Question for Short Debate (Lords) on Alcohol Harm Commission: Report 2020 - Apr 22
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Asked by Baroness Finlay of Llandaff To ask Her Majesty’s
Government what assessment they have made of the report by the
Commission on Alcohol Harm 2020 ‘It’s everywhere’—alcohol’s public
face and private harm, published on 14 September 2020. Baroness
Finlay of Llandaff (CB) My Lords, I had the privilege of leading a
group of 16 experts to investigate one of the most pressing issues
of the day: the harm caused by alcohol. I extend my sincere thanks
to each of those 16, who gave...Request free trial
Asked by
Baroness Finlay of Llandaff To ask Her Majesty’s Government what assessment they have made of the report by the Commission on Alcohol Harm 2020 ‘It’s everywhere’—alcohol’s public face and private harm, published on 14 September 2020. Baroness Finlay of Llandaff (CB) My Lords, I had the privilege of leading a group of 16 experts to investigate one of the most pressing issues of the day: the harm caused by alcohol. I extend my sincere thanks to each of those 16, who gave their time and expertise so generously in their dedication to reducing alcohol harm. The findings of the Commission on Alcohol Harm were stark. One cannot overstate the sheer scale of the harm caused by alcohol every day to individuals, those around them and society. Alcohol is linked to 80 deaths every day across the UK and, most worryingly, it kills people when they are young. Alcohol is responsible for more years of working life lost than the 10 most frequent cancers combined. However, the commission found that alcohol harm extends beyond health. We heard a great deal about the impact on families: 200,000 children are estimated to live with an alcohol-dependent parent, making them five times more likely to develop eating disorders and three times as likely to consider suicide. Some children are harmed even before they are born. Exposure to alcohol in the womb can cause foetal alcohol spectrum disorder, a lifelong developmental condition found in up to 17% of UK children. The links between alcohol, violent crime and anti-social behaviour are strong. Alcohol fuels almost 40% of violent crimes and half of domestic violence. Drunk-driving causes almost 9,000 casualties and 260 deaths a year. Police Sergeant Mick Urwin told us that “delivering a death message to a parent, brother, sister, son or daughter to inform them that someone has been killed by a drink driver is not something I ever got used to”. The burden falls on all society, particularly public services. There are 1.26 million alcohol-related hospital admissions annually and alcohol costs the NHS £3.5 billion. The cost of alcohol-related crime is even higher, at £11.4 billion per annum. That is why sentencing to alcohol abstinence and monitoring is so important, with its high compliance rate allowing people to face and tackle their harmful drinking, and it has been shown to decrease repeat offending. The extent of these harms is truly shocking but is no surprise, as alcohol is ubiquitous. That is why we titled the commission’s report It’s Everywhere—a quote from a witness. We heard how alcohol is all around us: at social gatherings, on TV, in supermarkets, card shops and the workplace, and at all times of day or night. People told us they could not escape from alcohol; “relentless” was a word we heard repeatedly. Although national consumption has fallen from 2004’s historical high, especially as more young people abstain, the increases in measures of harm and deaths persist. Alcohol’s harm is often hidden in plain sight, leaving people to deal with it alone, unsupported. The stigma of harmful drinking makes people conceal their problem. Children instinctively understand that they are expected to keep quiet about their parents’ drinking. To quote another witness: “Families and children like us didn’t and won’t discuss it for fear of being separated, being taken away from parents, being singled out ... feeling embarrassed, scared of repercussions and fear of retribution”. The alcohol industry’s “personal responsibility” framing blames individuals for their drinking. Stigmatisation makes it harder to seek help. Blame lies within the product itself: alcohol is addictive. It can turn people’s lives upside down, as anyone listening to “The Archers” at the moment will know. It warrants careful regulation, hence the commission’s recommendations. First, we call for an alcohol strategy. The last was almost 10 years ago. Revision is urgently needed—last year, alcohol deaths reached their highest level since records began. The updated strategy needs to include evidence-based policies to reduce the affordability, availability and marketing of alcohol. These tools, recommended by the World Health Organization, proved