Before we move to the next item of business, which is a debate on motion S4M-13358, in the name of Shona Robison, on making progress on changing Scotland’s relationship with alcohol, I remind members that for the purposes of the sub judice rule in standing orders, there should be no discussion of on-going legal proceedings about minimum pricing. I refer members to the advice that was issued yesterday on issues that should not be raised during the debate. The Presiding Officers will ask any member who refers to those issues to stop doing so and will make full use of their powers if they consider that any member is persistently breaching that rule.
14:42
Scotland’s relationship with alcohol has—rightly—concerned the Parliament deeply over the past decade and a half. We know that alcohol use is one of the top risk factors for non-communicable diseases. All too often, international comparisons place Scotland well behind the health curve of our European neighbours.
I called this debate following constructive cross-party discussions. I wish to enable a non-partisan and collaborative conversation that reaches across the chamber.
The Scottish Government’s strategy in “Changing Scotland’s Relationship with Alcohol: A Framework for Action” has seen a good deal of progress since 2009 and much of that work remains on-going. However, we cannot be complacent and we must look to the next steps for action in the medium term. That is why I am commencing today our cross-parliamentary consideration on where next for alcohol. I welcome suggestions and I look forward to substantive contributions from all participants.
Our 2009 strategy was based largely on recommendations made by the world’s leading authority on non-communicable disease prevention—the World Health Organization. The WHO’s priority actions are evidence based and encourage countries worldwide to implement 10 priority measures on alcohol, including measures on pricing, availability, marketing and advertising, as well as drink-driving policies, community action and health service programmes such as alcohol brief interventions. We are making good progress on the WHO recommendations and we should all be proud that the Scottish approach fares so well against the WHO checklist.
Just last month, another world-renowned body—the Organisation for Economic Co-operation and Development—published a report on the economics of tackling harmful alcohol use. The OECD further validated the Scottish approach and advised that the most effective and economically prudent package should include fiscal and regulatory measures, healthcare interventions and a strategy that combines healthcare and regulatory measures.
It is clear that international experts feel that we are heading in the right direction, but we are not there yet by any means. There can be no dispute that one death associated with alcohol is one too many. While there remain averages of around 700 hospital admissions and 20 deaths a week because of alcohol misuse, no morally responsible Government or Parliament can rest easy.
It is true that the number of alcohol-related deaths has fallen by 35 per cent since 2003—I welcome that, of course—but the number remains 1.4 times higher than that in 1981, which concerns me greatly. Furthermore, I am sure that every member will agree that the rise in alcohol-related deaths that is seen in the most recent data, for 2013, is of great concern.
It is too early to know whether that rise marks the beginning of an upward trend, but we must be alert to the possibility that alcohol-related harm may increase again as the economic climate improves. It is highly likely that declining affordability because of the economic downturn in recent years is responsible for a substantial proportion of the improvements that we have seen. That is why an effective pricing mechanism that is capable of responding to affordability is important. That view is endorsed by the WHO and the OECD.
Our European neighbours look to us as pioneers on pricing. Many await the outcome of the minimum unit pricing litigation. We have the support of many, and I thank people for all their efforts on that in many areas. I thank Alcohol Focus Scotland, Scottish Health Action on Alcohol Problems, the British Medical Association Scotland, Eurocare and the many advocacy bodies across Europe and the member states that have shown their support for many of our policies. We will wait and see. As the Presiding Officer said, this is not the place for the debate on minimum unit pricing. That matter will be determined in September.
Our framework for action goes much wider than minimum unit pricing. It contains more than 40 measures that seek to reduce consumption, support families and communities, encourage more positive attitudes and positive choices, and improve treatment and support services.
We continue to take a whole-population approach, because alcohol use impacts on people from every walk of life. Although it is true that heavy drinkers consume by far the greatest proportion of alcohol that is drunk in this country, the harms of alcohol use can be far ranging. Even relatively modest consumption patterns increase the risks of non-communicable diseases such as cardiac disease and cancers. Harm to others can manifest in many ways, from impacting on parenting capacity to potentially serious alcohol-related violence.
Our journey has seen great strides forward. Time constraints do not permit me to go into every detail of the significant progress that has been made across the breadth of the strategy, so I will highlight a few examples.
Our introduction of the quantity discount ban saw alcohol sales reduce by an estimated 2.6 per cent. We legislated to ban irresponsible promotions and we have made a record investment of more than £278 million since 2008, of which £250 million has gone directly to the 30 alcohol and drug partnerships that we have established to meet local priorities.
We introduced a lower drink-drive limit last year. That move is now being called for in other parts of the United Kingdom, and it has already had promising results. We have improved substance misuse education through the ability of the curriculum for excellence to take a broad look across health and wellbeing, and we have introduced a hugely successful nationwide alcohol brief interventions programme. More than 470,000 ABIs have been delivered.
I will touch on that programme for a moment. I am keen for us to get to the harder-to-reach consumers of alcohol through it. That is why we are doubling the capacity from this year for national health service boards to deliver ABIs in wider settings, from a 10 per cent to a 20 per cent quota.
We need to focus on health inequalities. We have seen improvements in alcohol-related health inequalities in recent years, but death rates for those in the most deprived groups are still six times higher than those in the least deprived groups. That is why we specifically emphasise tackling inequalities through the work of ABIs. We are also looking at how uptake can be facilitated in justice settings such as custody suites and prisons.
I will return briefly to education, because I am sure that there will be a consensus in the chamber that getting our messages right about alcohol is imperative. That is why I am delighted to announce that, this year, the Scottish Government will develop a new social marketing campaign around parents as role models, which will run in early 2016.
We must do all that we can to protect children and young people from exposure to alcohol-related harm. That is why the Air Weapons and Licensing (Scotland) Bill creates new offences of supplying alcohol to children or young people for consumption in a public place, which fulfils a manifesto commitment. That is also why I am sympathetic to the spirit of Richard Simpson’s ideas about advertising and marketing, where he focuses on the exposure of children to alcohol advertising. I am sure that we will have further positive discussion on that. The moral imperative is strong, and I look forward to finding areas of parliamentary consensus.
That brings me to one of the difficulties in taking a truly holistic approach to tackling alcohol-related harm—the limitations on the Parliament’s ability to take action in some areas. While powers on broadcast advertising remain reserved, we do not have the full levers at our disposal to protect children and young people from the more influential channels such as television and, increasingly, digital platforms, including social media.
The devolution of power over broadcast advertising was not among the recommendations to come out of the Smith commission process, and nor was the consultation that this Government requested on alcohol duty rates. With the chancellor’s recent abolition of the duty escalator, combined with cuts and freezes across various alcohol categories that will only make alcohol more affordable, the case for the Scottish Government to have a say on UK alcohol duty has never been stronger. The devolution of weights and measures powers would also allow Scotland to further tailor our approach to serving sizes, which would complement the multibuy discount ban.
I intend, in a positive and constructive way, to engage with the UK Government on those issues, and I hope that we can arrive at some consensus that will allow us to move forward on a UK basis. If not, I hope that Scotland will have the appetite to move forward on those issues.
The alcohol licensing regime, which is being further enhanced through the Air Weapons and Licensing (Scotland) Bill, provides a robust locally led system for regulating the sale of alcohol. Local licensing boards are equipped to take decisions on licence applications that take full account of the public health objective that Scotland has enshrined in the licensing system.
Our national alcohol charity, Alcohol Focus Scotland, has been working to empower local players to present robust evidence to local licensing boards that will support their consideration of applications for premises and help to tackle issues such as overprovision. Today, I am pleased to confirm additional funding to Alcohol Focus Scotland for a new post to assist in that.
This October, Scotland will have the great honour of hosting the prestigious Global Alcohol Policy Alliance conference, with international experts coming together to share knowledge and build capacity around tackling alcohol-related harm. I very much look forward to engaging in constructive discussion at the conference about the latest thinking worldwide. I am sure that there will be ideas that we will wish to capture for Scotland, and perhaps ideas that others will want to take forward in the rest of the world. I expect the next phase of our alcohol strategy to be ready in early 2016.
Over the coming months, I urge all members to reflect on the progress that we have made on the journey so far, since our framework’s launch in 2009. I have laid out some of that today, and I hope that there will be consensus that that has been a good start.
One of the provisions that the Parliament passed in 2010 gave local authorities the potential to impose a social responsibility levy. The Government had to produce regulations for that, but it decided not to do so. That was one of the ideas that came forward but, although it is in law, the Government has not acted on it, and I wonder why.
The short answer is that the decision was made because of economic considerations and the economic climate of the day. Members have heard John Swinney responding to that point and citing that very reason. It is because of the fragility of some of the businesses that would be involved. However, we obviously want to keep the position under review.
As I said, there has been a large degree of consensus—not on all matters, but broadly speaking—that the progress so far has been good. That progress has certainly not been by the Government alone. We have worked with a range of partners, including the NHS, the police, third sector organisations and the alcohol industry.
Many actions must be continued, and we will want to pursue new ideas. The opportunity today is to begin to tease out the areas on which there may be consensus.
I urge everyone to be cognisant of the likely impact of the economic recession on Scotland’s alcohol-related harm statistics. The impact of such harms continues to be felt across our communities. Only a comprehensive, sustained and preventative approach, which addresses the key WHO priorities, will turn around our relationship with alcohol.
That will not happen overnight. We have been working for more than six years on a sustained alcohol strategy, but even that timeframe is not long enough to turn around Scotland’s relationship, culture and behaviour with alcohol. That is a generational issue, so it will take us much longer to turn that around into—I hope—a more positive relationship with alcohol.
I hope that my speech has given members a flavour of where we are on the right track and what actions we want to continue. The Government is very open to hearing ideas from all sides of the chamber and to building a consensus on the strategy’s next phase. We will work on that phase over the next few months and introduce it early next year.
I am happy to accept the Labour amendment.
I move,
That the Parliament recognises the progress to date on tackling alcohol misuse in Scotland and the impact of the Scottish Government’s comprehensive 2009 strategy, Changing Scotland’s Relationship with Alcohol: A Framework for Action; further recognises the valuable contribution made to tackling alcohol misuse by local alcohol and drug partnerships, the third sector and the public sector, including the NHS and Police Scotland; welcomes the recent decline in some alcohol-related harms, especially in lower income areas; further agrees that substantial preventative action to tackle alcohol misuse remains essential, given the wholly unacceptable average of 20 alcohol-related deaths and 700 alcohol-related hospital admissions each week in Scotland; welcomes views on additional measures to help tackle alcohol misuse, and acknowledges the importance of price in any long-term strategy to tackle alcohol misuse and the Scottish Government’s commitment to introducing minimum unit pricing.
14:57
I thank the Scottish Government for bringing this important debate to the chamber.
Presiding Officer, I respect your initial remarks on the sub judice issue. However, I am confused about why a sub judice issue was included in a Government motion. My understanding is that Government motions set the parameters for the debate. I raised the issue with the clerks yesterday, and I was told that a sub judice issue could be included in a Government motion but could not be discussed. I accepted that explanation, although I am not sure that I understand it fully.
I am happy to say that Labour members will support the motion, and I thank the Cabinet Secretary for Health, Wellbeing and Sport for accepting our amendment.
