Meeting of the Parliament

Meeting date: Thursday, September 7, 2023

Official Report 1265KB pdf

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Alcohol Services

The next item of business is a members’ business debate on motion S6M-10032, in the name of Carol Mochan, on investing in alcohol services to reduce alcohol-related harm in Scotland. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises what it sees as the urgent need for action to address the highest number of deaths from alcohol in over a decade, with a reported 22% increase in alcohol-specific deaths in the last two years following the COVID-19 pandemic; believes that this increase is likely due to changing drinking habits, alongside reduced access to services; considers that the risk of alcohol harm is already greater for the most disadvantaged in society, with people in Scotland’s most deprived communities reportedly over five times as likely to die and six times as likely to be admitted to hospital because of alcohol than people in the wealthiest communities; believes that, while deaths are the most extreme form of alcohol harm, these are likely to be accompanied by increases in other harms, such as alcohol-related diseases, accidents, violence, unemployment, family and relationship breakdown, domestic abuse, child neglect and foetal alcohol spectrum disorder; notes the belief that a plan is needed to address what it sees as this public health emergency, and further notes the campaign by 36 charities and health bodies, including the Directors of Public Health in Scotland and the East Ayrshire, Dumfries and Galloway, Scottish Borders and South Lanarkshire Alcohol and Drug Partnerships in the South Scotland region, which calls for urgent action as well as increased and sustained investment in alcohol services and recovery support, alongside a renewed commitment to preventative policies recommended by the World Health Organization on pricing, availability and marketing.

12:50  

It is unfortunate that today’s debate is required, but I am pleased to have the opportunity to bring it to the chamber. At the outset, I wish to thank Alcohol Focus Scotland, Scottish Health Action on Alcohol Problems—SHAAP—and others for the briefings that they have provided members with ahead of the debate.

I am pleased that the Minister for Drugs and Alcohol Policy is attending the debate, and I am pleased to see some Government back benchers attending, too. However, as of this morning, not a single Scottish National Party or Scottish Green MSP had signed the motion. In his speech on Tuesday delivering the programme for government, the First Minister did not mention recently released statistics regarding alcohol-specific deaths. Yet again, we are promised a review of strategy and a review of delivery, but action feels as far away as it ever has been.

I offer these words to the minister: if our approach to investing in alcohol services to reduce alcohol-related harm does not include accepting where we have gone wrong in the past and where we are currently not quite getting it right, we are doing a disservice to those who already are—and those who will become—dependent on alcohol, as well as to their friends, their families and their communities.

It is important to note that, in total, 1,276 deaths were attributed to alcohol-specific causes last year. That is 31 more than in 2021 and is the highest number since 2008. That is 1,276 individuals whose lives were lost before time, and whose friends and families have lost a loved one.

This is a public health emergency. I think that we all accept that. However, I join with key stakeholders today in asking why the amount of alcohol-related harm and the number of deaths have not convinced the Government that the matter is worthy of an emergency response. We have had no ministerial statement, no debate in Government time and no real path to delivery from the First Minister or the Minister for Public Health and Women’s Health. We can do so much better. Those who are suffering due to alcohol-related harm deserve better, and so do the countless families, friends and communities that have seen too many lose their lives to alcohol without the correct support being in place.

Taking a somewhat deeper look at the tragic announcement in recent weeks, we see further causes for concern. While male deaths continue to account for about two thirds of alcohol-specific deaths, the number of female deaths increased by 31 in 2022. It is pivotal that we analyse the detail and do all that we can to ensure that the increased number of female deaths is not repeated, and that we also reduce the number of male deaths from alcohol.

As we see in the motion, although deaths are the most extreme form of alcohol harm, they are likely to be accompanied by increases in other harms, including domestic abuse and violence, and we know that those harms disproportionately impact women. I repeat that this is a public health emergency, and I highlight the importance of having a multilayered response that addresses key factors including causes, related harms and improving outcomes.

I often take the opportunity in the chamber to call for the reduction and eradication of health inequalities. As the motion states,

“the risk of alcohol harm is already greater for the most disadvantaged in society, with people in Scotland’s most deprived communities reportedly over five times as likely to die and six times as likely to be admitted to hospital because of alcohol than people in the wealthiest communities”.

That is the devastating reality—one that our most deprived communities have to live with every day.

A statistic that we have looked at before shows that binge drinking is more prolific in our most deprived communities than in our least deprived communities. That must point to the fact that there are fewer services available in our most deprived communities, which results in an imbalance in alcohol deaths. Does Carol Mochan agree with that?

