Alcohol
The next item of business is a debate on motion S3M-681, in the name of Kenny MacAskill, on alcohol. I invite members who wish to take part in the debate to press their request-to-speak buttons now.
I say at the outset that I will be happy to accept Pauline McNeill's amendment. We are seeking to address underage drinking and although we have laws, they must be enforced. She raises an appropriate point that other cultural matters that relate to the problem should also receive great consideration. We are more than happy to take that on board.
It is timely that we are having the debate during alcohol awareness week. We should recognise the valuable work, led by my colleague Shona Robison, in partnership with the alcohol industry, to tackle Scotland's complex relationship with alcohol. She will explain more about that later.
Although we are determined to tackle the problems of alcohol misuse, we are not prohibitionists—alcohol alone is not the problem. We are rightly proud of our brewers and distillers and the significant contribution that they make to the Scottish economy. Pub culture has been an important element of social life in Scotland for hundreds of years. However, the major problem now is our relationship with alcohol. It is not the drink but how we drink and, sadly, the balance is completely out of kilter. Drinking to get drunk is seen as acceptable behaviour. Alcohol is promoted, sold and accepted as just another ordinary commodity, and it is sold at an unacceptably low price—strong cider can cost less than bottled water.
I have said it before and I repeat it today—nothing is off the agenda in consideration of proposals to tackle alcohol misuse. The Government is serious in its commitment to tackle the problem head on. I make no apologies for that. Voluntary measures are an important part of the solution but so, too, are tough legislative measures and direct action. We must be prepared to consider new and innovative ideas. The problem cannot be solved overnight, which is why we are working across Government to develop a long-term strategy.
It will take time to change the culture, and the extent of our problem with alcohol means that we have no time to lose. We need to shake ourselves out of the complacency that surrounds alcohol. The figures are stark: one Scot dies every six hours as a direct result of alcohol. We have the fastest-growing cirrhosis rates over the past decade of 41 countries that were surveyed. Over 40 per cent of those who are accused in homicide cases were drunk at the time of the offence. The overall financial cost to Scotland of alcohol misuse is estimated at £1.1 billion.
Statistics do not show us the whole picture: behind them lie the personal experiences of families and communities that have to deal with the consequences of alcohol misuse—family breakdown, acute illnesses, absence from work and violence. In addition, front-line services such as the police and the national health service have to deal every day with the aftermath of alcohol misuse in our towns and cities, which places them under an enormous burden.
As well as the development of a long-term strategy, we can quickly put some measures in place. I have introduced regulations, instigated by the previous Administration, that will require off-sales premises to have separate areas for the display of alcohol. That means that there will be no cross-merchandising, no beer beside the barbeque charcoal, no wine by the pizza counter and no gin and tonic in the chiller cabinet alongside the lunch-time sandwiches. We are not yet talking about having shops within shops or separate check-outs—we are talking about dedicated areas for the display of alcohol in order that we can begin to shift attitudes.
Does the cabinet secretary share my concern that alcohol can be bought in garages and chip shops? Surely making it so easy to purchase alcohol increases the problems that he has just described.
Absolutely. The matter was flagged up by the previous Executive, and this Government will continue to move in the same direction.
The fact is that we have to change perceptions, which brings us back to Mr Whitton's point that alcohol has become no different to other products in shops. Where breaches of conditions occur, I will expect the licensing board to take tough action in determining whether the premises involved should continue to enjoy the right to sell alcohol.
At a recent meeting with a number of licensing board conveners, I re-emphasised that very point and set out our expectations with regard to tough and effective enforcement. As part of the culture change, the licensed trade must recognise that selling alcohol is a privilege, not a right. It must face up to its corporate social responsibilities and recognise that it is part of the problem, as well as being part of the solution.
Of course, moving alcohol to one part of a store will not affect how it is priced and promoted. We are all aware of the rising trend of front-loading, in which people buy a large amount of alcohol to consume at home before setting out for the pub or club. There have been many calls for meaningful action to prevent problematic off-sales promotions. We are all familiar with the multibuy offers that slash the price of alcohol to incredibly low levels and encourage people to buy incredibly large amounts. Recent promotions in which beer has cost less than water have been described as offering great value; however, in my view, they can also be described as irresponsible. Is it any wonder that people front-load when a pint can cost 43p at home but £2.50 in the pub? There has been speculation about a cut-price bonanza this Christmas to shift piles of extra stock that have been left unsold after the poor summer. That could mean prices being cut to the lowest possible levels.
Although retailers are to be congratulated on their efforts through initiatives such as challenge 21—which is increasingly becoming standard practice—I am not convinced that anything other than a regulatory approach will change for the better the promotion of alcohol.
Should we infer from the tenor of the cabinet secretary's comments that the Government wants the whole Parliament to urge the Chancellor of the Exchequer to increase the tax on alcohol?
This Government feels that we should have those powers because they are, after all, powers that any normal independent nation has that allow it to act appropriately to look after its interests. However, the Government has to take action under its current powers. We will do so and will make representations when we need to. The fundamental point is that if we want to change our country, improve our economy or change our drinking patterns, we need fiscal powers.
I will introduce regulations under the Licensing (Scotland) Act 2005 to end irresponsible off-sales promotions. Premises will not be able to have promotions that offer alcohol free or at a reduced price on the purchase of one bottle or more. Moreover, the regulations will apply to all premises that sell alcohol, regardless of whether they are supermarkets, convenience stores or corner shops. These measures will bring the off-sales sector into line with the on-sales sector, which is banned under the 2005 act from offering certain types of irresponsible promotions.
Of course, banning irresponsible promotions does not necessarily affect prices. Even though it will not be possible to offer multibuy promotions, the measure will not prevent premises from selling alcohol very cheaply. It would still be possible, for example, to sell beer at a lower price than water, and alcohol could still be sold at below cost price to tempt customers into a store. I have made it clear on many occasions that I do not think that that is acceptable, and I hope that every member agrees.
I am not sure that every member does agree. In other European Union countries, such as Italy, people spend a lot of money on alcohol and wine, and beer and spirits are sold very cheaply in supermarkets and as part of promotions, but they do not have the social problems that we have. Are we missing the target? Is the Government concerned only about the price of alcohol?
We said at the outset that although price is not the only issue, it is a pivotal factor. We want to address the culture of price promotion and a variety of other matters. It is not rocket science—if alcohol is piled high and sold cheap, more will be bought, more will be drunk and more problems will arise.
The Licensing (Scotland) Act 2005, which was put in place by the previous Administration, already deals with pricing, but I have asked for advice on what we could do to end deep discounting of alcohol. I want to progress that as part of a wider alcohol strategy.
I will not pretend that taking tough action on pricing will be easy, but there is evidence and a wealth of opinion that says that controlling price and availability can be key to achieving the cultural change that we require. I will examine those arguments carefully.
In our recent consultation on licence fee levels, I asked for views on whether local authorities should, on the polluter-pays principle, have a new power to apply an additional fee. The aim would be to offset the costs that pile up, whether for policing or anything else. Such revenue could be used for taxi marshalling, late-night transport or whatever the local authority thinks appropriate. I have also floated the idea of introducing places of safety in towns and city centres to ease pressure on police and accident and emergency departments. I want to explore the potential of those and other such schemes.
Let me be clear: selling alcohol is not a right. It is reasonable that the people who profit from it should be expected to meet some of the costs of the ill effects of alcohol. The Government does not seek to take all the credit—some measures were proposed by Paul Martin and the previous Administration, while others have been implemented south of the border. We will work with all parties to take up ideas, regardless of where they come from, that will ensure that we address cultural and other specific problems.
Whatever doubts some members may have, it is clear that it is time for comprehensive action. We must take direct action now, coupled with a long-term strategy. Sustained action is required to turn round our relationship with alcohol. Such action will produce a safer and healthier Scotland. We are all aware of the problems and the consequences of doing nothing. Can we all share a commitment to change our drinking culture for the better? I trust that members will support the motion.
I move,
That the Parliament notes Scotland's first Alcohol Awareness Week and endorses the partnership approach between the government, industry and the voluntary sector to educate consumers about alcohol units, while recognising that further work is needed to ensure that alcohol is accepted as different to any other product for sale; further agrees that tackling the problems surrounding the misuse of alcohol is one of the great social and public health challenges of our time, requiring direct, innovative, long-term and sustained action; recognises that this includes tougher enforcement action against those who sell and promote alcohol irresponsibly; notes the importance of close co-operation with, and support of, Scotland's police forces and licensing boards in this respect; welcomes the recent commitments by the Scottish Government to regulate the display and promotion of alcohol in off-sales premises and to find a method of ensuring that those licensees who profit from Scotland's alcohol culture help offset the damage done by that culture, as well as to develop a long-term strategy to tackle the negative effects of alcohol misuse, and further notes the need for the NHS to play its part in early identification and intervention for those individuals drinking at harmful or hazardous levels.
I should have said that we will be extremely tight for time if we are to fit everyone in, so I ask members to watch their time.
The Executive is to be commended for having a debate on alcohol during alcohol awareness week. It is important that members put on record our appreciation of the large number of organisations that provide support to people who suffer from alcohol abuse. Particular mention should be made of Alcoholics Anonymous, because the evidence that I receive from constituents is that that organisation performs an invaluable role in communities throughout Scotland. It does not receive—nor does it want—a penny of public subsidy for that work. All credit should go to Alcoholics Anonymous.
We welcome the opportunity to develop policies in partnership with the Executive and would like to comment on a number of issues that the cabinet secretary has raised. First, I will respond to his commitment to deal with licensed premises, such as supermarkets, that provide unsuitable displays of alcohol. Many of us, particularly those of us who have children, find it unacceptable that the message that is sent out to communities throughout Scotland is that supermarkets are places to buy cheap drink. We commend the minister for proposing measures that we hope can be enforced effectively.
The most recent "Scottish Schools Adolescent Lifestyle and Substance Use Survey National Report"—a survey of schoolchildren aged 13 and 15, which is conducted every two years—says that 20 per cent of 13-year-olds acquire their alcohol in off-licences, shops or supermarkets, and the figure rises to 44 per cent for 15-year-olds. Does Paul Martin agree that test purchasing, which is only just coming in, must be pursued rigorously and that people's licences should be affected as a result?
I thank Richard Simpson, who made—as always—a well-informed intervention. I will talk about underage consumption.
