Robert Madelin: European Commission does not support ‘an apartheid’ approach to alcohol policy making

In the run-up to the Swedish Presidency Conference, the Globe’s Andrew McNeill interviewed Robert Madelin, Director General for DG SANCO, the EC Directorate responsible for the implementation of the Alcohol Strategy.

AM The Alcohol Strategy followed on from the Food and Nutrition platform, which provided the model. What useful lessons did the Food and Nutrition Platform provide?

RM If we consider the Alcohol Strategy first, this is still bedding in. We’re only in 2010 getting to the stage of a formal full evaluation of the Nutrition Strategy, which is older than the Alcohol Strategy. So while we’ve been worrying about alcohol forever, the Alcohol Strategy is still relatively young in terms of the EU policy cycle.

What did we learn? I think we learned the best practice model from the Nutrition Platform in regard to requirements for monitoring, accountability and reporting, and we’ve been able to apply them directly to the alcohol process. Of course, we face the same problem on alcohol that we do on nutrition, which is that it’s a model for accountability about output, not outcomes. So we’re not yet able to measure the impact of individual measures. But that’s a familiar problem in work on health determinants whoever is doing it, and whether it’s done under the Health Forum, or by public executives.

Another lesson we’ve learned in relation to both nutrition and alcohol is that the science is less mixed in the messages it sends to policy makers than lobbyists would have us believe. Connected with this, I think that establishing a science group in the alcohol process with balanced representation of different sorts of scientists does, therefore, seem to come out as a helpful tool even if, at this stage, the output is limited, and obviously the capacity to do work is limited because these are not people working full time on issues coming out of the Alcohol and Health Forum.

AM It seems to me that both the Food and Nutrition Platform and the Alcohol Strategy are alike in being based on the optimistic assumption that it is possible to get diverse stakeholders together, a consensus will emerge and everyone will then work towards shared goals. Does not the history of the alcohol strategy, -for example, the reaction of the alcohol industry to the IAS report ‘Alcohol and Public Health in Europe’ suggest that the industry people did not want there to be a public health strategy on alcohol?

RM Well, it’s certainly true that if they could have delayed it further, some parts of the industry would have done that. So I think we were lucky that the responsible EU Commissioner, David Byrne, was prepared to bite the bullet and take the risk, because to have said that we were still reflecting on it would have been a more comfortable option for him.

On the question of optimism, I wouldn’t have been a public policy maker for 30 years if I wasn’t an optimist about the ability of society to come together to fix serious problems.

I don’t think you can create trust overnight and I don’t think you can pretend that very different opinions about what society really needs can be or should be set aside at the door. I do, however, observe that even where serious disagreement exists, talking to the other side in a structured way under public refereeship, so that it is a safe process that cannot be misrepresented by the other side, helps everybody around the table to set aside the worst of their misunderstandings. But it is a slow process.

I don’t believe, however, that there is a working alternative to this process. The point is that having an Alcohol Strategy is better than not having one. The world we were in before we had an alcohol policy was one that was comfortable for economic operators because there was no EU level pressure on them to do anything. It was all left to Member States, and not all Member States were equipped to create pressure at their level.

AM At this point in the proceedings, is the process where you wanted it to be at this stage? And are you basically content with how it has developed?

RM Well, I suppose the issue on which I would put a question mark is about creating an EU 27-wide, better policed network of national self- and co-regulation on alcohol advertising. That’s moving more slowly than I would perhaps hope. I want it to happen not because I see it as a panacea, because it doesn’t dispose of other unanswered questions about the right level of regulation, but because I think that it’s what we could do now. So that’s a bit slower than I would hope.

I also think the Clearing House tool should be useful in terms of taking these anecdotes of best practice and putting them all in one place where people can see them. This is because for some of the newer Member States and for emerging actors in civil society, and even for the research community, there’s still lots to learn.

But for the rest, I didn’t have specific critical path deadlines for individual components because I think that, while the Commission chairs this process, we cannot determine its rate of development. That depends a lot on the individuals in the room.

