Alcohol Consumption: Statements

I welcome the Minister of State at the Department of Health, Deputy Alex White.

I am pleased to be back in the Seanad and welcome this opportunity to discuss the difficult and challenging issue of alcohol misuse in our country. The national substance misuse strategy steering group identified the following four key harms of alcohol. First, 88 people died every month in 2008 from alcohol. Second, in 2007 the total estimated cost of alcohol misuse to the health care and justice systems, the economy and from alcohol-related road accidents was €3.4 billion. Third, alcohol is a contributory factor in half of all suicides, which means it was a contributory factor in the suicides of 245 people in 2010. Fourth, the group noted that alcohol was consumed in four in every ten episodes of self-harm in Ireland in 2010 and was a factor in 4,764 episodes of deliberate self-harm in 2011.

In addition, the 2011 Annual Report of the National Registry of Deliberate Self Harm Ireland declared the following: "In line with previous years, misuse or abuse of alcohol is one of the factors associated with the higher rate of self-harm presentations on Sundays, Mondays and public holidays around the hours of midnight."

I am sure that these kinds of figures on deaths, self-harm and monetary costs register with every Member of this House and make us wonder about the reason we are letting alcohol do that and the reason our legal regime governing the direct and indirect sale of alcohol - in the form of advertising - is a factor in all of this harm. If those four harms were not enough there is another series of problems that alcohol is causing according to the National Substance Misuse Strategy Steering Group. One in four deaths in young men was estimated to be due to alcohol; alcohol increases the risk of more than 60 medical conditions, including many cancers; it is associated with 2,000 beds being occupied every night in Irish acute hospitals; it is associated with a quarter of injuries presenting to emergency departments; it is estimated to be associated with 16% of child abuse cases; it has been reported that alcohol was a trigger in one third of domestic abuse cases in 2005; and it is associated with harms to infants as a result of mothers drinking during pregnancy, and a range of disorders known as foetal alcohol spectrum disorders are caused by mothers drinking alcohol in pregnancy. This series of harm patterns for alcohol would therefore seem to represent an insurmountable wall of harm, as it were, for a huge number of Irish people.

We cannot deny that alcohol is associated with many aspects of our social and cultural life; that is self-evident. It is part of our custom for sociability, relaxation and enjoyment. The pub often plays an important role in community life and it is also an attraction for tourists. The paradox of alcohol, however, is that its consumption for pleasure and hospitality, along with its economic benefits, is overshadowed by the harm and health problems it causes when it is misused or consumed in a harmful and hazardous way.

Worryingly, Irish adults binge drink more than any other European country; 25% of Irish adults have reported that they binge drink every week. Irish children are also drinking from a younger age, and drinking more than ever before. Over half of Irish 16 year old children have been drunk, and one in five is a weekly drinker according to studies that have been prepared. Ultimately, 1.5 million Irish adults drink in a harmful pattern according to the steering group.

Senators will be aware that there has been a proliferation of outlets and stores that sell alcohol, and not just in urban areas. Supermarkets, convenience stores and petrol stations now sell alcohol. I suggest it is not unreasonable to link elevated levels of alcohol consumption by the Irish population with this proliferation of availability. We must do something about that because if we do not, we risk ignoring the body of evidence that is plain for all to see.

The normalisation of alcohol in Irish society has been achieved partly at least by the manner in which it is promoted through various media. It is almost as if alcohol has become a basic everyday grocery product to be purchased with everyday consumables such as bread, milk and butter. On the contrary, alcohol is no ordinary commodity, to borrow the title of the World Health Organisation-sponsored study by Babor and others some years ago. It has major public health implications, and the State has a responsibility to preserve and protect public health and the general well-being of society. Furthermore, alcohol is a psychoactive substance that can impair motor skills and judgment, and its effects on the individual can occur at various points across a spectrum. It is a drug of dependence and can act as a gateway to the use of illicit drugs for some people.

It is imperative that we reduce the overall level of alcohol consumed in our society and tackle the problems of alcohol misuse. As Senators are aware, the report of the National Substance Misuse Strategy Steering Group was published last February. The steering group's objective was to set out an evidence-based framework which identifies effective policies and actions to tackle the harm caused to individuals and society by alcohol use and misuse.

The report made a range of recommendations that focused on key issues in the area of the misuse of alcohol. These issues include the supply, pricing, availability and marketing of alcohol along with preventive strategies including treatment, rehabilitation, alcohol and substance dependency research and information.

Some of the key recommendations within the report include the following - increase the price of alcohol so that it becomes less affordable; introduce a legislative basis for minimum pricing, along with a social responsibility levy on the drinks industry; commence section 9 of the Intoxicating Liquor Act 2008, which deals with structural separation of alcohol from other products in supermarkets and other outlets; introduce legislation and statutory codes to provide for a 9 p.m. watershed for alcohol advertising on television and radio; there could not be that type of advertising prior to 9 p.m.; alcohol advertising in cinemas to be associated with films classified as being suitable for those over 18 only; prohibition of all outdoor advertising of alcohol; all alcohol advertising in the print media to be subject to stringent codes, enshrined in legislation and independently monitored; phase out drinks industry sponsorship of sport and other large public events by 2016; develop a system to monitor the enforcement of the provisions of intoxicating liquor legislation; establish a clinical directorate to develop the clinical and organisational governance framework in order to underpin treatment and rehabilitation services; and develop early intervention guidelines for alcohol and substance use across all relevant sectors of the health and social care system. This will include a national screening and brief intervention protocol for early identification of problem alcohol use.

As stated earlier, the steering group noted that children are drinking sooner and drinking more than ever before. The group was wholly cognisant of children when framing its recommendations, as Senators will see from the document. These recommendations are generic and apply to all cohorts of the population, including children.

Members will see from the recommendations that there was a strong public health dimension to the steering group's work in dealing with alcohol misuse. Our agenda now is to protect and improve the health of Irish people on foot of the recommendations that have been made. The steering group's report was stark as to public health and protection given that it reported that potentially 1.5 million people in Ireland are drinking in a harmful way.

The burden of alcohol on our society and systems is overwhelming. This is an evidence-based statement based on what the National Substance Misuse Strategy Steering Group found and reported. These problems are patently obvious - the burden of hazards and pain that alcohol misuse causes; the trauma it is responsible for; the waste it provokes in the case of lost economic output, absenteeism and more; the adverse effects it has on families and children as a result of a family member misusing alcohol. It has been estimated that adult alcohol problems are associated with 16% of child abuse and neglect cases, and alcohol has been found to be a trigger in one third of domestic abuse cases.