effective at tackling tobacco use. Let us look at each in turn. Alcohol harm and price are directly linked. The alcohol duty system is inconsistent and perverse—white cider at 19p a unit feeds addiction. Affordability has grown significantly in the last four decades, driven by low prices in off-trade settings. Cuts to alcohol duty at the annual Budget have not helped—beer duty is now 21% lower than in 2012-13 according to the Institute of Alcohol Studies. We urgently need minimum unit pricing in England, as already introduced in Scotland and more recently in Wales. Tax should be proportionate to the harm caused. The commission heard from witnesses how the constant availability of alcohol affects those who drink. One individual told us: “My dad can’t help drinking. Every day we need bread, milk etc from the shop next to our house. When he goes in, the temptation is too much for him. It’s not his fault when it’s staring him in the face. Maybe if we didn’t live near a shop he wouldn’t be able to get drink as easily.” Local authorities told us that they struggle to reduce availability under the current licensing regime. The UK Government could follow Scotland to allow local authorities to consider public health as a distinct licensing objective when assessing licensing applications. Advertising and marketing set the tone for our relationship with alcohol. The alcohol industry spends hundreds of millions of pounds on advertising, much of which can be seen by children and vulnerable individuals, such as those with addiction. Children’s exposure to alcohol marketing makes them more likely to consume alcohol and to start consuming it at an earlier age. Opinion polling carried out for the Alcohol Health Alliance showed that 75% of the public support reducing children’s exposure to alcohol advertising. Many countries, such as France, restrict such marketing to better protect their populations. We should follow suit. Consumers have a right to know what they are drinking. It is bizarre that currently there are fewer legal requirements for information on a bottle of wine than on a carton of orange juice. Unlike soft drinks, alcoholic drinks do not have to list their calories or sugar content or ingredients. Consumer information is grossly inadequate, as there is no statutory requirement for drinks to carry a health warning, warnings about alcohol in pregnancy, or the weekly guideline for low-risk consumption. Without label information, consumers are unaware of the risks and cannot make informed decisions. Time does not allow me to cover the toll on the NHS and social care, where the burden of alcohol harm ultimately falls. Suffice it to remind your Lordships that alcohol is the leading risk factor for death, ill health and disability in 15 to 49 year-olds in England. It was causal in almost 12,000 cancers in 2015—that is 33 people a day—particularly cancers of the mouth, pharynx, oesophagus, larynx, breast, bowel and liver. It is also a factor in over 200 other diseases and injuries, including hypertension, heart disease, stroke, gastrointestinal disorders, brain damage and mental illness. Deaths from alcohol liver disease have increased 400% since 1970. The Government have tackled tobacco harms and shown in their recent obesity strategy a willingness to take bold action to protect the public’s health. With an estimated 1.6 million adults in England having some degree of alcohol dependency, I hope that the Government will show the same boldness and heed our report’s recommendations. 15:41:00 Lord Brooke of Alverthorpe (Lab) My Lords, I am most grateful to my noble friend Lady Finlay for her powerful introduction. I declare an interest as one of the members of her commission, which she so admirably steered to producing such a wonderful report. In the limited time that we have, I want to focus on calories. I have been banging on about calories since the Labour Government were in power and about the need for calories to be shown on labels for alcohol. Why is the drinks industry exempt from telling people what they are consuming and what it might do to them? I am pleased that we are starting to make some progress. There is a firm recommendation in this report and I hope that the Minister will be positive. One of the old excuses for why we could not do anything was that we were in the European Union and legislation and regulations there prevented us from acting unilaterally. We have now come out of Europe and we now have the freedom to do as we choose. I look to see whether the Minister will take sides on this issue, now that he has the freedom to do so, if required. I had a useful conversation this morning with Sir Keith Mills, who has been appointed by the Prime Minister to review the way in which incentives might be used to encourage people to reduce their weight and exercise more. He