I am sure that most if not all of us in the chamber and beyond the walls of the Parliament do not need to look far in our own lives to see how alcohol can impact individuals, relationships, families, children and people’s incomes, work, careers and friendships.
Today, we as a Parliament, along with the Scottish Government, consider how public policy can reduce alcohol consumption to mitigate some of those effects on people’s lives. The difficulty in doing that is that alcohol is legal, widely available, sociable and, in many ways, a good thing. Ultimately, it is up to our own volition and ability to moderate its consumption. That is a very liberal argument, but it is at the heart of the debate—the balance between restrictions through legislation and public policy and control of our own behaviour. What can be such a good thing in moderation—a libation, a social relaxant, a treat, and an enjoyable reward for celebration and hard work—can tip into being a culture, a crutch, and something that no event or social occasion can be without. That takes us to the place that, unfortunately, many of our communities are in, where too many lives are lost and impacted by its devastating consequences.
We cannot be under any illusion how damaging alcohol is to Scotland. The briefings that we have received for the debate have been helpful. They point out that, in Scotland, there are 20 deaths every week due to alcohol misuse. Deaths from liver cirrhosis in 2010 were around 40 per cent higher than the European Union average. We drink almost a fifth more than our neighbours in England and Wales. Despite modest recent improvements, rates of alcohol-related hospital admissions in Scotland are more than four times higher than they were in the early 1980s. Harmful drinking is not unique to Scotland, but seeing our name right at the top of the league tables on every measure of alcohol abuse is a deep stain on our image and pride in our country.
I have touched on the social and human impact of alcohol abuse, but it is important not to forget its effect on our economy and our ability to work and be productive. That, as well as the human cost and the health impact, must be a crucial element of the debate.
Rebalancing Scotland’s relationship with alcohol is a shared ambition across the Parliament. There is a range of views on how best to achieve that and a lot of consensus. I acknowledge the Government’s commitment to the issue, as noted in the motion.
Without easy or simple solutions, it is difficult to bring about the change of culture that we require. I am sure that the ban on multibuy discounts and other measures that the Cabinet Secretary for Health, Wellbeing and Sport highlighted played a significant role in the recent fall in consumption, although the economic downturn is acknowledged as another factor.
We welcome some of the modest improvements that have been made. Scotland was the first country in the world to implement alcohol brief interventions, whose effectiveness is long established, in a national programme. The fact that the programme has outperformed its initial targets is an excellent recommendation for the Scottish Government to continue it.
The reduction in alcohol-related deaths among the most deprived people in Scotland signals a small start to reducing health inequality, which we must welcome and fully support. Although there has been a 35 per cent fall since 2003 in alcohol-related deaths, that still leaves deaths 40 per cent higher than in the 1990s, according to Scottish Health Action on Alcohol Problems. As the cabinet secretary said, the rise in alcohol-related deaths since 2013 is concerning but does not challenge the overall downward trend.
I also welcome the constructive way in which the Government approached the motion and the cabinet secretary’s willingness to consider other additional measures. In that respect, I hope that the Scottish Government will consider the measures that my colleague Dr Richard Simpson proposes in his member’s bill, given his undoubted expertise in, and passion for, the subject.
I will take members briefly through some of the proposals in Richard Simpson’s bill. I do not want to leave that to the closing speeches, as I would like some of the issues to be debated. The bill has some constructive proposals in a range of areas, such as alcohol advertising and retailing, licensing laws and how we rehabilitate offenders with alcohol problems.
Packaging up multipacks and selling them off so that each unit is cheaper encourages heavier drinking, so there are proposals on that in the bill.
There are also proposals to restrict alcohol marketing, especially where children might be exposed. It is within the scope of the Scotland Act 1998 to do that in public areas on billboards, in bus shelters and on public transport. I noted the cabinet secretary’s initial comments that broadcasting is reserved to Westminster, but I am sure that, with the increase in representation at Westminster that her party has recently enjoyed, its MPs can make the case along with our colleagues there.
Richard Simpson’s bill proposes restrictions on caffeinated alcohol. It seeks to establish a legal limit of 150mg of caffeine per litre of pre-mixed alcoholic drinks, based on the limit in Denmark, that would apply to the retail of such products only. It does not propose an outright ban.
I know that the cabinet secretary feels strongly about alcohol education. The bill would require the Scottish Government to publish a programme of public alcohol education, evaluate its effects and report to Parliament on its successes.
Other ideas in Richard Simpson’s bill are a presumption against discrimination against 18 to 21-year-olds in off-sale premises, and community consultation, in which an approach similar to that of New Zealand would be adopted, where a neighbourhood is consulted and must have its views taken into account by the licensing board when it issues, renews or extends a licence. I am sure that the cabinet secretary will be aware of that example. It may sound overly bureaucratic but there was a situation in our home city of Dundee recently in which the health board objected to a local cafe’s application to sell alcohol. The community council’s voice was not part of that process. A community consultative approach, as Dr Simpson has proposed, might be a more inclusive and constructive way of engaging the community in licensing decisions, as opposed to a process in which organisations and individuals can lodge objections directly to the licensing board. I hope that suggestions in Richard Simpson’s bill will be discussed at greater length during the debate.
We know that Scotland is changing and I believe that our relationship with alcohol is changing, too. We would be silly to deny that the macho culture of hard drinking still exists in our communities. Much of it is ingrained in our identity and is still celebrated and joked about in an unhealthy way. My strong sense, though, is that people today—especially young people—have greater awareness of their health. They have a stronger desire to live healthier lives and understand that too much alcohol is not compatible with that.
In time, our health service and our justice system will see the benefit of that, but we must do much more to ensure that that trend is ingrained and continues, particularly given that, in the national health service, the pressure on our doctors and nurses grows every day. Every day in this Parliament, we should work towards our ambition for a healthier Scotland, in which people from all backgrounds are educated and empowered to make better decisions with healthy bodies and healthy minds. A big part of that is to tackle harmful drinking. We can look at the progress in recent years and take some comfort, while recognising the long way that we still have to go.
I move amendment S4M-13358.1, after “help tackle alcohol misuse” to insert:
“including restrictions on alcohol retailing and advertising, changes to licensing laws and improved alcohol-related rehabilitation for offenders”.
15:08
I have pointed out before that Scotland’s very sharp deterioration in its relationship with alcohol in terms of hospital admissions and deaths can be traced back to the end of 1990 when, by coincidence, Margaret Thatcher left Downing Street. Whether that therefore led to rejoicing in the streets—a binge party from which Scots never recovered—or whether Scots were consumed by grief at her departure, it nonetheless is a fact that, from that point onwards, there is a measurable deterioration in our relationship with alcohol.
Before members of the Scottish National Party get too excited about drawing a conclusion one way or the other, I should say that it is also the case that the improvement in the numbers of alcohol-related hospital admissions and deaths began when Alex Salmond came to office. I do not know whether that was because people no longer felt like rejoicing on the streets and had given up on life. Although the small improvements that we have seen are to be celebrated, I do not know whether we can be complacent about what might have underpinned the change in trend, to which I will return.
I thank the cabinet secretary for bringing the debate to the chamber. I said in a question not so long ago that it was two years since we passed minimum unit pricing and since we last debated the subject in the chamber. The First Minister got a bit excited by that. I did not mean to criticise the on-going work that is being done, but the debate on minimum unit pricing was underpinned by a determination to understand and address Scotland’s relationship with alcohol. That needs a sustained and continuing debate in this chamber. The minimum unit pricing legislation was passed in what I might call the salad days of the Government, and we have a chance to consider the issue again today, for which I am grateful.
There have been improvements. Some are maybe not so obvious. In 2013, Scotland had double the vodka off-sales of any other part of the United Kingdom, so we still have trends that we might not wish to celebrate. Jenny Marra and the cabinet secretary referred to consumption and the 1980s. Consumption is still at twice the rate of France, Portugal and Spain—as well as another country that I have written down incorrectly, which is not very helpful—and the rate of hospital admissions is four times the rate that we saw in the 1980s.
I acknowledge the work that has been done and the measures that have been taken; the improvement that has resulted from the alcohol framework; the fact that there has been a 2.5 per cent reduction in off-trade sales; and the better investment in treatment and care and in alcohol brief interventions. However, it is also the case that the deterioration in our relationship with alcohol can be directly linked to the affordability of alcohol over the same period.
I was struck by a paragraph in the fourth annual “Monitoring and Evaluating Scotland’s Alcohol Strategy” report, which was published in December last year. It said:
“declining affordability of alcohol due to the economic downturn and associated policy context across Great Britain in recent years is responsible for a substantial proportion of these improvements. However, the ban on quantity discounting of alcohol and the increased number of ABIs delivered are likely to be contributing to the improvements seen in Scotland. Changing knowledge and attitudes around alcohol are unlikely to be responsible for the recent declines.”
We still have a huge job to do with regard to the identification of culture.
I accept the findings of the MESAS report. Nevertheless, the decline in deaths began in 2003, which was a time of minimum unemployment—indeed, there were the best unemployment figures since the 1960s. We should greet the findings with some caution.
The report acknowledges the point that Richard Simpson makes. Nevertheless, if the increase was directly related to affordability, it may be that part of the downturn in the past few years might be related in part to affordability, too.
There has been a reduction in the number of young people drinking and, as the cabinet secretary said, there has been a reduction as a result of the new alcohol limits that have been imposed in relation to driving. On that point, I would be interested to hear the cabinet secretary’s view of the anecdotal suggestion that the reduction in the number of people who were stopped and breathalysed over the winter period last year was a result of extended leave being taken because of additional work patterns during the Commonwealth games. I do not know whether that is true, but I hope that it is not, because I hope that the legislation that has been passed has contributed in that way.
We can certainly look into that, but I get a sense—anecdotally, but I am sure that the evidence base exists—that people are just not taking the risk anymore. I think that the culture has changed in that regard.
I hope that that is the case, that the encouraging figures that we have seen for one year are sustained, and that, if the policy is seen to be successful, it is applied across the rest of the UK.
The principal challenges, therefore, concern culture and hospital admissions, in relation to the need to reduce the burden on the NHS.
How long do I have, Presiding Officer?
A little longer.
I thought that what Simon Stevens said yesterday was interesting. It touched on something that Hugh Henry, Duncan McNeil and others have mentioned, which is the need for people to become more responsible about understanding the relationship that they have with their healthcare.
People now understand that they could live much longer lives, potentially into great old age. We have to begin an education process at a much earlier stage whereby we inform people of the fact that the quality of the last 30 years of their lives can be dramatically compromised by the decisions that they make and the ways in which they interact with their health at an earlier stage.
Our health education policies tend to isolate our understanding of particular actions we can take, without necessarily trying to incentivise people, since the health service can never not treat people. However, we need to incentivise people to understand that the quality of life that they can ultimately enjoy will be dramatically affected by the decisions that they make. We need to start demonstrating to people—particularly those who are not addicted to alcohol but who drink too much on a sustained basis without properly understanding the issues that may materialise in later middle age, such as cirrhosis of the liver—the effects that their choices can have.
I will have more to say in summing up, but for now I am happy to support the motion and the Labour Party amendment.
We move to the open debate. We have a little time in hand for interventions.
15:15
It is indeed a pleasure—if not a source of rejoicing—to follow Jackson Carlaw, whose insight and wit was on characteristic display.
