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Alcohol policy sponsored by Bass - ...its like putting the wolf in charge of the sheepfold

The Conservative Government had an alcohol policy but failed to achieve its main targets. It simply fizzled out. Although the statistics relating to drink driving improved enormously, the ministers of the day refused to look for further advances by lowering the legal alcohol limit. Labour came to power on the promise of following this course and formulating a new and improved alcohol strategy. This was to be combined with far-reaching liberalisation of the licensing laws. Here we review the strange course of alcohol policy since the advent of the Labour Government.

In an astonishing move, the Government has put the formation of its alcohol policy partially into the hands of the drink industry. At this moment John Poleglass is working in the Department of Health shaping the way in which this country approaches the alcohol problem which dwarfs those caused by all the illegal drugs combined. Mr Poleglass has been seconded for this task from the sales department of Bass Breweries, usually regarded as one of the most aggressive companies when it comes to marketing its products including the notorious alcopop Hooper's Hooch. Critics comment that this is rather like putting the wolf in charge of the sheepfold.

Cut links

Commenting on the Bass secondment, the Institute of Alcohol Studies said that the government's new strategy for tackling alcohol misuse will only work if ministers are prepared to risk their close relationship with the alcohol industry. The Institute of Alcohol Studies, claimed that the government is "hand in hand" with the alcohol producers, and that the relationship could compromise any attempt to solve the problem. An IAS spokesman said: "All the appearances are that the government has a rather closer relationship with the alcohol industry than is desirable or is in the public interest... The government is giving the alcohol industry a place right at the centre of policy making that I don't think they would give to any other industry in a similar situation."

Policy

In the spirit of "joined-up government", the vogue phrase of the moment, alcohol policy was to be approached from all angles and be the result of co-operation between all interested departments.

The appointment of Tessa Jowell as Public Health Minister in 1997 was seen as an indication of the new Government's approach to public health policy of which a tough line against illegal drugs and smoking would be a main component. There were, however, mixed signals in relation to the Government's policy on alcohol. The Government made efforts to tackle alcopops, but its commitment to relaxing the licensing laws was clear and the Chancellor appeared unwilling to increase taxes on alcohol significantly.

Already the power of the drinks industry was making itself felt, especially through its fiscal significance. It could also be argued that the determination to liberalise the licensing laws appears to have had a wider effect in that the inevitable involvement of the industry in this area has eased its entry into the wider field of alcohol policy.

In late 1997 Mrs Jowell announced that the Government was to launch a new approach to public health strategy designed to tackle 'the root causes of ill health and, especially, health inequalities'. The implications of the proposed new approach for alcohol policy were unclear. Under the previous Government, the principal targets in relation to alcohol policy were contained in its health strategy, 'Health of the Nation'. The targets were reduced proportions of adults exceeding the 'sensible limits'.With the benefit of hindsight it seems likely that the argument was continuing within the Department of Health, or between different departments, as to which path should be taken. Would the Government follow the World Health Organization's recommendation and aim for a significant cut in consumption or would it prefer to regard alcohol problems as limited to those who 'abuse' the substance?

National Strategy

Alcohol Concern, whose Proposals for a National Alcohol Strategy for England was published earlier this year, has formally written to the Department of Health to protest at this extraordinary extension of drink industry influence. The Department has pointed out that it does not have the manpower to carry out the task of formulating the Government's alcohol policy and that Mr Poleglass will work in tandem with someone with a health promotion background. At the time of writing, this other person has not yet been appointed, whilst Mr Poleglass of Bass Breweries has been in post for over two months.

The Government published its useful "Statistics on Alcohol: 1976 onwards" at the beginning of October and Tessa Jowell, still at that point Minister for Public Health, had this to say: "It also indicates that the majority of people in this country drink at levels that are not likely to be harmful. As we announced in the White Paper "Saving Lives: Our Healthier Nation", we are currently developing the new strategy, in partnership with all the sectors involved: government departments, health and social services, the alcohol industry and law enforcement agencies. The agreed strategy will be published early in the next Millennium." Early in the next millennium, of course, leaves plenty of scope for delay, but the significant thing about Mrs Jowell's remarks are the positioning of the industry alongside the health services, the absence of any mention of agencies such as Alcohol Concern, and the implied minimisation of the problem. Mrs Jowell during her time at the Department of Health listened carefully to the industry's mouthpiece, the Portman Group, and shared its vocabulary. At the same time she set her face resolutely against the per capita consumption model of the alcohol problem, putting this Government out of step not only with the World Health Organization but also with the majority of other governments in Europe. It will be interesting to see whether the changes made by the Prime Minister at the Department of Health will bring about any changes to the formation of alcohol policy.