My view is that it is an extremely complex picture. A lot of our difficulties in more deprived areas are a result of the fact that services are much less accessible. We also have a system that builds in inequalities, so we have to look right across the board at what we can do to support such communities.

The impacts of alcohol harm are wide ranging and can affect anyone. However, the fact that, in 2023, those harms are still felt so acutely in our most vulnerable communities is appalling, and we need to ensure that our approach to tackling this public health emergency is underpinned by a desire to support those people who are most in need. The approach needs to be preventative in nature by tackling the root causes of alcohol harm, which perhaps comes back to Brian Whittle’s point. We must be strong in our approach to advertising where we have the powers to be so, we must put people before profits and, for those who are already dependent, we must have the right support services in place, through investment in our alcohol and drug partnerships, to give people an offer of hope at an otherwise incredibly challenging time.

As I said at the beginning of my remarks, this is not a debate that any of us want to have, but, due to the situation that we find ourselves in, it is necessary to have it. It is a debate that we need to have in Government time so that families and communities can see how seriously the Government takes the issue.

The number of alcohol-specific deaths in Scotland is at its highest level in 15 years, and, at the same time, there are 40,000 more children living in poverty in Scotland than there were a decade ago. The link between alcohol harm and poverty is damaging and well established, and we must do everything in our power to break that link.

Again, I pay tribute to the first-class organisations that research alcohol harm or suggest ways through this emergency; to those who provide services to people who are alcohol dependent; and to our great national health service staff, who always do their best to act when they are called on. They are all part of the fight, but they are being let down. They need a change of approach that shows urgency and tackles the emergency. So far, the Government has not stepped up to the mark, so I implore the minister to take the opportunity today to feed back and tell us how it will tackle what is an emergency for our communities.

12:58  

As co-convener of the cross-party group on drug and alcohol misuse, and as the vice-chair of Moving On Inverclyde, which is a local recovery charity, I thank Carol Mochan for securing the debate. She spoke in the debate on liver cancer on 14 June, which I secured. The same issues that were relevant to that debate are relevant to today’s.

In recent years, a greater focus has been given to tackling drug-related harm, which is welcome. However, many people in the recovery sector have expressed concerns about the impact that that has had on efforts to reduce alcohol-related harm. As per the motion,

“with a reported 22% increase in alcohol-specific deaths in the last two years following the COVID-19 pandemic”,

I am sure that we all agree that equal attention must be given to alcohol-related harm.

Sadly, between 2017 and 2021, Inverclyde reported the highest rate of alcohol-specific deaths in Scotland, with the majority of those deaths caused by alcohol-related liver disease. In addition, more than one in four people who live in Greenock and Inverclyde drink quantities above the chief medical officer’s low-risk drinking guidelines, placing them at a higher risk of developing alcohol-related liver disease. Sadly, that worrying local trend reflects an alarming national picture across Scotland, as the number of people in Scotland whose death was caused by alcohol has risen to the highest level in 14 years.

The motion before us suggests that changes in drinking habits, especially during the Covid-19 pandemic, have played a part in the recent spike in alcohol-related deaths. Through my involvement with Moving On Inverclyde, I can attest to that. Having been a board member of that organisation for eight years, I have seen it go through many changes. The reasons for people seeking help have varied. With the move out of lockdown, Moving On Inverclyde found that a greater number of people needed support for alcohol misuse. The minister heard about that when she visited Moving On Inverclyde over the summer recess.

It is easy to see how people being stuck in the house for long periods of time with little opportunity to interact with others at home or in public settings could lead to their drinking more heavily. It was always considered that other harms could follow on from the Covid restrictions, and the impact that those restrictions have had on people with substance dependence is clear. Figures from the National Records of Scotland show that 1,276 people died from alcohol-specific causes in 2022. That amounts to three people in Scotland dying every day because of alcohol harm.

I thank the British Liver Trust for bringing its “Love your liver” roadshow to Scotland earlier this year to help to raise national awareness of the risk factors for liver disease, which include excess alcohol consumption. I hope to bring the “Love your liver” roadshow to Inverclyde in the autumn, so that people in my constituency can access non-invasive liver scans and learn more about improving their liver health. Scanning using FibroScan technology is quick, easy and painless, and it could lead to some of my constituents learning that they might have liver damage and being given a letter to take to their GP that recommends further investigation. That could help them to reduce the risk factors and, ultimately, save their lives.