is looking at new technologies; there are some developments taking place that are of some significance. I see that the Minister is nodding in agreement, so perhaps when he comes to respond he might say a little more about that. A change would allow an app, on our mobile or on our wrist, to tell us, for all items that have calories marked on them, just what we are purchasing. We would know what is in our shopping basket while still in the supermarket. That would be a big change. We should not permit the drinks industry to be exempt from that change. I hope that the Minister will assure us that the consultation will be concluded soon and the Government will come out with a strong indication that, for the first time ever, we will have formal labelling on alcoholic drinks. 15:43:00 Baroness Randerson (LD) [V] My Lords, I declare an interest as co-chair of the All-Party Group on Liver Health, for which this is a very relevant debate. I thank the noble Baroness, Lady Finlay, for all her work in this field. What do we need to make inroads on this problem? Obviously, first, we need better access to treatment. Secondly, Scotland’s minimum unit pricing saw a net reduction in off-trade sales by 4% to 5% in its first year. That is worth while, but it is not enough in itself. Recent research by Cardiff University—I declare an interest as chancellor of that university—has demonstrated the link between food purchases and alcohol purchases. Buying the food for our meal literally prompts us to pick up the bottle of wine or beer from the next aisle of the supermarket. This research suggests that food and alcohol sales need to be separated and not part of the same trip to the till. Many other countries do this. I recall that in Australia the same supermarket sold both sets of items, but you went to a totally separate section and paid a separate bill for the alcohol. Finland, Sweden, Canada and some parts of the US apply similar rules. The Government should explore this. We need further controls on the advertising of alcohol. Finally, we need more information on labels and when we buy alcohol in the pub. If we buy a lemonade or crisps or a bar of chocolate, we know the calories and contents. When we drink a glass of wine, we deserve to have access to the same information on calories and the number of units. 15:45:00 Baroness Jenkin of Kennington (Con) My Lords, as another of the commissioners, albeit a rather absentee one, I am grateful to the noble Baroness for instigating this debate and to all those who participated in the report either as witnesses or by taking evidence. Its findings were powerful and worrying. The noble Baroness, Lady Finlay, and I worked together in 2011 to persuade the Government to legislate for compulsory sobriety tagging for alcohol-related crimes. The alcohol abstinence and monitoring requirement, which checks offenders’ intake every 30 minutes, was piloted successfully and is now rolled out across the country. There is a clear connection between problematic alcohol consumption and crime, particularly heavy drinking or binge-drinking and violent crime. The most recent findings, from the Crime Survey for England and Wales in 2018, estimate that the proportion of violent incidents where the victim believed the offender to be under the influence of alcohol was 39%. The estimated total social and economic cost of alcohol-related harm in 2018 was £21.5 billion. Reducing alcohol-related crime will mean fewer victims, save taxpayers’ money and have a positive impact in communities and on individuals. The legislation to introduce this solution to alcohol-related crimes took more than 10 years from conception, when Boris Johnson as Mayor of London first asked for it, to final implementation. It is a common-sense, effective, value-for-money solution. Why did it take so long? In the time I have left, I, like others, commend the Government for their commitment to calorie labelling of alcoholic drinks as part of the obesity strategy. Polling shows that the UK public are overwhelmingly supportive of health and nutritional information on alcohol labels. It is clearly absurd that alcohol-free beer, for example, shows nutritional information but ordinary beer does not. This has to change. It is another common-sense, effective policy and I urge the Government to stick to their plans. 