I warmly welcome the Public Health (Alcohol) Bill 2015, which has finally arrived in this Chamber exactly six years after the steering group's report on the national substance misuse strategy was published in February 2012. Some of us here remember that very well. Since then, every effort imaginable has been used by the alcohol industry to stymie, misrepresent, confuse, delay and kill off this strategy. Even before the strategy was published, the representatives of the alcohol industry who sat on the steering group did everything in their power to hold up its work, water down its proposals and delay the finalisation of the strategy. They ultimately issued their own minority report.
During the early stages of this process in 2012, I had responsibility for the substance misuse strategy in my role as Minister of State in the Department of Health, a position I held for a short period. At that time, departmental officials enthusiastically got to work on drafting legislation to give effect to the proposals in the strategy. When I consulted members of the Cabinet, it quickly became obvious to me that the alcohol industry had continued on its lobbying spree. It was particularly successful in targeting three particular Ministers. I refer to the Ministers for Agriculture, Food and the Marine; Transport, Tourism and Sport; and Justice and Equality at the time. For this reason, the Cabinet became particularly unenthusiastic about making progress with this legislation. The subsequent appointment to the Department of Health of the then Minister, Deputy Varadkar, convinced him of the importance of these measures and he progressed the Bill at that stage. However, the heavy lobbying continued apace. We know that 156 different instances of lobbying in respect of this legislation have taken place since late 2015. The lobbying register shows that officials have been extremely active in this area in respect of the legislation.
We also know that apart from the long list of Members of the Oireachtas who have been lobbied, as Deputy Collins referred to, many of the lobbyists themselves are ex-Fianna Fáil advisers and staffers who worked with various Ministers. It seemed for a period of time in recent years that there was seamless movement back and forth between the alcohol industry and the staff of Fianna Fáil. For example, one of the lobbyists with the Alcohol Beverage Federation of Ireland, ABFI, which is the most active group that is lobbying on behalf of the alcohol industry, was Ross Mac Mathúna, who is a former special adviser to the Tánaiste, Deputy Coveney. Lorraine Hall, who previously worked as a special adviser to the Minister, Deputy Humphreys, has also been lobbying in this area. We also know that Ciaran Conlon, who is a former special adviser to the Minister, Deputy Bruton, and a Fine Gael official, has lobbied on the Bill on behalf of Responsible Retailing of Alcohol in Ireland.
A former Fine Gael Deputy, Dr. Liam Twomey, is now serving as the medical director of DrinkAware, which is a so-called "responsible drinking initiative" that is funded by alcohol companies and large retailers. We also know that Imelda Henry, who was a Fine Gael Senator until quite recently, has been lobbying on behalf of the Vintners Federation of Ireland. I am concerned about the existence of this close relationship, to which I attribute the success of the alcohol industry in slowing down the passage of this legislation. It is entirely inappropriate that there should be such easy movement of staff back and forth between the lobbying wing of IBEC and ABFI and the Fine Gael Party. I do not think it is appropriate. I suggest there should be a significant cooling-off period after somebody has completed a period as a lobbyist or a period as an adviser to a Minister. There are clear conflicts of interest in this respect. The lobbyists have been very successful in holding this up.
It is highly regrettable that as a result of much of this lobbying, it was decided to ignore the area of alcohol sponsorship, especially regarding sport and music. The promotion of alcohol takes many forms. As we know, sports sponsorship is a significant component of this. While representatives of the three main participation sports in Ireland were reluctant to divulge all the information on how much money they receive as sponsorship from the alcohol industry, two years ago the indications were that these sports gain somewhere between €10 million and €20 million in funding each year from this source. The figures for some of the sports may be higher at this stage. I welcome the fact that the GAA has been consistently reducing its dependence on alcohol sponsorship. The other sports could take a leaf out of its book.
The dependence on alcohol sponsorship is heavier for soccer and rugby, particularly rugby, than it is for the GAA. Alcohol funding is now a relatively minor element of GAA sponsorship and is continuing to decline. We have to keep reminding ourselves that alcohol sponsorship is not done for philanthropic reasons. There is a sense that this is a kind of fuzzy, nice, good-willed philanthropic approach. It is clear that there is substantial commercial gain for the drinks industry if it is willing to spend large amounts of money on the promotion of its products. I ask the Minister to consider revisiting this aspect of the matter at some point. While it would be ideal if it were revisited in the Bill before the House, I am conscious that we need to get it through as quickly as possible. We cannot ignore sports sponsorship, which is the elephant in the room.
