Alcohol Misuse (SCPO Briefing 3 7)

March 2001

On 7 December 2000, Malcolm Chisholm, (Deputy Minister for Health) and Iain Gray, (Deputy Minister for Justice) announced that by the end of 2001 the Executive will have created an Action Plan on Alcohol Misuse, in response to the problems that excessive drinking causes in Scotland. Alcohol misuse is a real problem with 33% of men and 15% of women exceeding the recommended weekly units of alcohol according to the Scottish Health Survey for 1998.

Furthermore, most teenagers have begun to drink by the time they are fifteen years old. The costs in personal, social and economic terms are great; Malcolm Chisholm stated that there may be as many as three to four thousand alcohol-related deaths each year.


The two Deputy Ministers outlined the following two steps which will lead to the production of the Executive's Action Plan on Alcohol Misuse:
1. A six month consultation period that aims to seek the views of all interested parties on how best to tackle alcohol misuse.
2. A review of the current licensing laws which date back to 1976.

1. Consultation exercise

This "inclusive consultation process" has now begun, with a consultation paper and questions sent out to a wide range of interested parties. The purpose of the consultation is not only to receive responses to the questions, but also to find out:
• What is causing concern to organisations and individuals about drinking in Scotland
• Views on what needs to be done by all parties
• What organisations, sectors, and individuals can do as part of any agreed plans for action
To this end Ministers will be involved in a variety of discussion exercises and events during the consultation period. An interactive website has been set up at www.scotland.gov.uk/health/alcoholmisuse so that information and comments can be exchanged. The Executive "would like the process to be evolutionary, so would welcome early thoughts during the consultation on key issues". At the end of the six months all the responses to the consultation exercise will be analysed and will feed into the development of the Action Plan. The aim is to produce the plan by the end of 2001.

The consultation document also encourages networks to organise discussions on the issue and to let the Executive know about such discussions, as "Ministers in the Health and Justice Departments of the Executive would be interested to hear views directly and we hope there will be opportunities for this". Presumably, the Executive may send a representative to such discussions. The Scottish Churches Parliamentary Office will host such a discussion on 2 May at 2.30pm.
The plan for action, when completed is to be a "true partnership". Essentially this means that the plan will expect the alcohol trade, public bodies and the voluntary sector to take action.

2. Review of the licensing laws

The Licensing (Scotland) Act 1976 governs the sale and supply of alcohol in Scotland. A review of this legislation will be conducted by an independent committee with a wide-ranging remit. (Full details of the membership of that committee and how the review will be conducted have yet to be announced).

Iain Gray, the Deputy Justice Minister stated that the issue of alcohol misuse could not be comprehensively addressed unless the licensing laws were reviewed as they have not been reviewed for almost thirty years. He added that the drinks industry and licensed trade both support the need for such a review. In addition to opening hours, issues in such a review include whether the individual, rather than the establishment, should be licensed, and whether temporary extensions should be controlled by the police rather than by the licensing board. It is announced in the consultation document that "the review will link up with the development of the overall Plan for Action and will have regard to what emerges from this consultation exercise in reaching its conclusions".

(A) Current Scottish Executive Action

1. Scottish Advisory Committee on Alcohol Misuse. SACAM was set up last year in order to bring together representatives from key sectors in order to advise the Scottish Ministers on tackling alcohol misuse. The representatives on SACAM come from the health sector, local authorities, the police, the drinks industry, the licensed trade and the voluntary sector. Malcolm Chisholm, as Deputy Minister for Health and Community Care, has recently taken over the chair of the committee in order to give its work added political impetus. The Scottish Executive will consult with SACAM before producing the Action Plan.
2. Funding. The Scottish Executive made £2.5 million available over three years to support the strategic development of a new alcohol misuse strategy backed by SACAM. As a result of this, work is continuing on the development of a nationally recognisable proof of age card which is being piloted in Glasgow and Angus in co-operation with CoSLA and Young Scot. The Health Department is also funding the Server Intervention Project which provides training for licensees and their staff on alcohol misuse issues.
3. Television commercial.  The Executive launched a TV commercial in December (focussing on a bar located behind an accident and emergency reception desk) that highlighted the effects of alcohol-related violence. The commercial aimed to demonstrate the cost of inappropriate drinking and to encourage viewers to recognise such behaviour as socially unacceptable.
4. Healthier living schemes. The Executive have also taken some action on alcohol through general healthier living schemes. £26 million was invested in a Health Improvement Fund to tackle health inequalities which included practical action on smoking, diet, alcohol, drugs and exercise. £34.5 million was made available to the network of Healthy Living Centres which are designed to improve the health of families in Scotland's most deprived areas.
Malcolm Chisholm commented that the Executive wants to build on, develop and reinforce all the good work that is going on when they come to consider the Action Plan on Alcohol Misuse. "The Executive plans to bring all the various strands together into a comprehensive plan for action, which will act as a framework for action for all concerned at national and local levels".