15:47:00 Baroness Masham of Ilton (CB) [V] My Lords, I chaired a committee for the Home Office in 1987 on young people, alcohol and crime. Many of the recommendations in this report, ‘It’s Everywhere’ - Alcohol’s Public Face and Private Harm, are similar to those in the 1987 report. After the report in 1987, I learned that advertising for the alcohol industry is powerful, vigorous and effective. To balance that, it is vital that there should be a forceful, effective education policy to alert everyone, especially the young, to the dangers of unwise drinking. I had two goddaughters who died of alcohol harm, and my mother-in-law, who was an alcoholic, also died early. I spent many years working with young offenders and alcohol was one of the problems involved their lives. Alcohol causes so much violence and family stress. Recently, university students have died after rugby initiation drinking games. It appeared that they did not know of the dangers associated with drinking large amounts of alcohol over a short period of time. There should be far more forceful warnings about the dangers of excessive alcohol consumption across the country if we want to save lives. I thank my noble friend Lady Finlay of Llandaff for this report and I hope that the Government respond positively. 15:49:00 The Lord Bishop of Carlisle [V] My Lords, I too congratulate the commission on its work in highlighting the harm caused by the abuse of alcohol. I wish to focus my brief remarks on the relationship between alcohol and domestic violence. The statistics make this clear. Home Office figures indicate that alcohol is involved in up to 50% of cases of domestic abuse, as we were informed earlier by the noble Baroness, Lady Finlay. Though not necessarily a direct cause, it is frequently a significant contributary factor. What is more, when alcohol is involved, the abuse affecting children, as well as adults, is more likely to be serious, increasing the risk of physical, emotional and psychological harm. This has, of course, been a particular problem during the last year with the various restrictions that have been imposed to counter the coronavirus pandemic. The commission’s findings on this, as well as several other types of harm, must surely cause Her Majesty’s Government to rethink the statement made in January 2020 that they “are not planning a stand-alone strategy”—[Official Report, 21/1/20; col. 1043.] for alcohol. It would complement, rather than cut across, proposals made in the NHS Long Term Plan. The commission strongly recommends a strategic approach that would not only address the link between alcohol abuse and domestic violence but take into account some of the factors that frequently accompany harmful alcohol consumption. These factors include educational exclusion, social deprivation, financial distress, employment worries and psychological pressures. I wholeheartedly commend the commission’s proposal that the domestic abuse commissioner role, which is being created as part of the Domestic Abuse Bill, must have a duty to have regard to the link between alcohol and domestic abuse in its work. 15:51:00 Lord Rennard (LD) My Lords, introducing minimum unit pricing for England was a key recommendation of the commission. A strong evidence base for this was provided by a wide range of organisations, including the Children’s Society, the Association of Directors of Public Health, Cancer Research UK, the British Medical Association and several local authorities. A 50p minimum unit price in England has been estimated to lead to almost 22,000 fewer hospital admissions and 525 fewer deaths per year when in full effect. This would save the NHS £1.3 billion annually. As hospitals deal with the consequences of Covid-19, freeing up capacity is essential. People who live in poverty are more vulnerable to the effects of alcohol abuse. It is estimated that nine in 10 lives saved by minimum unit pricing would be from low-income groups. Yet the spokespeople for some business groups and right-wing organisations oppose minimum unit pricing, citing their previously rarely expressed concerns about poverty, when their real concerns are simply about profits. We need to remember that alcohol has a major impact on the public’s health. Alcohol can cause over 200 conditions including cancer, heart disease, liver disease, stroke and mental health problems. When I asked a Question about this issue three years ago, the noble Lord, Lord O’Shaughnessy, then the Health Minister, cited evidence that “in 10 years, minimum unit pricing could on an annual basis reduce alcohol-related deaths by 356, alcohol-related hospital admissions by 28,515, and crime by 34,931 crimes.”—[Official Report, 28/2/18; col. 654.] But we were told to wait for more evidence from Scotland and elsewhere. We now have that evidence. The policy is working in Scotland; it is being introduced in Wales. We should not have to wait any longer in England. 