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Alcohol-related Disease

Volume 758: debated on Wednesday 17 December 2014


Asked by

To ask Her Majesty’s Government what action they are taking to address the increase in alcohol-related disease.

My Lords, we have set out the Government’s approach to reducing the incidence of alcohol-related disease in the Government’s alcohol strategy. Our ambition is to radically reshape the approach to alcohol and reduce the number of people drinking to excess. We are seeing encouraging signs of change, with the first significant fall for some years in alcohol-related deaths in England in 2012.

My Lords, I am sure the whole House would wish me to congratulate the noble Earl on being nominated by Health Service Journal as the 29th most powerful person in the National Health Service.

Coming in at 95, I look on with admiration, but from some way behind. Did the noble Earl notice that a Mr Lynton Crosby came 50th in that list? Does he think that that reflects the rather close relationship between the Conservative Party and the drinks industry—and does that explain the outrageous delay in the publication of the Chief Medical Officer’s review of what safe levels of drinking should be?

My Lords, I am sure the noble Lord would not expect me to agree with him on the position of Mr Crosby in relation to the drinks industry. We feel it right to engage with the industry because it is in a position of influence over consumers, and we have seen, through the responsibility deals, some real progress, which it has instigated at our prompting. I recognise the issue that the noble Lord raises on price. That, of course, is only one aspect of the issue of alcohol consumption and its prevention.

My Lords, I declare my interest as professor of surgery at University College London. A recent Lancet commission on liver disease in the UK has identified alcoholic liver disease as an increasing cause of mortality in our country. What measures do Her Majesty’s Government propose to take to improve both expertise and facilities for the early detection and treatment of liver disease in primary care?

My Lords, increasingly, GPs are being made aware of the need to upskill in this area. Of course, it is not just GPs but local authorities who have responsibilities in the arena of public health to make sure that excessive drinking is discouraged. I can write to the noble Lord with the precise details of the GP training that I am aware of.

My Lords, does my noble friend agree with Professor Roger Williams, author of the Lancet commission report on liver disease, that with more than 1 million admissions per year due to alcohol-related conditions, and the developing tsunami of obesity cases, many of whom will present with non-alcoholic fatty liver disease, services will be seriously stretched in the future? What efforts are going to be made to try to stem this tide?

My noble friend is right. I am afraid that the figures for hospital admissions over the past 12 years make gloomy reading. Admissions relating to alcohol-related illness have more than doubled. We welcome the recent falls in alcohol consumption that we are witnessing, and the falls in alcohol-related deaths, but we should not be complacent—and we are not. Harms such as liver disease, as well as social impacts such as crime and domestic violence linked to alcohol, remain much too high, and Public Health England is giving priority to alcohol issues from this year, particularly through support to local authorities.

My Lords, on the point the noble Earl made earlier about Public Health England and dissemination of funds to local authorities, he will remember that that before Public Health England was set up, £800 million that was ring-fenced for drug use and drug treatment was given to the new body to disseminate to local authorities. Can he say how much of that funding is now diverted from the essential treatment that drug users need to people misusing alcohol, thus probably raising drug-related deaths, acquisitive crime and drug use generally across the country?

The noble Lord was kind enough to give me prior notice of that question just before we came in. I have taken advice on it, and the advice I have received is that there is no wholesale evidence of a shift of funding from drug treatment to alcohol treatment. There may be the odd example of that, but I can tell the noble Lord that Public Health England is monitoring this issue in local areas, to make sure that that shift does not take place in a disproportionate way in relation to the need in those areas.

My Lords, the BMA states that the misuse of alcohol is costing the UK £25 billion a year and imposing immense burdens on our overloaded health and criminal justice systems. Is not the answer to increase alcohol duty, starting with the alcohol duty escalator, which was withdrawn by the Chancellor, forfeiting £1 billion in revenue over the next five years, thereby also making it more difficult for us to meet our fiscal commitments? Increases in alcohol duties are the answer, as everybody who has studied the matter agrees.

My Lords, we have acted on alcohol pricing. We have to look at this in the round and in relation to what is happening. Alcohol consumption per head has fallen in recent years. Reduced affordability of alcohol—influenced, I may say, by tax rises above the RPI each year to 2013—has certainly been one factor in that, we believe. We are committed to reducing alcohol-related harm. We have already banned alcohol sales below the level of duty plus VAT, meaning that it will no longer be legal to sell a can of ordinary lager for less than about 40p.

My Lords, I declare an interest as a patron of the British Liver Trust, which was associated with the Lancet commission report. I am sure that the Minister will agree that deaths from liver damage related to alcohol are increasing, not decreasing. Although the Government have made changes to pricing, why is Public Health England stating that there needs to be significant movement on pricing and easy access to alcohol before there will be any effect not just on deaths but the wider problems that arise from alcohol harm?

My Lords, I take it that the noble Lord is referring to minimum unit pricing, among other things. The long-term trend in alcohol-related deaths is indeed upwards, although there has been a dip over the past four years. Minimum unit pricing is a policy that is still under consideration. It has only ever been one part of the Government’s alcohol strategy, which includes a range of national and local actions, including partnership with industry, as I said, and increased powers for local communities to tackle harm. There are various ways in which we can address the problem, which the noble Lord rightly highlights.