I again thank Carol Mochan for securing the debate. The issue of alcohol-related harm is a hugely important issue for the country. There is no quick fix. If there was, it would have been implemented by now. The motion talks about the need for a plan. Carol Mochan spoke about the urgency of the situation and said that we face an emergency. The use of the words “urgency” and “emergency” is entirely accurate. However, it will take a bit of time to develop a plan. Wide discussion and dialogue will be critical in enabling us to get to where we all want to be—in a situation in which fewer people in Scotland die as a result of alcohol-related harm.

13:02  

I refer to my entry in the register of members’ interests—I am a practising NHS general practitioner—and congratulate Carol Mochan on securing time for this most important debate.

We have a problem with alcohol. That includes the binge drinking that is seen up and down our towns at weekends. In my GP practice, I see many patients who have issues with alcohol or drugs, as a consequence of which their mental health is deteriorating. Many patients whom I speak to do not realise that drinking, say, two glasses of wine after work to relax and unwind equates to a minimum of 42 units a week. Given that 14 units a week is the recommended maximum level, they are shocked to discover that and, naturally, they want to reduce their drinking. Therefore, I support Drinkaware’s coming campaign to make more people aware of how much they are drinking.

The SNP has been responsible for health in Scotland since May 2007 but, last year, 1,276 Scots died as a result of alcohol. Their families are grieving. Alcohol-related deaths are at their highest level since 2008, with people in our more deprived communities suffering the most.

When it comes to alcohol, the SNP has tried one flagship approach, which has made alcohol more expensive for the less well-off. The trouble is that people are going without food instead. The minimum unit pricing policy has now been discredited by the SNP itself, yet it seems to be the only plan that the SNP has for tackling alcohol harms. That is why it put a more convenient and positive spin on a Public Health Scotland report into minimum unit pricing by shoehorning words such as “significant” into the draft in order to claim a slam-dunk success, but MUP has not been a slam-dunk success. The SNP also had to make a humiliating climbdown when it was accused of misrepresenting the analysis by spinning estimates as facts. In addition, it implied that the resounding success that it claimed MUP had been was based on 40 studies, which was not true.

Yesterday in Parliament, cabinet secretary Michael Matheson argued that many leading experts have repeatedly said that MUP is making a positive impact on the issue. What he failed to mention is the many evidence-based studies that question that analysis, which is why the Scottish Government and its spin doctors had to rewrite their public announcements. Furthermore, it is crystal clear that there are more alcohol-related deaths now than there were in 2018, when MUP was introduced. Men living in deprived areas are drinking more with MUP in place and others are switching to drinking spirits. MUP has abandoned dependent drinkers.

If we are ever to get a grip on the crisis, people suffering from dependence should have the right to access treatment and rehabilitation. That right to recovery approach is backed by front-line experts. The evidence suggests that direct intervention works and improves outcomes, so let us concentrate on that.

13:06  

I thank my colleague Carol Mochan for bringing forward this timely debate to highlight the rising level of harm being caused in Scotland by alcohol, which is exacerbating health inequalities and adding to the huge but avoidable pressures faced by our NHS, at huge cost to our economy.

Carol Mochan is right when she says that this is a national crisis. The latest figures from National Records of Scotland show that almost 1,300 people died last year from conditions caused by alcohol, which is the highest figure in 14 years and is up 2 per cent on the previous year. Although we can always use different reference points and figures, it is clear that the situation is becoming more serious.

Our most disadvantaged and marginalised communities are disproportionately impacted by the harms that are caused by alcohol. Shockingly, people in Scotland’s most deprived communities are reportedly five times as likely to die and six times as likely to be admitted to hospital because of alcohol as are people living in the wealthiest communities.

The crisis directly impacts my constituents. NHS Greater Glasgow and Clyde, my local health board and the largest in the country, recorded Scotland’s highest rate of mortality caused by chronic liver disease. This is, indeed, a crisis.

That is unacceptable and highlights the need for urgent action to strengthen prevention and improve access to services. It is important that there are facilities to help women offenders, which has been a key focus for this and previous Governments. There was a question yesterday about the 218 service, which is something that I know about because it was set up under a Labour Administration. It provides a very important alternative to custody for many women, including those who are alcohol-dependent, but it faces deep cuts. I wonder how that fits with the Government’s strategy on women’s offending and the crisis that we face.