15:54:00 Lord Smith of Hindhead (Con) My Lords, I add my thanks to those offered to the noble Baroness, Lady Finlay, for initiating this debate. I refer the Committee to my interests as set out in the register. I want to make just one quick point today: my belief that we need to be more careful about how we talk about the negatives of consuming alcohol and the need to be balanced in the advice given. Throughout this pandemic, we have seen the effects which lower socialisation has had on people’s health and mental health. I have always believed that a society which socialises together is stronger and healthier. Although alcohol does not have to be integral to a healthy social life, moderate alcohol consumption undoubtedly plays a large part in British culture and the social lives of many millions of people who enjoy pubs, clubs, bars, restaurants or indeed entertaining at home. It is widely acknowledged that the comments made by the previous Chief Medical Officer, Dame Sally Davies, when she said that women should think about the risk of breast cancer every time they reach for a glass of wine, were misjudged. They were ultimately rebutted and reworded, but the horse had already bolted. Another, more recent example is from Drinkaware, which advised people getting their Covid-19 jabs not to drink in the two days before the jab and for up to two weeks afterwards. That advice then had to be dismissed by Ministers and the UK’s Medicines and Healthcare products Regulatory Agency, not least because not one study has tested any correlation between alcohol and the efficiency of either of the vaccines on offer in the UK today, a fact that even Drinkaware acknowledged. Questions should be raised with Drinkaware about how this irresponsible advice could ever have been given, not least by the drinks industry, which for some reason continues to fund it. The problem caused by this type of nonsense advice is that it helps create a sense that all advice on alcohol consumption is nonsense. It undermines sound and sensible advice given by Governments and related health industries. Yes, of course overconsumption of alcohol is unhealthy, but our modern-day temperance movement needs to temper creating fear and to start acknowledging that most people have common sense and just enjoy a modest drink. The Deputy Chairman of Committees (Baroness Healy of Primrose Hill) (Lab) As the noble Baroness, Lady Boycott, has withdrawn, I call the next speaker, the noble Baroness, Lady Fox of Buckley. 15:56:00 Baroness Fox of Buckley (Non-Afl) My Lords, there is always a danger when addressing lifestyle choices that policymakers indulge in overreach. The relentless war on alcohol emanating from public health over recent years is no exemption. This can mean the state trampling on individual agency, a point well made by the noble Lord, Lord Bethell, in yesterday’s Question on obesity. There is another danger when reports are commissioned to look at harms: that they see only harms and see harms everywhere. This can mean a disproportionate focus on risk and a loss of balance. My concern about the direction of this report is that it moves away from the sometimes exaggerated health harms of individual alcohol use into the broader social and economic realms. In doing so, it may deploy guilt by association by linking alcohol and drinkers with reprehensible behaviours such as domestic abuse, family neglect, crime and child suicide and with a financial burden on public services. There is also the danger of conflating causation with correlation. This can mean that harms associated with a small minority are projected population-wide. Indeed, the proposed illiberal solutions, such as minimum pricing, treat everyone as a potential problem drinker and alcohol per se as a harmful substance. Surely we need balance. Alcohol is a legal and enjoyable part of human engagement and relaxed sociability for millions of people. The direction of this report could disproportionately penalise and unfairly demonise the vast majority of those who drink responsibly. Finally, can we remember the hospitality industry? With lockdown, some 10,000 pubs, clubs and restaurants were forced out of business in 2020. That awful loss of jobs and livelihoods looks set to continue. We have seen curfews and pubs open but with alcohol banned in Scotland and Wales. This smacks of a joyless puritanism. I appreciate that I am almost a lone voice here, but there is no democratic mandate for “Temperance UK”. Policy interventions should be targeted, discreet, and aware that alcohol can be harmful but usually is not, and that grown-ups should be free to choose how they use alcohol regardless of risks. 