‘Safe.Sensible.Social – The next steps in the National Alcohol Strategy’

The new Alcohol Harm Reduction Strategy for England was announced by the Government in June. It supersedes the Strategy launched in 2004,which was heavily criticised by the public health lobby for being too dependent on the voluntary co-operation of the alcohol industry and too cosmetic in intent.

The new Strategy got a generally favourable reception from alcohol problems and public health bodies apart from some complaints concerning lack of consultation. However, there is a question of whether the Government has surreptitiously raised the ‘sensible drniking’ limits (see page 8).

The New Strategy
The Government says that the new Strategy builds on the foundations laid and the lessons learnt since 2004 and that it will ensure the laws and licensing powers introduced ‘to tackle alcohol-fuelled crime and disorder’, protect young people and tackle irresponsibly managed premises are being used widely and effectively. It also sharpens the focus on ‘the minority of drinkers who cause the most harm’.

The ultimate aim, the Government says, is to reduce the harm to health, violence and anti-social behaviour associated with alcohol while ensuring that people are able to enjoy alcohol safely and responsibly.

Problem drinkers
The strategy highlights the country’s ‘problem drinkers’:

• 18-24 year old binge drinkers.

• Young people under 18 who drink alcohol.

• Harmful, adult drinkers who don’t necessarily realise their drinking is damaging their physical and mental health.

Focus on partnership and communications to promote sensible drinking
The Government says the strategy reflects its commitment to work together with all those involved in reducing the harm alcohol can cause, including the police, local authorities, prison and probation staff, the NHS, voluntary organisations, the alcohol industry, the business community, media and local communities, to shape an environment which actively promotes sensible drinking.

Key actions in the strategy include:

• Sharpened criminal justice for drunken behaviour.

• A review of NHS alcohol spending.

• More help for people who want to drink less.

• Toughened enforcement of underage sales.

• Trusted guidance for parents and young people.

• Continued investment in communications campaigns to promote a new ‘sensible drinking’ culture.

• Public consultation on alcohol pricing and promotion.

• Compulsory local alcohol strategies.
  

Reactions
Speaking for the Royal College of Physicians, Professor Ian Gilmore, RCP President and a liver specialist, welcomed the review of the Government’s Alcohol Strategy: “We particularly welcome the review’s focus not just on younger drinkers and binge drinkers, but on the previously neglected issue of adults drinking harmfully at home, unaware that they are damaging their health. It is clear that depending on voluntary partnerships with the drinks industry has not worked, and it is now time for much stronger cross-Governmental action on alcohol issues.

“We need to review and increase the NHS alcohol budget to address the gross deficiencies in both acute hospital services and community treatment services. For example, the RCP in it’s 2001 report ‘Alcohol: Can the NHS Afford It?” called for every acute hospital to have a specialist alcohol nurse as a cost-effective way of reducing harm, yet most are yet to employ one.

“International evidence shows that increasing price and reducing availability are the two main ways of reducing people’s drinking, and while we welcome the review of retailing and promotions, this should not be used to delay action in this area, as we already have enough evidence to make the necessary decisions.”

British Liver Trust
The British Liver Trust also welcomed the Strategy, particularly the government’s commitment to spend £10 million a year on alcohol campaigning. However, the Trust said that the government’s warning must be focused with an overwhelming priority on the health effects of alcohol.

“People in Britain are storing up huge health problems for the future if they continue to drink to excess.” said Alison Rogers, Chief Executive of the Trust.

“Hopefully the Strategy will put forward a clear health message. The habit of heavy drinking is leading to a frighteningly short road to liver clinics and transplant units. With the total UK household expenditure on alcohol running up £41.9 billion in 2005, making people more aware of the health issues associated with alcohol is going to be a long-term battle. Until people realise that a bottle of wine a night is damaging to their liver and their general health there will not be a change in behaviour.” added Ms Rogers.

Alcohol Concern welcomed the new Strategy as “a major step forward in Government thinking on the issue of alcohol misuse.” However, the charity added that there were some significant gaps in the Strategy, particularly with regard to service provision for people with alcohol problems.

For drug prevention charity Mentor UK, Eric Carlin, its chief executive officer, said: “I am disappointed with the lack of consultation on the next steps in the national alcohol strategy, not only with drug prevention agencies such as ourselves, but with young people who are key to minimising the problem of future alcohol misuse. Although the need for early intervention is already recognised at government level, with guidance issued from the DfES that education should start in primary schools before drinking patterns become established, there is no focus on prevention initiatives and the younger age group in this alcohol strategy.”

