HL Deb 31 October 1979 vol 402 cc379-94

3.5 p.m.

The Earl of KIMBERLEY rose to call attention to the growing seriousness of the problems caused by alcohol abuse in the United Kingdom; and to move for Papers. The noble Earl said: My Lords, the last debate in your Lordships' House on this subject was in March 1975, which is four and a half years ago. The Motion was then to call attention to the ever-increasing problem of alcohol abuse, May I state to your Lordships this afternoon that if ever Is use the words "he", "his" or "him", it refers also to "she". "hers", or "her".

As a recovered alcoholic, I am often asked for my definition of "an alcoholic". I reckon that it is someone who has a totally unsatisfactory relationship, both domestically and in business; someone who suffers from hangovers and amnesia and who is absent from work frequently. If these symptoms occur with monotonous regularity, in all probability that person has a drinking problem. Since our last debate, the problem has still further increased, causing even more devastation of both family and the community.


My Lords, perhaps the noble Earl will allow me to interrupt him. We on this side of the House quite frankly cannot hear him. Would it be possible for him to stand nearer a microphone? I would not interrupt him but for the fact that we want to hear what he says.


My Lords, I thank the noble Lord, Lord Wells-Pestell, and hope that my new position is better. This increase in the problem has been caused partly by general ignorance of the illness, coupled with a reluctance to recognise the scale of the problem. The services for the sufferer and the family are still inadequate. In industry, both management and the trade unions do not very often recognise the problem drinker. In 1975 I suggested that some proportion of the tax revenue from drink should be earmarked towards helping to meet this nationwide disaster which, let us face it, costs us millions of pounds in shoddy work, accidents and absenteeism.

Today the alcoholic is rarely the "meths." drinker on the park bench or the proverbial stage drunk propping up a wall, although we do have a phantom drinker in the Palace of Westminster who, most days, leaves an empty wine bottle in one of the waste paper baskets in the Library. However, there is a growing awareness of the problem. That awareness has largely been brought about by action by the Government, voluntary organisations and the medical profession, as well as by the not inconsiderable amount of publicity through the wireless, television, newspapers and magazines.

So who is the alcoholic? He is the man or the woman next door, the duke or the dustman; he is in the boardroom or on the shop floor; he is a sad and lonely figure who thinks that the rest of the world is out of step with him. But, above all, he is a sick person, suffering from a severe illness which only too often leads to an early death, thus causing untold grief and suffering not only to his nearest and dearest but also to many innocent bystanders. There are some narrow-minded and bigoted people who say that the illness is self-inflicted and, as such, it is a just punishment. It is, they say, "something one does not really want to talk about in the best circles". But that attitude only makes matters worse, as the sufferer also has to bear a quite unjustified stigma and, as a result, is far less likely to ask for help.

In 1975 it was estimated that there were 400,000 alcoholics in the United Kingdom; in 1976 the DHSS said that there were 500,000, and since then the Office of Population and Census has put the figure nearer 600,000. As the alcoholic affects his family as well as outsiders, there must be nearly 2 million people who realise the gravity of the situation and the problem with which we are surrounded.

I should like to give a few brief figures, simply for comparison. The total number of drunken offences in 1973 was below 100,000 and in 1978 it was just under 109,000. In drunken driving offences in 1973, less than 50 per cent. of the unfortunate people had a blood alcohol concentration of 150 milligrammes, but in 1978 that total was raised to 58 per cent. Lastly, the per capita consumption of absolute alcohol was in 1973 7.9 litres and in 1976 9.7 litres. I am afraid that I do not have the figure for last year. Those figures speak for themselves and I shall not bother your Lordships with any more.

The Royal College of Psychiatrists commented on this upward trend when concerning itself with alcohol. It said: In any population there exists a small percentage of people whose drinking is on the borderline between relatively safe and harmful drinking. However, in a population of millions, a ' small percentage ' will imply hundreds of thousands of people. If for that sector of drinkers alcohol is made more available, in a borderline of drinkers the increase may be just sufficient to damage some tissues of his body, or crucially impair the capacity to work, or to make the marriage intolerable for the spouse. A further grave possibility is that the borderline drinker will increase his consumption just sufficiently to induce the dependence syndrome". I think that the Royal College of Psychiatrists has given us a dire warning that we are in the grip of an endemic disorder of frightening magnitude". Even the Commission of the European Communities has now entered the field. A report for the Director-General for Employment and Social Affairs, Health and Safety Directorate, said: The increased use of alcoholic beverages throughout Europe over the last decade or so has now produced a situation warranting grave concern characterised by widespread damage to the social well-being, the economic function and the health of the population". The report goes on to urge action which needs to be taken by member Governments in the field of prevention, and the provision of treatment services, and also urges that these services must be adequately supported.