The steering group covered issues pertinent to children and families where it addressed the treatment and rehabilitation of people due to the misuse of alcohol. These include addressing gaps in child and adolescent service provision, and developing multi-disciplinary child and adolescent teams, along with developing an approach to addressing the needs of children and families experiencing alcohol dependency problems.

The extent of alcohol misuse warrants strong and effective policies that can address this pervasive threat to Irish public health. One such policy recommended by the steering group is a regime of minimum pricing. Minimum pricing is ultimately a mechanism of imposing a statutory floor in price levels for alcohol products that must be legally observed by retailers. The primary function of this measure is to reduce at risk levels of alcohol consumption, especially by those who drink in a harmful and hazardous way.

It also would have a greater impact on discouraging children to drink. In turn, this could then diminish the effect the misuse of alcohol and over-consumption would have on a range of social areas, including public services, crimes and public health, together of course with productivity in the economy. One cannot be ambivalent when it comes to the pattern of alcohol consumption and the harms for which alcohol is responsible. Ambivalence on alcohol is now inexcusable and the report of the steering group has made sure of that. The national substance misuse strategy points the way for the future direction of policy to deal with the use and misuse of alcohol. There are challenges with some of these recommendations and this is both clear and perhaps inevitable. Nonetheless, my Department is preparing a concrete set of proposals on the basis of the national substance misuse strategy report to which I have alluded. The intention is to submit these proposals to the Government for consideration and approval as soon as possible.

I welcome the Minister of State to the House and wish him well in his new office. This is not the first time Members of this House have had a debate on the misuse of alcohol. In fact, such a debate has been held in virtually all the years I have been a Member. Over those years, it was usually a knee-jerk reaction to some incident or report after which it seems to have been left at that. I wonder whether any other Parliament in the world also is discussing the misuse of alcohol. I doubt it and therefore there are two questions to be asked. Is it the case that they do not have misuse of alcohol or is it because we are more concerned here to try to do something about the effects of the misuse of alcohol? At the outset, I compliment the Minister of State because this was an absolute breath of fresh air. On previous occasions when Members debated the misuse of alcohol, the contributions made in this Chamber contained too many "ifs" and "buts". Even though everyone on the street knew the truth, Members kept adding riders to their points for various reasons. Perhaps they were looking over their shoulders at the drinks industry or perhaps they did so out of a fear they might offend people who simply have a social drink every day. However, this report is an absolute wake-up call. I will not reiterate the statistics, which are all readily available but it is not simply a matter of drinking to excess. All the other issues that arise therefrom, including suicides, deaths and child abuse are connected. Members are aware that whenever the issue of drugs has been discussed in this House in the past, they get very excited about it and rightly so. They work on legislation and seek more severe action to ensure there will be a clampdown. However, alcohol is every bit as much a drug and the statistics leave no doubt but there is widespread harm and damage being inflicted.

This morning, Members discussed the issue of St. Patrick's Institution on the Order of Business. The point again was made, not simply about alcohol, that many of the young people concerned have been damaged by the misuse of alcohol. For every issue of concern raised in this House, in some way there is a connection back to alcohol itself. The sad thing is Members are in a position to control the alcohol issue much more easily than is the case with the illegal sale of drugs because an industry exists in respect of the former and it should be possible to interact with that industry. I do not mean merely with a cosmetic exercise. We do not even have a health warning in respect of alcohol in the same way as we do in respect of smoking. There is a certain similarity in that when restrictions were introduced on smoking in public places, there was an outcry but it only lasted a short time. This was because when the debate took place, it became quite evident that cigarette and tobacco smoking was injurious to health. Once that message got across, people were prepared to accept highly restrictive measures in respect of smoking. People do not question it any more and it now is the norm in their lives. However, if one looks back a few years, it seemed like an immense hurdle to overcome at that time.

At present, drink is freely advertised on television and no matter what one might say, it is not done in a subtle manner. I note that half of 16-year-olds have admitted to being drunk at some point, which is a frightening statistic. However, if they are looking at television and the consumption of alcohol is associated with manliness, having a good time or whatever else in some way, the young mind undoubtedly will absorb a certain amount of that. For instance, I always have been disappointed after games in which a team won a cup that the first thing done was to fill the cup with alcohol and to pass it around to young people. Hopefully, in years to come when this is corrected, we will look back with horror on the fact we allowed this to happen with young people in local communities and that no one shouted, "Stop". Where does most of the action take place in the television programmes "Fair City" and "Coronation Street"? In the pub. It must be influencing the viewer when one sees famous actors and actresses on television and sees that drink is part of their lifestyle. Moreover, this is going out as a message. One can also look back to the time when the cigarette was in fashion. When one was being trained in drama groups, the big difficulty one had as an actor was what to do with one's hands on the stage. The prop that people generally were given was a cigarette. Even if one looks back at the films of those days, with professional actors and actresses such as Humphrey Bogart or whoever else, one may observe how often a cigarette was used. This is no longer the case and it gradually is being phased out. There must be some way to do something similar. I do not blame RTE, the BBC or anyone else as this is the culture that exists at present. This is the reason I call this a breath of fresh air. Members can promulgate this message strongly to the public in respect of the statistics they have not quantified but which they knew were there. For instance, they could suggest to RTE, in respect of "Fair City", that it would be wonderful for the station to take the first opportunity in that particular industry to ask whether it would be possible to phase out that type of glamorisation of drink. This would be absolutely vital.

As I noted, Members have had this debate several times previously but each time I see antisocial behaviour on the streets, I do not get angry towards the young people concerned. Instead, I feel absolutely sad and sorry for them because they never had the opportunity of developing in the way young people did years ago. What is happening is that before they are even sufficiently responsible to know what drink is doing, they become absolutely immersed. I acknowledge it may be peer pressure as well. I note 16-year-olds are mentioned and refer to a survey conducted five or six years ago that children of 13 years of age were not necessarily becoming drunk but were imbibing hard spirits. Therefore, is it any wonder that later on in life, they find themselves in difficulties and troubles? Incidentally, Members should not be criticising the young people but should be criticising themselves, as they had the opportunity to legislate, to put pressure on the drinks industry and to ban advertising. The big question in respect of this document, the statistics and the report of the steering group will be whether Members have the sense of responsibility to act on it. If they do, it will be the greatest contribution they will have made, particularly to young people and to families in which there is abuse and in respect of depression and suicide because that is what this is all about. It all is embraced within that and as far as that is concerned, I can only say, "Well done" to the Minister of State. I hope Members stick by it and have the courage to follow it to a successful conclusion.