Six months ago, Justina Murray of Scottish Families Affected by Alcohol and Drugs told the Criminal Justice Committee that one of the biggest barriers to effective change comes from implementation. She said:

“In Scotland, we are really good at writing down what we want to do—we have all the right things written in legislation, strategies and policies—but we do not implement what we say we will. We are good at saying what we are going to do, but we are not so good at doing what we should be doing. There is not really any accountability in the system ... there are still significant failings in treatment, care and support services.”—[Official Report, Criminal Justice Committee, 22 March 2023; c 7.]

Much more immediate work is required to reduce alcohol-related harms and death. The long-term funding of relevant services is absolutely vital in tackling the rise in alcohol-related deaths. We need services throughout the country, and the third sector must be appropriately funded in order to sustain those services for the foreseeable future.

Make no mistake: this is a public health crisis that should be taken as seriously as the crisis of drug-related deaths. In Scotland last year, 21 per cent more people died because of alcohol than because of drugs. It is clear that we must tackle both crises. Stuart McMillan made that point earlier and I agree with him. It is time to view alcohol as one of the biggest threats to population health. Every year, alcohol costs Glasgow, the region that I represent, an estimated £365 million, which equates to £615 per person.

Aside from the horrific impact that alcohol has on people’s lives, which Carol Mochan talked about, it has a hugely detrimental impact on economic growth and workforce productivity.

Every life lost is a tragedy, so we must do more to ensure that vulnerable people have access to local community services and the resources to reduce alcohol abuse and alcohol-related deaths in Scotland.

I want to make special mention of Alcoholics Anonymous, which is an organisation and a fellowship that has helped millions of people—and it means a lot to me. The mentoring system and the 12-step programme has given me the opportunity to try to understand alcoholism and the complexity behind it, and I realise that there is not one simple answer.

The organisation has something to offer to the overall strategy on alcohol. Sandesh Gulhane talked about the fact that alcohol is an issue that affects all communities and all classes, as well as about how dangerous it is to focus only on one policy. It is my personal experience, based on talking to people who have been seriously dependent and who have almost risked their lives, that people have been saved by services and by Alcoholics Anonymous. I also agree with Mr Gulhane’s point that affected people will do anything to get access to alcohol because of their dependency on it. There cannot be a one-size-fits-all solution to this. We need to realise that it is a complex issue.

Once again, I thank Carol Mochan for bringing this important debate to the chamber.

13:11  

I echo the thanks to Carol Mochan for securing time for this important debate. It is important that Government time in the chamber is made available for this vital topic. I also offer special thanks to the campaigners who have fought tirelessly to bring this conversation for public debate, some of whom are watching today’s debate from the public gallery. I hope that the debate can be the catalyst for more meaningful political action, and as I said, a debate in Government time.

We have heard that this is an emerging crisis. It is a hidden crisis, with more than 1,200 people losing their lives last year alone to alcohol-specific deaths in Scotland, which is the highest figure in 15 years. That is worthy of note, macabre as it is. We all agree that, behind each of those deaths is an irreparable tear in countless families and communities. However, that statistic only scratches the surface of the harm that alcohol misuse is causing in our communities. I want to ensure that when we discuss alcohol issues we recognise that, like other forms of substance abuse, it is a sickness that is caused by a multiplicity of factors, including socioeconomic issues—which I will speak about later—trauma, and potentially genetics. It is essential that any action that is taken is driven by understanding and, more important, that we act with compassion.

The long-term effects of alcohol misuse, including long-term health and addiction issues, can impact on future generations. At the beginning of the year, Scottish Liberal Democrat research revealed that, since 2017, more than 1,100 babies have been born dependent on substances, including alcohol. Alcohol misuse has other ripple effects, including the intensification of domestic abuse, child neglect and family and relationship breakdown.

I was listening to Alex Cole-Hamilton talk about the impact on the unborn. Does he also recognise that we are starting to understand the impact of foetal alcohol syndrome disorder, and that about 170,000 people in Scotland could be suffering from that condition?

I am grateful for that excellent intervention. It is vital that we consider the impact of that. The early days of life begin before birth, and what can happen in utero can lead to lifelong and life-altering consequences. Before I came to this place, I worked closely with other colleagues as part of the “Putting the Baby IN the Bath Water” coalition. We need to talk more about foetal alcohol spectrum disorder, so I am grateful to Brian Whittle for that intervention.

It is estimated that alcohol misuse costs Edinburgh more than £220 million per year and, during the past two years, there has a been a reported 25 per cent increase in alcohol-related deaths. That increase was in large part caused by the strictures of lockdown and the mental health impact of that, but we cannot assume that, with the abatement of the pandemic, those numbers will also abate. That supports expert theories that the Covid-19 pandemic has had a lasting effect on people’s drinking habits, which has subsequently led to an increase in high-risk and harmful drinking.