(B) Scottish Parliament Debate

Following an earlier Members Debate on a motion from Donald Gorrie, there was a full Parliamentary debate on alcohol misuse on 7 December 2000, around the motion "That the Parliament endorses the Executive's plans to work towards the publication of a national action plan to tackle alcohol misuse". Not surprisingly there was support for this motion, and MSPs had a lot to contribute. Rounding up the debate, Iain Gray said "Keir Hardie, stood on a four-point platform 100 years ago: the first three points were a Scottish Parliament, reform of the House of Lords and a guaranteed wage, all of which the current Labour Government has delivered. The punch line is that Keir Hardie's fourth election pledge was temperance. We will not deliver on that … I make that point lightly, but with the serious intent of underlining the fact that alcohol - its effects, its control and its production - is a strand that has always run through reformist Scottish politics".

Two underlying issues emerged from the debate - funding and the mammoth task of changing attitudes towards the consumption of alcohol.

1. Statistics

MSPs quoted a great deal of statistical evidence to demonstrate the gravity of alcohol misuse:
• an estimated 200,000 people in Scotland misuse alcohol
• 1 in 5 people in Scotland worry about their own or someone else's drinking
• at least 85,000 children in Scotland live with a problem drinker
• 75% of stabbings, 65% of murders, 56% of fire fatalities, 52% of wife battering cases, 50% of rapes, 41% of assaults and muggings and 25% of road deaths are alcohol related
• 1 in 5 of all violent crime take place in and around licensed premises
• 14 million working days are lost every year because of alcohol related problems
• the cost to industry is at least £2 billion
• 25% of accidents at work involve workers who misuse alcohol
• £180 million is the estimated annual cost of hospital treatment for alcohol-related illnesses in Scotland
• 1 in 7 acute hospital admissions relates to the misuse of alcohol
• an estimated 3,000 people a year die an alcohol related death (ten times the number who die from taking illicit drugs). The official figure for Scotland in 1999 was 1,103 alcohol related deaths compared to 340 drug related deaths.
• 40% of 13 to 14 year olds were drunk when they first had sexual intercourse, leading to unsafe sex

2. Funding Anomaly between Drug and Alcohol Misuse

One of the first and recurring issues that MSPs raised was that of funding. They welcomed the allocation of the £2.5 million over a period of three years for the development of the alcohol misuse strategy but argued that this was not enough and more funding would have to be made available for preventive work and service provision. They expressed concern at the lack of resources available for alcohol-specific projects, particularly in light of the money allocated to drug abuse. The Executive directly spent £1.3 million in 1999-2000 to address alcohol misuse but in the same period allotted the much larger sum of £143.5 million to be spent over three years on measures to tackle drug abuse.

MSPs welcomed the money spent on drug abuse but felt that there should be a matching commitment to alcohol misuse recognising that it is a much bigger problem. The statistics  demonstrated that more people die from alcohol misuse than they do from drugs. The official 1999 figures reveal a huge difference between alcohol- and drug-related deaths - 1,103 alcohol-related deaths compared to 340 drug-related deaths. It is estimated that there are between 30,000 and 40,000 drug injectors in Scotland but 200,000 problem drinkers. The proper services and resources needed to cope with alcohol misuse require appropriate funding and that is currently not there.

3. Attitudes and Culture

MSPs also highlighted the need to address the causes of alcohol misuse as well as its effects: unless the drinking culture within Scotland is changed then the problem of alcohol misuse will never be tackled successfully. To change things for the better will take nothing less than a wholesale change in the culture of drinking in Scotland, in which heavy and binge drinking are socially acceptable. This includes getting the 
right message across to under-age drinkers who view getting drunk as a rite of passage (a situation which is not helped by advertising that displays alcohol as attractive and glamorous). Comparisons were made with Mediterranean countries where under-age drinking and the accompanying problems  are much less prevalent, even though the age limit to purchase and consume alcohol is several years lower. It was felt that by changing the licensing system cultural attitudes could be changed within the law. Concern was also expressed about the inconsistency of messages about alcohol.