I welcome the Minister of State to the House and I thank him for his comprehensive speech on the issue. The Minister of State provided many figures but one interesting comparison was that in 1960 Irish people were consuming 5 litres of alcohol per adult on average. I understand this has increased to 11.9 litres per adult per annum, a remarkable increase. This equates to 482 pints of lager, 125 bottles of wine or 45 bottles of vodka per annum. This is where we stand now. During the past 20 years because of the economic progress we have made we have allowed this problem to develop without putting any restrictions in place or without examining the long-term policy in this area. We have not considered the real net cost. The Minister of State referred to this in his speech. There is a frightening cost of more than €3 billion in real terms associated with health care, loss of time at work, car accidents and all the attendant issues. We have allowed this to drift and now we must face this problem, deal with it and look to see what we can do. We should consider where we want to see ourselves in 20 years time.

I am not criticising anyone in particular but I was in Washington Street in Cork on Arthur's day at 10.30 p.m. and it was frightening. I do not understand why people cannot go out for a night without this behaviour. As I walked along one of the streets several people were getting physically sick in front of me. They were on the street and leaning up against office doors. They were mainly students who thought this was part of the norm because they were in college. It is frightening that we have come into this culture. It reached such an extent that I rang the Garda and asked whether the force would consider closing off Washington Street at 10.30 p.m. or 11 p.m. for health and safety reasons. It is frightening that we have reached this stage. I realise people had a good night but we should consider the effects such behaviour has on people's health.

The Minister of State referred to the effects alcohol abuse can have on family life. It is interesting to consider the figures. According to the ESRI, alcohol is a factor in one third of physical abuse cases. According to the Alcohol Forum in 2011 alcohol abuse was mentioned in 36% of cases as the reason for child protection.

Earlier I referred to education and early school leaving. I am involved in a project that is attempting to get 30 people back into the education system. These people dropped out of school, in some cases when they were as young as 12 years of age. We are trying to get them back in and we are trying to help them. They dropped out at an early stage and ended up with literacy and numeracy problems. It is an uphill battle to try to get the necessary support because they do not fit into the normal education system. Many of them do not fit in because they started off with alcohol abuse and then proceeded to drug abuse.

The Department of Health has not addressed the harmful impact of parental drinking, especially during pregnancy. Recently, I spoke to a nurse about this issue. She said that one can see the effects on a newborn baby as a direct result of foetal alcohol syndrome. Symptoms may include distinctive facial features, slow physical growth, before and after birth, vision or hearing problems, poor co-ordination, delayed mental development, abnormal behaviour and heart defects. These are some of the knock-on effects of a mother drinking while pregnant. We have not done enough with regard to education in this area and we need to do more.

Recently in the House I referred to the Rotunda Hospital in Dublin, where on average 40 babies are born who suffer from delirium tremens or cold turkey after being born. Much of this is drug related but there are some cases related to excessive drinking. It occurs because the supply is suddenly cut off once they are born and they suffer from delirium tremens immediately after being born. There are 20 such cases per annum in the other two hospitals in Dublin. These are the knock-on effects and we need to produce an education programme in this area as well.

How do we move forward? There have been several reports from the Joint Committee on Health and Children and the national substance misuse strategy steering group, which reported on 7 February 2012. They have set out clear guidelines with regard to the road we should go down. We need to take certain decisions. They will not be popular. An increase in price is one option and the introduction of minimum pricing is another. We must take certain actions and we cannot put them on the long finger anymore.

Let us consider the numbers of people in hospital as we speak. Some 2,000 people are occupying beds in Irish hospitals as a direct result of excessive drinking over several years. We need to ensure that the problems we have now are dealt and we must plan for the future and for 20 years time. However, we must make the right decisions now. The Minister of State may not be popular as a result of some of the decisions he must make but they will be in the best interests of the country. This is about providing leadership. Yesterday, we saw leadership with the announcement of the reform of local government. That area was untouched for 100 years and in real terms this issue has not been touched for 100 years either. Now is the time to do it. The Minister of State has my full support with regard to the decisions he intends to make on this matter and I encourage him to arrive at them at an early date.

Some 16 Senators have indicated that they wish to speak. We have one hour and 15 minutes before the Minister of State will be asked to reply. We must be strict on time. The speaker is Senator van Turnhout. She has eight minutes.

I will try to be succinct. I have five specific questions to ask the Minister of State but first I wish to comment briefly on the issue. I am speaking as a Senator, as a children's rights activist and as a proud Irish citizen. My first concern relates to the social and cultural acceptability of our excessive alcohol usage. It disturbs me how frequently and casually excessive drinking and being hungover are spoken about on the national airwaves, in the media and in discourse following sports events and other everyday conversations. For example, we use such expressions as "How's the head?", "I'm dying" and "It is the Irish "flu". This is acceptable discourse for us. We use these references and they are bandied about all the time. I am not trying to sound in any way pious and it is not that I have not misused alcohol myself but it is about the way we use these terms in common parlance. They are acceptable and tolerated. This is where I have a difficulty. We are sending mixed messages in our discourse on drinking. On the one hand there are drink awareness campaigns, especially those targeting young people. During the debate today I imagine we will refer to the scourge of binge drinking among young people and we will highlight the dangers of excessive drinking. On the other hand as adults we laugh it off. We are sending mixed messages.

Our international reputation as a nation of drinkers is seriously undesirable and is becoming increasingly so.

It is something that we should be working hard to overcome. While on holiday in the United States over the summer, I was shocked to see a T-shirt being sold in a tourist shop, among a number of T-shirts of a similar vein, depicting Irish yoga as a series of images of an extremely intoxicated man. I have a fairly healthy sense of humour but I did not find it funny. In fact, I was extremely embarrassed that this is the depiction, on several different types of T-shirt, of Ireland. There was nothing positive about that message.