15:58:00 Baroness Walmsley (LD) [V] My Lords, alcohol harm requires a cross-departmental response because of the range of harms that alcohol can cause. That is why I support the call of the noble Baroness, Lady Finlay, for a coherent, cross-government strategy. The commission says, “It’s everywhere”, and it is. Drama can often explore complex issues in real life. The writers of Radio 4’s “The Archers” know that, hence their recent storyline about Alice’s struggles with alcoholism. There are parallels with the obesity crisis, and there the Government have at last recognised that regulation has a part to play. The same goes for alcohol. We live in an obesogenic and alcogenic environment, and regulation can help. For example, people often do not know how much they are drinking or how strong a drink is. I have been asking for two decades for all alcohol to have its calories and alcohol units clearly labelled, but that still does not happen. I hope that will change now. Services are thin on the ground. When police are called to an event of domestic violence, they should be able to link the perpetrator to therapeutic services and the children to social services. But this does not happen because the services are not there. This is crazy because, putting aside the human cost, money could be saved if they were. Are GPs and antenatal clinics confident to ask questions and refer people to alcohol services, where appropriate? Probably not. Finally, the report says that, in Scotland, deprived groups are six times more likely to be admitted to acute hospitals and 13 times more likely to be admitted to psychiatric hospitals for alcohol problems than the least deprived groups. So the matter is often related to poverty. However, poor people can afford alcohol—because it seems to make things better; it is an escape from the misery of people’s lives. If we banish poverty, introduce minimum pricing and provide services, we can go a very long way to solving alcohol harms. 16:01:00 Lord Ribeiro (Con) [V] My Lords, I declare an interest as a fellow commissioner on the Commission on Alcohol Harm. We are all too aware of the impact of alcohol on adults and the increase in liver disease and premature deaths as a result. But it is important to recognise that the genesis of this addiction to alcohol may start with the very young. Our focus should therefore be on the negative effects of alcohol advertising on children. Professor Yvonne Kelly of the department of epidemiology and public health at UCL looked at social media and its impact on alcohol consumption in 6,700 British youngsters. Among 10 to 15 year-olds it was found that those who log on for one to three hours daily were 44% more likely to drink alcohol, while those who log on for more than four hours per day were 89% more likely to drink often. But those with no social media profile were 59% less likely to consume alcohol than those using social media, even those using it for less than one hour per day. Professor Kelly noted that “the pattern…among 10 to15 year-olds in our study is particularly striking, given that the purchase of alcohol for this group is illegal, coupled with the potential problems associated with the introduction of alcohol from an earlier age.” More must be done to protect children from alcohol promotion, including online and via sport sponsorship, as has been done successfully with tobacco advertising—a campaign that focused on the impact of smoking on children. We must now apply those lessons learned to alcohol. Will the Government take note of the WHO recommendation for the enforcement of comprehensive restrictions on alcohol marketing and apply them in the UK? 16:03:00 Baroness Jolly (LD) [V] My Lords, for such an excellent report, two minutes will not do it justice. The commission report that we are debating does not pull its punches and I would have been disappointed if it did. “It’s everywhere”—walk through any town or city centre in the UK from midday onward and it is difficult to miss those sitting on benches, amiable but often addicted to alcohol, drinking their cheap booze, which is often cider. At just over £1 for a litre of a supermarket’s own brand, that is a cheap way to get drunk. For the most part, they make no trouble early on; later, they can become rowdy and, after closing, violent. Local authorities license outlets—pubs, corner shops and supermarkets. Is it really necessary to have five outlets within a three-minute walk for a town with a population of just over 9,000? This all comes at a cost, but, for many, after time, there will be an impact on their friends and families. Addicts are not easy to live with and relationships suffer. Health suffers too. Service providers need to be aware that primary services for those dependent on alcohol need to be fairly close to places of work or home for those who need them. Funding for services for addicts is from local authorities. Can the Minister guarantee that local authority public health services will still be funded through the future health and social care Bill? To move addiction services to the NHS would be a retrograde step. There is also a woeful lack of psychiatrists training in addiction psychiatry in England. Can the Minister confirm that there is a nationwide drive to attract trainees? I realise that there is no instant fix, but how successful are the Government in encouraging young health professionals to train in these areas? 