After the general election of May 1997, there was a great deal of speculation as to the new Government's attitude. There were hopes for progress in a number of areas affecting alcohol policy. From the start Alert monitored events and attempted to read the auspices.

Alcopops

Having made threatening noises about alcopop advertising, the Government backed down. Two years ago, these Government threats were exposed largely as bluff when the much heralded Government crack-down gave the industry yet another last chance to 'prove that self-regulation works'. Critics, including the Institute of Alcohol Studies, welcomed some of the moves but said they did not go far enough and relied too heavily on self-regulation by the alcohol industry. This had already been shown to be ineffective.

Even at this stage, within months of taking power, the signs were that Mrs Jowell and other ministers involved in the subject were listening to the Portman Group, the industry's mouthpiece, rather than health professionals. In his first Budget, Gordon Brown, the Chancellor of the Exchequer, also disappointed expectations by ignoring the demands for a major tax increase on alcopops in his first Budget. In the event, despite the intense public clamour, and the fact that the alcopop manufacturers were clearly braced for a large tax increase, the Chancellor made no specific reference to the drinks and the tax on alcopops was increased only in line with inflation, along with all other alcoholic drinks. In contrast, in his last budget, Mr Brown's predecessor as Chancellor, Kenneth Clarke, increased the tax on alcopops by around 8 pence in response to worries about their popularity with under age drinkers.

Later in 1998 the way policy was likely to develop was further indicated by the Ministerial Group on Alcopops' endorsement of the work of the Portman Group. The ministers said that they were "much encouraged" by the success of the Group's Code of Practice on the Naming, Packaging, and Merchandising of Alcoholic Drinks. "There are fewer complaints made under the new Code and where they occur and are upheld, swift compliance with the independent panel's decisions is the norm."

The Ministerial Group on Alcopops issued their upbeat statement at a time of increasing concern about the extent and effects of under-age drinking.

Drink-driving

As early as the beginning of 1998 a weakening of the Government's commitment to lowering the limit was evident. Despite all indications that this would have overwhelming public support, there were reported divisions in the Cabinet on the topic, with the Prime Minister himself remaining unconvinced. Ministers questioning the lower limit cited the 'nanny state' image and damage to country pubs as their main concerns.

Despite a U-turn on the drink-drive limit seeming possible, the Government's own consultation document, Combating Drink - Driving - Next Steps, issued by the Department of the Environment, Transport, and the Regions, made a good case for the lower limit. It made the point that "about 80 road users per year are killed in accidents where at least one driver had blood alcohol over 50mg but where no driver had blood alcohol over 80mg." The government's stated opinion then was that at least 50 of these lives could be saved if the legal limit were reduced to 50mg and enforced as efficiently as the current limit." The estimate is that, in addition, approximately 250 serious and 1200 slight injuries could be prevented.

Road safety campaigners will of course be aware that the Governments' estimate of the number of lives saved by cutting the legal limit substantially exceed the number of lives lost in the Paddington rail disaster, the huge national reaction to which was led by Deputy Prime Minister John Prescott.

During the course of the year there was further evidence that the Government was having second thoughts about the lower limit. Alert reported a Road Safety and Health conference organised by PACTS (The Parliamentary Advisory Council for Transport Safety) at which Lord Whitty, the minister for roads, spoke. He refused to commit the government to lowering the drink-drive limit - an intention stated clearly both before the general election and immediately afterwards. The signs are that pressure to stick with the high 80 mgs per cent have paid off. At the same conference Tessa Jowell outlined the problems associated with road safety and failed even to mention drink driving.

It is reported that Ministers will shortly announce that they are setting a target of a 40 per cent reduction in the death toll during the next ten years. Enforcement of the drink-drive laws will be the main priority, along with stronger anti-speeding measures.

Lord Whitty said recently: "Later this year we intend to publish our new, comprehensive strategy to reduce casualties still further during the next ten years. That strategy will cover driving standards, speed limits, infrastructure, vehicle design, pedestrian protection, cycling and motorcycle safety, as well as enforcement and penalties, and publicity and education."

It is understood that the new road safety strategy is written and awaiting release. However, the legal blood alcohol level is left blank in the document, Ministers still not having decided what it will be.