There is an intrinsic link between excessive alcohol consumption and alcohol-related harm in Ireland. The negative impact, as has been testified to by the Minister of State, Deputy Alex White, and by my colleagues before me, on individuals, on families and on the Exchequer and society at large can no longer be justified in terms of the revenue the alcohol sector generates in and for Ireland, or how our pub and craic culture attracts tourism. I grew up with a definition of the idea of craic culture being about music, friendship and great fun, but we seem to have redefined what it means and this is something that we must seriously question.

Alcohol has been identified as a contributory factor in 97% of public order offences and, according to international research, there is a link between increased alcohol consumption and increased levels of public order crime. Alcohol related crime will cost us €1.2 billion this year. All of us here could make a long list of what we would like to spend that €1.2 billion on, and that figure relates only to crime and not the associated health costs.

I had the honour to write two European reports as a rapporteur for the European Economic and Social Committee on the harmful effects of alcohol. Often the employers' organisations would row in on the side of the drinks industry but, luckily, I was able to persuade many of my colleagues from the employers' organisations to support me in my work. The figures, for example, for increased absenteeism, show it costs Ireland €1.5 billion a year, according to a recent survey by IBEC, the very organisation that supports the drinks manufacturing industry of Ireland. Employers need to wake up to the cost alcohol imposes. Alcohol is the primary reason for 4% of short-term absences from work by male employees and 1% by female employees. On the impact on health, every seven hours someone in Ireland dies from an alcohol-related disease and alcohol is a factor in up to one third of all deaths of unnatural causes. The figures are quite startling.

The Minister of State mentioned the indirect effects on children. Between 61,000 and 104,000 children aged under 15 in Ireland were estimated to be living with parents who misuse alcohol, one in 11 children is impacted negatively by parental alcohol problems and one in six cases of child abuse is attributed to alcohol. We really must wake up. I am glad the Minister of State said that he will bring back the proposals as soon as possible but there really is need for greater urgency.

I have the following five concluding points. First, the Minister of State mentioned the national substance misuse strategy. I draw his attention to the report on the misuse of alcohol and other drugs, which Senator Colm Burke mentioned, published in January last by the Joint Committee on Health and Children. We came up with 13 recommendations. They were debated heavily at the committee but the meeting was one of those good days in the Houses where all members were on the same side in trying to work out the best recommendations. There is cross-party consensus on those recommendations and I would bring the report to the Minister of State's attention.

Second, there have been significant delays in the publication of both the alcohol action plan and the sale of alcohol Bill. They were expected in September and before the end of 2012, respectively. Can the Minister of State clarify when these will be published?

Third, the Minister for Justice and Equality, Deputy Shatter, was due to bring forward the recommendations of the RRAI voluntary code of conduct but he was also supposed to come back, prior to the summer recess, on section 9 of the Intoxicating Liquor Act 2008, which the Minister of State mentioned and which deals with the structural separation of alcohol from other products. The legislation is in place. It is a bizarre piece of legislation because the Minister has a choice when it comes to implementing it. I have never seen legislation that gives the Minister the choice. I think the Minister of State will find this interesting. I had to reread the legislation several times. I raised it here in the House with the Minister for Justice and Equality under an Adjournment matter. It is something that could be put into place now. We all talk about alcohol products straying into other parts of the supermarket but there is legislation to which we can give effect.

Fourth, given the legal challenge against minimum pricing being put to the Scottish Government, can the Minister of State clarify what changes in alcohol pricing will be introduced in Ireland and if minimum pricing cannot be introduced, will consideration be given to introducing a ban on below-cost selling?

Finally, a significant amount of work has been undertaken in Northern Ireland on alcohol advertising and price promotion. By the end of 2012, Northern Ireland will introduce additional regulations to ban certain irresponsible drink promotions that encourage excessive drinking and specified pricing practices. Further restrictions have also been proposed in Northern Ireland and are included in Scotland's licensing law which are intended to prevent supermarkets and off-sale premises advertising school offers anywhere other than within a licensed area of their premises. The restrictions would also apply to other advertising material, such as newspapers, in-store magazines and leaflets. Will the Minister of State give consideration to introduce similar measures? It is my understanding that the legislation currently exists in the form of section 16 of the Intoxicating Liquor Act 2008 and these changes could be brought forward fairly quickly.

Well timed, with one second to spare. The next speaker is Senator Gilroy, who has eight minutes.

I welcome the Minister of State, Deputy Alex White, to the Chamber. I will start by welcoming that he put into the arena here the figure that will give the lie to information that is always being quoted by those who are not in favour of reform around alcohol consumption in Ireland, that is, that €3.4 billion is the economic alcohol-related cost to the economy. When one says so, the argument is always that the Government raises more in taxes from selling alcohol than it costs the economy and there is somehow an implication that the Government is complicit in the promotion of alcohol as well. Our relationship with alcohol consumption is difficult and I do not think anyone here will disagree with that. Even though the aggregate amount of alcohol has been falling, and has fallen approximately 17% since 2001, drinking patterns have changed as well.

My chief concern relates to alcohol consumption and young people. It is easy for someone of my age to say that young people drink too much. Every generation laments and despairs for the generation coming immediately behind it. It seems that the current generation has developed a different consumption pattern but for a middle-aged man like me to stand up and start finger wagging at young people requires me to put up some information that will corroborate what I am saying.

Some 44% of those who drink alcohol in Ireland consume more than five drinks at any one time, which is classified as binge drinking. This dangerous intake level, especially among young people, is linked to severe long-term physical and psychological damage. It is not only physically hazardous and socially damaging, but is also the cause of much personal distress. We need to know that family, school and social obligations are social obligations are sometimes neglected and risk-taking behaviour increases as the decision-making process is diminished under the effects of alcohol. We have seen that in some of the figures the Minister of State quoted for public order crime, in self-harm and in suicide, and we also know that one death in four among young men is attributable to alcohol misuse. Those are the facts. We could list out any number of statistics to make the point but the one point we know is that alcohol misuse generally is damaging, and particularly so among young people.

The patterns of behaviour that are laid down when we are young tend to stay with us for the rest of our days and it need be no surprise for us to hear that age is significant when we talk about when people start drinking. The lifetime alcohol dependence rate for those who start drinking before the age of 14 is four times higher than that for those who do not start drinking until they are 20.