The fact that alcohol misuse appears to be worsening is just one reason why we need urgent action. Although the Scottish Government has recognised alcohol harm as a public health emergency, there is yet to be an emergency response. We desperately need a strategy and effective policies.

One such policy that has been adopted, whose impact we are just now seeing, is minimum unit pricing. My party supported the introduction of the policy, and promising data is being produced, but we need to continue to monitor its efficacy when we review its potential renewal—that is something that will challenge us all in the coming months.

MUP is just one tool, however, and it is by no means enough to tackle the issue. Alcohol services are still reeling from SNP-inflicted cuts. We remember that, in 2015, the Government cut funding to services in ADPs by nearly 25 per cent, and those have still received no real-terms increase in funding, according to Audit Scotland. As a result, they are struggling to maintain their service—the relationships that they provide and sustain—amid rising costs, coupled with rapid increases in demand. That is why 36 charities and public health bodies, including the directors of public health in Scotland, have called on the Government to urgently provide increased and sustained investment in alcohol recovery and support services.

As I alluded to, we cannot ignore the root causes of why people drink and why they harm themselves with alcohol use. People in the most deprived communities are five times more likely to die and six times more likely to be admitted to hospital due to alcohol-related causes. That is a health inequality and is attached to unresolved childhood trauma, as is drug abuse. That is why the Scottish Liberal Democrats would establish a new specialist family drug and alcohol commission, which would offer accessible wraparound services, taking a holistic, community-based and trauma-informed approach to substance and alcohol misuse.

The experts have been unequivocal about the extensive harm that alcohol misuse is inflicting on us and in their assessment of it. It is our duty to listen to them and to treat the issue with the attention, urgency and compassion that it deserves and requires.

13:17  

I, too, thank Carol Mochan for bringing forward the debate, and offer my condolences to anyone who has lost a loved one to alcohol misuse. I also thank Alcohol Focus Scotland and SHAAP for their tireless efforts to tackle alcohol-related harm. Every alcohol-related death is a preventable tragedy.

This is a human rights issue. As elected representatives, we have a responsibility to act on it. Many others have covered recovery and treatment services. My contribution will focus on the other side of the issue: prevention and the specific actions that we need to take to address the alcohol deaths emergency. Inevitably, that will mean tackling alcohol marketing, which encourages people to start drinking and to drink at higher levels.

We know that exposure to alcohol marketing is a cause of youth drinking. Decades of research have concluded that alcohol marketing leads young people to start drinking earlier and to drink more. Clearly, allowing the industry to self-regulate is not working. In a UK survey, 82 per cent of 11 to 17-year-olds reported having seen alcohol advertising in the past month.

Alcohol marketing affects not just young people. It encourages consumption and risk-taking behaviour among heavier drinkers, causes higher craving levels and fosters positive alcohol-related thoughts. That can seriously impact people who are struggling with their alcohol use, or who are in recovery.

Alcohol advertising makes drinking seem more attractive and encourages high consumption. Restricted alcohol marketing benefits everyone. In fact, it is recommended by the World Health Organization as one of the most effective ways of reducing consumption and the health and social harms that alcohol causes.

Other European countries have already taken action. Ireland recently introduced legislation to ban alcohol advertising during sporting events and—crucially—events that are aimed at children. It is also restricting alcohol advertising outdoors and on public transport, as well as how and where alcohol can be displayed in shops and supermarkets.

Scotland would do well to follow Ireland’s lead and be bold in its efforts to tackle the proliferation of alcohol marketing. Measures recommended by the alcohol marketing expert network include restricting advertising outdoors and in public places, in sports and event sponsorship and in retail display and promotion. Those measures should be introduced as soon as is practicable and I look forward to hearing any updates that the minister has about timescales for upcoming consultations.

I turn to the introduction of an alcohol levy. I have long believed that the polluter-pays principle should be applied to the sale of alcohol. The alcohol industry makes huge profits from the sale of alcohol and should contribute towards mitigating the harm that is caused by the products that it sells. Retailers should not be allowed to keep the additional profits that they make from minimum unit pricing, which should be invested into prevention and treatment services.

Alcohol Focus Scotland also advocates for the introduction of an alcohol harm prevention levy. That would be raised through a supplement on non-domestic rates for retailers and applied to premises licensed to sell alcohol for consumption off the premises. I have raised that matter in the past and I would be grateful if the minister could update the Parliament on the Government’s current position on the proposal and advise what consideration is being given to introducing such a levy.

