-effective approach. A simple measure such as
confiscation is useful on the streets and will be a step in the right
direction. Another simple measure that has worked for a century is
closing pubs at night. But while alcohol remains very cheap, very
available, and very big business, there is little hope of a significant
reduction in the late night disorder and noise that blights city life,
especially if the drinking carries on even further into the night as
recommended by Ms Jowell.
However, there are signs that at least some in the government
are fearful of what is now going to happen, and at last the newspapers
are beginning to tell it how it is. The Daily Telegraph published
details of a leaked report by the Metropolitan Police. The headline
read; 24-hour drinking ‘will fuel crime’. It is a damning indictment of
the government’s ‘strong belief’ that extending drinking hours will
reduce disorder.
The Met’s report also cites evidence from Dutch police who
have problems with British tourists. Is it true that wherever there are
Brits in bars there’s trouble brewing?
Talking of bars, when the Irish relaxed their licensing laws
to allow drinking through the night, Temple Bar in Dublin became the
‘Mecca’ for UK stag-and-hen parties. Although they represented less than
two per cent of the Dublin tourist market, their all-night drunken
behaviour put off 13per cent of visitors – a net loss of £57 million per
annum or around £285 million over a five year period. The Irish have
tougher licensing laws now but it was a costly lesson. Now the
stag-and-hen crowd have places like Bath in their sights.
The Home Office is right to be worried – but they should have
listened before. Alcohol Concern, the Institute of Alcohol Studies, the
Open All Hours? Campaign, and local authorities such as Westminster City
and Camden Councils, have been among those warning the government from
the beginning. Alas, the influential Association of Chief Police
Officers dithered. Now the Police are blowing the whistle. But, sadly,
it’s a bit too late.
Dr Sarah Webb is a Bath City Councillor
Top of pageThese footballers are models of British youth
Kevin Myers
Allegations about the Leicester City team going on the
rampage in Spain oblige me to confess. I was raised in Leicester,
whence the Myerses had emigrated from Dublin. I used to go to Filbert
Street in that distant epoch when just about the whole team were called
Len, with the exception of Albert Cheesewright. You wouldn’t even be
allowed to register as a professional footballer these days with such a
name.
Most of the players were bald and had false teeth, which they
left in the dressing room, and games consisted of 22 middle-aged,
pot-bellied footballers, their faces wizened like elves’, hoofing an
ankle-breaking medicine ball around the place. Those few chaps with hair
kept it in place with cement-mixer measures of Brylcreem.
Of course, they didn’t go to La Manga on the Costa Calida for
special training, but to Skegnessa, on the Costa Lincolnsha. They were
paid £17 basic a week, and they were as likely to run amok as they were
to read Jane Austen or crossdress. When a player’s bags were torn, which
happened perplexingly often, both teams would surround him to protect
his modesty while he changed into a fresh pair. Ladies, for whom
“roasting” was confined to Sundays, would avert their eyes and gasp.
Roasting these days in soccer parlance consists of two footballers (or
more) having simultaneous sex with a single woman, usually a stranger.
The term comes from “spit-roast”, with the volunteer host female being
skewered through either end (at the very least). When it’s over, the
spits retire to the bar, and the joint returns to her friends, to regale
them proudly with tales of who put what where. No, I don’t understand
it either.
That the scandal of Premiership footballers’ conduct should
now engulf inexorably drab Leicester is like hearing that Beefeaters are
soliciting for gay sex in the Mall and that the Law Lords are running a
chain of betting shops. So, now almost no team in England is safe. But
it’s not just a matter of football. Soccer, with its combination of
fame, money and libertinism, provides a congenial soup in which the
common bacteria of English misbehaviour can prosper in almost perfect
laboratory conditions. I say English, because the clubs are English, but
actually, the disease belongs to these islands: for in this regard, we
are truly a United Kingdom of Britain and Ireland (UKBI), a singular
realm distinguished by violent drunkenness and boorish, witless
promiscuity.
So it is far too easy to blame the Premiership, when the
players are merely enacting in exaggerated form what can be seen in most
UKBI cities any Friday or Saturday night. UKBI is now alcopopia, where a
Bacardi Breezer is diluted with a double Bacardi, where nights end with
people vomiting in the gutter, and where complete strangers have
incoherent, instantly forgotten sex in shop doorways - chip and kebab
wrappings at their feet obligatory, condoms elsewhere optional.