The challenge facing society is significant and needs to be approached in a strategic and multi-stranded manner. We need to take steps to have immediate impact on drinking patterns but we also need to keep a close eye on those initiatives which will do something that will work in the long term.

There is no immediate magic bullet. Minimum pricing has been shown to reduce alcohol consumption and sales, at least in other jurisdictions, and the abolition of alcohol advertising associated with sports events will make some difference, but we need to be conscious of the big-picture issues. Although politically expedient and, therefore, attractive to us as policy makers, they will not, on their own, change our unhealthy relationship with alcohol.

The report of the steering committee and its recommendations are very welcome but we must try to achieve a cultural change in our behaviour and this will not be done by finger wagging at young people. It will only be done by hard work and by people taking personal responsibility for their own drinking habits. We must stop normalising heavy drinking by using alcohol to celebrate, commiserate or commemorate at virtually every social occasion or event that comes our way. One thing that is particularly insidious and perplexingly foolish is the way that we celebrated "Arthur's Day" recently. It was a triumph of marketing over common sense, which enticed people to participate in a contrived celebration for the gullible. The insidiousness of this was portrayed by its promoters saying that it was only a bit of craic or a bit of harmless fun and indeed, for many people, that is what it was. However, the harmless fun was visible in the accident and emergency departments of our hospitals that night, to the gardaí, who were called to the scene of multiple public order offences on the streets and to business and home owners who had to sweep away the detritus the following morning. It was not harmless fun for a great number of people and the data provided earlier by the Minister of State concerning alcohol-related harm confirms that fact.

The visits of both President Obama and the Queen of England were hosted around the marketing of alcohol. We saw the President in a pub, holding up a pint and the Queen was brought to a well-known landmark in Dublin, closely associated with alcohol. As Senator van Turnhout pointed out, our cultural identity and reputation is closely bound up with the promotion of alcohol. We are confronted, of course, with a very powerful drinks industry in this country, which is forever dismissing those who raise concerns about the dangerous levels of drinking here as cranks or kill-joys. Representatives of the drinks industry appeared before the Joint Committee on Health and Children recently and put forward a most reasonable and benign case for the industry, which presented drinking in Ireland as fairly harmless. The representatives acknowledged that in a small number of cases, there were problems but argued that these problems primarily affected individuals and required interventions only at an individual level. The argument was plausible at first sight and was presented in a slick and professional manner and could lead to a certain level of forbearance in this area. There was no recognition at all by the drinks industry of the societal harm and the damage to the social fabric caused by heavy drinking. Nor was there a recognition of the fact that one person's drinking has effects outside the orbit of that individual or of the cost to society in economic and social terms.

We seem, as a society, to have lost our way in relation to drink but this is not a new phenomenon. Social commentators from pre-Famine times were preoccupied with the heavy level of drinking here and described Ireland as a society in despair. Of course, society cannot be the best judge of its own position on the historic continuum but I wonder, in the context of the consumption of 11.5 litres of alcohol per adult, whether at some time in the future today's society will be looked at as one that lost its way regarding alcohol and one that is in despair.

Drinks industry representatives tell us that alcohol advertising is not aimed at increasing alcohol sales and that the main aim is to capture market share from rival brands. However, I do not see advertisements with images of men sitting in a public park, slobbering over a bottle of wine. That is not the way alcohol is portrayed. It is portrayed as a product for cool young people in the company of other cool young people, having great fun and the message is very clear. Alcohol advertising targets young people.

I am glad the Minister for State is continuing the work of his predecessor on alcohol and his address to the House today was very good. I have worked in the mental health services for many years and have seen the harm that alcohol does. It is one of the most significant challenges facing our society and one that the Government must prioritise, without being paternalistic. An enormous level of personal responsibility is also required but the Government, and the Department of Health in particular, can devise the roadmap by which we can find our way in tackling the enormous challenge facing us. I look forward to supporting the initiatives of the Minister of State and congratulate him on them.

I will try to be brief as I know many Senators wish to speak on this issue. I welcome the Minister of State to the House.

There are certain dangers inherent in this debate and we must be careful in our use of data. The Minister of State made reference to certain data but I drew the attention of the House to data last November which indicate that drink consumption is falling in Ireland, not rising. Our three friends trying to balance the books, namely, the Minister of Finance, Deputy Noonan, Minister of State, Deputy Hayes, and the Minister for Public Expenditure and Reform, Deputy Howlin, will confirm that to the Minister of State. I am sensing an air of panic around this issue.

By international standards, drink consumption in Ireland is actually low. It is lower than in several countries referred to here today. According to the The Economist index, we are not in the top 22 countries for beer drinking, while for wine, we consume 41% of that consumed in Switzerland, but I do not recall the Swiss being pilloried for being drunk and falling about the place. In terms of alcohol consumption as a whole, we consume 64% of the amount consumed in Germany, so there are quite prosperous and thriving countries which seem to cope with alcohol much better than we do.

The price of alcohol is not falling. All consumer prices have fallen in Ireland but the belief that the country is drowning in a sea of cheap drink is not backed up by the CSO, which is in charge of measuring such transactions. While there is evidence in Garda reports of drink-fuelled crime by adolescents, it is important to state that probably 99% of youngsters do not get involved in alcohol related crime.

The danger in what we are engaged in here is that some parts of the drinks industry will use it to increase their income through minimum pricing. It is fantastic, really. They are saying, "I would like to sell my product for X but I will persuade the Minister of State and his colleagues to set a minimum price of 2X". That happened before when, in 1903, a Liberal Party Government was convinced by publicans to limit the number of people who could sell alcohol on the basis that it would make the Irish more sober but all it did was make the publicans a lot richer. All that has happened in recent times is that by around 2003, approximately 100 years later, young people began to buy their drink in places other than public houses. The overall level of consumption is falling. I do not believe that we can say, "Person X was drunk but because he bought his alcohol in an expensive hotel or in a golf club bar, that is okay, so let's pick on the teenagers because they paid less for their drink."

I welcome the fact that drink consumption is falling in Ireland. If we need to intervene, it should be through increasing tax on alcohol and I am sure the three gentlemen I mentioned earlier would be delighted with that. We should not introduce minimum pricing. If we do that, we enrich the industry and that is not something with which I want to be associated. I wonder whether the publicising of a view of Ireland as a drunken country, when the figures internationally do not support that, is part of a campaign by some parts of the drinks industry, who do not like losing market share to others, to get the Department of Health to intervene on their behalf. That is the kind of contest in which one should not get involved.