AM Allowing for that, do you believe that the process is satisfactorily bringing together all the policy tools available to the EU?

RM No. Maybe two things to say there. Firstly, it’s not yet satisfactorily bringing together all the actors. In regard to the economic operators, the extent of engagement down the value chain varies, so we need to work more on that. And also in terms of civil society actors, people like teachers for example, or community leaders, there are potentially other actors who can be influential at national and regional level but who are quite hard to reach sometimes from European levels. So for the people around the table I still have some recruitment ambitions.

In terms of the tools, the Forum is a tool but it’s not the toolbox; therefore, there are other tools which are not in the Forum and never could be because they’re public policy and this is a tool among others. In regard to the broader debate with Member States, I think there as well it’s a bit too early to judge. Member States are all beginning to move towards a more comprehensive implementation of the ideas in the Alcohol Strategy but I think many of them would say we’re not quite there yet. That’s something where we probably do need another year or so to judge.

AM So you are pretty confident that the EU Alcohol Strategy has had a beneficial effect at Member State level?

RM Well, the officials who come to the alcohol policy meetings seem encouraged by the fact that they have an EU level benchmark against which to push. But that’s very much at working level. What we lack, I think, is a big enough focus on public health promotion as a component of health responsibilities in most if not all Member States. So the existence of the Forum and the existence of the group of officials is not, in itself, delivering that and I don’t think it can. I don’t think the EU can tell Member States to rebalance towards more public health promotion, but the trend is there.

AM What about within the institutions themselves, the other directorates for instance? Do you feel that they are on board satisfactorily?

RM These organisations, Nutrition Platform and the Alcohol Forum, are both set up on the basis of a very formal political decision by the Commission, which means that its much easier to get other DGs to co-operate with them and with their policy area than it is if I just have an ad hoc conference on youth or sport or something like that. In this particular field, perhaps there is less that other DGs can do on alcohol than there is around the food chain. For example, on the food chain it is very obvious you need DG Agriculture. Some of these issues have not yet been unpacked in the same way in the alcohol debate as they have on nutrition so I would say that, on alcohol, people in other DGs are a bit less sure what they can contribute and the Forum itself, to be honest, has not been so interested yet. In the Nutrition Platform there was a lot of desire to talk to other DGs and we haven’t seen that so much on alcohol yet. Not as strong evidence of engagement as we had for nutrition, but maybe that’s because we haven’t been pushing them.

AM Can I ask you now about the attitudes of some of the people on the NGO side which, as you know, have been ambivalent about the Alcohol Strategy because they do not like the involvement of the alcohol industry. I assume you do not regard this kind of criticism as fair or reasonable.

RM Going back to your optimism and pessimism, I am an optimist but I expect the worst. My view on this is that every position is legitimate. In the first such Forum that I ever established, which goes back to my time working on trade policies in the 1980s, yes there were some NGOs that boycotted the process and others that chose to come into it. I think that, from the Commission’s point of view, we should only embark on such processes if we’re sure that they are potentially useful, and we can’t give a veto to any particular part of society. So our position is not to precook the results but to be honest as public policy makers in saying we think we need more co-operation around the reduction of alcoholrelated harm. And then the people who wish to join the process will, and others will not.

I personally believe, almost as a societal value, that engagement, not boycott, is the duty of responsible organisations in public policy making and I think that’s true in public health and in every other field. To say that different players have different roles is one thing. But I don’t think you can have a sort of apartheid approach towards policy making, and I think, in particular, that in an area which is focused on the behaviour of citizens in society, in today’s society in Europe, you’ll never achieve behavioural change by an apartheid approach. Yes, it’s possible to reject co-operation and lobby instead for hard law public interventions, and clearly it is always possible that at some stage in the future there’ll be a much bigger political will to legislate, and maybe that’s all we need. But my own view is that, even if you have legislation you also need co-operation. The two are not mutually exclusive. In the area of food safety, where there are huge statute books, I still need civil society, consumers for example, and economic operators to get together and co-operate simply to implement the law.