Take it out of the doorway, put it in a nightclub, swap the
Breezer cocktail for a horse-trough of vintage champagne at £200 a
bottle, and you have the Premiership today. Young men of even average
talent whose libidos have never known any restraint, and who earn in a
week what would have been a world record transfer fee when I was a child
in Leicester, will behave precisely as young men have always done when
not socialised in discipline and continence.
On the Continent, these qualities are still prized, at all
levels of society. There, the violent, drunken crowds that bring a
grisly uniformity to Grimsby, Dublin, London, Swansea and Glasgow at 2
am, simply don’t exist. So footballers in UKBI are not the exception to a
society which is otherwise sober and celibate: rather, they are the
exalted exemplars of a society which is the very opposite.
Yet such conduct is unthinkable within an essentially foreign
“British” club like Arsenal. One can’t imagine the sophisticated aristos
of Highbury breaking up a hotel room at 4 am, or lying in the gutter
drunk, or giving a 10-second roasting to Charlene, who has been lying
awake, fantasising about this moment ever since her best mate Kiely was
roasted by the Accrington Stanley second team, plus a few of their
wives.
Perhaps both islands are reverting to those bawdy ways which
were the norm of merrie, bear-baiting Englande and chaotic, pre-Famine
Ireland. But merely identifying the disease does not mean we are closer
to a cure. For this is a disease of volition: getting drunk, smashing
down doors and exchanging bodily fluids with whatever strangers’ parts
are within pelvic reach - these are clearly desirable objectives for
many within our two islands.
So in both their celebrity and in their excess, footballers
today simply embody the values of the society around them, but only more
so. They are extravagant, hall-of-mirrors reflections of what large
numbers of young people seek to be or already are. And denouncing them
alone for such conduct is just another symptom of the UKBI illness.
Kevin Myers article first appeared in the Sunday
Telegraph on 7th March, 2004 and we are grateful to the editor and the
author for their kind permission to reproduce the article.
Top of pageThe NACOA Helpline
Making a difference in the lives of children of alcoholics
Hilary Henriques
The National Association for Children of Alcoholics was set up
in 1990 to address the problems experienced by children growing up in
families were one or both parents suffer from alcoholism, or a similar
addictive problem.
Our current research indicates that there are 920,000 children
and young people under the age of eighteen, living in the UK today with
one, or perhaps both parents who have a problem with alcohol. Of these,
644,000 will try to hide the problem from the outside world.
It is clear from research studies that alcoholism as an
outcome is but one risk factor for the offspring of an alcoholic. For
children of alcoholics the home environment is very often characterised
by inconsistent parenting, with unpredictable rules and limited, chaotic
or tense family environments; parental violence and spouse abuse;
unpredictability; broken promises; loneliness and isolation as family
members attempt to hide the family’s problems. Research also shows that
the degree to which children are able to shelter themselves from the
negative impact of alcoholism plays an integral part in their growing up
to be well adjusted adults.
Although some alcohol services offer family based therapies
for families, there are few services, which offer help for the vastly
greater number of children who suffer from the problematic drinking of
parents who neither acknowledge nor seek help for their problems. These
children find themselves with no one obvious they can turn to for help.
NACOA addresses this need by providing information, advice and support
through our free telephone helpline, website www.nacoa.org.uk and
supporting services.
Loneliness, fear and confusion are the three problems reported
most often by children of alcoholics calling the NACOA helpline.
Fourteen year old Tim, told one of NACOA’s volunteer counsellors:
‘Sometimes I don’t think anyone sees me. I feel so alone and
so different from the other kids in my class. I used to try to talk to
my Mum but that would upset her. I was frightened when I saw my Dad
lying passed out on the floor but Mum said ‘it’s all right’. So we
ignored him and pretended that nothing’s wrong, although we know there
is. We walk around him, we have tea in the kitchen and we can’t watch
television because we mustn’t wake him up. We all pretend its normal but
I know its not.