We must check the data. If the Departments of Finance and Public Expenditure and Reform need the money, then let us increase the tax on alcohol in the budget. I urge the Minister of State to beware of some parts of the industry campaigning against other parts on the basis that those other parts are, in some mysterious way, serving seriously cheap drink that causes riots in the streets. If they were allowed, they would only serve expensive drink and keep the money themselves, enjoying an increase in profits brought about by a Government intervention which never started out with the intention of enriching the drinks trade. I do not share that objective either.

I take this opportunity to congratulate the Minister of State on his appointment and wish him well in his post.

We know about the serious problem of alcohol abuse in this country. Approximately 60% of alcohol sales are off-trade now, and gone are the days when people drank in a controlled environment, that is, the pub. If one entered a pub having had too much to drink, one was not served. If one had too much to drink in a pub, one was asked to leave. Generally speaking publicans, and I am one myself, run very good houses. The problem now with alcohol abuse is the availability and the price.

Alcohol is available in too many places, including supermarkets, small shops and petrol stations. I do not know, however, if we can change this. Every week, particularly on Sunday, advertisements in the newspapers promote cheap alcohol. We all know that a bottle of beer is cheaper than a bottle of water. In January the Joint Committee on Health and Children was shown pictures of selection boxes sitting on top of slabs of beer in a certain supermarket. I recall a campaign which promoted cheap alcohol for First Holy Communion celebrations. Some young people purchase alcohol in the local supermarket and get tanked up at home before going to the pub. This often leads to anti-social behaviour and, in some cases, publicans are wrongly blamed. The joint committee spent several months investigating this issue and our report has been submitted to the Minister of State. I ask him to ensure it is not allowed to gather dust on the shelf, which is the fate of too many reports.

I have spoken previously about educating young people about the harmful effects of alcohol. The north-west alcohol forum runs a very good education programme in counties Sligo, Donegal and Leitrim. I would love to see this programme being expanded throughout the country. Earlier this week I heard an individual who lives in Denmark speak on radio. He stated that even though alcohol was more widely available and cheaper in Denmark, it did not give rise to the problems experienced in Ireland. We need to educate our young people while they are in national school.

I have spoken on many occasions about minimum prices. The reality is that such policies will not work. Scotland has run into difficulties with European competition law in trying to implement a policy on minimum pricing and had to delay its plans by up to three years. We are in the same position.

The code of practice is not adhered to and section 9 of the legislation should have been implemented a long time ago. Alcohol should be stored in a segregated area with a separate cash register manned by a mature person. Senators have argued that small shops cannot afford to implement such changes, but when the smoking ban was introduced, publicans made the case that it would be too expensive to provide a proper smoking area. That was a health issue and this is the same.

We recently discussed the gathering with the Minister for Transport, Tourism and Sport. He wants pubs to get involved. Pubs provide good food and are places where visitors can hear traditional music. However, our trade has almost died. Senators may think I am biased, but I feel strongly about the issue of alcohol abuse. I hope the Minister of State will deal with the issue urgently.

I wish the Minister of State luck in his responsibility for primary care services. It was interesting to hear about Senator Imelda Henry's personal experience of operating a licensed premises. Senator Sean D. Barrett's views were also interesting. Alcohol consumption is decreasing in Ireland according to CSO figures, but people must be responsible for themselves. I like a glass of wine, but I take personal responsibility for my behaviour because otherwise I would not be able to come into work or could feel depressed. There is something radically wrong in the Irish character if people let themselves go to hell by overindulging.

In 2008 I wrote a policy paper on what we could do in dealing with the issue of suicide. I identified three ways by which it was possible to reduce the suicide rate. One suggestion was cutting alcohol consumption, which had been internationally proved to be a factor in reducing suicide rates. The Intoxicating Liquor Act 2008 was debated in this House while the Minister of State was still a Senator. Has that Act been implemented? We fail to implement many of the laws we introduce. My policy paper recommended that the Garda vigorously use the powers granted under the 2008 Act to carry out test purchases of alcohol by under-age youths in off-licence premises. We need a national conversation on why Irish people overindulge.

Fianna Fáil is constantly criticised in this Chamber for everything that went wrong.

For obvious reasons.

The leader of Fianna Fáil, Deputy Micheál Martin, introduced the ban on smoking in public places, about which there was a hue and cry. The former Minister for Justice, Equality and Law Reform, Dermot Ahern, introduced a code of practice for the display and sale of alcohol which now applies to nearly 2,500 supermarkets in every part of Ireland. Supermarkets no longer display or advertise alcohol in their windows and newspaper advertisements for alcohol products are restricted to a maximum of 25% of the space used. Alcohol is now usually located towards the rear of shops, although issues continue to arise for convenience stores and garages. I can see by my colleagues' faces that they do not believe this.

It is not true.

A 24-hour hotline has been established for customers to register complaints about breaches. Fianna Fáil put in place a transparent and politically accountable process to check compliance with the code. A national audit of compliance is conducted every year and the independent chairperson, Mr. Padraic White, who happens to be my husband submits annual compliance reports for publication by the Minister for Justice and Equality.

The responsible retailing of alcohol organisation wants to make the code more effective by putting it on a statutory basis. This would offer a stronger legal basis for taking action against any store or group which persistently breached the code. I hope the Minister of State will support that proposal.

I propose to share time with Senator Marie Moloney.

A recent UK report which suggests the cost to the health system of alcohol consumption among older people far exceeds that for younger people offers a balance in this debate. My own generation and the one before us were more likely to drink and drive in a way that young people of today would not dream about.

We must have some perspective on this.

That said, I do not disagree with Senator Barrett with regard to the cost of alcohol. I remember when I started university, £1 would get a person two and a half pints or 50 cigarettes. At the time, I would get £2.50 for a night's baby-sitting. Therefore, it is not necessarily true to say that drink has become as cheap as chips. The fact is that nowadays our children have a lot more money than we had when we were growing up. We need to accept this calmly. The reality for our children is that they can buy and consume alcohol at pocket money prices. We must deal with this. Consider, for example, the cost of the average weekly risk free consumption limit for a woman or a man, €7 for a woman and €10 for a man. Price, therefore, is a problem, whether we consider the individual price of what is being purchased or whether wider issues in society do not simply relate to the price of alcohol.