Road Safety Campaigners will also recall that it 1991 Mr Prescott himself called for the legal limit to be reduced to 50 mg per cent.

No nannies

As 1998 progressed it became increasingly apparent that the Government was listening more and more to the Portman Group and the industry. In the spirit of New Labour's obsession with being 'on message' their vocabulary was often almost identical:

"The 'sensible drinking' approach to reducing alcohol-related problems is being re-examined by the government in the context of its health strategies for England, Scotland, and Wales.

"The government has made it clear that it intends to tackle drinking and driving and alcohol-related violence. Ministers are anxious to distance themselves from the image of their's as the nanny state party, and, in the green papers recently issued, they appear to be undecided as to whether they wish to continue the 'sensible limits' approach to alcohol education and to keep in place the health targets based on those limits promulgated by their Conservative predecessors. However, whilst soliciting views on this issue, Health Ministers have given their backing to the Portman Group's new campaign, 'It All Adds Up!', which seems to indicate that the revised 'sensible drinking' limits introduced by the previous government will be endorsed."

When Frank Dobson, the then Secretary of State for Health, presented the Green Paper for 'Our Healthier Nation' to the Commons, it was clear that he and other Labour ministers were positioning themselves to steal a march on the Tories by portraying the Opposition as the advocates of the nanny state. Concern was expressed that the tone of the paragraph on alcohol in the green paper implied a watering-down of the Government's attitude to the problem and the abandonment of the commitments set out in the Conservatives' Health of the Nation, where it was stated that:

  • "health will be one of the factors taken into account by the Chancellor of the Exchequer in deciding alcohol duties.

  • the commitment within the framework of the family health services to the promotion of the sensible drinking message will be strengthened.

  • an agreed format for the display of customer information on alcohol units at point of sale will be considered jointly with the alcohol trade associations.

  • there will be a new initiative to monitor the penetration of the sensible drinking message.

  • continued encouragement will be giv-en to employers to introduce workplace alcohol policies and to monitor their impact.

  • the expansion and improvement of voluntary sector service provision."

PREPARING THE WAY FOR THE NEW ALCOHOL MISUSE STRATEGY

In one of her last statements as the Minister for Public Health, Tessa Jowell, said she was preparing the way for the new alcohol strategy with the publication of the Department of Health's bulletin "Statistics on Alcohol: 1976 onwards".

"The publication of this bulletin, said Mrs Jowell, "is an important step towards

bringing together key data on alcohol consumption. Our aims are two-fold: to increase public understanding of sensible drinking limits and to continue efforts to tackle alcohol misuse.

"Alcohol misuse affects individuals, families and society at large. It is an important issue not only in terms of its effects on health, but also on public order and safety. The bulletin highlights some areas that are of great concern, including:

  • The worrying number of children aged 11-15 who drink regularly and excessively.
  • The increasing number of women drinking above the previously
    recommended sensible drinking level since the early 1980s.

"It also indicates that the majority of people in this country drink at levels that are not likely to be harmful.

"As we announced in the White Paper "Saving Lives: Our Healthier Nation", we are currently developing the new strategy, in partnership with all the sectors involved: government departments, health and social services, the alcohol industry and law enforcement agencies. The agreed strategy will be published early in the next Millennium."

STATISTICS ON ALCOHOL: 1976 ONWARDS

A summary of the Statistical Bulletin quotes some of the figures against which the success or failure of any alcohol strategy will be measured:

  • In Great Britain in 1998, nearly two fifths (39 per cent) of men drank more than 4 units of alcohol on one day in the previous week; around a fifth of women (21 per cent) drank more than 3 units of alcohol on one day in the previous week.
  • In 1996, mean weekly alcohol consumption in Great Britain was 16.0 units for men and 6.3 units for women.
  • In 1996, 27 per cent of men and 14 per cent of women aged 16 and over were drinking more than 21 and 14 units a week respectively. Drinking at these levels amongst men has remained stable at about 27 per cent since 1986; that of women has risen from 10 per cent to14 per cent in the same period.
  • Over a quarter (27 per cent) of pupils aged 11-15 drank in the previous week in 1996, in England, compared to a fifth (20 per cent) in 1988.
  • It is estimated that the annual prevalence rate of alcohol dependence in private households is 75 per thousand population among men aged 16-64 years and 21 per thousand population among women in the same age group.
  • During 1997 in Great Britain there were 16,800 casualties in traffic accidents involving illegal alcohol levels, 5 per cent of all traffic accident casualties.