We are all happier when he is sleeping because things are calm
for a while, although we are dreading him waking up. What will he be
like when he wakes up? Will he be angry or happy? Will he go to the pub
or to the shed to start drinking again leaving us to worry until he
passes out again? We replay the same game over and over in our heads.
What will he be like when he wakes up, dad or some raging drunk who
hates us, who blames me for his problems – if only I could do better at
school, then maybe he would not have to drink.”
Tim is one of 7,284 callers to the helpline in 2002-2003.
Tim’s family life is torn apart by violence, by failing relationships,
by constant arguments, by financial hardship and by constant neglect of
the little things that are so crucial.
The NACOA helpline provides the anonymity and safety needed by
children who may be afraid to ask for help, feel they are betraying
their parents or think they will not be believed. There are no magical
solutions but every caller is counselled as an individual with
individual problems and needs; not simply an extension of a parent’s
drinking problem. We use a five-step approach, researching services and
resources from our library and databases of information, collated over
the past fourteen year.
For Tim
- we listened and helped him to explore the problems he faces and his feelings in a non-judgemental way
- we provided information on alcoholism, stressing he was not
to blame, that he could not stop his father drinking but he could do
something for himself
- we helped him to work out what he could and could not do,
both for his father and himself. We helped him to find new ways of
coping and ways to have a life for himself irrespective of whether his
father continued to drink, or not
- we helped him to work out who he could talk to – people he
could trust with his private thoughts and feelings, and also who he
could not trust
- we referred Tim to a local drop in centre for young people
in his area and introduced him to youth groups and other activities so
he could start to enjoy himself outside the family home
Tim’s father still drinks but Tim knows now that he is not
alone. He is still frightened by his father’s drunken rages but he knows
that he can go to his friend’s house, without having to explain
anything and go home when he feels safe. Tim is still confused by his
Mum who continues to try to ignore his Dad’s drinking but he now trusts
his own feelings and feels happier that the problem is not his fault or
in his imagination. Tim continues to call the helpline when he wants or
needs to - he knows we will be here for him and will help him to face
problems. He is not alone.
Hilary Henriques is
Chief Executive of NACOA
NACOA welcomes calls from children of alcoholics of all ages and anyone concerned for their wellbeing.
For further information please contact:
Helpline
0800 358 3456 Mon to Fri 10.00 am to 7.00 pm
helpline@nacoa.org.uk
Website
www.nacoa.org.uk
Admin
011-924 8005 Mon to Fri 10.00 am to 4.00 pm
Admin@nacoa.org.uk
For information about the NACOA training programme for
helpline volunteers, or other volunteering opportunities please call
Anna Saunders on 01176-924 87005
or email volunteering@nacoa.org.uk.
Top of pageAlcohol and re-offending - Who cares?
Thousands of prisoners with severe alcohol problems will be
released from jail this year without having been treated to prevent them
returning to heavy drinking and crime according to a new report
published by the Prison Reform Trust.
The report, Alcohol and re-offending – who cares? reveals that
the Prison Service does not have an alcohol harm reduction strategy to
address the behaviour of prisoners who have severe alcohol dependency
problems despite the government’s concerns about alcohol- related
violence and public disorder. Nearly two-thirds of sentenced male
prisoners (63 per cent) and four-fifths of female sentenced prisoners
(39 per cent) admit to hazardous drinking which carries the risk of
physical or mental harm. Of these, about half, amounting to 20,000
people, have a severe alcohol dependency.
The annual estimated cost of alcohol-related crime and
disorder, which will have affected many communities over Christmas and
New Year, is around £7.3 billion.
Overall two-thirds of the 74,000 prisoners in England and
Wales are hazardous drinkers but the report says that a recent Prison
Service survey found that only one jail had policies dedicated to
dealing with prisoners who have been hazardous drinkers.
The report highlights the fact that in some prisons half of
all inmates have serious alcohol problems which are related to their
offending. It says there are very few programmes available that will
actually make a difference and change their drinking habits. In
addition, there are limited opportunities for aftercare on release from
prison due to a chronic shortage of community based alcohol services.
Such as exist are starved of resources, largely as a result of the
government’s failure to set priorities for alcohol problems in a
yet-to-appear national strategy.