On the proposal to ban certain drinks promotions, Labour members condemn retailers who seek to benefit from drinks promotions that encourage irresponsible alcohol consumption. However, we must be careful about how we deliver a ban. We considered the issue carefully during the passage of the Licensing (Scotland) Bill. Some people take advantage of drinks promotions responsibly—I hope that that includes most members—and should be entitled to have the opportunity to do so. We must consider whether evidence backs up the cabinet secretary's proposals. We must place on retailers a social responsibility to ensure that they do not encourage irresponsible consumption. Perhaps the simplest argument that we could put to retailers is that it is not in their interests to shorten consumers' lives by providing opportunities for alcohol abuse. The more we work with the industry to get that message across to retailers, the more successful we will be in implementing our strategy.
We must accept that alcohol abuse takes place in our streets and fuels antisocial activity throughout Scotland. I am sure that all members have heard from organisations in their constituencies who have expressed concern about the consumption of alcohol in public areas, particularly by young people. Such behaviour sets the wrong example for the next generation of young people. I am proud of the measures that were delivered by the Licensing (Scotland) Act 2005 and the Antisocial Behaviour etc (Scotland) Act 2004 to ensure that legal remedies, such as dispersal orders, are in place to tackle unacceptable behaviour in streets throughout Scotland.
The zero-tolerance approach to such behaviour is welcome, which is why we have difficulty in accepting the Liberals' amendment. We support rehabilitation, but we must send a clear message of zero tolerance of irresponsible behaviour on our streets. On many occasions, rehabilitation has been offered and a number of other avenues exhausted before dispersal orders were considered.
There is no doubt that underage drinking presents a serious challenge to many communities throughout Scotland. The Labour amendment urges the cabinet secretary to call a summit of political leaders and relevant stakeholders in Scotland, to provide a framework and to develop not a strategy but an effective action plan to deal with this serious issue. At least 52 per cent of young girls in Scotland get drunk twice a month, which is unacceptable. I am sure that the cabinet secretary wants to work with us to create opportunities to tackle that.
We welcome the minister's commitment to ensuring that the polluter pays, but I will strike a less consensual note by quoting the following comment:
"I argue against the measure because it is punitive, as public house premises and clubs pay the Exchequer substantial amounts of money … in particular, through non-domestic rates."—[Official Report, 16 November 2005; c 20743.]
Those are not my words; they are the words of the Cabinet Secretary for Justice's deputy, the Minister for Community Safety, Fergus Ewing, who is not in the chamber.
I will quote another member:
"The way to address the problem is to deal with it through the bill and the new licensing regime. If necessary, the premises can be shut down. That is what we should do with these places. We should not enable them to bring in other measures as that could legitimise the antisocial behaviour."—[Official Report, Local Government and Transport Committee, 3 October 2005; c 2948.]
Bruce Crawford said that when he spoke in opposition to the amendment in my name, which was agreed at stage 2 of the Licensing (Scotland) Bill, the object of which was to ensure that licensed premises pay for the additional policing costs of dealing with any unacceptable activities that may result.
I commend the cabinet secretary for bringing forward a measure that was the subject of a successful Paul Martin amendment. Unfortunately, Fergus Ewing, now the Minister for Community Safety, lodged a stage 3 amendment that resulted in the measure being deleted from the bill. Labour Party members are happy to commend the SNP for emulating Labour Party policy and we look forward to providing the Government with many other examples of Labour amendments that were unsuccessful because of SNP opposition.
Of course, the Labour Party welcomes the opportunity to tackle the problem. We want to work with the wide range of organisations that have a role to play in tackling alcohol abuse, including Alcoholics Anonymous, to which I referred earlier, all of which have a serious role to play. We have to work together in Parliament on the issue. On occasion, that will mean that the Government will have to adopt policies that its members rejected when they were in opposition in a previous life.
I ask the chamber to support the amendment in Pauline McNeill's name.
I move amendment S3M-681.2, to insert after "product for sale":
"further notes the high incidence of underage drinking and the harm done to those young people and the negative effect that underage drinking can have on Scottish communities; believes that the Scottish Government should call a summit of all relevant stakeholders to develop an effective strategy to tackle underage drinking;"
The debate is on a reasonably consensual matter; indeed, the Conservatives find the Labour Party and Liberal Democrat amendments acceptable. There is also much in what the cabinet secretary said with which we agree, apart from one item to which I will turn presently.
It is idle to suggest other than that the use of alcohol has been a major part of adult social culture in Scotland for many years but—as we all know—it is possible to have too much of a good thing. Excessive and irresponsible consumption of alcohol is a serious matter that can have devastating effects on individuals and communities. The problems in respect of young people are particularly apparent.
My colleague, Mary Scanlon, will deal with the health issues, but there can be no doubt whatever that things can go terribly wrong as a result of excess drinking. Many young men, and an increasing number of young women, find themselves in accident and emergency units and in the High Court.
In many ways, the portrayal of alcoholic drink in Scottish culture is problematic and that is at the root of the problem. Instead of being characterized as a relaxing social catalyst to be enjoyed only in moderate amounts, alcohol is too often depicted as simply an avenue for abandoning one's inhibitions and having a wild time. That must be changed, and true change must always begin at the fundamental level. It is time to take seriously the notion that in schools, the media and, most of all, the home, the attitude towards alcoholic drink must be improved. We must change our culture in order to rightly characterise excessive drinking and unruly drunken behaviour as shameful, embarrassing, and socially unacceptable.
The solution for changing public attitudes to drinking is education, not the implementation of rigid alcohol unit systems, which dictate rigid, prohibitive and arbitrary limits on what it is acceptable for someone to drink. They are also ineffective in reaching the public. The people who are involved in promoting them are perceived as preaching and as being self-righteous and condescending, and the systems make no allowance for variable factors such as individual body chemistry or metabolism.
Does Bill Aitken not accept that the whole point of alcohol awareness week is that people should know their own drinking limits? Surely each person should assess his or her own drinking and decide whether it meets the guidelines on safe limits. The idea is to get people to look at their own drinking levels, which is exactly the point that the member made.
The words to stress are "their own". We are talking about individual levels. That is the way forward, but we have to recognise that each individual has a different sense of what is good for them and of what may lead to an adverse effect.
Essentially, Scottish people do not need to be told by their Government exactly what volume of alcohol is acceptable and what is not, but they should be prepared to let the Government advise them on how to think about and conceptualise the act of drinking. The way to accomplish that is through effective education and not rigid standardisation.
Other institutional reforms have been proposed recently—the cabinet secretary referred to some. They include the banning of deals on cheap alcohol. That might prove to be an ineffective and possibly unjust solution to the problem. Although it might be easier and more financially convenient for an individual who has a drinking problem to continue drinking if it comes at a low price, it is also perfectly reasonable to infer that, if an individual has a drink problem, the cost will not be material. It is equally reasonable to assume that such sales will usually be utilised by responsible drinkers who simply know a good deal when they see one. The fact that one can buy 12 cans of beer for the price of six does not necessarily mean that one has to drink the 12 cans within the same period of time in which one would normally drink six. Old-age pensioners might utilise such a deal to buy two weeks' drink, for example, but they will now be prohibited from doing so.
Does the member agree that the evidence clearly shows that rates of consumption have gone up? Where young people are concerned, there is a direct correlation between consumption and price.
I will explain where my concern lies. Suppose a supermarket does a deal that involves selling 12 cans of lager for the price of six. If an old-age pensioner who typically drinks two or three cans at the weekend goes along and buys 12 cans, he will take four weeks to drink them, and he will save money. Is that a bad thing? Of course it is not.
I turn to the question of licensed alcohol distribution. The cabinet secretary was right to point out that there is irresponsibility in how alcohol is sold by some people. We must therefore focus on that irresponsible minority in the licensed trade who are prepared to sell drink, in particular, to underage people. We must make it clear that continued behaviour of that type will result in the loss of licences and we must demand that licensing boards be much more proactive than they have been until now. People must not be able to sell drink to underage people with impunity and retain their licences. That message must be sent out loud and clear.
As I said, there is a wide consensus around this issue. My one objection is that the innocent are being punished along with the guilty. Nevertheless, we will work with the Scottish Government to achieve a tightening up of the existing licensing regime. I am convinced that a happier position can be achieved if we work together.
I move amendment SM3-681.1, to leave out from "notes the importance" to end and insert:
"and underlines the fact that those who do so should face losing their licences; notes the importance of close co-operation with, and support of, Scotland's police forces and licensing boards in this respect, as well as developing a long-term strategy to tackle the negative effects of alcohol misuse, and further notes the need for the NHS to play its part in early identification and intervention for those individuals drinking at harmful or hazardous levels."
I welcome the cabinet secretary's securing of this debate on alcohol. I also welcome many of his remarks, particularly those on the importance, difficulties and culture of alcohol in Scotland, together with the alarming and staggering figures that we must face. The Liberal Democrats are clear that tackling alcohol misuse must be viewed as a key public health priority; that is why I, as health spokesman, rather than a justice spokesperson, am leading for my party in the debate.
We welcome the attention that is being devoted to the issue during alcohol awareness week. Like other MSPs who attended last night's event, I was staggered to discover exactly what one alcohol unit really means. It was important to find that out. That relates to the point that Shona Robison made in her intervention about the need to be much more aware of levels of alcohol, and to the point that Bill Aitken made about people knowing their personal limits. We are also clear that we need to change not just the culture but the individual's perception of that culture. It is important that the individual must take responsibility for his or her behaviour when consuming alcohol.
Our concerns about the motion are genuine. The cultural aspect indeed underlies the problem and, although we accept that the criminal justice system has a key and vital role to play, and will be a vital buttress to any societal change on which we embark, we do not view it as providing the essential thrust of how we tackle the problem.
I have two issues with the wording of the Government motion. Having looked for historical precedents, I am concerned about the view that alcohol must be accepted as being different from any other product. Of course it is harmful, as are other products, but history tells us that, when we seek to set a substance apart, that does not effect a cultural change, but has quite the opposite effect.
Is the member suggesting that the ways in which alcohol is promoted that I mentioned in my speech are acceptable? Is it acceptable that beer is displayed with the barbecue charcoal or that wine is displayed with a variety of other products? Does the member not accept that there is a subliminal message, but that we are talking about a commodity that is vastly different, given its effects?
That is not the point that I am making, although I can see where the cabinet secretary is coming from. History shows that there is a danger in the sort of wording that is used in the motion. That is not to say that we do not understand the problem that the cabinet secretary mentioned.
The second difficulty that I have with the motion is one that Paul Martin raised. It concerns the curious notion that we should simply seek to get those who profit from alcohol to deal with the costs. Premises may be run successfully by responsible landlords who choose to take steps to exclude from the premises persons who are not drinking responsibly. Profit is not the criterion that we should use in judging whether to deal with people. We must be clear. Rather than deal with the generality, as stated in the motion, the licensing boards and courts must deal with the people who create the problem.