So if the question is, are those around the table in the Forum right to be there in their own interest? I’m convinced the answer is yes. We are committed to making sure that there is no abuse or misrepresentation. Is it a useful expenditure of their time? Only each organisation can answer that, but my own view is that if you look at the nutrition area you can see issues where the change comes out of the debate in the platform even if there are then underpinnings in legislation later.

AM But there are still fairly fundamental differences between, say, the Eurocare people on the one side and the beer and spirits people on the other.

RM I think that’s true. But I would suggest that there are probably differences between economic operators, and probably also differences between NGO participants in the Alcohol Forum as well. I think part of the answer is you can’t effect social change unless you engage with other actors in society so even if you’re pessimistic and mistrustful, if the public authorities say we want a conversation and civil society says we don’t care, we’re not coming, you have to be sure you’re right, but it is your call. At a second level, I am optimistic that exposing, in a structured way, the individuals working within the alcohol value chain to the knowledge and experience of voices of civil society changes them. They are getting input they don’t get when they’re allowed to sit just in their own little groups. So I think that there is a public good investment just sitting opposite people even if you disagree with them.

AM There is a fairly heavy emphasis on youth in the Strategy. Are you content that the appropriate means have been found for involving youth in the process, which I assume is a necessity, at least at the political level?

RM I think that the focus on youth is not because all the alcohol abuse takes place among young people. It’s an optimistic endeavour to fix the future, because if the behavioural challenges which are prevalent in society can be reduced in their prevalence among the under 30s, over time the norm will change. The second point, I think, is that, in terms of health policy, Commissioner Vassiliou has made a big issue about focussing on youth across the board, not just on alcohol. So the youth focus is not specific to alcohol. Are we finding the right ways to involve youth? We’re trying hard, but it’s a hard to reach group. Organised youth is one thing, and there are several organisations around the alcohol issue who are there, but unorganised youth is another and I think we shouldn’t just be politically correct and say you can only do youth health policy when young people are in the room. You need the voice of youth but you also need expertise about youth which doesn’t only come from young people themselves.

AM The last question. Take this as flattery but with a sting in the tail. The Eurocare consultation exercise about the Strategy found that people were very happy to give you full marks for pushing the alcohol strategy along, for being the driver behind it; the sting in the tail is the question whether it depends too much on you? In other words if you were run over by the proverbial Brussels bus, what would happen to the Alcohol Strategy?

RM Well, I am, as the Chairman of the Alcohol Forum, the visible face, but as the Eurocare members should know better than me, the alcohol policy work began long before I arrived in this job in 2004 and every day it depends on the contribution of many people who are not me, so I think that where we are today doesn’t depend on one person and therefore, if that one person moves on much will depend on the successor. In terms of the personal role, I chair the Forum so whoever takes over from me when I go to another job will have to do a good job as well, and there are lots of experienced and committed people in the Commission. The Commission’s rule is Directors General move between their 5th and 7th year in the job, and I’ve done 5 years and I’ll have done 7 years at the beginning of 2011, so probably the new Commission which is expected now to come into office, lets say, very early in the New Year will make decisions about moving Directors General around sometime in 2010. So it’s not an abstract question but I wouldn’t personalise it as much as your commentator did even though its deeply flattering. I think in the end if there weren’t a political will to work together the Chair of a process couldn’t make it work and if there is a political will to work together then the Chair of a process can clearly mess it up but the Commission has a range of good officials capable of not messing it up.

AM So you are confident that the Alcohol Strategy has been sufficiently institutionalised that it will carry on?

RM Yes. It is always possible for the next Commissioner to adjust policy, , but in terms of the agenda for the next Commissioner around health determinants work the youth thread needs a push, health inequalities is the next one requiring proposals, the Nutrition Strategy needs evaluation and those would, I think, be the priorities for change and innovation in 2010. Alcohol comes after that when it’s had a little bit more time but I believe that we have, in the life of this Commission, achieved the recognition that there needs to be an alcohol strategy at EU level and that the next Commission and my successor will be devoted to trying to make it more effective.