As Labour Party spokesperson for children and youth affairs, it is important for me to reiterate the cost to society, and to young people in particular, due to the use of alcohol. Apart from the psychological impact, depression in particular - which is almost a national epidemic - there is neuro-scientific evidence of long-term damage to children and their health, in particular with regard to brain chemistry and to establishing addictive patterns at a young age. This is an issue we need to take seriously.

I would like to address a particular issue to which Senator Henry alluded, namely, the issue of product placement. From a very young age, children are sitting in shopping trolleys surrounded by milk, juice, water and wine. I understand what Senator Henry said, but in my local supermarket, which used confine alcohol to a side aisle, alcohol is now part of the mainstream area in the middle of the store. Therefore, I believe the only way we can get around this is to limit the availability of alcohol. I ask the Minister of State to consider that.

I would like to raise a point of order. This is a very important debate and a number of us have been told it is unlikely we will get the opportunity to speak. I had an arrangement to share time with Senator Barrett, but due to a series of briefings and a prearranged interview, it was not possible to contribute at that time. I know my colleagues Senators Mullen, Crown and Quinn all want to contribute and I am sure Members from other parties want to contribute also. Is it possible to ask the Leader to continue this debate on another day rather than finish it today?

That would be a matter for the Leader. I am sure he is aware of the Senator's request and we will report accordingly.

It would be wonderful if the Minister of State could be here if the debate is allowed continue on another day. If not, we could send him the report of what is said. I know he would be meticulous about reading it.

We will attempt to establish whether the Senator's request can be acceded to.

I would be very grateful for that.

So many Senators wish to contribute that it is unlikely they will all get in on this session. Senator Hayden has exceeded her time. Does she wish to hand over now?

I ask the Chair to be indulgent and allow Senator Moloney contribute.

Senator Hayden took well over three minutes out of the five available. There is less time available now for Senator Moloney.

I welcome the Minister of State to the House and am glad to see him take up the position vacated by Deputy Shortall.

We in this country can guarantee that this issue will always be a topic of conversation here. People talk about the weather, they talk about football and they talk about how much they had to drink at the weekend or the night before. We are currently campaigning for a "Yes" vote in the referendum on the rights of children, but we have a duty of care to children who cry themselves to sleep at night. We have a duty of care to women who are used as punchbags by drunks and we have a duty of care to men who consider ending their lives following alcohol abuse. It is important we continue to consider the issues along these lines.

I do not agree that drink has not got any cheaper. It has. One can now buy a bottle of beer for the price of a bar of chocolate. I know as a non-drinker that if one buys a pint of beer in pubs, it is cheaper than buying a mineral. What does this say to young people going out to pubs or night clubs? It says that it is cheaper to drink beer than to drink a mineral. Therefore, we are not doing anything to discourage our young people from drinking. We must look at this. People are drinking a lot more at home and we cannot blame them. The drink driving laws and the price of drink in pubs mean it is easier for people to drink at home. Therefore, it is natural for people to buy alcohol in supermarkets and local shops.

We must keep a watch on the price of alcohol, because we are making it very easy for people to drink. Perhaps I should not mention it, but one can buy a whole slab of 25 large cans for €25. This is exceptionally cheap. One day when I went into the supermarket I saw a man with a trolley full to the top with alcohol and wondered whether it was for his own consumption or whether he was buying it cheap to sell it in a pub. These are all issues we must address. We could speak about this topic all day, but I have no more time. I thank the Chair for his indulgence.

I welcome the Minister of State to the House and wish him good fortune in his new ministerial position. Previous speakers have made many of the points I wished to make so I will go straight to a point that has not been made which I would like everybody here to consider seriously.

We have all become very exacting consumers. We like to know what we are going to eat and value our health above anything else in this world. Thus the food industry has become very transparent and food labelling has become an onerous task for food manufacturers. I am a manufacturer and I welcome this, because my product is a natural one. However, I am amazed that in 2012, no food labelling is required for whiskey, cider, beer or wine. EU regulations do not force our alcohol producers to label their products.

I would like to read some items of interest. EU regulations allow for more than 50 different flavourings, additives, preservatives and agents to be added to wine. Only sulphites, which are used as preservatives and have a possible causal link to asthma, must be listed on wine labels. I cannot pronounce the names of half the additives and flavourings, etc., allowed - which sound terrifying - but I believe that if I read them out, the Minister of State will never touch wine again.

Isinglass is something that comes from the bladder of a fish. Others include copper sulphate, diammonium phosphate, thiamine hydrochloride, lysozyme, dimethyl dicarbonate, bentonite and potassium ferrocyanide. I did not make this up. Why are we not asking the drinks industry to put labels on wine. I bet that one of us in here is coeliac. There are 12,000 coeliacs in Ireland. God help those who are coeliacs, because people who are coeliac cannot drink beer, lager, stout or ale, because they all contain various amounts of gluten. However, if one is obese or overweight, one can have cider, wine, sherry, spirits, port and liqueurs. How many calories are in a bottle of wine? I do not have a clue and I am sure the Minister of State does not know either.

Deputy Martin made a profound statement with regard to stopping us smoking. Please let us be the first country in Europe to put labelling on alcohol. This might add something to the costs for suppliers, but it will certainly provide a much better choice to consumers, because some very unhealthy additives are being added to many products.

I apologise for being so unprofessional and standing up again, but I would like to make a quick final point that is of relevance in the run-up to the children's referendum. We know the children's allowance is going to be changed. I implore the Minister, Deputy Burton, to turn the children's allowance into food and clothes stamps. Some children's allowance moneys are being spent as if they were alcohol stamps. We all know that is happening. I ask the Minister of State to write that one down. It is an easy win. We need to make sure our children's money is being spent on food and clothes for them.

I would like to make two points. I have made them before. I welcome the Minister of State's speech. I was interested in a point he made about the "proliferation of outlets and stores that sell alcohol". We know that, as he said, "supermarkets, convenience stores and petrol stations now sell alcohol". I agree with him entirely that "it is not unreasonable to link elevated levels of alcohol consumption by the Irish population" with this phenomenon.