As the cabinet secretary said, there is no one solution—the matter is complex and requires sustained commitment from everyone involved. We must start with education, as Bill Aitken said forcibly. I cannot recall a single visit to a school in recent years when the question of alcohol abuse did not arise and the pupils did not say how ignorant they were of the effects of alcohol and the impact that it has on them. As Bill Aitken said, we must start with education, both at home and in the education system. We must bring that together, as well as considering what we do in relation to the media.
Producers and retailers have a key role. They have signed up to the responsible drinking agenda, which is helpful. We heard at an event last night that some producers are moving rapidly on the labelling issue, which is to be warmly welcomed. The Liberal Democrats welcome the fact that a range of information will now be included on labels. As a minimum, labels will have unit consumption data, a sensible drinking message and the recommended guidelines. That is important. We also think that we need to do more on alcohol treatment, which Paul Martin mentioned. I hope that the cabinet secretary is making a serious bid in the spending review for increased funding during the next period for rehabilitation and other matters. We need to care for people, notwithstanding the points that Paul Martin made.
Cheap alcohol is a problem, but we must consider the matter carefully. I take the cabinet secretary's point about deep discounting and I certainly wish to exclude that, but it is odd that, as a nation that has one of the highest levels of duty, we still appear to have a major problem with pricing. We need serious research on how we can best tackle the problem, although some of the bans that the Government has introduced will be helpful. We need to extend the test purchasing schemes that have been introduced and review the progress of the challenge 21 scheme.
In changing perceptions, we must begin from the premise that alcohol is a public health and cultural issue. We should use all the resources that are available to us in a co-ordinated way to bring about the right result. We should acknowledge that the criminal justice system is a buttress to that and not the lead party.
I move amendment S3M-681.3, to leave out from first "notes" to end and insert:
"welcomes Scotland's first Alcohol Awareness Week and calls for a co-ordinated approach by all relevant stakeholders to tackle the problems of alcohol misuse that are a key social and public health priority; recognises that tougher action against those who sell and promote alcohol irresponsibly is a necessary step but must form part of a comprehensive strategy that emphasises the importance of education and addresses the social and cultural factors related to alcohol misuse; believes that this policy framework must strike a balance between state and individual responsibility and must not be overly reliant on the criminal justice system to bring about the changes desired, and calls on the Scottish Government to commit additional investment to treatment and rehabilitation."
We move to the open debate, with speeches of a tight six minutes, please.
We have heard and will hear more about the strategies that have been suggested for educating consumers on the dangers of excess alcohol consumption and about the justice system's role. I will say no more about those aspects of the alcohol challenge, except to make a plea to encourage licensed premises to make available a wide range of attractive non-alcoholic drinks at competitive prices. A glass of orange can occasionally cost more than a pint of beer, which is clearly wrong.
I draw the Parliament's attention to projects such as Albyn house in Aberdeen, to which people whom the police find to be drunken are taken for care and recovery. Regular attenders can be counselled and offered help, which is a far more humane and efficient way of tackling the problem than throwing someone into a police cell and giving them a criminal record the next day.
I will consider the part that the national health service can play in helping individuals who have an alcohol problem through providing appropriate treatment and support to those who wish to have help in giving up alcohol. In 2003, 42,000 people visited their general practitioners with an alcohol-related problem. In my practice, a patient survey some years ago showed that more than one in 10 men over the age of 45 who lived in a particular housing estate had an alcohol problem. There is no reason to believe that the situation is any better today, and the true picture is likely to be even worse, as that survey included only people whose problem was known to the GP, whereas many who have an alcohol problem hide the fact—it is a silent epidemic.
When we consider the ways in which we respond when someone with an alcohol problem seeks help, an immediate obstacle becomes apparent. The voluntary organisations and other organisations that offer help are often poorly co-ordinated and the quality of service varies greatly from one area to another. Unfortunately, the treatment service that the NHS offers is—like many others—top down rather than from the grass roots up. Typically, a huge population may be served by an alcohol problems consultant, who has perhaps a few hospital beds. Below that level will be a few psychiatric nurses who specialise in alcohol problems. A person who requests help wants it now, not after the many weeks that pass before a referral to the area community psychiatric nurse is rewarded by an appointment.
What is needed is a refocusing of our efforts so that plans are laid to respond immediately a person asks for help. In the health centre or surgery, receptionists, nurses and doctors must know the appropriate response and who to approach for further help. Doctors and nurse practitioners must acquire the knowledge and confidence to initiate brief pharmaceutical detoxification programmes. The specialist CPN can fulfil an educational role as well as providing a second specialist opinion when treatment problems arise. The alcoholic epidemic is too overwhelming for us to pretend any longer that we can rely on a highly specialist service to cope with the challenge unaided. Part of the knowledge that all need to acquire is of services that exist locally, such as Alcoholics Anonymous, and in which circumstances their skills can assist.
The urgency and size of the problem make it unfortunate that, although alcohol screening and brief interventions have been made one of the nine possible services for 2007 to 2009 that are listed in the recently announced Scottish enhanced services programme for primary and community care, health boards and community health partnerships have to choose only three of those services to implement. Furthermore, I gather that some organisations, including NHS Lothian, have chosen not to make alcohol services part of their enhanced services. I have no doubt that they have their reasons, but how they can ignore the most major health problem that faces us is beyond my comprehension.
All is not lost, however. NHS Health Scotland is funding a steering group to develop a co-ordinated national drugs and alcohol strategy. It aims to have an implementation plan in place by spring 2009 and the description that I have read suggests that that plan might achieve some or all of the desirable objectives that I have outlined. Those of us who have worked in the field are used to false dawns, but let us hope that the strategy will succeed—the health and happiness of many thousands of Scots and their hard-pressed families depends on it.
One of the most harrowing experiences I had as a social worker was taking into care, in the early hours of a morning, a young baby of about six months whose mother and brother had died in a fire. The fire had started after the father had come home from the pub drunk, had been smoking, and had fallen asleep—members can imagine what happened.
Today, alcohol is a direct factor in more than half the deaths that are caused by fire in Scotland. The tragic accident that I described took place in the mid-1980s, and our drinking culture has changed dramatically since then. Research has been done into the misuse of alcohol in pregnancy—others will speak about that—into alcohol in the workplace and into different types of alcohol culture in Scotland.
The evidence is there, but the question is how we pull it together. How do we introduce education, information and—very important—enforcement strategies that will make the changes that are needed to support those who have a drink problem? Good practice exists: Claire Baker and others will give good examples of it later. However, the statistics are still bleak. Binge drinking remains common. It is clear that many people, especially young people, go out solely to get drunk. They do not go out to have a drink; they go out to get drunk. The most difficult problem for us is in trying to change that culture.
Education, with agencies working together and exchanging information, will help. However, alongside that there must be tougher intolerance of excessive drinking and its subsequent behaviour. How many of us in the chamber can honestly say that we have never encouraged somebody to take that extra drink, particularly if they are a happy drunk? The attitude is that they might not be a good singer, but it is okay to let them have another drink because they are a good laugh. There is a bit of responsibility on us to think about how someone like that got the money to drink and what they might do when they go home.
What can we do to change things? There are some hard political choices to be made. We will be accused of being a nanny state and of the infringement of people's civil liberties and rights. Paul Martin has shown in the Local Government and Communities Committee how Labour tried to pursue the issue of the social responsibility that lies with those who sell alcohol. It appears that the Scottish National Party Government is moving in that direction.
Paul Martin has also spoken about the need for stricter enforcement. We need hard-hitting messages about drink-driving, for example, not only at Christmas but throughout the year. Further, I still have concerns about a drinks industry that spends more than £200 million a year on advertising and sponsorship. I would like to see the end of sponsorship for sporting and entertainment events that target young audiences.
Young people in Scotland have the highest level of drinking and drunkenness in Europe. It is not just about going out for a drink—they have to get drunk. Alcohol education is patchy and there is a need for a review. We need to explore the contribution that is made by the multi-agency teams and voluntary organisations—I am not sure that we are managing that integration—and ask whether the intervention is happening early enough.
As Dr McKee knows, intervention is difficult. Those of us who have worked with problem drinkers of all ages know that our contribution is worthless if they are not ready to give up the drink, or at least control their drinking. We must recognise that, in some cases, the nature of the work will mean that we will be in legitimate conflict with those whom we are tasked to help. For example, if I had a referral from a court or a children's panel to go out and help someone and give them support, I could talk from then to the next Sunday, but it would be no good if the person did not want to be helped. Believe me, working with problem drinkers is not easy, particularly for those on the front line.
It is not easy, for example, for someone to go into work on a Monday morning to be told that they have a referral for a family in which the father is in hospital because he is drunk and the mother is in a terrible state because she and the kids have been battered. The worker may not have heard of the family before and not know who they are, but they have to make a cold call to the family's door to try to help them and try to get the father to look at his drink problem, which is the last thing that he wants to do. It is all right having all the ideas about enforcement and working together, but at the end of the day somebody will have to do that job—that is where we must put our support.
I am well within my time, because I know my job, so I will ask three or four questions. Will the minister give us an update on the industry partnership agreement? Where does the 2007 alcohol action update sit and does the minister think that it needs more investment? Will the minister consider introducing standardised alcohol education in schools? With regard to health, the motion says that the NHS will play its part; I am not sure what that means. I would also be interested in an update on the national licensing forum.
We can make a difference through strong enforcement; sticking by our commitments; good, sensible multi-agency working with the industry and with Government; and a strategy that we can all sign up to. Judging by what the cabinet secretary has said, we are halfway to doing that. We can go some way towards changing the drinking culture of this nation, but, believe me, it is a hard job and it will take us a long time.
In August 1994, while I was on holiday in Austria, I got the phone call that no one wants to receive. My mother called me to tell me that my father had died. Although she told me that I did not have to return home to Scotland to attend his funeral, I felt that it was my duty to do so.
My father was a chronic alcoholic, and it killed him at the age of only 57. By then, he was a wreck of a man—the pregnant skeleton that Dr McKee and Dr Simpson would recognise as being the end stage in the life of an alcoholic. In the last 25 years of his life, I do not think that I saw my father sober more than half a dozen times. Over those years, I doubt that anyone in our home had a decent, uninterrupted night's sleep. We had a terror of the clock striking 10, because that was when the pubs closed and my father was due home. As a result of that, my sister left home at 15, and I soon after, at 17. My mother felt that it was her duty to stay, and to stand by my father to ensure that he had a bed at night, and a meal, on the rare occasion on which he was capable of consuming one. Such years of love and devotion demonstrate loyalty that is often unrequited.