There are many actions that we can take to tackle alcohol-related harm. Now is not the time for timidity or hesitation. Too many lives and too many families are being destroyed. We must act and we must do it now.

13:21  

I thank Carol Mochan for bringing the debate to the chamber. As we get the welcome news that drug deaths have started to decline—which is excellent news, albeit that their numbers are far too high—we are hit with the news that alcohol deaths are rising. It is important to note that, for people who are caught in addiction, alcohol and drugs are almost interchangeable. In fact, especially with drug addiction, there is usually an alcohol element as well.

I want to clarify my intervention on Carol Mochan. I am co-convener of the cross-party group on health inequalities. I was surprised to hear at the CPG that people in the most deprived areas are more likely to abstain from alcohol than those in the least deprived but that the impact of alcohol abuse and consumption is much more catastrophic in the deprived areas. We talked about the inequality of access to services about which Carol Mochan spoke.

In the previous session of the Parliament, we all agreed to minimum unit pricing, albeit with a sunset clause. We need to understand why the figures are so stark despite the introduction of minimum unit pricing and what impact the measure has had. Even if it has had an impact, which I hope it has, alcoholism will not be cured by increasing the price of alcohol alone. I am concerned that the Scottish Government’s approach has relied far too much on minimum unit pricing and that not enough has been done on education, for example. I refer not just to direct education on the dangers of alcohol abuse but education on the alternatives that are offered to our youngsters.

Members will not be surprised to hear me refer to the inequality of access to sport, music, art and drama, and increasing budgetary constraints on our third sector organisations, which Pauline McNeill mentioned, in relation to the rising addiction numbers. In many cases, the third sector organisations are the ones that have access to the people who are most isolated in our communities

I ask the Minister for Drugs and Alcohol Policy to inform members how she is working with her colleagues on the matter. It will take work across portfolios, especially with the Cabinet Secretary for Education and Skills and the Cabinet Secretary for Social Justice, to address it. The issue is complex, as Carol Mochan said, and it will take much more than we are doing to tackle the problem. The minister will understand that this is an issue that unifies us across the parties.

During the minister’s recent visit to Inverclyde, a number of the service users of the organisation that I referred to pointed out the amount of activities that are available in the local area and said that, prior to their addiction, whether to drugs or alcohol, they did not realise that there was so much to do in the area. The member’s point about the issue being complex is an accurate one, but his trying to lay the blame on the lack of funding for third sector organisations or in communities is not entirely accurate.

I thank Stuart McMillan for his intervention, but I have to disagree with him on a specific point. I have a specific interest in sport, and I have mentioned often in this chamber that sport is becoming the domain of the middle classes. How we allow access to sport and many other activities surrounding it is an issue that we need to consider. I have talked many times about the school estate; indeed, that is why I have mentioned the education establishment. It is one of the battlegrounds where we need to tackle this matter, as it will allow us to engender different interests in people.

However, I do not think that we are speaking at cross-purposes here. Our views are very much in the same vein, and perhaps enthusing our youngsters to do something else or ensuring that there is something else on offer other than the boredom that leads to much of this will be part of the complex response that we need to make. In that respect, I would be very grateful if the minister could let us know how she is working with colleagues across other portfolios, especially in education.

Once again, I thank Carol Mochan for bringing this important debate to the chamber.

13:26  

I congratulate Carol Mochan on sponsoring the motion and for bringing the debate to the chamber. I agree with her that, as the evidence that we have heard over the past 45 or however many minutes shows, we need a proper debate in the chamber during Government time to discuss this very important issue.

As we all know, our country has a complex relationship with alcohol. That is not a recent discovery—it has been going on for generations. I completely agree with the quotation that Pauline McNeill read out; I do not know who it was from, as I did not write it down, but I was struck by it. We are so good at talking about the problem and at producing words, papers and strategies, but we are just not any good at delivering any change on the issue. That has gone on for far too long, and I therefore absolutely echo Carol Mochan’s comments about the need for a full debate in Government time, with all the parties putting forward their ideas on what we will do to change our country’s trajectory in relation to alcohol consumption and dependency.

Enough is enough. People are dying, and anyone who has ever spent time supporting someone struggling with alcohol dependency and dealing with all the illnesses that are contingent on their alcohol addiction will know that it is heartbreaking. Through that one person’s life, so many hearts are broken.