16:05:00 Baroness Thornton (Lab) My Lords, I thought I would read out all the recommendations very quickly. They are: “1. A new comprehensive strategy… 2. Alcohol harm should be a specific part of the remit of the new Domestic Abuse Commissioner … 3. All professionals who have regular contact with children and families must have a core competency to intervene and provide support in cases where alcohol harm is evident … 4. Action to prevent, identify and support Foetal Alcohol Spectrum Disorder … 5. Reduced price promotion of cheap alcohol through increased alcohol duty and minimum prices with regular reviews of prices in relation to inflation and income … 6. Restrictions on availability of retail alcohol through reduced hours of sale and reduced density of retail outlets … 7. Comprehensive restrictions on alcohol advertising across multiple media, including restrictions on sponsorships and activities targeting young people … 8. Alcohol labelling to provide consumers with information about alcohol harm … 9. Treatment and care for alcohol use disorders and co-occurring conditions … 10. Brief psychosocial interventions for people with hazardous and harmful alcohol use, with appropriate training for providers at all levels of healthcare … 11. Action to reduce drink driving”. Almost every one of those has been mentioned in some way or other during this brief debate, so I hand them all over to the Minister, asking whether the Government agree with them. Will they enact them, and in what timeframe? 16:07:00 The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) That is a tremendous challenge by the noble Baroness. I will do my best, but before I do, I congratulate the noble Baroness, Lady Finlay, on securing this important debate. I commend her on her commitment to reducing alcohol-related harm and I pay tribute to her and her team for spearheading the excellent report of the Commission on Alcohol Harm. I welcome the report’s recommendations and the opportunity to debate them. Before I make progress, I shall make a disclosure that my wife is a director of the company Diageo. I acknowledge the report’s emphasis on wanting to change the conversation within society about alcohol and challenge alcohol’s position in our culture. Alcohol is not something which affects only the “weak” or “irresponsible”. It affects many people. We know that most people drink responsibly. I take on board the warnings of the noble Lord, Lord Smith, and the noble Baroness, Lady Fox, that we must be careful about overstating the specific dangers of alcohol or demonising those who drink responsibly. There is some good news in this area: we are seeing an overall decrease in the amount of people drinking, especially young people, which is highly encouraging. But we cannot avoid the fact that there are still those who drink at very harmful levels and where alcohol misuse leads to significant harms for the people involved and their families. I speak as one whose mother died of her alcoholism when I was of a young age, and I know from personal experience the huge impact that alcoholism has on those concerned and their families. We recognise that there is still much work to be done. I completely agree with the rapporteurs that alcohol has large impacts on society that include costs to health, lost productivity and poor quality of life. Excessive alcohol consumption is the biggest risk factor attributable to early mortality, ill health and disability among 15 to 49-year olds in the UK—full stop. It is considered to be the third-largest lifestyle risk factor for preventable diseases in the UK, after smoking and obesity. The Government are committed to supporting the most vulnerable at risk from alcohol misuse. We have an existing agenda on tackling health harms from alcohol, and I would like to touch on some of that today. I completely hear the call of the noble Baroness, Lady Finlay, for a new government alcohol strategy. The Government have committed to publishing a new UK-wide, cross-government addiction strategy. This will consider a range of issues, including drugs, alcohol and problem gambling and will involve many departments at the same time. While each comes with its own set of issues, there are large amounts of common ground and significant benefits in tackling addiction in a comprehensive and joined-up way. The scope of this addiction strategy is still being developed, so this debate is most timely as we consider what more can be done to protect people from alcohol-related harms. On alcohol labelling, the Government completely agree with the noble Baroness, Lady Randerson, that people have a right to accurate information and clear advice about alcohol and its health risks to help them to make informed choices. We have worked with the alcohol industry to ensure