It is self-evident that alcohol is an integral part of Scottish life. The Scottish beer and pub sector accounts for around 5,000 pubs and more than 80 breweries, supporting more than 60,000 jobs and contributing more than £1.5 billion to the Scottish economy. That is before we take into account the white spirits industry and the fact that we are renowned across the globe for our most famous export: whisky. Our relation with alcohol is economic as well as being part of the social and cultural life of Scotland.
However, alcohol misuse is far too prevalent across our society. Despite the Scottish Government publishing its comprehensive framework for action on tackling alcohol abuse in 2009 and introducing measures in recent years to help rebalance our relationship with alcohol, the fact remains that alcohol-related harm is a major feature of Scottish society. We see that in the number of alcohol-related hospital admissions in Scotland, which have quadrupled since the 1980s and, as the cabinet secretary said, in the number of alcohol-related deaths, which are 1.4 times higher than in the early 1980s. We also see it in the fact highlighted by Jenny Marra that we drink almost one fifth more than our counterparts in England and Wales.
I mentioned the economic benefits of alcohol, but there is also an economic cost and loss of productivity through sickness. Alcohol misuse costs Scotland £3.6 billion each year, which is £900 for every adult in Scotland. Behind those statistics lie many human stories: heavy drinking causing premature death; alcohol-fuelled crime and disorder played out in the accident and emergency departments of our major hospitals every weekend; and family breakdown. Although the Parliament is rightly focused on legislation, strategies and policies, we should never lose sight of the fact that the issue directly affects thousands of individuals and communities across Scotland.
This week, I had the privilege of hosting an exhibition in the members’ lobby, and last evening I hosted an event in the Parliament. The theme of the exhibition and event was to highlight an innovative and important project that afforded people affected by alcohol-related harm the opportunity to document their daily lives, environment and recovery, through the use of photovoice, a technique using photographic art and narrative.
The work was a collaboration involving the University of Edinburgh, the National Galleries of Scotland, Rowan Alba and the Serenity cafe. It was supported by NHS Lothian and Scottish Health Action on Alcohol Problems. I was delighted that you were able to support the event, too, Deputy Presiding Officer. I welcome to the public gallery this afternoon Dr Aisha Holloway and Dr Sarah Rhynas of the University of Edinburgh, and I thank them for bringing the voices, stories and pictures of people affected by alcohol to our Parliament.
I would like to highlight two specific areas in which the Scottish Government is taking steps to positively change our relationship with alcohol: reducing drink-driving offences, and protecting children and young people from alcohol advertising.
Following the introduction of a lower drink-driving limit in December last year, the figures released last week by Police Scotland showed that the number of drink-driving offences fell by 17 per cent between January and March this year compared with the same period last year. Fewer drink-driving offences shows that in Scotland we are leading social and legislative change in the UK on this matter, a fact that was recently reflected by the Police Federation of England and Wales, who last week issued a call for the legal drink-driving limit in England and Wales to be brought in line with Scotland.
It is important that we continue to build on those promising early figures for the rest of 2015 and beyond. Last week’s launch of the Scottish Government and Road Safety Scotland’s summer drink-drive campaign, “Don’t spoil summer”, will remind drivers that getting behind the wheel after even one drink is not worth the risk or the potential consequences.
Evidence shows that even one alcoholic drink before driving makes the driver three times more likely to be involved in a fatal accident, and it is estimated that one in eight deaths on our roads involves drivers who are over the legal limit. The director of Road Safety Scotland, Michael McDonnell, reinforced that point when he stated:
“the best advice is just don’t risk it.”
Continuing to campaign on drink-driving and raising public awareness of its dangers and consequences will, I hope, serve to further reduce offences and the impact that they can have on the victims, those who are behind the wheel and their families.
Looking ahead, a culture change in our relationship with alcohol would benefit those who are currently affected by alcohol misuse and our young people and future generations. There are widespread concerns across the health sector about the impact that alcohol adverts have on our young people. Although current regulations prevent alcohol advertising around children’s television programmes, alcohol adverts are still permitted to be shown during early evening family viewing while many children are watching television.
I was struck by something that Dr Aisha Holloway said during her presentation at the event in Parliament yesterday evening. She said that alcohol is visible everywhere, and that is certainly what the research tells us. It should be of concern to us all that a survey that was published recently by Alcohol Focus Scotland highlighted the fact that 10 and 11-year-olds were more familiar with alcohol brands than with leading brands of crisps and ice cream. That is nothing short of a scandal, and it underlines the fact that children and young people are not being adequately protected from potential alcohol-related harm.
I welcome the call by our Minister for Public Health to the UK Government to ban alcohol advertising on television before the 9 pm watershed. I am also pleased that the BMA has highlighted the dangers of alcohol advertising and has supported the ban.
It is important to reinforce the message that Scotland is not an anti-alcohol nation but an anti-alcohol-abuse nation. We have a positive relationship with alcohol because of its economic value to Scotland in the jobs and industry that it supports and the enjoyment that moderate and responsible drinking can provide, but alcohol abuse remains far too prevalent and widespread in Scotland today.
We should be encouraged by the effect that legislation such as that for minimum unit pricing and the efforts to reduce the drink-driving limit have had on the improving and rebalancing of our relationship with alcohol. We should also pay tribute to the contribution of alcohol and drug partnerships across the country, as well as to the work that is undertaken by the third sector, the national health service and Police Scotland.
We can build on the progress that has been made to date. We should support families and communities who are affected by alcohol abuse across Scotland. We can bring about the positive change that we all want to see if we unite as a Parliament and a country to bring about that change.
15:22
I was struck by Jim Eadie’s comment that Scotland is not an anti-alcohol nation; it is an anti-alcohol-abuse nation. That chimed neatly with the cabinet secretary’s points. She was right to point out the efforts that have been made to tackle alcohol abuse and to look at some of the successes that we have had.
It is also right to put that into some kind of context, as the cabinet secretary and others have done. Although our society has made progress, compared with other countries our record is still shocking. When I read the BMA briefing, I was struck by how bad some of the figures are. During the past 30 years in the UK, not just Scotland, UK cirrhosis mortality has risen by more than 450 per cent across the population, and Scotland now has one of the highest mortality rates in western Europe. As Jackson Carlaw said, we cannot be complacent, although we should retain a sense of realism and perspective.
We sometimes blur the lines when we talk about alcohol and we too quickly classify everyone as the same. That is not necessarily always the case. Going back to the idea that we are not an anti-alcohol nation, I note that in our everyday language—and, indeed, on radio and television—a good night out is associated with consuming huge amounts of alcohol. It is just accepted. When we talk in those terms—this is what I mean when I say that we blur the lines—we do not distinguish between those who abuse alcohol and the people mentioned by Jackson Carlaw who drink too much on a particular night out.
It is easy to look at those who have an alcohol problem; after all, that problem and its associated difficulties are very evident, and I will come back to that. However, one of the challenges that our society faces is how we deal with those to whom Jackson Carlaw referred—those who have not been classified as alcoholics, or as having an alcohol problem, but whose sporadic consumption of alcohol throughout the year can lead to longer-term problems. One of the groups at risk in that respect comprises people who are better educated and have better incomes. Indeed—and I do not want to appear sexist when I say this—that group includes young women, who now have the economic wherewithal and purchasing power that they might not have had in years gone by. I have seen in my own family and social circles young women on specific occasions and nights out drinking far more than my mother’s generation would ever have contemplated.
I thought about that point and looked at the figures. Funnily enough, the figures for 15-year-olds show that boys and girls are drinking the same amount of alcohol and have been doing so for many years. The only difference is that they are not drinking the same alcohol; girls are more likely to drink spirits and the alcopops that were introduced in the 1990s, and boys are more likely to drink cider or beer. The point is that, as far as consumption of alcohol is concerned, there is no great difference between boys and girls. We have to reflect on that and to be very careful when we talk about both.
I will give you a little extra time, Mr Henry.
Mr Allard’s comments just prove what I am saying. When I look back—again, I will use my mother’s generation—I see that the alcohol consumption figures for males and females were not the same; the figures were much lower for females. The fact that women are now drinking at those levels means that more women are being brought into the risk category than in the past. Thinking generationally, I remember that in my family it was always the men who had alcohol problems, who had the tendency to abuse alcohol and who spent more on alcohol. If our society allows young women—indeed, young people in general—to think that just because they have money in their pockets and they are not alcoholics they can have these episodes of alcohol abuse, we need to think about the longer-term health risks and dangers associated with that.
I have spent more time on that matter than I had intended, because I also wanted to talk about some of the justice and antisocial behaviour issues associated with alcohol. Excessive alcohol consumption has a huge cost to our society. We need only look at the public disorder issues in many of our towns and cities at weekends, and the damage can be seen not only on the streets but in hospitals when people end up there and in the pressures that that puts on accident and emergency. We still need to address the issue of excessive consumption of alcohol in our towns and cities and the subsequent public disorder, because the situation is completely and utterly unacceptable. Each and every one of us has a responsibility in that respect; we should not just leave it for the police to deal with.
I wonder whether the cabinet secretary or the minister—whoever responds to the debate—can give us any information that they have on community payback orders. I know that in the past Richard Simpson and others have mentioned extending drug treatment and testing orders to alcohol, but it was suggested that that was not necessary because community payback orders would do the same job. How effective have they been? What are the statistics and how well are they working? Could we apply any issues regarding drug treatment and testing orders to alcohol?
We have a multifaceted problem, and it is not merely for our doctors, nurses or police officers. As Jackson Carlaw and others have said, it is a matter of education and we all have a role to play. Equally, we should not treat lightly the consequences not only of binge drinking but of continued and constant drinking, albeit within safe levels, as evidence shows that that can also do significant long-term damage.
15:31
The title of this debate—“Scotland’s Relationship with Alcohol”—is central to tackling alcohol abuse. Many people are reluctant to discuss their relationship with alcohol at all; perhaps they are worried that if they admit they are drinking too much, they will be labelled an alcoholic. I use the word “labelled” deliberately because alcoholism still comes with a stigma. Terms such as “alkie” or “jakey” are used to describe people, and if it was another form of drug abuse the term would be “junkie”. We must move away from that type of unhelpful and stigmatising language, because it means that those who have significant problems are far less likely to come forward and ask for support.
Our relationship with alcohol is contradictory and perhaps best captured in the “Go on, take a drink. Nah, I’m aff it” sketch from “Chewin’ the Fat”. We stigmatise those who have significant problems with alcohol, but we are also suspicious of those who do not partake of a drink—just to be social, of course. That contradiction is a key part of the debate on Scotland’s relationship with, not addiction to, alcohol, and in that context I want to explore one or two themes this afternoon. We have heard already about alcohol brief interventions, and that should be viewed as part of this strategy. Consider some of the numbers—there have been 477,000 alcohol brief interventions, which exceeds targets set by the Government. That scheme has been successful and was targeted at over-16s who were suspected to be drinking hazardous and harmful levels, hoping to moderate their intake. Evidence shows that those who are targeted will reduce their intake for a short time at least. That leads to health benefits, even if people reduce their intake only for a short time, and it will have long-term benefits.