Of course, my father did not recognise that he had a problem until he was unable to deal with it. In his view, the fact that he was able to get up for work in the morning meant that there was not really an issue. I have no doubt that my upbringing was not so different from that of many, many thousands of Scots who have had their lives blighted by the problems of alcohol. It is extremely important that the Parliament does whatever it can to change attitudes and behaviours in that important area.
The protection of children from the adverse impact of alcohol is fundamental. At the very least, society must do its utmost to protect those who are the most vulnerable: our unborn children. As members will be aware, on 27 September I submitted motion S3M-561, headed "Alcohol and Pregnancy: A Dangerous Cocktail", to highlight the impact of alcohol on unborn children. I am indebted to Gail Grant of the British Medical Association for providing me with a copy of "Fetal alcohol spectrum disorders—a guide for healthcare professionals". Subsequently, I have received welcome assistance from Paula Evans of Children in Scotland.
Foetal alcohol spectrum disorder covers a wide range of disorders, encompassing everything from behavioural problems to extreme physical and neurodevelopmental disabilities. There is no cure. FASD is a lifelong medical condition that can prevent children from succeeding in school, leading healthy lives and becoming productive adults. It is, by its nature, extremely difficult to diagnose. Indeed, if we compare figures from other developed countries, not least the United States of America, we can see that it is likely that the condition is seriously underdiagnosed. As a result, it is difficult to ensure that the needs of a child with FASD, and its most severe manifestation, foetal alcohol syndrome, are met. Prevention is the key, which is why it is of some concern that six out of 10 women in Scotland drink during pregnancy.
How much is safe for a pregnant woman to drink? The chief medical officer sensibly suggests nothing at all. The BMA, the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives support that view. It is vital that that position is promoted by the Scottish Government. No one really knows how much alcohol, if any, it is safe to imbibe in the womb. Each foetus develops neurologically at slightly different rates, and although the pathways are the same, it is not known when a specific development may occur and when a child may therefore be vulnerable to alcohol in the womb. So why take risks?
Down south, the National Institute for Health and Clinical Excellence suggests a maximum of no more than 1 to 2.5 units a day, which is not far short of what is suggested for an adult woman who is not pregnant. What does that mean, though? A card that I picked up in the Parliament at lunch time tells us that 25ml of gin, rum or vodka represents 0.9 units, with an alcohol level of 37.5 per cent by volume, while 175ml of wine, at 12 per cent volume, is 2.1 units. It is extremely difficult for people to get their head around that, which is why I suggest that the Parliament should promote the view that no alcohol should be drunk during pregnancy. In the USA, all bottles containing alcohol display a warning that simply states:
"According to the Surgeon General, women should not drink alcoholic beverages during pregnancy".
I support the BMA's recommendation that further research into FASD be conducted. Guidance and training for health care professionals on the prevention, diagnosis and management of FASD should be implemented at the earliest possible opportunity. Public awareness of FASD and the adverse effects of alcohol in general should be raised.
We need to place a higher priority on dealing with addiction and must increase funding to tackle it. In schools, a comprehensive education programme needs to be introduced, starting at primary school. It is my understanding that education on alcohol misuse is patchy. We need intense public information campaigns to bring home the health and social impacts of misuse. Those must be helped by responsible promotion by the industry, which must include clear labelling—I have touched on that—and sensible drinking messages.
As the cabinet secretary indicated, we need a crackdown on underage drinking, including action to stop the deep discounting of alcohol—especially alcohol bought in bulk—which is one of the reasons that I welcome the motion. A zero-tolerance approach by law enforcement agencies towards alcohol misuse on our streets is essential.
With a comprehensive, co-ordinated national strategy for the treatment of alcohol addicts and alcohol misuse, we can take a major step towards reducing some of the severe problems that we encounter in the streets and homes of Scotland due to alcohol misuse.
I welcome alcohol awareness week and its efforts to encourage sensible drinking. However, as other members highlighted, an unhealthy attitude towards alcohol remains across all sectors in Scotland. The abuse of alcohol not only damages the individual concerned but has a major impact on friends, families and communities—Mr Gibson spoke powerfully about that.
It is undeniable that alcohol costs our society dear in many ways. We are witnessing an explosion in alcohol-related health problems, while alcohol-related violence and other antisocial behaviour remain unacceptably high. Underage drinking rates are also worrying. The latest SALSUS national report shows that 36 per cent of 15-year-olds and 14 per cent of 13-year-olds reported drinking alcohol in the last week. However, it would be wrong to think that unhealthy drinking is confined to young people, men, deprived areas or city centres at the weekend. Unhealthy relationships with alcohol exist in families of all backgrounds, in all areas of Scotland and across all age groups.
Those are the problems, but what can we do about them? I will focus on two alcohol-related issues in particular: underage drinking and drinking in pregnancy. I will try not to repeat points that Mr Gibson made, many of which I agree with.
For young people, alcohol can be a gateway to risky behaviour—unprotected sex, violence and, more generally, an air of invincibility. Early alcohol misuse can be an introduction to illegal drugs or to smoking under age. Also, drinking under age can lead to a legacy of misusing alcohol later in life. Many members represent communities where the extreme antisocial behaviour that is driven by underage drinking is threatening and highly disruptive. In the environment of the inevitably macho group mentality of teenagers—boys and girls—binge drinking can and has become the norm. If binge drinking is acceptable at 12 or 13, by the time a young person reaches 18, unhealthy drinking habits will already be entrenched and ingrained. I am pleased that the cabinet secretary accepts Labour's amendment on that issue.
The proper enforcement of the age limit for buying alcohol is crucial. The rise in the age for purchasing tobacco to 18 gives the Parliament an opportunity to introduce new measures to enforce rigorously the age limits that we have in place. I hope that, along with any new initiatives on underage drinking, resources will be provided for proper enforcement of the age restrictions for smoking and alcohol consumption. Too many retailers regularly sell alcohol to people who are under age.
I urge an extension of the test-purchasing scheme. The results of the pilot that was conducted in Fife were worrying: 26 per cent of retailers in west Fife and 16 per cent of those in east Fife failed the test purchase. Retailers should be supported in enforcing age restrictions, but there should also be heavy punishments for those who are caught selling to underage children.
As well as working to reduce the supply of alcohol for underage drinking, we need to reduce the demand. In my region, the Drug and Alcohol Project (Levenmouth) started an initiative in partnership with Fife Constabulary that targets underage drinking and deals with it holistically. The initiative is one of the first of its kind. When an underage drinker is picked up by the police, they are referred as a case to project workers at DAPL, who visit the family and work through any related issues with them. Working in that way, we can try to tackle the root causes of underage drinking. It is essential that projects such as DAPL have secure funding to provide a much-needed community service.
The second issue that I highlight is alcohol and pregnancy. From the moment a woman becomes pregnant, she begins to influence the future child's life chances. Her decisions on smoking, alcohol, diet and her own well-being all have implications for the future child. The lack of clarity in the recommended drinking levels and information on the potential health impacts of alcohol has made it difficult to deliver a coherent message to pregnant women. At the extreme, alcohol can cause permanent damage to embryos while they develop in the womb and can cause foetal alcohol syndrome, which permanently impairs brain and nervous system functions. However, there are increasing concerns that drinking alcohol during pregnancy can lead to a wide range of disorders and there has been a clear move towards supporting a precautionary principle.
Although it is socially acceptable for women to avoid soft cheese and peanuts during pregnancy, avoiding alcohol seems to be a different matter. The unhealthy relationship with alcohol that we have in this country seems to make abstinence from certain risky foods far easier than abstinence from alcohol during pregnancy. However, the evidence is inconclusive and the matter must be approached in a sensitive and reasonable manner. Women must be able to make informed decisions. To enable that, the Government must work closely with the medical profession; guidance on alcohol consumption should contain specific advice on drinking and pregnancy; and any voluntary labelling initiative with alcohol producers should include information on the risks and potential consequences of drinking while pregnant.
Alcohol awareness week is about changing our drinking culture. The Scottish Parliament has done much to recognise Scotland's problems with alcohol. Although problem drinking is an issue throughout the UK, Scotland has particular health, crime and social consequences that arise from our relationship with alcohol, and we all have a responsibility to recognise and address that.
Excessive alcohol consumption is a growing problem throughout Scotland, including in my constituency in the Borders. Lifestyles and the way in which alcohol is presented have changed. Increasingly, alcohol is used simply as a means to get drunk as quickly as possible rather than as a means to relax and socialise. Recent statistics show that alcohol abuse is extending its harmful effects to include increases in crime, death, disease and the consumption of alcohol among underage children.
We believe that the problem deserves immediate attention and effective laws, not only to address the problem and find solutions but to raise public awareness and prevent the future growth of alcohol abuse in Scotland.
The excessive alcohol consumption in Scotland in recent years has been highlighted in a number of studies. Some suggest that alcohol consumption in Scotland has risen by 23 per cent in the past 10 years. In 2002-03, the economic cost of alcohol misuse in Scotland was estimated to be £1.1 billion per annum. In 2003-04, more than 26,000 people were admitted to hospital with alcohol-related illnesses, and in 2005 there were 2,372 deaths with alcohol as an underlying factor.
The member makes an important point, but the early stages of alcohol-related brain damage result in repeated admissions, so the important point is not just the high number of admissions but the fact that people go round and round. When I was working as a consultant in addictions, alcohol and drugs in August, I did a case study with someone who had ARBD and discovered that they had 11 separate records. The disintegration of the service, to which other members referred, is difficult.
Indeed. I agree.
Men and women in Scotland drink more frequently than men and women in England. Men and women in Scotland are also more likely to exceed the daily benchmarks. Scotland has one of the highest rates of alcohol consumption in the United Kingdom, and we rank among the top 15 countries in the world on this issue.
Excessive alcohol consumption has also contributed a significant amount of crime—something that was all too apparent to me during my night shift with the Hawick police service. It was reported in 2001 that one in six road accident deaths in Scotland was due to drink-driving, and that one in three accidents in which adult pedestrians were killed on the road was due to a drink-driver. In addition, alcohol is a factor in over half the deaths caused by fire in Scotland.
A recent survey reported that 93 per cent of those surveyed believed that crime was a problem in Scotland; the only issue that was considered more problematic was drug and alcohol abuse. The survey also reported that, among respondents who were able to say anything about the person or people who had committed a crime, 45 per cent said that the person or at least one of the people was under the influence of alcohol at the time.
The increase in the abusing of alcohol consumption has also proven to have severe effects on health. It has contributed to a number of liver diseases and other alcohol-related diseases. The national health service alcohol briefing in 2003 reported that 42,000 people had visited their GP with an alcohol-related problem. In addition, one in 10 accident and emergency admissions in Scotland can be attributed to alcohol. The number of patients discharged from hospital with alcohol-related liver disease has more than doubled in the past 10 years.
