The statistics tell us:
- That 45% of adults in Wales drink more than daily guidelines at least once a week, and more than a quarter binge drink every week
- That between 3-5% of all absences from work are alcohol related
- That around 1,000 deaths are attributable to alcohol per year in Wales
- That almost half of all violence is linked to alcohol
These are shocking figures. But even they do not do justice to the human misery that is caused by alcohol misuse – the individuals whose health is damaged, the families that are blighted by alcohol related domestic abuse, and the communities suffering from the crime and anti social behaviour that is all too often associated with the excessive consumption of alcohol.
These figures also begin to suggest the significant burden that alcohol misuse places on our public services – in particular the health service. The cost to our NHS is around £70-£85 million. In the coming years, when we will need to do more with less, we must tackle robustly all the public health issues that increase these burdens on our NHS, and we know that alcohol is one of the biggest causes of preventable ill health we face. That is why as Health Minister I am determined that we should tackle alcohol misuse with every tool at our disposal, and I know that there is consensus across the Chamber on this.
Some people will tell you that excessive alcohol intake is somehow part of our character, just the way it has always been. That is a message of defeat – it suggests that we should just focus our attention on picking up the pieces, rather than tackling the root causes. I do not accept this analysis.
Alcohol has always been part of our culture, but it has not always dominated it in the way it now seems to. It is not the case that we have always drunk so much – in 1947 we consumed approximately three-and-a-half litres of pure alcohol per head; that has now risen to nine and-a-half litres.
So what has changed? Many factors have contributed to the increases in alcohol consumption, but there is no doubt that alcohol is now far more affordable – it has increased in price but that increase has been dwarfed by increases in our income.
In recent years, we have seen a much wider availability of cheap alcohol. This has been through discounting in supermarkets – including so called ‘loss leaders’ – and through the irresponsible promotions in some of our bars and clubs. Some studies have found alcohol on sale for as little as 11p per unit. At that price, a woman can drink three times the recommended limit for under £1 a day.
In some ways, it is common sense that lower prices lead to more consumption. But there is now strong evidence to support this assertion – major reports produced by the Institute of Alcohol Studies, and by the University of Sheffield, have demonstrated that increases in affordability of alcohol lead to increases in consumption. They have also shown that increasing the price of alcohol will reduce consumption, particularly amongst young people, binge drinkers, and harmful drinkers who are dependent on alcohol. So we believe that there is now a strong case for the introduction of a minimum price for alcohol.
But what can we do about this in Wales? Our substance misuse strategy sets out our determination to tackle the harms associated with alcohol misuse, and commits us to press for robust action to tackle the availability of alcohol, including:
- Stricter rules on the promotion of alcohol;
- Consideration of reducing demand by introducing minimum pricing; and,
- Increased taxation, linking levels of tax more closely to alcohol strength
We do not currently have the powers to implement these changes ourselves. Our focus has been on making the case to the UK Government, and I and my Ministerial colleagues have written on a number of occasions to highlight these issues. And I believe that opinion is swinging our way. In recent months we have seen calls for minimum pricing from the BMA, the National Institute for Health and Clinical Excellence, and the Parliamentary Health Select Committee.
But what would this mean for our citizens? In his Annual Report in 2008, Sir Liam Donaldson called for the introduction of a minimum price per unit of 50p. He suggested that after ten years, this would be expected to reduce the annual number of deaths from alcohol-related causes in England by over one-quarter. The Scottish Government has commissioned work that suggests that a minimum price of 40p would result in a fall in alcohol-related deaths in Scotland of about 70 in the first year, and about 370 per year after 10 years - a drop of nearly 20 per cent.
We do not have specific figures for Wales, but this evidence suggests that after 10 years, a minimum unit price of between 40p and 50p could reduce the number of alcohol-related deaths in Wales by 20-25%. This would equate to 200-250 fewer deaths per year after 10 years. That is why my own Chief Medical Officer, Dr Tony Jewell, has also called for the introduction of minimum pricing.
Some argue that a minimum price penalises all drinkers, not just those who drink to excess. I do not accept this argument – the impact on those who drink within sensible guidelines will be small, and the work commissioned by the University of Sheffield suggested that a minimum price of 40p per unit would cost a moderate drinker about an extra 11p per week. It is those who drink a lot more who will notice the difference, and therefore hopefully moderate the amount they consume, particularly young people.
Tackling alcohol harms is not just about price of course – it is about education and prevention, about better information for consumers, and support for those with alcohol problems. And we have invested heavily in these areas – our substance misuse budget now stands at £52.6million. To help people understand the health risks associated with exceeding safe drinking limits, we are using screening and brief interventions in primary care and during hospital admissions with nurses in A and E being trained to give advice to binge-drinkers on sensible alcohol consumption.
But prevention is better than cure: we are working with further and higher education colleges to reduce alcohol harms, and we will soon be consulting on good practice guidelines for this sector. We are also working with NUS Wales to look at the opportunities for student unions to promote the sensible drinking message amongst university students. We also want to ensure that parents understand the impact that their own drinking can have on their children, and we are supporting Gwent Police to pilot a series of parenting evenings for parents to raise awareness of the consequences of the harmful use of alcohol and illegal/other drugs. And we have established Strengthening Families Programmes in seven areas. These aim to strengthen the protective factors within families that can help to prevent alcohol misuse by young people
The Welsh Assembly Government has worked very hard to tackle alcohol misuse using all the means at its disposal and will continue to do so. But it is important that we do not ignore the evidence that making alcohol a little less affordable has the potential to significantly reduce the blight of alcohol misuse on our society. And I am very clear that if we do not see the action we want at UK level very soon, then the time will come when we seek more powers to act ourselves.