Of course we must do better. Those brief interventions have a short-term benefit, but we must consider how we can connect that to changing someone’s relationship with alcohol in the longer term. That comes down to education. We are always saying that more should be done in schools, but this is about education in the family and the workplace. It is about education before someone goes to a football match and after they come back, or when they go to a family wedding reception. It is about discussing our relationship with alcohol openly and honestly. Yes, we should do that in schools, but it cannot be done only in schools, and we all have our personal and community responsibilities.
Let me mention one group that does a wonderful job in fulfilling their community responsibilities. It is a while since I have done this, but one Friday night I walked the streets of Glasgow with the street pastors. They did an amazing and wonderful job, particularly in helping vulnerable young women in the city centre. They did not lecture them about their alcohol intake, but they were there to offer a pair of flip-flops rather than high heels to those who had had too much to drink. They did not stop people going on to the next bar, but they let them know that they were there if they needed a hand to get a taxi home or a wee half hour out. It was a bit of friendship. I want to put on record the amazing job that I saw the street pastors do when I was out with them.
We have made some progress, and I will mention one or two statistics in that regard. Alcohol-related hospital discharge rates have reduced by 20 per cent since 2007, but they are still 3.4 times higher than they were in 1981 and 1982. Unlike Jackson Carlaw, I will not relate that to the then Conservative Government.
My point is that we have to look at the trend over a significantly long period of time so that we can even out short-term but non-enduring impacts in assessing the success of policies. Alcohol-related mortality has fallen by 35 per cent since its peak in 2003. I will not list all our successes, because I think that we all admit that those successes must, as welcome as they are, endure long term.
One policy that I think will endure long term is the ban on buying alcohol in multipacks. The quantity discount ban led to a 2.6 per cent decrease in sales of that type, and of alcohol more generally. We were able to quality assure that by comparing areas in Scotland with similar areas in England where such a ban was not implemented, and the results still showed a 2.6 per cent drop in intake.
Access to alcohol is important, and we need to consider the view of alcohol as a cheap option or a bargain. I am guilty of that: if I am in the supermarket and I see a nice bottle of wine, I go, “Oh, that’s down to a fiver, I’ll have that.” If it is nine quid, I will not.
We looked in detail at price sensitivity across all income groups in relation to minimum prices. I will not give details of that, Presiding Officer, because we are not allowed to, but the information is on the record without my repeating it this afternoon.
Yesterday in the chamber, I asked Michael Matheson, the Cabinet Secretary for Justice, whether he would consider using cashback moneys to tackle health inequalities from 2017. He said that he would give that significant consideration. Looking at health inequalities, and at the effect of alcohol on communities, I cannot think of a better use for that money, and I hope that Scottish Government policy might develop in that area.
15:37
As a former member of the Health and Sport Committee, I am pleased to participate in the debate. I sat on the committee for a number of years, and I was heavily engaged in tackling Scotland’s relationship with alcohol. Although I am no longer a member of that committee, the issue remains very much on my agenda.
I come to the debate as someone who does not actually drink alcohol; I have been a non-drinker all my life. Actually, that is not quite true: I once got drunk in Greece after sampling a local drink called retsina. It was certainly very nice, but I failed to heed the warnings from my friends that it was a very potent tipple. I was drinking to taste, not for the effect, but, not being accustomed to alcohol, my constitution could not handle the effects. Would I drink retsina again if I returned to Greece? Yes, I am sure that I would, as I love Greece and its people, but I will approach retsina very cautiously in future.
I have no hang-ups about people who enjoy a drink. In fact, I believe in what my mother taught me long ago, which was that a little of what you fancy does you good. Drink in moderation and enjoy it, is my advice. I believe that a little alcohol can actually be beneficial for people, but we should beware of the danger of excessive drinking, which I call the Scottish disease.
It is clear from looking at the stats that, when it comes to the misuse and overuse of alcohol, there are significant problems that urgently need to be tackled. If we do not want to address the issue for ourselves, surely we have a responsibility to sort it out for our young people. We need to make the step change right now so that they appreciate that not taking up the habit is much easier than giving it up.
I have—or, I should say, had—some very close friends who had enormous talents, particularly in the arts, but could not function without drinking alcohol, which they did right up until they could not function in the arts world at all because of their reliance, and it ultimately led them to their graves. That was such a loss and a tragedy, not only for them but for their families and society as a whole. I am sure that I am not alone in the chamber in having experienced such tragic circumstances.
I recognise that kicking a habit is not easy, whether it involves drugs, alcohol, smoking, gambling or even food. If it was that easy, the highly talented and intelligent people whom I knew would not have succumbed to addiction in the first place. On the other hand, with good support—if it is accepted, of course—for those who need it and with their determination, things can turn out for the best. When I was very young, my father was an extremely heavy drinker, like so many of his generation. He was certainly a great man without the drink but Mr Hyde with it. He woke up one day and decided to stop drinking. Yes, he would still have the odd beer but it would be only one and he never sunk back into his earlier excesses. The benefits to him as an individual were immense. His appearance, his mood and his manner changed: he was a new man. However, the benefits for my family, particularly my mother, were life changing: we were a happy family. We were not wealthy, but what we had was well spent.
That story is one that numbers of people can relate to but, sadly, too many cannot as they have never experienced the positive changes that can happen when someone stops drinking. Sadly, comparing the alcohol stats for Scotland with those for nearly every developed country in the world backs up that point, so no one can argue that a change is not needed. Scotland consumes a huge amount of alcohol—for example, recorded consumption in 2010 was twice the world average and well above the European regional average. That consumption is having a detrimental impact on the health of our people. Indeed, Scotland’s overall death rate from liver cirrhosis in 2010 was around 40 per cent higher than the European Union average.
I am pleased that the Scottish Government has not sat idly by but has been aggressively engaged in tackling the problem head on. Policies such as a ban on quantity discounts in off-sales that encourage customers to buy more than they might have done and the implementation of restrictions on where material promoting alcohol may be displayed are having a positive impact. However, more must be done, and the Scottish Government’s framework for action outlines that in detail.
Urgent change is required if we are to break our country’s relationship with alcohol. I commend the motion and the Labour amendment to Parliament.
15:43
Scotland’s problems with alcohol are deep rooted. The statistics demonstrate that, and as we have heard, I imagine that the lived experiences of everyone contributing to the debate show that, too. However, that does not mean that we can simply shrug our shoulders and accept the situation. I am therefore pleased that there is cross-party support for tackling Scotland’s alcohol problems.
The British Medical Association has described Britain’s relationship with alcohol as an “epidemic” and has outlined the scale of the problem in Scotland. Alcohol is related to more than 60 types of disease, disability and injury; more than a million people in Scotland are drinking hazardously or harmfully; and over the past 30 years, UK liver cirrhosis mortality has risen by more than 450 per cent across the population. I looked at that figure as I was waiting to speak and thought, “Can that be right?” I checked it in my papers and 450 per cent is right. It is a stunning figure.
The BMA further notes that, in recent years, the number of alcohol-related hospital admissions has fallen, although the figure remains higher than the figures for the rest of the UK and Europe. However, the BMA goes on to note that alcohol-related hospital admissions are approximately six to seven times higher for patients living in the most deprived areas compared with those living in the least deprived areas.
When faced with such knowledge, there is often a rush to create new offences and new regulations: when we see a problem, we understandably want to try to tackle it. However, before looking to manufacture new rules, we should always ensure that the current ones are enforced. As Frances Ennis, an expert on licensing law at the respected law firm Pinsent Masons, has explained,
“One of the main problems with the Scottish licensing system is not the lack of appropriate legislation. If the vast majority of existing legislation was properly funded and implemented, then there would be little need for additional provisions.”
Alcohol misuse is not something that can simply be corrected by new statutes or improved enforcement. For many people, alcohol misuse is often a function of the shocking absence of life chances. It is no accident that there is a relationship between alcohol misuse and poverty. It is critical that we change our approach to one of early intervention, health awareness and community-based support. All of that costs money, however.
My colleague Dr Richard Simpson raised the Government’s failure to act on the idea of a social responsibility levy. That idea sounds like a good one to me, as it could provide a way of enabling the many groups that are rightly praised in the motion to take more action on alcohol-related problems.
Richard Simpson’s Alcohol (Licensing, Public Health and Criminal Justice) (Scotland) Bill, which is currently before the Parliament, contains many commonsense provisions. Increasing the length of time for which a statutory notice for a new alcohol licence is made public is a sensible provision. The same can be said about imposing a statutory duty on the Scottish Government to update and report on its alcohol strategy.
At the heart of the bill is the idea of drinking banning orders, involving GPs and other professionals in helping those who have a problem with alcohol. That is the sort of bold measure that we need in order to tackle our alcohol problem seriously. A multisector approach, with criminal justice professionals, social workers and the medical profession working together, will yield the best results.
The Fife alcohol fixed-penalty diversion scheme, which has been running under the Kirkcaldy-based Fife Alcohol Support Service, started as a pilot scheme in 2011. Dr Simpson’s bill takes much from that scheme. I hope that the bill is given proper consideration by the Parliament.
In Fife, there has been some great work aimed at tackling alcohol misuse. Fife Council has provided funding of £250,000 for residential rehabilitation for both drug and alcohol use. Although that is not a new concept, it is new money, which was secured when my colleague Alex Rowley was council leader. It is a relatively small project, with 16 people benefiting last year, nine of whom had difficulties with alcohol. However, those are people who otherwise would not have had the opportunity to get the comprehensive and intensive access to rehab that is afforded by that investment. The project recognises that many people who abuse alcohol also abuse other substances, which is an approach that is more holistic than many others.
The Scottish Drugs Forum’s addiction worker training project, which in Fife is jointly funded by the alcohol and drug partnership and Fife Council, is an initiative that is open to people who are recovering from alcohol or drug problems. It allows them to train for a career in social care, with particular emphasis on substance misuse services, providing them with real workplace-based training and an opportunity to obtain a level 2 Scottish vocational qualification in social care. The aim of the AWTP, which launched more than a decade ago, is therefore to help former drug and alcohol users to prepare for employment in social care through in-work placements and formal learning. It is the first project in Scotland to offer former drug and alcohol users the opportunity to gain supported work experience and a qualification while receiving a wage for the duration of the course. The project develops a multi-agency approach to employability for former substance users.
Those schemes are grounded in their communities, and they strike the correct balance between supporting those who misuse alcohol and ensuring that the community is protected from the negative consequences of such misuse. I believe that the Scottish Government should closely examine them.
I agree with Alcohol Focus Scotland about creating health-promoting communities, where citizens play an active role. Ensuring that the licensing system supports meaningful community involvement is an accountable and responsive approach. It is not an easy task, however. It will necessitate cultural changes across Scotland in families, schools, colleges, universities and beyond. The Parliament can only do so much to encourage people to make the necessary changes.
We must refocus our efforts to tackle Scotland’s problematic relationship with alcohol. The work that has been done in Fife and across Scotland, largely by local authorities, charities and voluntary organisations, is beginning to show results. We must work collaboratively with them and with the public to take the steps that are needed to sort out Scotland’s relationship with alcohol.
15:49
I thank the Scottish Government and the cabinet secretary for bringing the debate to the chamber. The motion is entitled “Scotland’s Relationship with Alcohol”, but the issue is about much more than that.