I have never felt that it was my job as a politician to tell people how to lead their lives—I just do not see that as my role—but I absolutely believe and agree with colleagues who have said that it is our duty as parliamentarians to work together to create public policy that makes a difference and which enables people to make better choices. To those who argue that alcohol consumption is entirely a personal decision that is nothing to do with the Government or with public policy, I am afraid to say that that argument crumbles in the face of the gentlest scrutiny and all the evidence of our life experiences.

In his remarks, Sandesh Gulhane talked about the nature of the impact of this problem on families, communities and society at large. We do not live our lives as isolated beings; even though we have our individual identities and preferences, we are woven together. I absolutely subscribe to the notion that we are our brothers’ and sisters’ keepers, and that is why we as members of the Scottish Parliament have a solemn responsibility to do something about alcohol addiction as it impacts and harms individuals, families, communities and our country.

However, prioritising collective actions or blunt instruments over individual responses is not the answer. Again, Dr Gulhane made very clear our position on minimum alcohol pricing. As well intentioned as that is, it is not meeting need. Frankly, it is easy for all of us to picture someone with an addiction, but what do they do when they face higher prices? They do without in other essential areas, and that impacts other people in the process.

My time is up, so I will conclude by saying that we need to chart a new course for Scotland on this issue. Enough of the talking, the strategies and the reviews—let us do something. Let us, for example, invest in local rehabilitation centres across the country, and let us put help easily within the reach of every person who needs it and those who are trying and striving to support those who are struggling with the problem.

Moreover, let us educate our young people. We must deal with the problem at root and create a better relationship between the people in our country and alcohol. Let us deal with the behaviour issues that arise from the misuse or abuse of alcohol through binge drinking and other activities and deal properly with the antisocial behaviour that arises through such abuse. Let us deal with the issues that my constituents in Falkirk, for example, talk about such as excessive noise, violence, graffiti and litter left in the wake of those who have been intoxicated and disruptive in the street or the community.

The failure to hold individuals accountable for their behaviour sends a destructive and dangerous message about what behaviour is permissible. By failing to act, we are perpetuating a vicious cycle of harm, and I therefore appeal to the minister to talk to her colleague, the Minister for Parliamentary Business, to see that there is a full debate on this issue as soon as possible.

13:32  

I thank Carol Mochan for lodging her really important motion, and I also thank members for their considered contributions this afternoon. From the outset, I want the chamber to know that I support the motion.

We all agree that urgent action is needed to address the number of deaths from alcohol and to reduce alcohol-related harm. I offer my condolences to all the families who have been impacted by alcohol deaths and restate my commitment to do everything in my power to tackle this public health emergency. As a member of a family that has been affected by the matter, I have to say that it is personally important to me.

As we have already heard, National Records of Scotland has reported a 2 per cent increase in the number of alcohol-specific deaths in 2022. The mortality rates in the most deprived areas are more than four times as high as those in the least deprived areas, and according to Public Health Scotland statistics, admission to hospital was six times higher from the most deprived areas. Those gaps are reducing over time, but they are clearly still far too large, and tackling poverty must remain a clear focus for us all.

I am also particularly concerned by the reported rise in the mortality rate for women and the over-65s. We must ensure our prevention policies and treatment services address the specific needs of those groups and are tied into the work being carried out across Government that Brian Whittle and others have talked about. We need to respond the health inequalities that are experienced acutely by women but by other groups, too; indeed, we should also note the increase this year in the deaths of women by suicide. We need to look at how all of these things are tied together and whether, as Alex Cole-Hamilton has suggested, some of this has come out of the pandemic. It remains to be seen whether the situation will continue, but we really need to keep a close eye on it.

The motion asks Parliament to note its belief that

“a plan is needed to address”

this “public health emergency”. In response, I will set out the Government’s plan for doing so. However, I agree with everybody: the issue is so large that we need to find time to bring it back and Government time to start considering it fully.

On pricing, we will soon be laying our report on the operation and effectiveness of minimum unit pricing in line with our commitments under the Alcohol (Minimum Pricing) (Scotland) Act 2012. I look forward to discussing with Parliament the next steps for that flagship policy, as well as launching a public consultation on its future. It is, as some members have said, not a single magic bullet, but is part of a suite of things that we are trying to do.

Minimum unit pricing was a whole-population attempt to drive down consumption. From the reports that we have seen, we know that there has been a 3 per cent reduction in overall consumption, but I am acutely aware of how that impacts dependent drinkers, so I will keep that under close consideration. We will have a full debate on that when we get to it.