Industry reactions
Reactions from the alcohol industry were also fairly restrained, though there was obvious unhappiness at not being fully consulted. A clear division began to appear between different sections of the industry, with spokesmen for the on-trade welcoming the proposed review of cut price alcohol promotions while those speaking for the off-trade took the opportunity to deny any responsibility for promoting the binge drinking culture.

John Grogan, MP for Selby and chairman of the All-Party Parliamentary Beer Group and a well-known spokesman for the ontrade said: “The announcement that the government is planning to hold a public consultation on alcohol pricing and promotion is excellent news. This is a major step forward for the campaign to get the supermarkets to end irresponsible drinks promotions. It is the first sign that government ministers are now taking this issue seriously.”

Tony Payne, chief executive of the Federation of Licensed Victuallers’ Associations,welcomed news that supermarket pricing would be targeted.He said: “Cheap prices are just encouraging people to buy more and drink more. It’s good the government is to look at supermarkets and venues that offer promotions such as ‘drink as much as you want’ for a fixed price.”

British Institute of Innkeeping chief executive John McNamara commented: “A pub can be one of the most responsible places to drink alcohol. While binge-drinking is an issue that needs to be continually tackled, I am heartened that the government has recognised the impact of drinking in the home.”

The British Beer & Pub Association also welcomed news that supermarkets’ loss-leading on alcohol will be investigated.

TheWine & Spirit Trade Association questioned why the Strategy had been drawn up without full consultation with the trade.

British Retailers Consortium
However, the British Retailers Consortium took a different view. It joined with major retailers to meet with MPs to “debunk a series of myths and spell out their commitment to public health and responsible alcohol retailing”.

The BRC’s Parliamentary Briefing was held on the same day the Government published the Alcohol Strategy. The BRC denied that supermarkets caused excessive drinking and claimed that, in fact, they were at the forefront of the drive to encourage responsible consumption and prevent underage sales.

BRC ‘evidence’ showed supermarkets were rarely the outlet of choice for people buying alcohol to drink immediately. Overwhelmingly, alcohol was bought from supermarkets as part of a routine shop for a full range of groceries with only one in a hundred transactions being of alcohol alone.

BRC Director General Kevin Hawkins said: “Alcohol price cutting by supermarkets does not create problem drinking. Very few supermarket customers buy just alcohol and it isn’t aimed at immediate consumption. Banning discounting, even if it was possible under competition law, would simply penalise the vast majority of customers who take it home to drink over a period or at family events.

“Retailers are leading the alcohol industry on efforts to prevent underage sales and they are providing customers with clear information to enable them to make sensible choices.

“On excessive drinking and its effects, retailers are an easy target but not the right one.”

Political reactions
For the Conservative Party, shadow Home Secretary David Davis described the new Alcohol Strategy as an admission of failure on the part of the Government. Mr Davis was particularly worried by the Government’s proposal to introduce conditional cautions for drunken behaviour.

Mr Davis said:“We will look at these proposals in detail but it is important they do not become yet another stealth mechanism for the Government to ditch their responsibility to tackle serious crime. People should remember that half of all violent crime is fuelled by alcohol.

“The public will not tolerate a situation where - as with shoplifters – alcohol- fuelled crime becomes effectively decriminalised with offenders getting a caution in exchange for undergoing a course that may not work.

“In any event this is an admission that the Government has failed on alcohol abuse. They are now acknowledging the serious harm alcohol does both to public health and public safety. If this is the case why did they simply unleash 24-hour drinking on our towns and communities instead of listening to our calls to pilot the scheme so its effects could be properly assessed?”

For the Liberal Democrats, Norman Lamb MP said: “A fresh look at tackling the growing problem of excessive drinking is long overdue. Too little has been done by this Government, which has allowed public health budgets to be raided to cover deficits elsewhere. The Government’s trumpeted 2004 Alcohol Strategy is now merely gathering dust. The same must not be allowed to happen to these latest plans. Urgent action is needed to stem the binge drinking culture which takes root in so many people at a young age and leaves them with health problems for life. Someone drinking as a young teenager is far more likely to be dependent on alcohol in adult life.”

The new timetable for action