The growing problem of the abusing of alcohol consumption has had the most shocking effects on children. A significant part of the problem of the increased consumption of alcohol by children in recent years—which also adds to underage drinking—is the alcohol obtained in off-sales. According to the "Alcohol Statistics Scotland 2007" survey, between 1990 and 2004 there was an increase in the percentage of alcohol sales made through off-trade premises and a decline in on-trade sales. The second most common way for children to buy alcohol was through an off-licence shop, with 7 per cent of 13-year-olds and 19 per cent of 15-year-olds obtaining alcohol in that manner.
The Licensing (Scotland) Act 2005 introduced measures to simplify the licensing regime, but it failed to introduce any measures to curb underage drinking. Instead, it targeted the majority of Scots who use alcohol sensibly, and it passed the costs of policing on to premises that are not responsible for bad behaviour.
Although Scotland's problem of excessive alcohol consumption has grown significantly in recent years, it is a problem that can be resolved with increased awareness of the harmful effects of alcohol and with more effective legislation. Education on those harmful effects is imperative, especially for young children. Policing of licensed premises is necessary, and stricter enforcement will involve co-operation between the police and, importantly, the licensing boards. Businesses that conduct themselves irresponsibly should lose their licences, but responsible sections of the trade should not be penalised.
We welcomed the recent partnership announcement between the previous Scottish Executive and the alcohol industry—especially the suggestion that there should be a crackdown on owners of licensed premises that sell alcohol to underage drinkers. Scottish Conservatives have called for that before; we have also called for businesses to become more involved with those initiatives.
Excessive alcohol consumption is a problem that not only can be prevented from growing but can be eliminated. With increased education and stricter legislation aimed solely at the irresponsible licensees, that can be achieved.
Scotland's somewhat unhealthy relationship with alcohol is nothing new, as most of us know. The scale of the problem is obvious; it is growing and has been for many years. However, as previous speakers have said, this is a cultural issue. We almost sanctify the dissolute life—in many tracts of our literature, both popular and classic, and in our cultural icons. We need look no further than the Canongate church and the life of Robert Fergusson, or the back issues of our newspapers, national or local, to see that we have a long history of alcohol abuse one way or another.
Today's debate is far from the first to try to find some solutions—nor is it likely to be the last—as politicians have been tinkering around with legislation on the issue for many years. In that regard, I welcome the thrust of the approach that the cabinet secretary has said that the Government intends to take.
In my view, the problem is substantially an historical, cultural and attitudinal issue, which cannot be changed simply through criminal justice measures. That approach was tried in the United States in the 1920s, but it resulted in a whole lot of unforeseen circumstances. Therefore, let us be cautious about supporting the effectiveness of extreme legislative change as some kind of magic bullet. We need to tackle our attitudes and social norms root and branch, so that we deal with the foundations of the problem.
Will the member explain what he believes are the extreme legal interventions that the Government is proposing? I view our regulations on liquor licensing as perfectly moderate. From where does he get the adjective "extreme"?
I did not actually connect the word "extreme" with the cabinet secretary's proposals. He should listen carefully.
Even a Liberal, Lloyd George, attempted to solve the problem in 1916 by nationalising the pubs in Cumbria to stop Scots coming across the border to get alcohol. Despite a raft of measures that included a ban on the buying of rounds—some members might be sympathetic to the idea of reintroducing such a ban—his attempt was not successful. Anecdotally at least, the measure led to a substantial increase in the production of illegal alcohol. That draconian step—bear in mind that I am describing a Liberal policy, rather than a Scottish nationalist one—remained in force until the 1970s, but it made no difference whatsoever to the consumption of alcohol in and around Carlisle.
No one doubts that in Scotland as a whole—and certainly among some teenagers—there has been a dramatic and substantial increase in the consumption of alcohol, but please let us be careful. Please do not let us use the increased consumption levels of a minority of teenagers as another weapon with which to demonise our teenagers and young people by calling them not only antisocial hoodies but drunken antisocial hoodies. Let us be very careful about doing that.
As Ross Finnie said, the problem is substantially a public health issue. Figures from the BMA, the NHS and Alcohol Focus Scotland all bear that out. Effective action requires a multidisciplined, joined-up approach as the way forward.
We must be cautious about using taxation and pricing as control mechanisms. Although loss leading by the retail trade is, if not illegal, morally questionable, research evidence from the Amsterdam Group and the University of Copenhagen goes some way towards undermining the claim that pricing and taxation are an effective way of proceeding. It seems significant, if not a little contrary, that alcohol consumption by young people has steadily climbed in northern Europe countries such as Denmark, Sweden, Finland and the UK—where the laws and taxes on alcohol mean that the prices are among the highest in the world—whereas such consumption has remained at substantially the same levels in southern European countries such as Greece, Portugal and Italy, despite the fact that alcohol is much more readily available and much cheaper in those countries. Consumption levels in those countries have been stable and consistent since the 1960s.
As Ross Finnie said, the problem is substantially a public health issue, for which a stand-alone criminal justice approach will not work. I welcome the cabinet secretary's announcement that the Government intends to have a co-ordinated strategy. The Government and the Parliament need to ensure that we enforce the current legislation and engage in health education and school education, but we also need to ensure that the industry—both retailers and producers—takes on board its responsibilities. At the moment, the industry sometimes seems more than a little disingenuous.
We must tackle the problem with a united front; it is not a matter for party-political division. I look forward to cross-party support for the measures that will be introduced.
I would like to address three issues. The first is the size of the problem. The second is the existing recommendations for maximum consumption. The third is the vexed issue of discounting.
All members have alluded to the size of the problem. I have heard a lot of statistics but not the figure that I am about to give to the chamber, which may put the issue on a sensible footing. The average intake of alcohol in the UK, as calculated by HM Revenue and Customs, is around 19g per day. If we assume that only adults over 16 drink alcohol—clearly a doubtful assumption, but it will get us a number—that equates to 23g per day, which is almost three units per day. Even though the figure makes no allowance for any alcohol that may be imported from the continent or for anything that may find its way into the system illegally, that means that every man and woman over the age of 16 in the UK population drinks the equivalent of a pint and a half every day of every week of every year of their lives. That number gives members some idea of the problem that exists, because it is an average—we all know folk who drink nothing like that much.
The recommendations to which Kenneth Gibson referred have been criticised recently for being no more than guesswork. We would really like science and epidemiologists to tell us something like the following: every member of the population who consumes more than 1,000mg per week of vitamin G17 will be fine, but every member of the population who does not will get fungiitis after 20 years. The example is completely made up, so members should not quote me on it. The point is that the statistics do not come out like that. The statistics lean in one direction or another, and that will always be the case. The best answer that we can get is that the relative risk of liver disease is twice as great in men and women who drink between two and three units of alcohol per day as it is in those who drink one unit or less. If people drink four or more units per day, the risk is about five to seven times as great. That is a real figure. The nature of the available science is such that we can do no more than say that four units sounds like a sensible norm. I ask folk to recognise that all recommendations are based on that kind of science and not to expect the science to be more accurate than that—frankly, it is not going to be.
Bill Aitken, who is no longer in the chamber, argued against measures to prevent discounting. From my experience of working in a soap business, I know that there are good reasons for putting bars of soap in packs of four. It makes life a great deal easier in the factory and in the transport system. The product is also much easier to handle in the shop, and it is much easier for people to put into their bags and troll off home with. There is real value in bundling that works its way right the way through the system and reduces costs for all concerned. There must be a similar effect with cans and bottles of alcoholic drinks, although I suspect that it is rather smaller.
However, I have no problem in recognising that alcohol is different; in large quantities, it is dangerous stuff. I would have no problem in saying that the unit price of my can or bottle must be the same, regardless of whether I buy one or 20. If that causes other people a problem, perhaps they should think about why that is the case. Given that many folk are not very good at resisting what they think is a bargain, and those are probably the kind of people who will suffer from an alcohol problem, we owe it to them to eliminate the kind of bargains that are doing them no good at all. We should have the courage of our convictions on the issue. Discounting is not allowed in pubs, and it is not obvious to me why it should be permitted in shops or supermarkets.
I welcome the opportunity to participate in this debate, as the issue that is being discussed is important not only to parts of Scotland, but to every neighbourhood and all individuals who make up our communities.
It is right to acknowledge that drinking alcohol is not a bad thing per se, but the effects of misusing alcohol are, unfortunately, a problem for far too many people in our society, whether they are users of alcohol or sufferers at the hands of those who drink to excess. Indeed, the misuse of alcohol has probably become the major source of most of society's ills—literally, in respect of its health impacts.
Alcohol is a powerful drug, but it can be a source of enjoyment if it is used properly. That is the problem that we must face in debates on alcohol or alcoholism. Alcohol is too often a problem, but we can do more than hope that it will not be a problem for ever. As members have said, we must change attitudes so that alcohol use can be more of a social and health benefit—if that is possible—than a problem.
That was why I welcomed the enactment of the Licensing (Scotland) Act 2005 in the previous parliamentary session. It was the first legislation for many years that not only attempted to tackle how the sale of alcohol was regulated but tried to educate those who mistreat drink into adopting more appropriate alcohol-related behaviour. I took slight issue with Hugh O'Donnell when he said that we had tinkered around with the issue for too long; in fairness, no one could say that the 2005 act tinkered around with the issue. It addressed the fact that its subject matter was not only a criminal justice issue but a health problem that cost our national health service more than £1 billion a year. One in 10 accident and emergency admissions was attributed to alcohol. People who lived in the most deprived areas of Scotland were four times more likely to die an alcohol-related death than those in less deprived areas. We could no longer allow such things to happen, and we tried to ensure that they did not.
That the act aimed to tackle underage and binge drinking in particular was vital. The attitudes of far too many people towards drink were becoming alarmingly dangerous. That was why we focused on bringing into the licensing regulations many modern social trends that had overtaken the existing legislation, such as dial-a-drink services and party limousines. Members who were also members in the previous session will be sick of hearing me banging on about those two things, which I did as the Licensing (Scotland) Bill went through the Parliament. However, the police raised such issues with me because they had identified that no legislation existed to allow them to deal with the trends that had emerged. Such issues were having such an immediate impact on the attitudes of young people that addressing them became important and the bill was the vehicle that allowed us to consider them.
It is right to blame underage drinkers for much of the havoc that alcohol can bring to society, but we must be careful not to single out a particular group, because the misuse of alcohol is a widespread problem that occurs across all age groups and social backgrounds. In fact, alcohol-related hospital discharges are most common in the 45 to 54 age group. That certainly surprised me and such statistics may surprise many other people.