that alcohol labels reflect the UK Chief Medical Officer’s low-risk drinking guidelines. The industry has committed to complying with this requirement, and we are closely monitoring progress. As part of the Government’s latest obesity strategy, we committed to consulting on the introduction of mandatory calorie labelling on pre-packed alcohol and alcohol sold in the on-trade sector. This consultation will be launched this summer. My noble friend Lady Jenkin raised the shocking statistic on alcohol-related violence, and I completely agree with her analysis. It is shocking to me that between 2016 and 2018 alcohol was a factor in 66% of violent incidents that took place in the street, pub or club and on public transport; this compares with 30% of violent incidents in the home. Between 2017 and 2019, one in five homicide suspects is recorded as being under the influence of alcohol at the time of the homicide, as is a similar proportion of victims. I have a deep wad of statistics that make extremely grim reading on this matter. On the specific issue of domestic abuse, we are making progress. We know there is frequent co-existence of domestic abuse, mental health problems and the misuse of drugs and alcohol. Research indicates that in 34% of incidents of domestic violence, the victim perceived the offender to be under the influence of alcohol. The Domestic Abuse Bill will see better protections for victims and more effective measures to go after the perpetrators. We will reflect the importance of joining up domestic abuse, mental health and substance misuse services in the supporting statutory guidance. One action of this important Bill is to establish in law the office of the domestic abuse commissioner, with strong powers to tackle domestic abuse. The description of the commissioner’s role states that they must adopt a specific focus on the needs of victims from groups with particular needs, which could include mental health or substance misuse. My noble friend Lord Ribeiro asked about restrictions on alcohol advertising. I remind him that there are already substantial restrictions on the advertising of alcohol, but we are working to review and improve them. The Government are working with industry to address concerns over irresponsible promotions, advertising and marketing relating to alcohol. Material in the Committee of Advertising Practice and Broadcast Committee of Advertising Practice codes relating to the advertising and marketing of alcohol products is extremely robust already, recognising the social imperative of ensuring that alcohol advertising is responsible and, in particular, that children and young people are protected. None the less, the Government are reviewing how online advertising is regulated in the UK, taking into account the many serious points made by my noble friend Lord Ribeiro and looking at how well the current regime is equipped to tackle the challenges posed by the development of online advertising. The noble Baroness, Lady Masham, spoke so movingly about children and family life. The evidence is absolutely clear that growing up in a family affected by parental alcohol dependency can cause significant harm to children’s well-being and their long-term outcomes. Thanks to the personal testimony and campaigning of many noble Lords in the Grand Committee today, the Department of Health and Social Care and the Department for Work and Pensions have together invested £6.5 million on a package of measures, over three years, to improve outcomes and support for children whose parents are alcohol-dependent. The noble Lord, Lord Rennard, asked pressingly on minimum unit pricing. There are no current plans to implement MUP in England. MUP has been in place in Scotland for less than three years and the Scottish Parliament will not consider its extension until April 2024, when much more will be known about the overall impact on consumption. We will continue to monitor the evidence as it emerges from Scotland and Wales. In the meantime, we are committed to reducing alcohol-related harm and so have already banned alcohol sales below the level of duty plus VAT. This means it will no longer be legal to sell a can of ordinary lager for less than 40p. I close by reiterating the Government’s commitment to supporting the most vulnerable at risk from alcohol misuse. We already have a strong programme of work under way to address alcohol-related harms, and the new UK addiction strategy will provide an important opportunity to consider what more can be done. This activity will be informed by the best available evidence, including the report from the noble Baroness, Lady Finlay. I thank her very much for pushing so hard on this important issue and securing such a thoughtful, interesting and passionate debate today, and I thank all noble Lords who have taken part. |