When I came to this country 30 years ago, I was shocked by Scotland’s relationship with alcohol—a relationship that cannot be found in any other country. Our attitude to alcohol is completely different from that in any other country, believe you me. Members have talked about countries that produce alcohol. France produces a lot of alcohol, but people in France do not drink the same way that we drink in Scotland. That is my first point, which is very important: Scotland’s relationship with alcohol is very different.
I would like to take that a bit further, because we have talked about Scotland’s relationship with alcohol for many years. I want to talk about what we as individuals can do about our relationship with people who have a problem with alcohol. Those people are among us. Sometimes, those people are us: sometimes, we have a problem with alcohol for one night or one week. We can have a problem at any time: when we are young or when we are older and feel a little bit isolated. We are all at risk.
A lot of my colleagues talk about education. This week, more than any week, we have been reminded that politicians, with all our knowledge, education and understanding, can still be caught up in problems with alcohol—God, a lot of politicians are caught up in them down in Westminster and even here in this Parliament.
The issue is not only about policies, although we have great policies here. The issue is not only the Government’s responsibility, or, as some have said, the responsibility of people who abuse alcohol—those who do not drink in moderation. I do not like the phrase “drinking in moderation.” For a lot of people in France and in Scotland—for people all over the world—there is no such thing as drinking in moderation. Some people cannot drink alcohol at all. We can blame them for the disturbances that they create and for the money that we have to spend on the NHS, or we can see what we can do ourselves, as individuals.
I revert to the point that this is a societal problem. We have a Government that has introduced and is doing a lot of fantastic things. However, as a society—as individuals—we need to change our attitude to not only alcohol but people who have an alcohol problem.
We cannot let this go. We are, far too often, the alcohol buddies—the drinking buddies—who facilitate somebody’s drinking. Sometimes, it is the contrary: we are the ones who end up in a bad state—in peril—after drinking alcohol because we have buddies around us who think that it is a good idea.
Members have talked about women, but I do not want to target women. What did we expect? Of course equality is coming and of course women have the same opportunities, including money wise—everybody has a lot more money in their pockets—so of course the problem will affect both genders. I am not sure whether the problem is worse for women than it is for men, because men are still drinking a lot, although women—especially young women—have decided to go from drinking alcopops to drinking spirits as well.
I wanted to start with those points, but I also want to talk about drink driving. I was on the Justice Committee when we introduced the new drink-driving limit. Of course we had to do that. I cannot understand why our country ended up with a drink-driving limit that was higher than that in countries that do not have the same problem with alcohol. One reason was that the issue was reserved to Westminster, but we managed to get that through, after some constructive negotiations with Westminster. I encourage the cabinet secretary and the minister to keep up that constructive dialogue with Westminster so that all the issues that we have not got the power to address here can still be addressed.
I am delighted that, because of the change to the drink-driving limit, in Aberdeen, Aberdeenshire and Moray, in my region of North East Scotland, the number of people caught driving under the influence of drugs or alcohol has fallen by 23 per cent. That has made a big difference,
However, the biggest difference in all this is that people have stopped drinking during the week. That is a fantastic change of attitude. I would call the drink-driving legislation that we brought forward drink-living legislation, because we have changed the way we live. We knew that that was important: in order to drive to work every morning, we decided to change the way we live.
If we can use ideas like that to change our attitude to alcohol, it will affect not only the people who have a problem with alcohol, because we all do to a certain extent, but even the people who do not drink. We need to understand that part of the population will have a problem with alcohol.
It is important to have a lower drink-driving limit for drivers other than drivers of cars. I have suggested that we could ask Westminster to have a lower limit than we have just now for lorry drivers and bus drivers. That is an important point.
People in England and Wales are drinking a lot less than we are. That applies especially to young people. Even though our young people are drinking less than they used to, they are still behind in terms of the consumption of alcohol in comparison with young people in Wales and England.
The Police Federation of England and Wales has called for the legal drink-driving limit in England and Wales to be in line with the limit in Scotland. It is good news that we are ground breaking and finding ways to address the issue.
Businesses have a responsibility as well. This February, I was delighted to see that the Albert Hotel in Peterhead, Aberdeenshire, had begun to stock an extensive range of alcohol-free beers and wine. That brings me back to what we can do. I was at the event hosted by Jim Eadie last night, with all those people who do fantastic work. I suggest that members go to see the photo exhibition and to Serenity cafe, the little cafe adjacent to the Parliament—it is just opposite the SNP headquarters—to see the fantastic work that has been done.
When the event finished last night, I came down to the bar in the Parliament, where there is an advertisement for a beverage called Hee Haw, which is a new alcohol-free lager—it is a fantastic name. I will tell everyone what really annoyed me. I asked the people behind the bar when they started selling it and how much they had sold. They started to sell it two days ago and I will let members guess how much has been drunk—hee haw, despite the sign being right in front of the bar. That is the problem. Despite all we do and all the regulation that we have—the Scottish Government is doing fantastically—if we do not do anything about this as individuals, the result will be hee haw.
15:58
I see Jackson Carlaw shaking his head. The lager is called Hee Haw because there is hee haw alcohol in it. I thought that I would just explain that. I must admit that it was offered to me, but I do not drink lager, whether it is Hee Haw or not, so I did not accept it.
I thank members for their contributions, which have all been excellent and have covered a great many areas, from alcohol intervention by NHS Scotland and record investment in tackling alcohol misuse to the setting up of alcohol and drug partnerships.
However, as a number of members have said, there are on average 20 alcohol-related deaths a week and 700 alcohol-related hospital admissions each week, which is totally unacceptable and shows that we still have a very long way to go. I realise, as I am sure we all do, that there is no quick fix and that it will take a long time. We need a change of culture in this country and a change in our relationship with alcohol.
I live in Glasgow city centre and, unfortunately, I see a lot more young women partaking of more alcohol than maybe they want to. I agree with Hugh Henry that we are talking about alcohol abuse and alcoholics, but there are people with long-term drink problems who are not deemed to be alcoholics. Basically, they go through their lives with a terrible problem, which obviously has an impact on the economy, their work and their families.
I welcome the cabinet secretary’s announcement of the social marketing campaign that is aimed at educating parents, and I echo her comments on advertising, particularly the advertising that is aimed at young people. I urge the Westminster Government to devolve broadcasting to the Scottish Parliament. I thank Jenny Marra for mentioning the Scottish National Party’s success in returning 56 MPs to Westminster. I hope that they will deliver that devolution to the Scottish Parliament.
It was Jackson Carlaw, I think, who raised the issue of how cheap alcohol is now compared with many years ago. It is far too cheap. Minimum pricing has to be looked at. I hear from pubs and clubs that, like other people, young people partake of cheaper drink from supermarkets before going into the pubs and clubs.
I want to clarify Sandra White’s reflection of the point that I made, which I do not think was completely accurate. I said that the new group of representatives at Westminster would be able to lobby the Government there for changes in advertising and broadcasting. I believe—and I am sure that she does, too—that changes in alcohol advertising through broadcasting would benefit people across the United Kingdom, not just in Scotland.
Absolutely. I agree with Jenny Marra. I took on board what she said. There is a slight interpretation issue, but I absolutely agree with her. I said that the 56 MPs—which is more than the SNP has ever had before—will make a big difference; indeed, they are making a difference just now. I agree that the issue is not just in Scotland but throughout the UK; unfortunately, however, we cannot deal with what is on our TV screens.
As I said, we need to look at alcohol’s cheapness and minimum pricing.
I want to concentrate on the human costs of alcohol abuse, whether the person is an alcoholic or a long-term heavy drinker.
Jim Eadie had an excellent event last night. I was not able to go to it, but I went to the stall—I see that the people involved are in the gallery. Serenity cafe does a fantastic amount of work, and lots of such work goes on in every member’s constituency. In my constituency, Partick healthy living centre runs film nights, music nights and club nights without alcohol. I will give members an example of how welcome that is. A lady who was at one of the nights said to me that she had not been out with her husband for many years—they could not go out to a pub simply because he had a drink problem. For once, they were able to go out—they went to a club night and enjoyed the music. That is really positive.
Another issue that we have to look at is one on which I know Serenity cafe has done work, as has the addiction service in St Vincent Crescent in my area. I have spoken to people at that service—obviously, I will not name them, but they include a gentleman who had a drink problem but was able to come off alcohol. He had many friends, who obviously liked a drink, and they would go to one another’s houses. When he came off alcohol, he stayed in the same environment, and he had to still let them into his house or he would not have friends. One night when his friends came round, he locked himself in the bathroom simply because, if he had not done so, he would have succumbed to alcohol again.
We therefore have to look at social care and healthcare. Someone can manage to get off their alcohol addiction but they may stay in the same environment with the same people because it is very difficult for them to get away. Perhaps all members have constituents who have experience of that.
One lady who, unfortunately, had an alcohol problem ended up being not very well at all. She was a very successful businesswoman, but lost her house, business, family and grandchildren. I think that we all have such constituents. Alcohol misuse is a terrible issue that we need to take seriously.
A number of facts and figures have been mentioned. Alcohol has a human cost, not only a cost for the economy, and for the people who are affected by alcohol addiction and for their families the cost is absolutely tremendous.
I agree with one of the points that Hugh Henry made regarding young women. It is something that we have to tackle and we must look at the cultural aspects of alcohol consumption in Scotland. Education for everyone, from young to old, can certainly be useful. As I said, there is to be an advertising campaign to show the harm of alcohol and the effect that it can have on families.
I thank all members for their contributions and I thank the Government for bringing the debate to the chamber today. I look forward to moving on and releasing some of the negative aspects of the cultural love affair that Scotland has with alcohol.
16:05
I am pleased to have the opportunity to contribute to this debate, as alcohol is a matter of great and on-going concern to many of the constituents of all members. Alcohol misuse and its consequence for health and community safety remain a significant challenge, not only in Scotland but throughout the UK.
We all know how important relationships are. They are central to our lives and important to our wellbeing. We have to look at our country’s relationship with alcohol, and I am sure that we can all agree that it is a relationship that is severely harming health and wellbeing, affecting our communities and undermining our potential as a nation of individuals.
The people of Scotland have the ability and ambition to lead in plenty aspects of global affairs, but the current alcohol statistics in Scotland leave us nothing to be proud of. Alcohol consumption in Scotland has reduced since 2009, but alcohol sales remain higher than in 1994. Scotland’s consumption of alcohol was twice the world average in 2010 and well above the European regional average.
Alcohol-related hospital admissions in Scotland are four times higher than they were in the early 1980s. That is on average 700 hospital admissions as well as 20 deaths that are directly related to alcohol each week. Young people are under a lot of pressure to start drinking at a young age. Alcohol today is affordable, available and heavily marketed. As a result, young people are growing up in a pro-alcohol society where drinking is seen as the norm. We should therefore begin by denormalising alcohol for children and teenagers. Experimenting with alcohol is a phase that many go through, but the age at which young Scottish people start experimenting is younger than for our European partners, and their use of alcohol is much more frequent.