Licensed premises that make money from the sale of alcohol must recognise that they are part of a community and that they provide a service that is unlike any service that other businesses provide. Given that such premises have an impact on wider society, we should ask them to pay a bit more if they do not provide their service responsibly. Therefore, I support the cabinet secretary in holding licensees to account for the social problems that they exacerbate as a result of their poor sales practice, just as I supported Paul Martin when he first raised that issue in 2005. I am sorry that other parties that were represented in the chamber failed to give their support, but it is a case of better late than never, I suppose.
I pay tribute to Kenny Gibson in particular for his speech. My parents were teetotallers, and I did not have to endure the types of experiences that he obviously had to. When I was thinking about what I would say, I wondered how I could bring some reality to the debate. The only story that I could think of was a light-hearted one that a friend told me recently. I do not want to tell it because I want to tell a joke; rather, I want to make a point.
The story is about a married couple who were sitting in a restaurant one evening. At an adjacent table, a woman was becoming uproariously drunk. Most people in the restaurant were being distracted by her, but the woman in the couple noticed that her husband was paying particular attention to the drunk woman and her behaviour, so she asked him why. He said, "You don't know this, but I was formerly engaged to that lady. It was about 10 years ago, before we were married." He went on, "I have had a happy life since that time. She has taken to drink in the manner that you see throughout all that time." His wife said, "That's a long time to celebrate."
The point is that people see the use of alcohol differently. We have to strike a balance on the issue. Some will use alcohol appropriately and others will not. Some licensees will take their responsibility seriously while others will be more lax. Some people think that alcohol is evil and want it to be restricted; others see it as a good thing and want easier access. If the minister gets the balance right, I will support his efforts to address one of Scotland's most serious problems.
There has been a degree of consensus in today's debate, as there is in the motion and the amendments. Consensus can be a good thing, but there are times when it hides uncertainty, perhaps between the different approaches that Michael McMahon outlined in his closing remarks.
The motion and the amendments say a great deal about determination to tackle the problem, about how it is a great public health challenge, about long-term, comprehensive, and co-ordinated strategies, and about co-ordinated approaches by stakeholders, policy frameworks, and the like.
I am reminded of our recent debates on the idea of a smoking ban. We were conscious that it was a bold, clear, radical, public health measure that would have an impact. In considering the various proposals on alcohol—there are lots of them, and some of them are minor—with which most of us agree, I find myself worrying that none of us yet knows which ones might work and how well they might work. If there is a radical public health measure for alcohol that is politically acceptable, I am not sure that I have yet heard it. However, there are some ideas in the Government's motion and in the amendments, so I will be happy to support them even if I might have liked them to go further.
There is no getting away from the fact that some aspects of the problem are urgent and widespread—but they are not new. Binge, underage and excessive drinking, or drinking to get drunk, were not invented in the 20th century, but there are new aspects to the problem. What are they? There have been trends in the industry during recent decades—I would say specifically since the 1960s—that were conscious, deliberate and designed to increase consumption without regard to their impact on health or society. New products were introduced, such as lager in the 1960s, to replace drinks that took longer to drink. More lager can be consumed in a certain amount of time, and so more can be sold over the bar. Such products also changed the tone and culture of pubs; they brought in a younger generation who could be more easily encouraged to drink more substantial amounts more quickly.
Since then, other products have been introduced—pre-mixed drinks, alcopops and other sweetened and flavoured drinks—that were designed to promote unhealthy consumption. Changes in the pub and retail industry have also brought about the same effect, whether we are talking about mega-pubs, which have fast employee turnover, poor training and fewer social connections between the buyers and sellers of drink, or whether we are talking about supermarkets. I have argued much the same case about the big four supermarkets over a range of areas in which they overuse their market dominance.
Kenny MacAskill said that alcohol is not like any other product; I argue that, too often, the industry is regulated much like any other industry.
Alcohol is a legal recreational drug that I enjoy myself and I would not want to say anything that could be misinterpreted as being puritanical. I cannot help but recall the stage 3 debate on the Licensing (Scotland) Bill, in which I perceived something of a—no doubt unintentional—judgmental undertone. After all the calls for national restrictions on opening hours, irrespective of local knowledge or circumstances, and all the expressions of concern about impacts on communities having too much access to alcohol, we trooped downstairs to the huge trays of wine that awaited us at that evening's reception.
I do not think that anyone intended to be contradictory or hypocritical, and I would not want to make such accusations, but we have created around us a working environment that promotes unhealthy drinking. Only very rarely on a Tuesday, Wednesday or sometimes Thursday evening does a glass in this building go without being refilled.
We need to resolve the tension between public health priorities set by the Government and personal freedom. That will not be easy in this case. We could do it with the smoking ban because that was about recognising the freedom of non-smokers, but such a measure does not exist in relation to alcohol.
If we are going to restrict anyone's freedom, we should begin with the industry that has up to now exercised its own freedom without any reference to public health.
As members have already said, according to Alcohol Focus Scotland, alcohol problems cost the Scottish taxpayer an estimated £1.1 billion a year in their effects on the NHS, social work, police and emergency services and in wider economic costs. Indeed, there are also unquantifiable human costs. That figure is not surprising when one considers the recent NHS Scotland briefing that pointed out that one in 10 accident and emergency admissions in Scotland can be attributed to alcohol and that alcohol-related deaths, which now stand at 2,000 a year, have more than doubled over the past decade. Those figures are a stark reminder of the scale of the problem.
Most disturbing was the research highlighted by Children in Scotland, which showed that one in every 100 live births suffers from foetal alcohol syndrome. The statistic suggests that, of the 55,000 Scots born last year, 550 had FAS. Kenny Gibson and Claire Baker have already highlighted the problems associated with the condition, and the emotional hardship and trauma faced by the families and children who are affected each year by this completely avoidable affliction are truly upsetting.
Scotland's drink culture was recently the subject of a study by Scottish Health Action, which revealed that 47 per cent of men and 36 per cent of women consume alcohol to dangerous levels. The message is clear: Scotland has an unhealthy relationship with alcohol and measures must be taken to tackle it.
Kenny MacAskill has already sent out a clear message that we will no longer tolerate either unruly behaviour motivated by alcohol or the outdated and irresponsible use of alcohol as a scapegoat by those who commit crimes while under its influence. I also welcome his call to extend to off-licences and supermarkets laws that already ban irresponsible promotions in bars, as the availability of cheap booze deals has undoubtedly played a significant role in the fermentation of Scotland's binge drinking culture. Martin Woodrow, the secretary of the BMA in Scotland, welcomed Kenny MacAskill's announcement by stating:
"the Scottish Government is taking the nation's alcohol problem seriously. We support these tough measures to end the deep discounting of alcohol by off-sales and supermarkets which, in some cases, has led to alcohol being cheaper than bottled water."
For the sake of the nation's health, we must seek to change attitudes and behaviour towards alcohol. It is time that we engaged the public and broadened the debate, and Scottish alcohol awareness week is the perfect platform in that respect.
Will the member give way?
I am sorry; I do not have much time.
This is not about forcing people to change; it is about making them aware of the facts to allow them to reach their own judgments on the basis of solid medical evidence.
A reduction in the legal drink-driving limit would help to focus people's minds on the dangers of drink. For the past few months, I have been working on a campaign to reduce the legal drink-driving limit from 80mg to 50mg of alcohol per 100ml of blood because I firmly believe that the issue is intrinsically linked to the alcohol debate as a whole.
I decided to pursue the matter after learning that, during a two-week campaign in August, Northern Constabulary caught 28 drivers who were over the limit and after reviewing Scottish Government figures that highlighted the fact that the number of people who are involved in accidents and who have been drinking is 27 per cent higher in the Highlands and Islands than it is in the rest of Scotland. On Scottish roads, one in six road accident deaths are due to drink-driving, which equates to around 60 deaths per year. It would be a great step forward if we could save even one of those lives.
Lowering the legal drink-driving limit is by no means a new issue—the European Commission has been pressing for a reduction in the UK limit for the past six years. The UK is now one of only four European Union nations that have a drink-driving limit of 80mg per 100ml. The remaining 23 EU member states have a limit of 50mg or less.
The UK Government has claimed that the issue is under review and that it will debate its findings in the new year. I would like the limit to be reduced throughout the UK, but if Des Browne fails to act on a UK level, I want action to be taken in Scotland. Unfortunately, the signs of a UK solution are not hopeful. The UK Government has had the findings of the UK Parliament's Transport Committee for a year, but the secretary of state still talks about formalising arguments. Frankly, I am not prepared to sit and wait until another life is lost as a result of drink-driving. Westminster should either reduce the limit or give us the power to do that in Scotland.
I take the opportunity to build support in the Parliament for a reduction in the legal drink-driving limit. I have lodged a motion that points out the needless loss of life that drink-driving causes each year on Scotland's roads and which asks for support for the undeniable case for lowering the limit to 50mg. I hope that I can count on all members' support.
I am pleased to take part in a debate on alcohol during alcohol awareness week. This week we have heard and read many facts and figures about alcohol usage, some of which are truly shocking. If one types the words "Scotland" and "alcohol" into the Google search engine, it produces more than 2 million results. Scotland has an unfortunate reputation on alcohol.
The other 2 million figure that is associated with Scotland and alcohol is the £2 million that the NHS in Scotland spends every week to deal with the misuse of alcohol. As members of all parties have pointed out, the true cost of alcohol abuse in Scotland is staggering. The entire nation suffers the health, safety and financial consequences of the drug. Criminal justice and emergency services spend more than £5 million each week on what are described as human costs.
Most people use alcohol sensibly but, as has been said, it takes a heavy toll on others. It sometimes results in personal breakdown and family break-up and it is implicated in antisocial behaviour on the streets, psychological damage to children, drink-driving, violent crime and suicide. A major consideration is that alcohol, unlike other drugs, has not been criminalised. I believe that we cannot make significant progress and necessary changes if we deliberate solely on alcohol consumption and do not consider the connections with other drugs and their use.
The fundamental question to ask might be, "Why do people take drugs?" The answers will, of course, be wide ranging, but each of us must take responsibility for our actions and returning to a state of prohibition is not the solution. Addressing excessive alcohol consumption is a worthy goal for the Parliament, but if we do not address the underlying causes, there is a danger that we will merely place an ineffectual sticking plaster over deep-rooted issues.
I urge close consideration of the gender disparities in drinking culture, but not only because of the danger of foetal alcohol syndrome that Claire Baker and Ken Gibson mentioned. I emphasise that it is important that we do not spread panic among women, who will often not know that they are pregnant until a number of weeks—in some cases, a number of months—have passed. Stress and anxiety are also harmful in pregnancy.