4. Member's/Committee Bill

Donald Gorrie suggested a Member's Bill on the issue in order to offer a quick improvement. and Richard Simpson thought that it could go forward as a Committee Bill as it had widespread cross-party support. But no action has been taken on this as yet. Tommy Sheridan has tabled a motion challenging newspapers to "show their sincere commitment to prolonging the lives of Scottish citizens" by refusing advertising "from society's biggest drug dealers, namely the tobacco and alcohol industries", and calling for a comprehensive ban on such advertising.
It was clear from the debate that MSPs want action to be taken to tackle the problem of alcohol misuse and will support the Executive in this matter.

Responding to the consultation

The consultation questions appear as an insert in this briefing paper.
Written responses should be sent to: Mrs J McLeod, Alcohol Misuse Plan for Action: Consultation, Substance Misuse Division, Scottish Executive Health Department, St. Andrews House, Regent Road, Edinburgh, EH1 3DG; Phone: 0131 244 2612; Fax: 0131 244 2689; Email: alcoholmisuseconsultation@ scotland.gsi.gov.uk; Website: www.scotland. gov.uk/health/alcoholmisuse

Responses should reach the executive by 29 June 2001, but as mentioned above any issues mentioned on the website forum may be taken up earlier, so there is a point to responding early on this occasion.

Theological and Church Context

Attitudes to alcohol in Scotland's churches clearly vary from strict principled teetotalism to a more liberal "relaxed" approach to drinking. Both find Biblical justification, and each has its dangers - from charges of self-righteousness or even hypocrisy in the former, to a failure to take the painful effects of this drug seriously in the latter. In a sense, this could be a "no win" situation for churches to get involved in making pronouncements. A desire to avoid sounding sanctimonious or out of touch might inhibit us from saying anything which may (and probably will) be misconstrued into a caricature of Holy Willie; but we have a constructive contribution to make that is about more than our own image.

Recognising these cultural pressures might help us appreciate that this is not an easy area for politicians to get involved in either, and therefore to welcome the realism of the current debate. Equally realistic is a great deal of work done by churches in supporting people who (one way or another) are victims of the abuse of alcohol. That experience will be an important starting point for our contribution to this consultation.

An open meeting at the Scottish Churches Parliamentary Office on Wednesday 2 May at 2.30pm aims to pool that expertise, and our faithful understanding, and help prepare the way for the responses that churches may wish to make. A representative of the Executive's Substance Misuse Division will attend. Please let the Office know if you intend coming.

Consultation Questions

1: How should we define alcohol misuse? (You might like to think about both consumption and the consequences of alcohol misuse)
2: What concerns you most about current patterns and trends in drinking in Scotland?
3: Are there priority groups or individuals whose drinking we should try to influence in the Plan for Action?
4 : What specific objectives, and activities designed to achieve these, would you like to see in the national Plan for Action? For example:
• To change the ways individuals or groups within the population, including children and young people, perceive the use and misuse of alcohol?
• To affect patterns of alcohol consumption by individuals or groups.
• To affect overall levels of consumption?
• To reduce misuse of alcohol by people of all ages and to promote sensible drinking?
• To make sure that existing law relevant to alcohol is enforced properly and consistently?
• To improve services that help people deal with their own misuse of alcohol?
• To improve access to such services?
• To improve services to those affected by other people's alcohol misuse eg relatives and carers, victims of crime?
• To improve relevant information available to the general public, service users and service providers?
5: Would you like to see changes in aspects of the law relevant to misuse of alcohol? In particular, how would you like to see the law on liquor licensing change to produce a system of licensing that reflects the modern view of the place of alcohol in Scotland?
6: Of the objectives you suggest at Question 4, which require action (either singly or jointly) by government, statutory bodies, industry, employers, communities, individuals or others? If several bodies are involved, which has or have the key responsibility?
7: What gaps do you identify in action that is currently being taken? For example:
• To influence, educate or inform individuals and specific groups?
• To affect patterns of drinking?
• To enforce the law?
• To improve services?
8: What can your organisation or sector do to address the gaps?
9: What support structures will be needed to deliver the national Plan for Action? For example, should local co-ordinating arrangements through Alcohol Misuse Co-ordinating Committees be strengthened and, if so, how?
10: What measures should be taken to ensure that the general public and specific groups get information about the national Plan for Action when it is ready, from your own organisation or from others?
11: How should all concerned be held accountable for what they do under the Plan for Action?

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