The Chief Inspector of Prisons, Anne Owers, recently told the
Home Affairs Select Committee that she was concerned about the shortage
of provision for prisoners with alcohol problems. She said:
“At the moment all that is available is tied into programmes
designed for other kinds of substance abuse, for drug programmes, there
is nothing specific and nothing specifically ring-fenced and I
definitely think there should be.”
Six out of ten prisoners are reconvicted within two years of
release from jail and three-quarters of young offenders return to crime.
The report notes that recent research has found that programmes for
offenders with drinking problems can reduce the likelihood of
re-offending. It concludes that there is an urgent need to put in place a
well-resourced alcohol harm reduction strategy. It proposes:
The Prison Service, supported by the NHS, should draw up an
alcohol harm reduction strategy that provides guidance to individual
prisons to have alcohol intervention programmes in place that link up
with drug treatment work in prisons. The strategy needs to be supported
by significant extra investment.
There should be effective screening tools put in place such as
the AUDIT tool developed by the World Health Organisation to identify
hazardous drinkers as they are received into custody.
There should be ring fenced alcohol treatment programmes
available, particularly in training and dispersal prisons, for severe
dependent alcohol users and motivational programmes for hazardous users.
Onward referrals should be set up for those on release from
custody to provide offenders with continuing support once back in the
community.
Procedures need to be put in place to monitor the number of
people who enter prison with alcohol problems, the numbers who then
complete detoxification courses and the numbers who take up and complete
an intervention programme.
The courts should be encouraged to divert offenders with
alcohol related problems who have committed non-violent offences into
treatment programmes or education schemes in the community.
Enver Solomon, author of Alcohol and re-offending – who cares? and PRT’s policy officer, said:
“Prisons, particularly young offender institutions, are
flooded with prisoners with alcohol problems. It is a failure on the
part of the Prison Service that so little has been done to change their
behaviour. In most cases they will leave prison unchallenged and
unchanged. Access to alcohol treatment is not a luxury it is a necessary
step to prevent further offending and more victims.”
Juliet Lyon, director of the Prison Reform Trust, said:
“We are used to hearing about drug-induced crime but it is
alcohol which fuels violence, public disorder and road traffic
accidents. Far more could, and should be done, by the NHS and the
criminal justice system to reduce hazardous drinking.”
Top of pageLicensing Guidance - not worth the paper it's written on
Westminster City Council has told the government that its
Guidance on how its new Licensing Act will work is not worth the paper
it’s written on.
Commenting on an earlier draft of the Guidance, Councillor
Audrey Lewis, the Council’s Cabinet Member for Licensing, condemned the
document as “contradictory, full of holes, legally suspect and a
virtually useless collection of bland statements that have no practical
application.”
Councillor Lewis continued: "If the government and all its
advisers do not know how this legislation is going to work then what
hope do council licensing officers have? Councils will have to decide
what conditions should be attached to premises licences with no help
from this so-called Guidance while dealing with a huge volume of
applications during the transition period. There needs to be a road map
of how this legislation is going to work. Unfortunately what we have at
the moment may as well be a blank page.”
The City Council’s concerns were conveyed to the Government in
a letter to Richard Caborn, Minister of State at the Department of
Culture, Media and Sport.
Cllr Lewis wrote: "Even issues that the government has
attempted to address, such as the cumulative impact of licensed premises
in a particular area, are addressed in an incoherent way."
‘Cumulative impact’ – the cumulative problems that arise from
concentrations of alcohol and entertainment premises in particular areas
– was one of the major issues that arose during the passage of the new
Act through Parliament. Originally, DCMS planned to deny the new
licensing authorities any specific powers to deal with cumulative
impact, and conceded on the point only very reluctantly and as a result
of strong representations. On this issue, the DCMS view was and
presumably remains the exact opposite of the Home Secretary’s, and the
grudging nature of its concession perhaps explains why, in Councillor
Lewis’s judgement, what the Guidance says about “cumulative impact” is
confused, and demonstrates that the issue has not been understood.
Councillor Lewis’s letter reads:
“There are many problems with (this section of the Guidance), but to take three by way of example:
(i) It is clear that the Secretary of State thinks that
cumulative impact is only an issue for premises selling alcohol
(paragraph 3.15). That is not the case in Westminster, which has areas
where the number of late night cafes causes problems, and also the West
End, where late night cafes add to and exacerbate the problems caused by
drink- led premises. The incidence of disorder around late night cafes
has been of great concern to the Police.