Current media scrutiny has served to highlight the genuine challenges that women face as alcohol continues to take its toll on some women's lives. Alcohol-related deaths among women doubled in the past decade. Excessive alcohol consumption can be catastrophic for women, because our physiology is not equipped to deal with too much alcohol. A woman's liver takes longer to recover from damage and cleanses the body of alcoholic toxins more slowly than does a man's liver. Women undergo many more physical changes during their lifetimes than do men, which has a direct impact on their ability to deal with alcohol effectively and safely.
However, it seems that more and more women are using alcohol to cope with stress and problems, for example as a result of their roles as a parent or carer. Some women use alcohol as a prop—a crutch—to help them cope with exhaustion, isolation, relationship difficulties and work. The list of serious life challenges for women that has been produced by Libra, a counselling service for women, demonstrates that there are no easy answers. Libra considers the issues that underlie drinking, which range from worries about money, housing and employment to depression, abuse and eating disorders. It is essential that services such as Libra are supported and available throughout Scotland.
Given the evidence that members have talked about, I welcome BMA Scotland's five-point plan to tackle alcohol misuse in Scotland. It represents an important step towards improving health and addressing the social implications of alcohol abuse. In particular, I welcome BMA Scotland's call for mandatory labelling of alcoholic drinks. It is as important to label drink as it is to label food, as Alcohol Focus Scotland says.
We need to work to prevent young people from buying alcohol by enforcing age limits more strictly, particularly in off-sales premises. I welcome acceptance of the Labour amendment in that regard. Such work needs to be accompanied by sustained public education about the misuse of alcohol and about healthy living and well-being. Short-term campaigns that change attitudes towards alcohol misuse are commendable.
I commend motion S3M-668, in the name of Bill Wilson, on pilot studies in Scottish educational institutions to consider perceived norms of alcohol and tobacco consumption. Members of all parties should support the motion. I hope that gains that are made from such studies are not short term and continue beyond the survey period, so that a lasting change in attitudes towards alcohol use is achieved.
We have had a good debate. I welcome the debate, particularly as it has taken place during Scotland's first alcohol awareness week. On behalf of Liberal Democrats, I echo Paul Martin's words on the work of Alcoholics Anonymous and other bodies in the field.
I welcome the Cabinet Secretary for Justice's commitment to address alcohol misuse. The issue was considered by the previous Executive, but it is an on-going problem for society in Scotland. As members from all parties have said eloquently, alcohol misuse transcends social barriers. It affects rich and poor, male and female, young and old, from cradle to grave. It can shatter families, destroy careers and ruin lives—Kenny Gibson made that point powerfully. It is a problem for individuals, families, communities and the nation.
Behind the statistics that members have mentioned are people whose lives have been affected by the most intoxicating and seductive of legal drugs. Shona Robison was right when she said earlier this year that we should develop a long-term strategy that changes attitudes by "de-normalising excessive drinking" among not just young people, but all of us. Members of all parties have accepted the challenge and acknowledged that there is no magic bullet that can solve the problem. There is a need for a comprehensive strategy that offers a holistic approach that covers different strands, in and out of the Government.
Ross Finnie, John Lamont and other members talked about the major public health challenge and the impact of alcohol on our national health service. Alcohol also presents a challenge for our education system. It is essential that we talk to our children about the importance of a sensible approach to drinking. It is equally important that we listen to our own advice.
As justice spokesperson, I am acutely aware of the impact on communities of alcohol misuse and binge drinking. Nearly half Scotland's 7,000 prisoners say that they were drunk when they committed their offence, and 70 per cent of people accused of murder had been drinking or taking drugs.
Across Scotland, serious and minor antisocial behaviour is fuelled by a heady cocktail of underage drinking, cheap alcohol and peer pressure. According to Alcohol Focus Scotland, drink is a factor in 62 per cent of domestic abuse incidents. When they have been drinking, people often put themselves into greater danger than they would when they were sober. The point was well made by Trish Godman when she talked about alcohol and death caused by fire—an issue that has affected some of my constituents.
There is a need for greater clarity, across the board, about what are safe limits. I am thinking in particular of the safe limit for drink-driving. Liberal Democrats seek a reduction that is much in line with the view that Dave Thompson proposed. We are committed to a range of measures that we believe would help to tackle the problem. We support many of BMA Scotland's recommendations, including that for more research into the impact of pricing. As Hugh O'Donnell said, it is still unclear that pricing mechanisms are effective in discouraging alcohol consumption. It is certainly clear that pricing mechanism are not enough in and of themselves.
The Licensing (Scotland) Act 2005 included measures to target deep discounting and promotions in licensed premises. I support plans to extend those measures to cover supermarkets, off-licences and other outlets. The former Local Government and Transport Committee, of which I was a member, took that approach in its scrutiny of the bill—we were seriously concerned at the impact of the off-sales market.
However, we must base the introduction of any such measures on evidence. Across Scotland, we must also make use of test purchasing and bottle marking schemes, to help gather evidence locally for use nationally. We must also bear in mind the impact of such measures on small corner shops, which exist on tight margins. We are in the kind of territory where throwing one pebble into the river will cause a great number of other things to happen. That is an argument not for doing nothing, but for ensuring that we know the response to and the results of the actions that we may take.
We must improve access to counselling and rehabilitation for people with an alcohol problem—that point was well made by Ian McKee, Richard Simpson, Trish Godman and other members. Our manifesto committed us to doubling the funding for drug and alcohol treatment—more than £100 million of additional funding. I hope that that is the kind of approach that the cabinet secretary will take.
Given the key part that alcohol plays in offending behaviour, it is essential that schemes such as Sacro's alcohol education prohibition—that was a Freudian slip—probation service are supported. Given that two thirds of prisoners say that their drinking is a problem, it is essential that they are given an opportunity to address their alcohol problems while they are in prison.
When we were in government, we introduced pilot test purchasing schemes and we support their introduction across Scotland. We also support bottle marking schemes that identify who is selling alcohol to underage drinkers. I strongly believe that we should take tough action against those who persistently supply alcohol to those who are underage. Ultimately, they should have to face the consequences of their actions and pay the ultimate sanction of losing their licence. Their actions are driven by greed, and they should pay the price. The result of their actions should result in an impact on the economy of their business.
We are willing to investigate ways to ensure that those who profit from alcohol pay for the consequences. We will support the SNP motion at decision time. However, as Ross Finnie highlighted, there are inherent difficulties in making the proposal work on a case-by-case, local basis. We are talking about not only underage drinking outside off-sales, but the need for the pub trade to do a lot more in refusing to sell alcohol to people who are clearly drunk. The trade must take greater responsibility than it has in the past.
Such a measure would place restrictions on sensible drinkers, too, but the price is worth paying for the greater good. I believe that the 93 per cent of Scots who view alcohol as a social problem will also agree with that.
I agree that the debate has been a good one in which many excellent speeches have been made.
In particular, I commend the last line of the Government's motion, in which it
"notes the need for the NHS to play its part in early identification and intervention for those individuals drinking at harmful or hazardous levels."
I look forward to hearing further information from the cabinet secretary on that. As many members, including Kenny Gibson, said, help comes only when someone recognises that they have a problem. Often, someone seeks help only when they have lost their job and family and they are in dreadful health.
An article in The Press and Journal this week highlighted the problem of drink and young offenders. The article was based on research by the governor of HMP Barlinnie and academics at Glasgow Caledonian University. It was found that, in 1979, just under 50 per cent of young offenders aged between 16 and 21 were drunk at the time of their offence. That figure has risen to 74 per cent this year. Another startling comparison that the study revealed was that, in 1979, 7 per cent of young offenders were drunk daily before they were convicted of a crime, whereas the figure today has rocketed to 40 per cent. Those are alarming figures that alone undoubtedly justify the holding of alcohol awareness week and of this debate.
Dave Thompson spoke about the Highlands, where there are particular issues. According to the recent crime figures, the recorded rate of drunkenness in the Highlands is high, and it is rising at a faster rate than anywhere else in Scotland.
It is right, during Scotland's first alcohol awareness week, to highlight the fact that the consumption of alcohol has increased by 23 per cent over the past decade. That has a cost for people all over Scotland—in health, justice and social services—of more than £1 billion per annum, not to mention the huge cost on families, with up to 100,000 young people living with a parent who has an alcohol problem. That is why the Scottish Conservatives will continue to work towards our manifesto commitment to invest £100 million in drug and alcohol detoxification and rehabilitation facilities. That is a clear investment to save, not only in public services and health but in supporting families. That point was acknowledged by Kenny Gibson.
Twenty-five per cent of women in Scotland exceed the recommended daily limit, which has contributed to the doubling of alcohol-related deaths among women over the past 10 years. More than half of all alcohol-related deaths have a diagnosis of alcoholic liver disease, and the problems are worsening. The number of patients who have been discharged from hospitals in the Highlands with alcoholic liver disease has trebled over the past decade. In the Western Isles, it has quadrupled.
On the subject of labelling, the Minister for Public Health said in an interview on 22 October:
"It can be difficult to know how much you are drinking when drinks can vary so much in size and strength."
If I have learned something this week, it is that one glass of wine is not the same as another glass of wine—it is not a homogenous product. We sometimes get conflicting messages. We are often told that a glass of wine at night is good for our health, in particular the circulation, but we do not know whether the alcohol content of that glass should be 3 per cent or 14 per cent. The Scottish Conservatives would welcome and support clear information on the strength of drink, which should be more clearly labelled.
We acknowledge that many people drink more than the recommended limits and that many people have serious alcohol addictions, but what happens when they ask for help—for detox and rehab? I agree with Paul Martin about the excellent work that Alcoholics Anonymous does. I point out to Ian McKee that Beechwood house in Inverness is a similar facility to the one in Aberdeen that he mentioned.
I asked a parliamentary question on detox and rehab. I was initially told that the information is "not held centrally". The answer from the Cabinet Secretary for Health and Wellbeing on 3 August was:
"The varied range of alcohol detoxification and rehabilitation services and the different ways of accessing these services has meant it is not possible to collect waiting time information.
We will give further consideration to the feasibility of collecting such information in the future."—[Official Report, Written Answers, 3 August 2007; S3W-2338.]
I agree with Ian McKee that, when people need and ask for help, they should not be placed on a waiting list and told to come back after a number of months. That is why I raised the issue of waiting times with the Cabinet Secretary for Health and Wellbeing yesterday.
I look forward to the Justice Committee, the Health and Sport Committee and the Local Government and Communities Committee working together to better scrutinise the budget so as to understand where the budget commitments lie in this area.