As a mother of three children, two of whom are teenagers, I cautiously welcome the data from the Scottish schools adolescent lifestyle and substance use survey, which reports a substantial reduction in alcohol consumption among young people since 2010. The survey shows that 19 per cent of 15-year-olds reported that they had drunk alcohol in the past week, which is down from 34 per cent in 2010, and that 4 per cent of 13-year-olds reported that they had drunk alcohol in the past week, which is down from 44 per cent in 2010. Those are still staggering and worrying statistics that need to be addressed so that we can move forward without alcohol being a huge component of young people’s lives in Scotland.
It is our underlying duty to help anyone who has an issue with alcohol, but we need to implement tougher measures as well as more education on the issues for our young people, so that we can break the cycle at a young age, as that is where the problems start. Teenage drinking can cause both immediate and long-term health problems, with most of the admissions of teenagers into hospital resulting from alcohol consumption. Although that is the immediate impact, heavy regular drinking in a person’s younger years can lead to the development of chronic diseases such as liver cirrhosis.
Our drinking habits have to change, because if we condone that behaviour and do not make substantial attempts to change it, we will be left with a chronically ill young adult population. The earlier that teenagers are exposed to alcohol, the more likely they are to face challenges in later years. Therefore, we must address the problem at its root, and provide more support and education in schools on the harmful side effects of alcohol consumption.
For a long time, there have also been concerns about the possible effects on children’s attitudes towards alcohol that exposure to alcohol advertising might have. Along with the BMA, I consider that we should restrict the advertising of alcoholic drinks. In particular, alcohol advertising should be banned near places that children use, such as schools, as well as at events targeted at children, in order to reduce that exposure.
Alcohol consumption cannot go on at the current rate. The strain that alcohol puts on public services is costly and time consuming. If we could work together to safeguard our population from alcohol, we would have fewer alcohol-related challenges. Members from across all political parties are determined to tackle Scotland’s drink problem. However, in order to be successful, a shift in Scotland’s culture is essential. We must contribute to delivering that change right away.
16:11
Scotland’s relationship with alcohol is as well known as it is complex. We drink far more now than we did a generation ago, and alcohol consumption is almost a fifth higher here than in the rest of the UK.
I accept that drinking in moderation can have beneficial effects for some people. However, heavy drinking places a burden on society. It does not just damage health or cause premature death; it contributes to crime and disorder.
Binge drinking, particularly among youngsters aged between 18 and 30 on Friday and Saturday nights remains a problem. There is an economic cost to our unhealthy relationship with alcohol, including a loss of productivity through sickness. Alcohol misuse costs Scotland £3.6 billion a year. To put that into perspective, that is £900 for every adult in our country.
However, I recognise the progress that we have made in tackling alcohol misuse, and the impact of the Scottish Government’s comprehensive 2009 strategy “Changing Scotland’s Relationship with Alcohol: A Framework For Action.” The framework contains a range of measures, including education, support for families and communities, and preventative public health measures, together with minimum unit pricing and other regulatory measures on issues such as the irresponsible promotion of alcohol.
It is not all bad where our youngsters are concerned. The Scottish schools adolescent lifestyle and substance use survey 2013 informs us that 13 to 15-year-olds are consuming less alcohol a week compared with 2010, and that consumption is at its lowest level since records began in 1990.
Many young people living with someone with an alcohol problem take on additional caring responsibilities in the family unit, which can be detrimental to their life opportunities. That is often underreported or undisclosed to those outside the home.
To engage young people, the Scottish Families Affected by Alcohol and Drugs group has adopted a range of consultative measures involving workshops and prevalence studies. That involves challenging social stigma as a barrier to accessing support; changing social attitudes towards drinking; supporting those living in remote and rural communities; and assisting with training and resources.
As other members have mentioned, we could not have a debate on Scotland’s relationship with alcohol without mentioning the Alcohol (Minimum Pricing) (Scotland) Act 2012, which was passed unopposed by this Parliament in June 2012.
It is hoped that the Government’s alcohol framework, which is under development, will breed the cultural changes that are required to affect positively Scotland’s relationship with alcohol. Other measures have shown that that can be done. The lowering of the drink-driving limit in December last year—a campaign that I was heavily involved in—has led to many people leaving their cars at home when they go out or not drinking alcohol if they take their cars. Figures from Police Scotland show that the number of motorists caught drink driving in Scotland during the first festive period following the introduction of the new law was down almost a third on the previous year’s figure. I hope that Jackson Carlaw’s earlier comments on that are, indeed, incorrect.
As the motion states, it is wholly unacceptable that there is an average of 20 alcohol-related deaths and 700 alcohol-related hospital admissions each week in Scotland. Furthermore, Scotland now has one of the highest cirrhosis mortality rates in western Europe and is ranked eighth in the world for alcohol consumption per head of population.
We all have a role to play in tackling this scourge. We must continue the good work that has been done and the progress that has already been made.
I am teetotal. I have not drunk alcohol for nearly 15 years. I was born and brought up in Lossiemouth, which is a fishing town. There were many fishermen in that town who drank heavily and many religious fishermen who did not drink at all. In my early 20s, I moved to Stornoway. Members will all have heard about the Gaelic Mod, which is also known as the whisky Olympics.
I started drinking at a young age and, over many years, I progressed from pints of beer to whisky and so on. I was probably a pretty typical young man in the Highlands. I tended to go out on a Friday night and would drink Friday night and Saturday. I would often not drink on a Sunday but, by the time Monday came, would have a bit of a hangover and would not really be 100 per cent.
Drink creeps up on people. It is an illness. It very gradually takes hold of people. Many of us have to look at our lives, think about what we are doing and ask ourselves whether we want to carry on doing it.
I took the decision to stop drinking after I became a Christian. I was helped greatly and would say without hesitation that, if it was not for God, I would probably still be drinking. It was the best thing that I have ever done. It has changed my life. I had a successful career and was doing everything well but, at the weekends, I was drinking more than was good for me or for the people round about me. Therefore, I feel passionately about the matter.
We have to help people who have alcohol problems. Our society does not help them at the moment. Young people who start drinking go on to the flavoured alcoholic drinks—the alcopops and other things that are available these days—which draw them in far too quickly. It is like drinking lemonade. When I started drinking, people had to get used to the taste of gin, rum, vodka, whisky, beer or lager.
Anything that we can do to improve the situation must be good. We will need many different measures to deal with the problem and I am pleased that the chamber will come together and vote as one on the motion and amendment to help us to tackle the scourge of alcohol.
16:18
I welcome the opportunity to speak in the debate. I have listened with great interest to the contributors from around the chamber. I will focus most of my speech on the personal impact of alcohol dependency and misuse.
Scotland is currently ranked eighth in the world for alcohol consumption per head of population. According to the BMA, more than 1 million people in Scotland drink hazardously or harmfully. Scotland now has one of the highest cirrhosis mortality rates in western Europe. Indeed, every 15 minutes, someone in Scotland is hospitalised with an alcohol-related illness, which means that nine people will be hospitalised with an alcohol-related illness during this debate. Nine people this afternoon alone are now in hospital because of alcohol.
Scotland has a problem with alcohol—it cannot be denied and it must be tackled. With the cost of binge drinking estimated to be £4.9 billion throughout the United Kingdom and an average cost of £114 per accident and emergency visit, we must direct additional resources to education and prevention.
The results of the Scottish social attitudes survey in 2013 reveal just how uninformed many people in Scotland are about the amount of alcohol that they are consuming. One third of those questioned did not know what the daily guideline for alcohol consumption was for men and women and a further quarter got the daily guideline wrong. We must ensure that people are fully informed and educated on the effects and dangers of excessive alcohol consumption.
One danger that has long been identified is the link between alcohol and crime. In 2012, the Scottish consortium for crime and criminal justice found that 62 per cent of violent crime victims stated that their attackers were under the influence of alcohol. Furthermore, half of Scottish prisoners state that they were drunk at the time of committing their offence. Offenders are a particular concern as they are three times more likely than the general Scottish population to have an alcohol problem. That issue must be tackled and we must do all that we can to ensure that offenders do not end up with alcohol dependency after their release from prison.
It is crucial that we tackle alcohol dependency, not only because it affects the individual but because it affects their family and friends. We must take a more inclusive approach to helping individuals who suffer from alcohol abuse. Research by Scottish Families Affected by Alcohol and Drugs outlines the many benefits of involving families in their relative’s treatment and recovery. First, it increases the likelihood that an individual will enter treatment and remain in treatment longer. Secondly, it increases the likelihood that the individual receiving treatment will achieve their goals, both during and after rehabilitation. Finally, it improves the general wellbeing of family members by creating an environment in which an individual in recovery is less likely to return to alcohol dependency. It is imperative that we take the appropriate action to give family members the correct level of support in their own right to help with a relative’s addiction.
The average weekly consumption among harmful drinkers is considerably higher in Scotland’s lowest-income communities compared with the rest of the country. It is in our deprived communities where most harm is experienced. Many members will know that I spent 20 years working in retail. It was there that I witnessed the struggles of alcohol addiction and misuse that were faced daily by many customers. For example, if a customer did not have enough money to pay for basic food items, they would frequently return the essential items before they would return their cans of lager or cider or their bottle of vodka. On a daily basis, people picked alcohol over essential food. We all know the phrase, “Eating or heating”, but for many in society, it is “Eating or drinking”.
We regularly saw people waiting for the alcohol aisle to open in the morning so that they could purchase their first drink of the day. That serves as a reminder that, every day, people in every community, the length and breadth of this country, face a struggle with alcohol dependency. That is why it is crucial that we change the way in which we view alcohol and face up to the size of the challenge.
The final issue that I want to raise is the important issue of the abuse that is faced by retail staff. Again, from my time working in retail, I have first-hand experience of the kind of abuse that front-line workers receive every day from customers with alcohol problems. Across the UK, there are 2.7 million retail workers, and they regularly deal with abuse and violence. I accept that not all of it is caused by alcohol, but the vast majority of it is. Shop workers deal with abuse, threats, harassment and violence for simply upholding the law and refusing to sell alcohol to people who are already intoxicated. My union, the Union of Shop, Distributive and Allied Workers, has led on the issue with its freedom from fear campaign, which seeks to prevent violence, threats and abuse against retail staff, and its annual respect for shop workers week.
Alcohol affects almost everyone in society. For too long, some in Scotland have viewed people with alcohol problems as affable individuals who do no harm to anyone, without taking into account the harm that is done to the individual, their families and society. We need a fundamental change in Scotland’s relationship with alcohol, and we need it now.
16:26
I stopped drinking about 20 years ago, for a number of reasons. I did not like the person that alcohol sometimes made me, although many of my friends did. I recognised that I was struggling physically to cope with the aftermath of a typical Saturday night session and I realised, even at around 40 years of age, that unless I stopped drinking I would never achieve my full potential. I have no doubt that I would not have become a politician and be speaking in the chamber if I was still drinking.
It took me almost two years from the time that I decided to stop to actually stop. What held me back? What was the hardest part of giving up the drink? It was not the going teetotal and it did not relate to the change that drink could make to me—sometimes good, sometimes less so; it was the social pressure to continue to drink. People who did not drink were not seen as one of the lads. The “You think you’re better than us” attitude still prevailed back then. I have no doubt that, if I was in the same situation now, I would find it much easier to give up drink because, thankfully, society has moved on. It is much more socially acceptable to be a non-drinker, and we are all better for it. People no longer have to put up with people saying, “Come on, just have one, it won’t do you any harm—blah, blah, blah.”