(ii) The Guidance appears to permit policies to address
cumulative impact only in relation to applications for new premises
licences, not in relation to applications to increase the trading hours
or capacity of existing premises by variation of the licence (paragraphs
3.16 and 3.26); and
(iii) The Guidance does not permit a special policy relating
to cumulative impact to address the terminal hour. The combination of
points (ii) and (iii) leads to the absurd position that where it is late
night premises which are the problem that problem cannot be dealt with
by the adoption of a policy preventing more premises from opening late
at night, and an application from premises proposing to open until
twelve midnight must be regarded as just as objectionable as one from
premises proposing 24 hour opening. It is dishonest of the Guidance not
to recognise anywhere, even in the chapter on Hours of Trading and even
in the Annex dealing with conditions relating to public nuisance, that
nuisance is worse at times when people are trying to sleep than it is at
ordinary times of the day. This simple fact could surely be
acknowledged without compromising the commitment to the principle of
flexible opening hours, and the fact that it has not been does seem to
indicate the very narrow, "applicant-focused" perspective from which the
Guidance has been drafted.
Westminster’s anxieties related to a whole range of issues
that it believed the Government had neglected or failed to understand.
These included the transition period; the absence of guidance on
conditions to be attached to licences; the form applications for
licences will take, and a lack of clarity about the role of Councils as
objectors to licence applications.
DCMS clearly felt it unnecessary to pay Westminster the
courtesy of a reply, despite its being the premier licensing authority
in the country.
Top of pageBook Review
Alcohol: no ordinary commodity
Reviewed by Andrew Varley
This is a major publication and a landmark in the
development of our understanding of public policy as regards alcohol. It
includes sections on epidemiology and the need for an alcohol policy;
strategies and interventions; and the formation of effective alcohol
policy. Its contributors include the leading international scholars in
the field and their combined experience and ideas provide compelling
evidence for the importance of effective alcohol policy around the
world.
The authors are ambitious in their claims and not afraid to
stress what they perceive to be the contemporary importance of the
subject: “People consume not only goods, but also services, and alcohol
policy is one such service. In any jurisdiction alcohol policy serves
two purposes: to enhance benefits resulting from the use of beverage
alcohol, and to contain and reduce alcohol-related harms. Citizens have
the right to assess and audit policies on health care provision,
education, and crime prevention. They also deserve to know whether
enacted alcohol policies are apt and well-chosen. Alcohol policy issues
overlap with almost every aspect of the public policy domain.
Alcohol-related issues are pervasively important for the state at both
central and local levels; they cannot be minimised or ignored. In an age
of consumerism, it behoves policy-makers to ensure that alcohol
policies are fashioned with public health interests in mind.”
Referring to the fact that alcohol consumption plays a major
role in morbidity and mortality on a global scale, the authors point to
the progress made during the last fifty years in the scientific
understanding of the relationship between alcohol and health. “Ideally,
the cumulative research evidence should provide a scientific basis for
public debate and governmental policy-making.” It is inevitably the case,
however, that a great deal of this scientific evidence is reported in
academic journals and often appears to have little reference to
prevention or treatment policy. This led to the formation in 1992 of the
Alcohol and Public Policy Project: a small group of experts brought
together with the intention of providing “a policy-relevant review of
the literature”. In fact, a very effective start to the process had been
made almost twenty years earlier when Alcohol control policies in
public health perspective appeared in 1975. Under the impetus provided
by the APPP, the successor publication, Alcohol policy and the public
good, appeared in 1994.
At an alcohol policy conference, held in Chicago in 1998, a
group of APPP experts agreed to begin plans for another volume. This
book is the welcome result. Alcohol: no ordinary commodity sets out to
describe recent advances in alcohol research that have direct relevance
to the development of alcohol policy throughout the world at all levels.
The intended audience of the book includes, of course, researchers,
addiction service providers, clinicians, and prevention planners, but
the authors have especially had in mind policy-makers – the people who
have immediate responsibility for public health and welfare. It is to be
hoped that they keep it by them and apply its lessons: the world will
be a healthier place if they do.
Top of page