Many people with alcohol problems have underlying mental health issues, such as depression, but many treatment establishments will treat either alcoholism or mental health. As people cannot be in two places at once, we need to ensure that treatment centres are fit for purpose. I have recently been supporting a constituent who has bipolar disorder and is an alcoholic. According to him, he could find only one place in Scotland where he could have joint treatment, which was the Priory clinic in Glasgow.
I welcome the debate and acknowledge that we still have a long way to go to deal with the alcohol problem in Scotland.
As others have said, we are not the moral majority on alcohol—Patrick Harvie is right that we are not in a position to be that. However, we are identifying that we have a drinking culture and a trend of heavy consumption of alcohol, with corresponding disastrous effects. The cabinet secretary talked about the statistics on the relation of alcohol to murder and death and we have heard from others about the impact on women's health. It is clear that alcohol is, first, a health and welfare issue, but that a bit of enforcement is required to act as a deterrent.
Setting the boundaries through enforcement is key to tackling the complacency that the cabinet secretary talked about. It sends a message to those who sell alcohol that there will be boundaries and that we will regulate if necessary, although in the wider public interest and not just for the sake of it. If we see irresponsible behaviour and difficult consequences, we should act. We need to turn round the idea that we do not have a big problem in Scotland—we need a new social responsibility. I hope and believe that there is consensus among the parties in the Parliament on the need to create a renewed social responsibility.
I am pleased that the cabinet secretary has agreed to accept the Labour amendment, which is on underage drinking, an issue that is important to us and which other members have talked about. Underage drinking can be harmful to young people. However, as Michael McMahon pointed out, it is important that we do not demonise all young people because, in 2004, 32 per cent of 13-year-olds did not drink at all and, of those who did, 42 per cent did so only occasionally. In tackling underage drinking, we are trying to prevent a culture from developing and becoming the norm.
We are thinking about the safety of young people and about the zero-tolerance approach in communities, which Paul Martin talked about. It is odd that the police can stop anyone in the street—not just a young person—who has bought a product illegally and then pour it down the nearest drain, but that they can do nothing further. It is worth considering what should happen next in such situations—we should consider giving the police powers to refer. We are particularly pleased that, in accepting our amendment, the Government is, I presume, accepting our point that a summit involving all the parties and the wider stakeholders would be useful. I agree with Bill Aitken that enforcement is important in relation to licence holders and that we should take a hard line on that.
Assurances are needed. The Scotch Whisky Association, which has briefed us all, has concerns about where we might go on the matter. We must assure many people that our aim is to tackle the long-term behaviour of heavy consumption, not drinking in moderation. I want to talk about the boundaries for the sale of alcohol. I agree with Ross Finnie that education is key and that there is a welfare issue. However, we have a responsibility to set the parameters for the sale of the source of the problem. For today's purposes, Labour agrees with the principle of not ruling anything out. We must get across the message that the act of sale does not end the seller's responsibility. There is a fine line in determining which types of sale to restrict to reduce heavy consumption, because we do not want to penalise those who drink safely. Therefore, we must discuss the finer detail of how to achieve that.
We must examine the fact that the huge cost of dealing with the consequences of irresponsible behaviour is paid for exclusively by the public purse. Labour has already signed up to the notion that those who benefit may have to pay some of the real costs. I believe that that is heading in the right direction.
I will say a word or two about Michael McMahon's work on the Licensing (Scotland) Act 2005. The issue is not only about pubs and clubs; it is about supermarkets and anyone who has a licence. Anyone who has been in Hope Street on a Saturday night will have been staggered—I was, certainly—by the number of limousines and the size of them. They are getting bigger and bigger. The people who pour out of those limousines on to the streets are clearly not sober. The serious point is that those operators must be covered by the act and must pay for the consequences of the behaviour of people who spill out on to the street.
Not long ago on the same street, the police could do nothing to close down a club at which serious and violent assaults took place. That situation must end. I hope that the cabinet secretary will come to my constituency, which has the highest concentration of clubs and pubs, to see some of the policing challenges in Glasgow city centre. I am sure that that would be a teetotal night.
I will finish by discussing scrutiny of the 2005 act. The cabinet secretary can correct me if I am wrong, but I have been advised that he said no when the chair of the licensing forum asked to meet him to discuss the act's impact and delivery. Perhaps the cabinet secretary will clarify the position. I am a wee bit concerned that, despite the excellent work that members did to develop an act to promote responsibility and safe drinking, some people think that the act will deregulate licensing. Clubs and pubs are already extending their hours in the expectation that the act will deregulate the licensing regime. Some serious discussion must take place to ensure that the act's intention comes to fruition. I hope that the cabinet secretary is prepared to meet all those who are responsible for implementing the act in the way that the Parliament intended.
In the short time that I have, I cannot summarise all the speeches. The debate has been productive and excellent. Dr Ian McKee talked about places of safety—the idea is good and worthy of consideration. Kenny Gibson made a brave speech and I am sure that we all thank him for bringing his experiences to the chamber. It is a tragedy for families to live with the abuse of alcohol. Paul Martin and Mary Scanlon were right to talk about the value of Alcoholics Anonymous, which has been an important organisation for many people. Claire Baker, Trish Godman and Marlyn Glen talked about the gender issue and foetal alcohol syndrome.
Labour supports a radical approach on alcohol misuse. The Government has our support in that direction, but we reserve the right to discuss the detail of proposals. The tide is turning and we will support the changes, which we hope will be made on a cross-party basis.
It is clear from today's constructive debate that awareness is growing of the problems that alcohol misuse causes. They range from short-term and long-term physical and mental health harm to antisocial behaviour and the damage that is done to our communities and to all our efforts to help Scots and Scotland reach our full potential.
Tackling alcohol misuse is Scotland's top public health priority. As members heard in the Cabinet Secretary for Justice's opening speech, the figures are frightening: one Scot dies every six hours as a direct result of alcohol. As a nation, we have one of the fastest-growing liver cirrhosis rates in the world, not to mention the huge cost to the NHS of that alcohol misuse. Everybody accepts that we cannot sit back and do nothing; we must think seriously about alcohol's place in Scottish society.
We must make it clear that the Scottish Government is not anti-alcohol, but anti-alcohol misuse. We acknowledge that alcohol can be enjoyed sensibly and responsibly as part of a healthy lifestyle—after all, it features in many aspects of our lives, from social gatherings to celebrations—but too large a proportion of Scottish adults regularly drink more than is good for their health.
We must dispel the myth that alcohol-related health harm is a problem that affects only those with a chronic alcohol dependency or so-called binge drinkers, although I recognise the harm that chronic alcoholism does to families, as Kenny Gibson showed in his personal account of that impact.
We also recognise the impact of young binge drinkers, but we all have to accept that anyone who regularly drinks even a little too much can put their health and well-being at risk in both the short and the long term. It is that part of society, which includes all of us and our families and friends, that puts the real burden on the NHS, when people's drinking comes back to haunt them after a number of years.
That is why it is so important, as a first step, to ask the Scottish public, through the national alcohol awareness week, "Does your drinking add up?" This week offers a fantastic opportunity to get Scots talking about alcohol, not only about units, but about their own drinking habits in relation to sensible drinking messages. It is also an opportunity to show what can be achieved when the industry, health professionals and the Government work together in partnership.
I thank colleagues in the Scottish-based alcohol industry for stepping up to the mark on this issue and showing leadership in promoting responsible drinking. However, as a Government, we will ask them to go further. Whether they will come with us on that journey remains to be seen.
More needs to be done. The time has come to take action to match the scale of the problem of alcohol misuse in Scotland. We must ask ourselves where we want Scotland to be in 10, 15 or 20 years. If the long-term trends in increasing alcohol misuse and in alcohol-related harm continue, the future of Scotland looks bleak. We do not want to sit idly by and allow that to happen.
We want to live in a country in which people live longer and enjoy better health and well-being as a result of having fewer alcohol-related problems. We want people to enjoy a better quality of life because they are less likely to become victims of alcohol-related crime or violence and more likely to live in cleaner, quieter streets and communities. In the Scotland of the future, Scots would view as unremarkable someone deciding not to consume alcohol, either as a one-off or in the longer term, and would be able to make informed choices about their alcohol consumption and its potential consequences. Scotland should enjoy a healthy culture of sensible alcohol consumption.
So how do we get there?
Order. Apologies, minister—there are too many conversations. Members have all day to talk to each other. They do not have to do it in the chamber.
Thank you, Presiding Officer.
We will continue to deliver the commitments that have been set out in the updated plan for action on alcohol problems. I commend the previous Administration for publishing that work. However, we are clear that to complement that action, a longer-term approach is required, if we are to tackle Scotland's complex relationship with alcohol and deliver the change in attitude that we all seek. We will work together across the Government to identify effective, evidence-based interventions to tackle the problems associated with alcohol misuse.
Members have heard about the range of measures that will be introduced under the Licensing (Scotland) Act 2005, but that is only one part of the solution. The role of education is being reviewed to ensure that there is a more consistent, standardised and effective input into schools. Trish Godman requested that that be done—it is essential that it is. We need to ensure that others, such as the NHS, play their full role, recognising that much more can be achieved in partnership than can be done alone on such a complex issue. It is important that clear messages are given out, such as the chief medical officer's advice to pregnant women that no alcohol is the safest route. A number of members raised that issue during the debate.
On implementation, will a national licensing forum be called into existence? I understand that that has not happened so far.
A national licensing forum was wound up by the previous Administration. Its role was to advise on the development of the Licensing (Scotland) Bill. However, we will keep the issue of such a forum under review, and if we think that there is a place to re-establish it, we will consider that.
Returning to the NHS—this is an important point—brief interventions have been shown to be successful in leading to a reduction in alcohol consumption among harmful and hazardous drinkers. Current best practice is published as guideline 74 by the Scottish intercollegiate guidelines network. It recommends that, when patients attend primary care settings with symptoms that may be linked to alcohol, staff should ask about alcohol consumption. To ensure that that is being implemented effectively, we have, as Ian McKee said, made available an enhanced service for alcohol screening and brief interventions through the Scottish enhanced services programme. Let me make it clear—as we did to the chairs of the health boards at one of our early meetings, soon after coming into government—that we expect that to be the core business of primary care. That is what GPs and other primary care staff should be doing as a matter of course, and we will ensure that that is what happens throughout health boards in Scotland. Over the coming months, we will be considering a range of options for effective interventions over the longer term, and we will consult on the new long-term strategy, setting out the direction we intend to take.
We have made a start with alcohol awareness week, which we hope will pave the way for a much wider, productive debate about the place of alcohol in our society.
I thank members for helping us to keep on track in what was a very tight debate.