I would like the Minister of State to examine something I have encountered on a number of occasions in Cork. I know it is happening around the country. When local communities, with the support of local gardaí, object to the provision of an off-licence, their objection might be upheld at local District Court level, but that decision is usually overturned at a higher court or by An Bord Pleanála. I agree with what has been said about examining the number of outlets. This issue was raised time and again during the years I spent as a member of a local authority. Many reports called for a reduction in the number of outlets. However, we are powerless to do that when the planning process gets under way. We need to consider this matter. I have direct experience of three operations. I take this issue very seriously. Over the summer, local gardaí went to court to object to a new outlet on the basis of the number of existing outlets in the local area and the level of anti-social behaviour they have to deal with, for example, by arresting minors for over-consumption of alcohol. If the gardaí who are dealing with this issue on the ground do not want an additional outlet in an area, we should take that seriously and help them with the job they are doing. It is fine to make provision in this area, but it needs to be translated into planning laws.

The National Off-Licence Association has proposed the mandatory training of all those who sell alcohol in off-licences. We know that publicans and those working with them are trained well in judging how much alcohol to sell and serve. I am sure many off-licences have a similar approach. It is important for those working in off-licences, including younger members of staff and those from other jurisdictions who might not be familiar with the impact of the sale of large volumes of alcohol, to have the confidence to ask for ID when dealing with young people. There are many factors to be considered. The National Off-Licence Association has made an important recommendation. I urge the Government to examine this simple idea and to take it up. Such a move would be welcomed by the association. It would go a long way to reduce irresponsible behaviour. If one sees persons of 18 or 20 years of age trying to buy a large volume of alcohol, one should ask what they are planning to do with it. I suggest that in many cases, they are intending to sell it on to under age drinkers. These two practical suggestions will go a long way in helping the Minister of State to do the job he has to do.

I welcome the Minister of State. I look forward to working with him in the years to come. I have a particular interest in health issues. I do not think the Government's thinking, as set out in its strategy, goes far enough. It is time for a little radicalism in its approach. Like most people in this Chamber, I am speaking with the internal conflict of someone who culturally grandfathered himself into the drinking culture of which he is a member. We would all like to think things could be done differently.

I remind Senators that alcohol is an addictive, cancer-causing toxin. That is what it is. I ask them to imagine what would happen if everyone in Ireland stopped drinking alcohol completely tomorrow. It would be a better place. We would have a colossal decrease in the prevalence of cancer of the head, neck, oesophagus, stomach, pancreas, breast, colorectum and the liver. Chronic liver disease would become rather uncommon. Obesity and diabetes, and all the complications associated with them, would decline dramatically. We would have a colossal decrease in violent crime, domestic violence, violence against women and rape. We would have a colossal decrease in road traffic accidents and some decrease in traffic deaths. We would have a major decrease in the use of our accident and emergency departments. We would have a major shortening of the waiting lists for our health facilities. There would be a decrease in absenteeism at work.

Another side of this issue that is not often commented on is the opportunity cost of alcohol consumption. The opportunity cost to society of alcohol consumption is colossal. The money spent by families on alcohol could be spent on food, clothes and education for their children. If the amount of time parents spend drinking were spent parenting, it would have a beneficial impact on educational outcomes and on many of the indices of social decay in our society. There is a colossal opportunity cost for our health service. If we were spending less money on alcohol-related ill-health, we would not have to discuss whether we can afford expensive cancer drugs and expensive drugs for multiple sclerosis.

Several of my colleagues have seemed to suggest that we are somehow in a healthy place in the international alcohol consumption league table.

I must correct Senator Barrett, who is normally very numerate and statistically astute. He is incorrect in this regard. The reality is that Ireland is placed approximately third in the global league table for the documented consumption of raw alcohol, as measured in terms of litres consumed per head of population. The figures referred to by Senator Barrett related to litres of alcoholic drink. In that league table, a litre of beer, which might be 4% alcohol, would count the same as a litre of whiskey. That is the problem we have there.

The reality is that Ireland's consumption of pure alcohol, per head of population, increased from approximately three or four litres in the 1960s to approximately 17 or 18 litres at the height of the Celtic tiger before dropping slightly to approximately 14 litres in recent years due to recessionary pressures and, perhaps, some issues relating to health consciousness. If one tries to convince the few citizens who are aware of what is discussed in this Chamber that we are somehow in a healthy place in the international alcohol league table, or if one tries to make that point outside this Chamber, one will be incorrect.

I would like to make it clear, with deference to my colleagues, that publicans are not social workers. It has been suggested in this House and at the Joint Committee on Health and Children that alcohol is somehow healthier when it is supervised and administered by friendly apron-wearing publicans who care for one when one enters the premises, who make sure one does not over-consume and who see one safely home. That is not the case. I am sure there are individual publicans who are deeply dug into their communities and are highly responsible people. The alcohol industry collectively exists for the sole purpose of selling alcohol. The governmental public health process is diametrically opposed to the entire apparatus of the alcohol industry, from the friendly local publican to the member of the board of a major international drinks conglomerate. We are adversaries. We are trying to do different things. They want more people to drink more alcohol. We want fewer people to drink less alcohol. This is the exact reality. We should not engage with them other than to rein them in and discipline them. It is insane to see them as partners in a process of reducing alcohol consumption.

A comparison can be made with the new codes of practice that are developing around the issue of tobacco. There is a worldwide movement to have no contact between politicians and those representing the tobacco industry. The same thing should happen in the case of the alcohol industry. We should be trying to rein in its activities. We should set our noses into the wind as we strive to accomplish our goal of decreasing this country's alcohol consumption dramatically - perhaps to a level one half, one quarter or one third of what it is now. On the way to that nirvana, we should set a goal of having zero advertising of alcohol. I remind the House again that it is an addictive, cancer-causing toxin. Who should be allowed to advertise the sale of an addictive, cancer-causing toxin? I suggest that this prohibition should extend beyond the classic paid or for-profit advertising that is administered by the advertising sector. We should have no more pictures of Taoisigh, Presidents or Ministers using wine, beer or other types of alcohol as the centrepiece of their welcome to dignitaries who are visiting Ireland. It is no longer appropriate. I am sure they can be socially photographed with a glass of wine in front of them if they are at a dinner.

I wish the Minister of State well. He has taken on a tough job in a big tough macro-health-economic situation. I believe we can afford to make changes in this area. We cannot afford not to make them.

I would say to him to be bold, brave and revolutionary.