Chamber and committees

I agree with our stakeholders that progress has been disappointing and I am not entirely sure why it has been so. The consultation on the matter has been delayed by the UK Government, and we do not know when it plans to run the consultation. We are keen to work on a four-nations basis and for the consultation to be across the UK, which we think is the most effective approach. During the pandemic, we have learned a lot about public health, including the fact that, where possible, working on a four-nations basis is absolutely the best way forward. Therefore, we, too, are disappointed that the UK Government’s consultation has stalled. Despite our attempts to get clarity on the timetable, we have not got it. I am disappointed to report that I cannot tell you when the consultation is likely to happen.

I have not had a direct indication from industry. However, one of the things that I regularly say in life is that the most solid predictor of the future is the past. What happened in the past gives us a reasonably solid idea of what could happen as we go forward. It is a multimillion-pound global industry that will want to protect its interests.

If you think about it, that is what the policy was intended to do: it was meant to make alcohol more expensive. What we found was that, before the introduction of minimum unit pricing, it was possible to exceed the 14 units per week recommendation for £2.50. The issue that you raise is not a downside of the policy; the intention was that people would have to spend more in order to buy each unit of alcohol. I might be misunderstanding or oversimplifying your point, but is that not what was meant to happen?

Absolutely. I am always happy to work with the committee.

I am not aware of anything that has been done regarding television advertising. Perhaps Amy Kirkpatrick can tell us what is happening on a four-nations basis.

The study that you have quoted shows that people are buying more expensive alcohol. Other studies show that, at a population level, we are consuming less alcohol—the lowest level of alcohol consumed by people in Scotland for 26 years. Per head of population, we are consuming only 18 units of alcohol a week. That is still in excess of the recommended 14 units and it does not quite explain the whole picture because, within that, there are some people who are abstinent or drink very little, and there are others who drink heavily. However, at a population level, both points are true: we have reduced the amount of alcohol that we drink; and the alcohol they we are buying to drink is costing us more. However, that second point is in line with what the WHO said that we had to do in order to tackle alcohol harm, which was to make alcohol less affordable.

In this policy area, I probably cannot. Brexit is a very recent phenomenon, so when we think about how our systems are working since we left the EU, it is quite difficult to think of examples. However, what you suggest is perfectly possible, if we think about how the structures work. For example, Food Standards Scotland advises the Government on the safety of food products. It might be that the EU body will give the EU different advice and we will decide to stick with the advice that we have been given in Scotland. That is possible.

However, we will align with the EU where we possibly can. It is clear that Scotland did not want to leave the EU, and the Scottish Government is keen that we rejoin it as soon as we are an independent country. In the meantime, we have structures in place that will give us independent advice, and we will make decisions that are best for Scotland at the moment.

In our analysis—and this is why it causes so much concern—the operation of that act means that, irrespective of the necessity or proportionality of any public health priority in Scotland or, indeed, in any other part of the UK, any national measure could be caught and radically undermined by the automatic application of the act’s market access principles. In place of a common framework that is designed to manage policy divergence through dialogue and agreement, we would have, in effect, the automatic recognition of standards that had been set elsewhere, regardless of local circumstances, the wishes of the relevant legislature or the policies of the relevant Administration.

I do not particularly have concerns about the framework. As I have said, it establishes a healthy method of working in collaboration with the four UK nations, a way of resolving conflict, and a way of enabling divergence, should that be required.

I have more concerns about the United Kingdom Internal Market Act 2020 on that front. That act tramples over devolution, and it was not consented to by Scotland or Wales for exactly that reason. The public health concerns around that act were well rehearsed as it passed through Parliament. That piece of legislation concerns me. It might well constrain or weaken my ability to take public health action in Scotland, because products that can be sold in England will automatically be able to be sold in Scotland, too.

I am glad to have your allyship on women. As women’s health minister, it would be remiss of me not to highlight the health inequalities that women face.

You are absolutely right: there is a stark social gradient for alcohol harms, with people in the most deprived areas being the most affected. We need to take a whole-population approach when tackling alcohol consumption and the risk of alcohol-related harms, which will, in turn, drive reductions in alcohol harm in our most deprived communities. Whole-population measures such as minimum unit pricing of alcohol will have an impact in those communities, as well; such measures will not affect just them or rich people but everyone. We will feel the benefit right across society.

I mentioned the study by SHAAP that highlighted the effectiveness of alcohol nurses in deep-end practices in Glasgow. Those nurses support people with alcohol problems who have complex needs. The Scottish Government is really keen to understand that. We find that some people really need effort put in to ensure that they are able to receive joined-up services. There are probably lessons to be learned about improving access to services for everyone across the board, but there is probably a particular population for which we need to do something slightly different. We need to reach out to them, hold on to them and make sure that we do not let go until they are on a more healthy footing. I think that that is what that work was doing, so I am keen to explore that further.

I mentioned the work of the Simon Community in its managed alcohol programme, which is particularly targeted at homeless people. A very small number of people are involved, but we are keen to get the lessons from that to see whether it could make a difference for that population.

My final point—we have had this discussion before—is that we need to think about what drives alcohol harm. We need to tackle poverty and inequalities, we need to provide good-quality, affordable housing and we need to enable children to have the best start in life. We should all be laser-focused on that when we think about tackling alcohol issues.