Linked to that work is the outcome of our alcohol marketing consultation, which closed in April. In the coming months, we will publish the findings and our next steps, including how we further engage on this critical issue. We will also continue to keep any proposals for a levy under consideration.

On harm reduction, alcohol brief interventions can help clinicians and patients to identify harm-reduction behaviours or the need for outside support in reducing alcohol intake. We have just completed a comprehensive review of ABIs, which will be published shortly. It will include recommendations, and we will provide Parliament with details of the actions that will be taken in response to those to make improvements that help reduce harm and can improve outcomes for people impacted by alcohol.

The earlier that we can do the work to identify people who are drinking at harmful or hazardous levels, the better. I welcome the work that Drinkaware is undertaking on helping people to self-identify issues and I look forward to seeing how that can work in tandem with the review of alcohol brief interventions.

On increasing access to treatment, we have asked Public Health Scotland to investigate the reduction in numbers for referrals to services. We need to ensure that referrals are made wherever appropriate and that there is capacity within services to meet peoples’ needs. Therefore, it is vital that we understand what is behind the data.

I also want to understand where the gaps in data are, as Pauline McNeill mentioned. How do we understand how many people are engaged in fellowship organisations throughout the country? Those organisations are vital and help many people.

I used to question the Minister for Drugs Policy about this. If we can understand why Scotland has such a problem with drugs and alcohol, it would be very helpful for finding a solution to the matter. Is the Scottish Government doing any work to understand why we have a particular issue in Scotland?

We saw the findings of the Scottish Drugs Deaths Taskforce. Some of those findings on drugs can be extrapolated to alcohol harms. However, as Carol Mochan pointed out, the picture is complex. We need to continue to examine the matter to understand what is driving consumption in our communities. Some of it is to do with poverty and inequality but a lot of it is to do with other matters. The increase in over-65s is particularly perturbing to me. Is there something to do with retirement age that means that people’s habits start to change? I assure Brian Whittle that examining that matter over time is a key part of what I want to do.

Will the minister take an intervention?

I cannot, sorry. I do not have enough time. There is just too much to talk about. That speaks to why we need a further debate in the chamber.

We have just commissioned Healthcare Improvement Scotland to take forward work to enable us to deliver our mental health and substance use plan. The first part of that work is currently under way as HIS works with stakeholders to develop an exemplar operational protocol to set out how mental health and substance use services should work together. That is vital, given the number of alcohol-specific deaths that were caused by mental or behavioural disorders. We cannot allow people to be bounced between services.

Workforce—recruitment in particular—is a challenge across all services at the moment. In the autumn, we will publish a workforce action plan on alcohol and drug services to help shape recruitment, retention and service design. That should help to create service capacity to make improvements, such as establishing alcohol care teams in hospitals to identify people with underlying alcohol problems earlier. I am meeting the chair of the group on that this afternoon.

I am meeting local leaders across the country to ensure that they are committing effort and resource to ensure services are in place, accessible and effective. I also recently wrote to ADPs to reassure them that it is welcome if they use national mission resources to support services that offer treatment and support to people who are impacted by alcohol use alongside those who are impacted by drug use. Any concerns that they have should be flagged to my officials.

To help to ensure that changes are delivered, the Government has committed to developing treatment standards to offer people better access to support and a wider range of choices in treatment, in line with what is available through the medication-assisted treatment standards. The standards will be informed by the United Kingdom-wide clinical guidelines for alcohol treatment that will be launched in the coming months. The implementation of those guidelines and our proposed standards will provide the impetus for improving the identification and testing of patients who are at risk of liver disease in primary care. As we have heard from Stuart McMillan, that is welcome.

On recovery services, we are encouraging specialist services to link more closely with recovery communities and we continue to provide funding to third sector recovery groups. We are on track to increase our beds from 425 to just shy of 600 in this session of the Parliament, which is a 40 per cent increase. That represents about 1,000 publicly funded placements, which is important.

There are innovations such as the Simon Community’s managed alcohol programme, which seeks to drive harm reduction for people who are drinking at the most harmful levels.

There is so much in the issue that I cannot get through all of it. However, as the minister with responsibility for both drugs and alcohol, my role is to drive improvements in outcomes for people who are impacted by alcohol, drugs or both and do so in all the ways that help to tackle the twin public health emergencies. The Government will continue to work with statutory and third sector partners to deliver the plan to reduce alcohol harm and alcohol deaths. I will work at pace to bring all of that together to ensure that our ambition is communicated effectively, and I will seek to bring the matter back to the Parliament.

13:41 Meeting suspended.  

 

14:00 On resuming—