I would like to refer to important analysis that has been conducted by Professor Gerard Hastings into sponsorship of sports and music events by the alcohol industry in the UK. Internal industry documentation was sourced as part of an investigation into the conduct of the UK alcohol industry by the health select committee of the House of Commons. Professor Hastings's analysis, which is entitled "They’ll drink bucket loads of the stuff", highlights the deliberate use of sports and music sponsorship to recruit young drinkers, particularly young male drinkers. It refers to an internal document from Carling which concludes that the point of Carling's sponsorship of these events is "to build the image of the brand and recruit young male drinkers". The Carling document also points to the attractiveness of being able to "piggy back" on the heroes of young people. It concludes, "They [young people] think about 4 things, we brew 1 and sponsor 2 of them". Having read this evidence, it would be impossible to conclude anything other than that the promotion of alcohol, including sports sponsorship, leads to earlier initiation of drinking, higher levels of consumption and greater health risks than would be the case in the absence of such promotion.
We have a serious problem with alcohol in Ireland. We have a very unhealthy relationship with it. We have allowed it to permeate many aspects of our culture. In many ways, we have allowed it to define us as a people. By any standards, we drink too much. We drink approximately 25% more than the OECD average. That equates to approximately 130 bottles of wine, 46 bottles of vodka or 500 pints per person per year. When one considers that many people do not drink at all or drink very little, that means the rest of us drink to excess.
The volume of alcohol which we consume is actually increasing, in spite of what the industry is saying. In 2016 our consumption rose by 4.8% according to Revenue statistics. While we like to think of ourselves as fun loving, the reality is that we pay a very heavy price for our love affair with alcohol. The estimated cost of alcohol-related illness and harm is €2.35 billion. Every night, as we know, 1,500 hospital beds are occupied by people with alcohol-related illnesses. That has to be taken into consideration in the context of the demands for increased numbers of hospital beds. There are other, more creative and effective ways of dealing with this. The abuse of alcohol is the big culprit.
Alcohol is a contributory factor in depression and other mental health conditions and is implicated in half of all suicides. Nearly 300,000 work days are lost due to alcohol and it is a significant factor in reduced productivity and competitiveness. Alcohol is also a factor in violent crime, domestic abuse, sexual abuse, marriage breakdown and child neglect and obesity; it costs us very dearly as a society. Alcohol takes a particularly heavy toll on children, both because of their parents' harmful drinking and also their own early initiation into drinking, often at binge drinking levels - activity which is harmful to their physical, emotional, mental and social development. As adults, we often like to tut tut at the problem of youth drinking, but is it any wonder that they engage in this when we as adults set them such bad example? Many of us find it difficult to celebrate, have fun, enjoy ourselves or relax without the assistance of alcohol. We really do need to re-evaluate our relationship with alcohol and take steps to modify our behaviours around it.
We all have personal responsibility regarding our health and our behaviour. However, the prominence of alcohol all around us, its heavy promotion, its close association with some of the great things in life like sport and music and the unrelenting marketing and cost-cutting of alcohol all conspire to put it at the centre of our society in a way that makes changing our habits very difficult. That is why the problem must be tackled on several fronts: price, advertising, labelling, promotion and other areas.
On minimum unit pricing, we know that there is a direct correlation between price and problem drinking. Over the past decade, we have seen a cultural shift in people’s drinking habits. Increasingly, people are drinking at home and then going to the pub or club. Sometimes, after a session at home they continue drinking in the club. There is also the phenomenon of more people just drinking at home, stocking up in the supermarket and generally always having alcohol around the home. I do exactly the same thing myself. It is not that long ago that it was just for a special occasion, at Christmas or whatever that there would be alcohol in the house. For many people now it is a standard commodity to have in the house, if we can call it a commodity. If we go to visit somebody or somebody comes to visit us, the likelihood is that a glass of wine will be offered rather than a cup of tea. That is an indication of just what a central part alcohol has come to play in our lives and how it has managed to wend its way into so many of our different activities.
The change in drinking habits coincided with the selling of alcohol at or below cost price, mainly in the big supermarket multiples. These are usually heavily promoted in-store at almost giveaway prices. This is very misleading of course, as supermarkets have to recoup these loss leaders by hiking up the price of foodstuffs and other goods. We are not actually getting a bargain. However, these kinds of offers are too good to refuse for many people, especially young people and problem drinkers. Alcohol is now available at literally pocket money prices, sometimes cheaper than water. The net effect is that consumption levels increase and people get more bang, or more harm, for their buck. A deep irony of this situation is that the multiples can claim a rebate on VAT due to the fact that they are selling below cost. It is a win-win situation for them.