I was not an alcoholic. I could have taken a drink or left it. However, I knew that drinking was not doing me any good and that it was not helping me to create the life that I wanted to create for myself. I realised that when I was nearly 40.
Previous speakers, including Mary Fee, have spoken about the damage that is done to retail workers. My partner is a nurse. She works in a neonatal unit, but she used to work in accident and emergency and she tells me that there was never an A and E shift during which she did not get some kind of verbal or physical abuse, almost without fail from somebody who was drunk, although it was sometimes from someone who was on drugs.
As the cabinet secretary said, there is no room for complacency. We spend £3.5 billion every year on the direct and indirect costs of alcohol misuse. We need to get that figure down, but we must do it by continuing to change our relationship with alcohol at a societal level while supporting those who are affected by alcohol misuse.
We know that that misuse affects not only the individual but their family and friends, as well as their community. It continues to be a concern that there is still a huge difference in hospitalisation and discharge rates between the most and least deprived areas of Scotland. That has a knock-on effect in those communities, most prominently in antisocial behaviour that relates to drunkenness, be that general vandalism, antisocial neighbours or the creation of an unsafe environment for people on Friday and Saturday nights. There cannot be an MSP who has not had to deal with constituents’ complaints about neighbours whose drinking makes them antisocial.
Tackling alcohol misuse at a community level is also key to changing our relationship with alcohol. We have heard a lot today about many fantastic organisations that work across the country to help folk who have a problematic relationship with alcohol to get the appropriate support and help that they need in their community.
FASS, which is for families affected by drug and alcohol abuse, is a confidential service that works in my constituency and across Glasgow. It offers support, counselling, advice and information to parents, spouses, partners and adult family members who are feeling the negative impact of a loved one’s alcohol or drug problems.
I visited FASS, which has a project whereby bereaved family members get the opportunity to participate by putting something on to a quilt. The stories on the quilt would break members’ hearts. The squares are made by families who have lost someone close—perhaps a son, daughter, sister or father—through addiction. One family had three squares on the quilt because they had lost three family members to drugs and alcohol.
FASS offers support to kinship carers. That includes practical support, such as helping them to get the right level of access and assisting with paperwork, and it involves working with FASS’s partner, Geeza Break, to offer respite.
FASS runs a clothing project, which started in 2008 and has gone from strength to strength. The original idea of the project was to help kinship carers with clothing items for children who were put into their care at short notice. Many families are affected in such a way that, although there is a long-standing alcohol problem, there is one trigger that brings the services in to protect the children—perhaps there is a death in the family or someone is hospitalised, which means that the children have to be taken elsewhere to be looked after, usually by a grandparent. That service has grown over the years and FASS is now able to offer adults’ as well as children’s clothing.
FASS is one of many organisations and support groups that work across my constituency and the city of Glasgow to help people who have a difficult relationship with alcohol.
One of the most recent ways in which the Scottish Government has taken a lead on alcohol is through lowering the drink-drive limit on our roads, which has been mentioned several times. That change will undoubtedly save lives.
I am sorry, but I have to stop you for a minute, Mr Dornan. I ask Labour’s front-bench members to listen to the last bit of Mr Dornan’s speech.
Thank you, Presiding Officer. I am shocked and disappointed. [Laughter.]
The drink-drive limit change will save lives and show that our thoughts can shift. I am of the generation that used to think that drink driving was okay. It was not uncommon for people who were drinking at house parties to think nothing of driving home, despite their condition. I shudder when I think back to the number of times when I as a young man—there were cars when I was a young man—got a run home or was driven to a party by someone who, we would now recognise, was clearly over the limit. That is—rightly—not socially acceptable now.
The introduction of the legislation, which has taken us in line with the rest of Europe, has had an impact. As we have heard, since the introduction of the new lower drink-drive limit, there has been a 17 per cent reduction in drink-driving offences. That is a positive story for Scotland that shows that we are again leading the way on social and legislative change in the UK.
The Police Federation of England and Wales recently asked for the legal limit in England and Wales to fall into line with that in Scotland. Given the impact that has been felt in such a short period here, I hope that that will be considered. The new lower drink-driving limit shows that legislative changes can have a positive impact by changing attitudes to drink, so the other legislative changes that we are looking to make, including those on minimum pricing, could have the same impact.
We are all in this together; there is not a person in Scotland who has not in some way been affected by alcohol misuse, directly or indirectly, and it is incumbent on us all to do what we can to change our country’s relationship with alcohol through changing legislation, challenging attitudes and supporting people and organisations, such as the police and the NHS, that deal day in, day out with the effects of alcohol in our society. It is not inevitable that Scotland has to have such a relationship—we can, will and must change it.
16:33
I assure Mr Dornan that there has been no chatter among Conservative front benchers and that we have been unanimous in our attention to his speech.
This has been the debate that I wanted to hear. I would like to make four points, and the first relates to the Labour amendment. Some of my more free market and libertarian colleagues were somewhat concerned that the amendment was a thinly disguised attack on the retail industry—perish the thought that such a thing could ever come from Labour. I told my colleagues that they should not be concerned. Initiatives such as challenge 25 emerged from the retail industry, and much can be achieved not just by resorting to legislation but by working with other parties to bring forward measures that will assist the situation.
The second point that I will make is the one that Jim Eadie developed when he talked about the change in levels of drink driving. I posited my slight concern that resource issues last Christmas and new year might have meant that fewer people were stopped, but I hope that the figures are sustained and prove me wrong in the longer term.
The most important thing is not the number of people who are stopped and who test positive when they are breathalysed but a reduction in the number of road accidents and fatalities that are caused, often not by someone who is just over the limit but by serial drinkers. If the legislation dissuades those people from taking the risk, we will be able to say that it has led to a genuine change in culture and in people’s approach to alcohol.
The member might be interested in the fact that some states in the United States have breathalyser locks put on the cars of people who have been convicted. They cannot drive their cars without ensuring that they are below the limit or free of alcohol.
I am grateful for that information.
The only surreal moment of the afternoon was a Frenchman saying, “Hee haw, hee haw, hee haw,” repeatedly into the microphone. As Bob Doris and Sandra White saw, that left me bewildered as I looked for the beret and onions, thinking that some hugely stereotypical performance was going on. It was suddenly explained to me that that is the name of a non-alcoholic drink, although it is not one that I have come across or know anything about, so I was grateful for the explanation.
The third point that I want to make comes back to culture. I enjoyed most of the contributions that started to address the way in which Scotland deals with our cultural relationship with alcohol. I came from the motor industry and I know that cars used to have a relatively short shelf life. If a car had 100,000 miles on the clock, it was regarded as something of a dangerous old banger that ought to be scrapped. The car that I am driving now has something like 120,000 miles on the clock. Car lifespans have been extended through the careful care and maintenance of vehicles over a long period, so people can enjoy that extended lifespan.
In that sense, human beings are no different. If people are to enjoy a much longer life and if we want it to have quality, we need to find a way of encouraging the public to engage more directly on alcohol, tobacco, obesity and all the preventable conditions.
Given the billions of pounds that the health service costs, we should consider whether the chief medical officer should be involved in more direct dialogue with households, to give the education that we discussed earlier. Bob Doris talked about education, education, education—much like another politician somewhere else and at a previous time—but it was not clear what that education should consist of.
If we are not going to deny people treatment, which none of us believes is the right approach, we need them to understand the effect that what they do will have on their lives in the future. This is not just a case of a universal GP-attached health visiting service. I am talking about the whole-of-life education that will make sure that people take more direct responsibility and so have a longer and healthier life.
I did not discuss my final point, which is on hospital admission, in my earlier speech. Of the 40,000 alcohol-related discharges from hospital, 92 per cent were through accident and emergency. We know that accident and emergency departments are under considerable pressure and that an ageing demographic is presenting at accident and emergency. If we cannot bring down the number of alcohol-related admissions, we will compound what could be an avoidable problem.
That is why I have discussed with the cabinet secretary, and why I commend, the safe zone initiative in Edinburgh. On Friday and Saturday nights, there is a safe zone bus near the Omni centre in Edinburgh. The bus has seen 1,300 people, and 60 per cent of those who have been referred to it have been referred by Police Scotland. Of those, 42 per cent would otherwise have been admitted to accident and emergency departments. They were accident and emergency admissions that were avoided.
There are similar bus schemes in other cities, but they are a bit piecemeal and their funding is a bit haphazard. If we want to look at a preventative measure to ensure that some people get home safely later in the evening—Mr Doris talked about that in a slightly different context—and to head off what might otherwise be accident and emergency admissions, we should be prepared to invest in initiatives like the safe zone bus, especially given the billions of pounds that we otherwise spend. Perhaps such a bus should be available not just for a couple of nights a week but more regularly and when the occasion demands, particularly seasonally. That might reduce the number of people who present in accident and emergency departments.
The debate has been energising. We have had some discussion about the complicated relationships that some have had with alcohol, and that has underpinned many of the actions and initiatives that led to the Parliament passing minimum unit pricing legislation, which we hope will find its place in due course.
The issue is the fundamental relationship that we have been discussing, which is about not just alcohol but all the preventable conditions that a generation ago did not have the same impact on and cost to our health service or, indeed, human life. If we cannot find a way to get people to engage with this more directly on a personal and individual basis, it will not only overwhelm our health service but fundamentally undermine the quality of life that many might hope for, if that life is longer than was previously expected.
16:40
I remind the chamber that this is not the first time that Scotland and the UK have faced an alcohol tidal wave, or what the BMA has called an “epidemic”; it is actually the third time. We got through the previous two waves, and we must hope that the decline that many members have referred to in the numbers of deaths and hospital admissions and other statistics, which started in 2003 and has continued since, with slight variations, is the beginning of the end of this wave. However, as all members have, I think, agreed this afternoon, that will not happen without our continued effort as a Parliament and as a society.
The prevalence that has been referred to is important, given that 138,000 individuals in Scotland—plus or minus 10,000 or 15,000—are alcohol dependent. That is a huge number and, as Mary Fee made clear, some of those people will choose alcohol over food when assessing their weekly shop.
One issue that has not been covered that well is data collection. The figures that we have are approximations; the monitoring and evaluating Scotland’s alcohol strategy programme does a good job in analysing what is happening with alcohol in Scotland, but we need to be clear about data collection. One area in which we have an opportunity to do this is the new drug and alcohol information system—or DAISy—which is, as we speak, being developed by the Information Services Division in a working group. As we said in last week’s debate on caring, that system must look at, for example, the role of young carers who are looking after people in families in which there are alcohol problems and the effect on families and children, given that 50,000 to 58,000 children in Scotland will be affected by alcohol.
We know from WHO that the two things that a Government or Parliament can focus on to best address an alcohol problem are price and availability. In 2001, when I was justice minister, we set up the Nicholson commission, whose work led to the Licensing (Scotland) Act 2005. That was designed to address availability by bringing in public health and the protection of children as licensing objectives. The effect of that has been some measure of control with regard to licensing but, as Alcohol Focus Scotland and others have pointed out, the situation is very patchy and we need to address the issue in a much clearer way. I note that 96 per cent of all licences are accepted—that is too many. If 40 per cent more licences are being granted in areas of deprivation where we know that there are alcohol problems, that must be addressed, and we must also find a mechanism for ensuring that our licensing boards have the power, the authority and the money to be able to go to court. Some of the supermarkets that apply for licences are very wealthy and will challenge decisions in the courts, but councils simply do not have the money to oppose them. We need to be sure that they can.