Budget

In his 1998 Budget, Gordon Brown strengthened the impression that the drink industry was to be treated with kid gloves. Despite the automatic cries of "Foul!" from the industry, the Chancellor in effect left the alcohol question on hold. He could have gone either of two ways. In order to combat the considerable problem of cross-channel smuggling, he might have taken the bold step of slashing duty as demanded by the industry. On the other hand, he had the opportunity of listening to the public health lobby and imposing increases which would have had a real effect on consumption. He has chosen to temporise.The argument that tax increases have a direct impact on public health and the environment is accepted in the cases of tobacco and petrol, but not when it comes to alcohol, was the clear implication of Gordon Brown's budget. Whilst a swingeing 20p was added to the price of a packet of cigarettes, beer escaped with 1p a pint, wine with 4p a bottle, and for spirits there was no increase at all. In other words, the Chancellor did no more than keep any alcohol price rises in line with inflation and these were not to come into effect until 1st January, 1999.

Alcohol also escaped virtually scot free in the 1999 Budget when the Chancellor said that duty on alcohol would not be increased before the Millennium. It seemed that the most important thing was not to mar in any way the booze-up planned for the end of the century. The only alcoholic drinks to be subject to any increase were sparkling cider and low-strength sparkling wine - an insignificant section of the market.

Our Healthier Nation

One of the most important events of the year in the run up to the formulation of the Government's own alcohol policy was the launching of Alcohol Concern's proposals for a national strategy.

The green paper Our Healthier Nation committed the Government to such a strategy and, in enlisting the help of Alcohol Concern, it allowed extensive consultations to take place. It seemed likely that some of the conclusions drawn in the proposals would meet opposition:
"Given the government's rejection of a strategy to reduce per capita consumption, the first objective in Alcohol Concern's proposals may not be welcomed by ministers. It reads: 'Should the annual national consumption of pure alcohol rise to more than 8 litres per head of the population, the highest recorded level since 1965 being 7.8 litres, accompanied by evidence of a rise in alcohol misuse, [the objective will be] to reduce levels of consumption to those rates pertaining when the strategy came into operation.' This is a modest aim since the latest figures available show that 7.6 litres of pure alcohol were consumed per head of the entire population (9.4 litres for those aged 15 and over)." (Alert, No. 2, 1999).

The proposals needed to be seen in the context of the World Health Organization's aim as set out in the first European Alcohol Action Plan (EAAP) which was to reduce consumption by an ambitious 25 per cent. Whilst this has been met in only three countries, others are taking measures to approach the target, possibly by the end of the second EAAP in 2004. In France the intention is, by the turn of the millennium, to reduce the average consumption of alcohol by people over 15 by 20 per cent. In Spain, the Health Minister recently declared that a reduction in the per capita consumption of alcohol was the "path that we have to follow if we do not wish to pay the high price implied by the scientific evidence. This evidence categorically shows that higher levels of consumption go with higher rates of sickness and mortality."

New brooms

We are often told to concentrate on issues rather than personalities, but it would be foolish to ignore the possible effects of the significant changes in the ministerial ranks of the Department of Health. Alan Milburn, who takes over as Secretary of State for Health, is regarded at the age of 41 as a man to watch. He has already served a term as a junior minister at Health before becoming Chief Secretary to the Treasury. Whether the influence of the Portman Group will continue under Mr Milburn is debatable. In 1995 the All-Party group on Alcohol Misuse, which he chaired, brought out an important report, Alcohol and Crime: Breaking the Link. Alan Milburn's committee recommended that the government should sponsor a high profile, national campaign, similar to that on drink driving, to combat alcohol and crime, especially where violence is involved. In addition, the All-Party Group report concluded that the contribution of alcohol to crime was such that the charge for liquor licences should be increased to cover the cost of alcohol education for offenders. Mr Milburn's efforts were attacked by the Portman Group which attempted a spoiling tactic by bringing out its own report attempting to demonstrate that there was no proven connection between alcohol and crime - a report which was greeted with incredulity and ridicule. The new Secretary of State may well remember the incident now that his has the overall responsibility for alcohol policy.

The other major change at the Department of Health is the departure of Tessa Jowell who has gone to Education. She is replaced as Minister for Public Health by Yvette Cooper. Miss Cooper is only 30. She entered the Commons in 1997 as Member for Pontefract and Castleford and is regarded as one of the most able of that intake.

Perhaps the changes will bring about a policy influenced more by the agencies dealing with alcohol problems than by vested interest.