We know from research that minimum unit pricing can lead to a significant 15% reduction in consumption among problem drinkers. It specifically targets very cheap lager, cider and spirits off sales and has no impact at all on pub or restaurant prices. Its impact on average priced alcohol for moderate drinkers will be negligible. The advertising restrictions proposed in the Bill are very minimalist and, as I said, it is unfortunate that there was a caving in at political level on the original proposal to ban sponsorship of sport and music events. The proposals on health information labelling are sensible. We all need reminding of the direct links between the use of alcohol and a number of health conditions, including some cancers. Information on calorie content is helpful in tackling obesity as the high calorie content of alcohol is often overlooked in weight management.
It is especially important to warn people of the dangers of alcohol intake when pregnant. This is a serious issue which needs a far greater level of attention. It is an issue which was highlighted by Dr. Mary O'Mahony, a specialist in public health medicine, at last year’s AGM of the Irish Medical Organisation when she stated that Ireland features as one of the five countries with the highest prevalence of alcohol use during pregnancy and consequent cases of foetal alcohol syndrome, FAS. It is estimated that 600 babies are born with FAS in Ireland each year, with an estimated 40,000 people living with the condition in this country. Some 80% of Irish women pregnant for the first time reported consuming some alcohol in pregnancy. Dr. O'Mahony was quoted as saying that drinking alcohol during pregnancy can cause a permanent disability called foetal alcohol spectrum disorder, FASD. She said that among the consequences is induced brain damage, which is permanent and is associated with physical, mental, educational, social and behavioural difficulties. At one end of the spectrum, FAS may have visible signs of abnormalities and be recognised at birth. FASD is not recognisable until preschool or school age when difficulties manifest. Children born with FAS can show the following: 50% developmental slowing down; severe brain dysfunction at ten years; 10% attention problem at five years; 60% attention problem at ten years; only 30% have IQ below normal but 100% have severe dysfunction in areas such as language, memory and activity levels. FASD has a huge societal impact and many children are misdiagnosed. As Dr. O'Mahony said at the conference, "Children with FASD fill our foster care places, adults with FAS fill our jails and many people are misdiagnosed."
More support for women and more resources in the form of screening and interventions for alcohol and health promotion campaigns to educate women on the consequences of drinking during pregnancy are urgently needed. These are very difficult statistics to talk about but we cannot ignore them any longer. For too long, we have swept them under the carpet and have not addressed this serious problem in respect of drinking during pregnancy and the resultant very significant problems that arise for children in that situation. FASD has a very significant impact on our population. There are 40,000 people living with it. It cannot be ignored.
In a response to a parliamentary question I tabled a few years ago, I was told:
Currently a Senior Psychologist in early intervention services who specialises in FASD provides training to clinical staff in the west and north-west area in so far as resources allow. Any additional resources required to develop screening tools for foetal alcohol syndrome or FASD, associated education programmes and specialised follow up services for children with positive diagnosis would have to be considered in the context of emerging priorities, service delivery plans and budgetary controls.
That reply is a couple of years old, and I do not know if anything has changed in the meantime. I certainly hope it has, and I will ask a follow-up parliamentary question on that, because this is a huge, very neglected area which needs to be addressed.
Another area dealt with by the Bill is the separation of alcohol in shops. This has been greatly watered down since the original proposal. An industry organisation, Responsible Retailers of Alcohol in Ireland, RRAI, is the body charged with overseeing adherence to guidelines on displays. This is self-regulation at its best. Every year the RRAI produces a glowing report on its members. This is despite the fact that there was no difficulty finding a shop which blatantly breached the guidelines and had slabs of cheap larger stacked high at the front of the shop, in its window and generally in-your-face and impossible to avoid. Whether in the local mini-market or in the big supermarkets, the effect of these displays has served to normalise alcohol with the intention of encouraging shoppers to treat it as a normal commodity.
There are areas not covered in this Bill, for example the need for greater enforcement of the law in respect of underage access to alcohol. We see very few prosecutions or closure orders for this offence. More commonly, it is a frequent occurrence for an adult to buy alcohol on behalf of minors and pass it on outside a shop. This too is an offence but it is rarely policed. Another phenomenon is alcohol deliveries to homes or even to public places. This is a key source of alcohol for young people, but there is little Garda activity in the area, and there remains confusion within the Garda about the legality of taking cash on delivery in those circumstances.
Ultimately, the biggest encouragement for young people to drink is Irish society’s ambivalent attitude to it. We prefer to turn a blind eye to the use and the abuse of alcohol, as manifested on our streets in every city and village at weekends. Many parents will say that at least it is not drugs, but we know that alcohol is now the number one substance of abuse among young people. It is condoned, it is tolerated and, in many cases, it is facilitated. For their sake, and for the sake of everyone else in this country who has a problem with alcohol, I urge the Minister to ensure that this legislation is passed as a matter of urgency and that we do not have any further delay.