What is happening in our society? The figures have already been highlighted by many members, which I very much welcome, but I also think that certain important signs of cultural change are reflected in the Scottish schools adolescent lifestyle and substance use survey report that Anne McTaggart quoted from. For example, 19 per cent of 15-year-olds reported that they had drunk alcohol in the past week; that figure is down from 34 per cent in 2010. Also, 4 per cent of 13-year-olds reported that they had drunk alcohol in the past week; that is down from 44 per cent, which represents a big change and, I hope, reflects a change in attitude in the next generation.
Perhaps the education system is beginning to work. I am not allowed to do so, but I would love to ask the pupils who are in the gallery this afternoon whether they feel that the education that they are getting is worth while. When I was a minister, I was told by young people from the Scottish Youth Parliament that the education at that time was ineffective. It was a bit like sex education—if you were off that day, you missed it. That is not good enough and we must ensure that we deal with that issue.
Social norms have not been mentioned today, although they have been studied widely in America and researched in the UK and now in Scotland. Will the social marketing programme that the Government announced today include consideration of social norms when tackling young adolescents and how they perceive their peers drinking? There is no doubt that the biggest influence on an adolescent’s drinking is what is happening around them, but it is their perception of what is happening that is important, not the reality, and that is what research into social norms shows. Jackson Carlaw referred to older people and said that this is about investment not just in a pension but in someone’s quality of life in the future, and that is important. As Jayne Baxter said, cancer and many other conditions are caused by alcohol but also by smoking, being overweight or having the wrong diet. We must encourage that investment in lifestyle and tell people before they get to that point that such investment is necessary now.
As I have said, we are bringing about change. For example, hazardous drinking appears to have declined since 2003 from 33 per cent to 22 per cent in men, and from 23 per cent to 16 per cent in women, which is excellent. Binge drinking by 16 to 24-year-olds has also reduced, perhaps partly due to challenge 25, which the industry introduced. I do not deny that the industry has a role to play and we must work in partnership with it. We must recognise that it is trying to sell as much of its product and make as much profit as it can, so we must sup with a slightly longer spoon that we would use in some other instances. However, what the industry is doing is excellent. It promoted community alcohol partnerships, which started in England and are now happening in Scotland, which is welcome. It supported the drinkaware, serve right, and best bar none programmes. There are many such programmes and I want the social responsibility levy that this Parliament has passed to raise funds so that local authorities can encourage those things to happen. The economy is improving and the time has come for that to be implemented. We should not delay.
I do not have time to go into all aspects of my Alcohol (Licensing, Public Health and Criminal Justice) (Scotland) Bill, but I will speak a little about one or two aspects. First, however, I will deal with one or two other points. Alcohol brief interventions are the first such national programme in the world—excellent. However, as I think Bob Doris said, we must look at outcomes as well as short-term effects. I am retiring next year and, if I get the chance of a valedictory address, I will say again and again that this Parliament is far too preoccupied with process and not sufficiently preoccupied with outcomes. The ABI programme is good and has an evidence base, and it is right to introduce it, but we must also consider the longer-term effects.
As the cabinet secretary said, we need to put more money into other venues to address the issue. In accident and emergency, reports indicate that it is difficult and there are big challenges in changing the culture and even in recording people who repeatedly attend with alcohol problems. That should be a fundamental. In the 1990s, I was on the chief scientist’s committee when we funded a programme to put mental health nurses into accident and emergency as a scientific project. It was successful. Today, I spoke to Derek Bell, who works in London and is now vice-chair of the Academy of Medical Royal Colleges and Faculties in Scotland. He said that his A and E unit in England includes an addiction worker and that, when somebody comes in with an alcohol problem, it is addressed.
There are other venues. Arrest referral exists in five out of eight sheriffdoms. Why is it not in all eight, to ensure that people are picked up and addressed in custody? We must look at our specialist services, and we have a good record internationally. About 38,000 of the 138,000 people with alcohol-related problems are in treatment, but there are problems such as alcohol-related brain damage. That is an area of high cost to the health service. When people get to the stage of being admitted to the gastroenterology unit with hematemisis—bleeding as a result of their drinking—it is almost too late. When I did a study in St John’s hospital in Livingston there were 11 different case records for those individuals. There was no co-ordination, and such cases are very expensive.
I do not have any more time, Presiding Officer—I see that you are shaking your head.
I am afraid that you do not—you must conclude.
I am grateful to all the members who referred to my member’s bill. I hope that people will look at the bill and at what we are doing.
I will finish with three brief points. Mary Fee rightly called for family support; Gil Paterson’s story about his family was an excellent personal testimony; and Sandra White was right to draw attention to the need for community rapport beyond the immediate recovery.
I finish by agreeing with Jim Eadie, who said that we must welcome recovery and promote those who have recovered as models for those who are seeking to do so. We are at the beginning of change, and we need to work together to achieve it.
16:50
I thank all members in the chamber for their contributions. I have listened to the range of views expressed on all sides of the chamber and, although we may not agree on everything, I believe that there is genuine scope for consensus on a topic that continues to affect our nation so profoundly.
Most members mentioned Scotland’s relationship with drink. As many members said, we are not an anti-alcohol nation—indeed, a number of members highlighted alcohol’s contribution to Scotland’s economy—but we are very much a nation against alcohol abuse. Many members—Christian Allard, Dave Thompson, Mary Fee, James Dornan and others—told us very movingly about their own experiences.
None of us wishes to see the harm that can be associated with alcohol impacting on individuals, on their families or on communities. Our work on protecting children and tackling alcohol-related violence must continue. That is why cashback for communities—for example, the £75 million that has been spent on diversionary activities—is most important. I also highlight the Lloyds TSB Foundation’s partnership drugs initiative, which has close links to ADPs.
Will the minister give way?
Just a minute, Mr Henry.
Since 2001, Lloyds has contributed £21 million to the initiative, and the Government has contributed £700,000.
I was just going to mention CPOs—I presume that that is what Mr Henry wanted to ask about. I see that he is nodding. I welcome the question that he raised in his speech about community payback orders. They are a robust and credible alternative to custodial sentences, and they facilitate payback to communities while at the same time addressing the underlying causes of offending.
CPOs are not a soft option—they have been proven to work. Individuals who are released from custodial sentences of six months or less are reconvicted more than twice as often as those who are given CPOs. In 2013-14, 18,600 CPOs were issued, in comparison with 16,100 in the previous year, and I was at a meeting today at which I heard that offending among young people is declining dramatically.
The CPO scheme has resulted in the imposition on offenders of some 1.8 million hours of unpaid work, providing punishment for their offence while giving payback to the community. I hope that Mr Henry is as pleased about that as I am.
Jim Eadie mentioned the photovoice event that was held last night in the Parliament, and the Serenity cafe. Like many members, rather than stay in the building all the time, I sometimes pop round to the Serenity cafe for a quiet bite to eat. However, I visited it formally a few weeks ago, when I was privileged to see the many local projects that are assisting individuals in their recovery from addiction to alcohol, drugs or both. On that occasion, I was delighted to see the substantial progress that is being made on a range of individual journeys. I am reminded once again of the need for the right local infrastructure, which is essential in supporting successful recovery for individuals through people being together and helping one another.
We have heard quite a lot today about what we are doing at the national level, but a huge amount of what matters happens at the local level. From going out to visit alcohol and drug partnerships and projects that are run by the third sector, I know that what really matters to individuals is the support that they receive to overcome the barriers to achieving recovery. Jayne Baxter’s comments about what is happening Fife reinforce that point. I have seen that it takes a lot of strength and commitment on the part of individuals to achieve recovery, so I pay tribute to the individuals who are working towards recovery and the people who support them. In particular, I pay tribute to our 30 alcohol and drug partnerships, the many third sector partners who deliver front-line services, the NHS staff who work tirelessly—often in challenging circumstances where alcohol is concerned—and, of course, Police Scotland.
Yesterday, I visited the Lanarkshire ADP, which is leading the way in the work that it is doing, for which it has won awards. I was struck very forcibly by the peer support that recovering alcoholics and drug addicts offer there, which is so important. It makes a big difference to a recovering alcoholic or drug addict if they have support from someone who has already been on the same journey. Many ADPs recognise the need to do more, to drill down and to reach out—for example, by offering their services to people who face homelessness and to offenders who are coming out of prison. Just today, I had a meeting with ministerial colleagues to see what can be done by all of us, across portfolios, to offer the services that those people need.
We have heard about places of safety in the evening for those who have drunk too much alcohol. ADPs are responsible for assessing the requirement in their area for such services and for putting the best arrangements in place, and some have opted for safe zone buses. I launched the Edinburgh safe zone just a couple of months ago, and we have provided funding for such buses not only in Edinburgh but in Dundee. Other areas use other models—for example, some have safer streets initiatives, with street pastors and taxi marshals. However, as Christian Allard said, this is not just about the community’s responsibility, but about our individual responsibility. It is important that places of safety are available, but the need for them must be evidenced and, as many members have said, in the first place we need to prevent the circumstances that require their provision.
Scotland is by no means unique in being a society where alcohol consumption and drinking to get drunk are normalised, but the consumption and the alcohol-related harms that we see here are pretty stark. NHS Health Scotland’s monitoring and evaluating Scotland’s alcohol strategy programme is, as Dr Simpson said, invaluable. We know that Scots drink almost a fifth more than their counterparts in England and Wales, which of course fuels our much higher levels of alcohol-related harm. Alcohol is now around 60 per cent more affordable than it was in 1980, with the trend being driven by off-trade sales. It is disappointing that the Tories have broken the important link in that regard, because, as has been said, the duties on alcohol are not keeping pace with the harms that it causes and the costs for the public purse.
Labour members mentioned the social responsibility levy, which is something that we and our finance colleagues can look at. However, pubs and supermarkets are still reporting financial challenges, even though the economy is recovering, so introducing the levy might not be without its own challenges.
Despite falling by 9 per cent between 2009 and 2013, including a 2 per cent decline in the past year, the volume of pure alcohol sold in Scotland per adult increased by 5 per cent between 1994 and 2013. Per adult sales have been 17 to 19 per cent higher in Scotland than in England and Wales over the past five years, with the difference largely due to spirit sales.
The debate that we have had today will help us to take forward the strategy further. I return to the World Health Organization priorities for action on alcohol, which were our starting point. On the preventative measures that the WHO recommends on price availability and marketing, I have written to my counterpart at Westminster, and I am pleased to say that my Welsh counterpart is backing me up on the request that we made on advertising. I very much hope that we can reach consensus that the next stage of the journey in tackling our nation’s relationship with alcohol needs the strong backbone that the World Health Organization priorities provide.
I look forward to discussing the proposals in Richard Simpson’s Alcohol (Licensing, Public Health and Criminal Justice) (Scotland) Bill.
While I anticipate that there will be, in due course, a more formal consultation process for the next phase of our strategy, at this stage I welcome any and all contributions to the next steps. As Minister for Public Health, I will gladly discuss ideas with all members in the coming weeks and months.