It is most gratifying that the last two Governments, both Tory and Labour, encouraged local services for alcoholics by making matching grants with local councils. These local councils have been more than ably aided and abetted by the National Council on Alcoholism under its indefatigable chairman, Sir Bernard Braine, and its director, Mr. Derek Rutherford, as well as the rest of his highly efficient though very small staff. But there are grave fears about the maintenance of these existing services, not just for the unmet needs in many areas but for sustaining even the present assistance, which in many cases is still not adequate. If the public expenditure cuts fall on these services it will, alas! in many cases mean no service, because alcoholism is still a dirty word and it is also unfashionable. In 1975 the Secretary of State for Social Services set up an Advisory Committee on Alcoholism, and it issued three reports. The first one was on Prevention; the second on the Pattern and Range of Services for Problem Drinkers; and the last one was on Education and Training. Professor Kessel of Manchester University and his colleagues deserve our congratulations. However, I understand that there has as yet been no official reply from the Government.

There are five main points that I should like to bring up over prevention. First, health education designed to alert people to the dangers of alcohol and to discourage excessive drinking should be encouraged and expanded. Secondly, the presentation of alcohol to society, particularly in advertisements and the media, should be modified to produce a less one-sided picture of its effects. Thirdly, fiscal powers should be utilised to ensure that alcohol does not become cheaper in real terms. Fourthly, legal restrictions on availability of alcohol should be enforced rigorously and not relaxed until there is sufficient evidence that to do so would not cause increased harm. Fifthly, people who may be developing a drinking problem should be encouraged to recognise the problem and to seek help.

The second report, on the Pattern and Range of Services for Problem Drinkers, emphasised the role of the primary care team and social workers in identification of the problem, backed up by specialist workers at the secondary level. I should like to give two short quotes here. First: We intend that every person with a drinking problem should be able to find the help he needs. Secondly: People should find treatment and care near where they live, and the services providing this must be responsive to their individual needs, personal and social, and therefore capable of adapting to a variety of circumstances by providing a comprehensive range of treatment and care measures. Having praised the report, may I say that perhaps it did not go far enough financially, but maybe this was because the shadow of economic restraints held it back. However, it pointed out that even within the present manpower resources, and with better co-ordination and co-operation between existing statutory and voluntary services, with only a little extra financial outlay a considerable effect and improvement could be achieved. But to tackle the problem 100 per cent, more money would be needed. If society wants to drink alcohol, then society should pay for the services for those who suffer, especially the families.

I am an executive member of the National Council on Alcoholism, and the council often finds itself in an impasse, as local authorities are often too slow or too idle to take advantages of the finance offered them by the Government. One local authority misguidedly thinks that if there is a deficit Central Government will make it up and, as a result, the local council gets no further grant aid. Somehow the Secretary of State must find an answer to this if these local services are not to suffer. Pressure must be put on the local and area health authorities to do more, but they must be backed up by a national response.

The Advisory Committee further urged the DHSS and the Welsh Office, regarding grant aid to voluntary bodies, to review their policies, with a view to providing a more flexible range of help to voluntary agencies as well as continuing a modest expansion of the hostel programme. We also consider that DHSS and Welsh Office should examine ways of providing an impetus to the development of services. In particular we consider that the provision of financial help from authorities to enable services in this field to be established should be considered. Possible ways of providing this finance would be:

  1. i. special payments by DHSS and Welsh Office to Local and Health Authorities to help establish services;
  2. ii. special arrangements to authorise for the same purpose;
  3. iii. active support for urban aid proposals related to those with drinking problems;
  4. iv. the provision of money to help for the payment of key staff. We consider that this is particularly important as the provision of one active co-ordinator in each Health Authority could, at only fairly slight cost to DHSS and Welsh Office, provide a considerable thrust to the development of services".
As I have said, the lead that the last two Governments have given has been most encouraging. There are now 20 Local Councils on Alcoholism. But this is only a beginning. The demands for these services grow daily. Since the last time I asked that industry and the trade unions should take a keener interest in this matter, the National Council on Alcoholism Working Party, under Sir Bernard Braine's chairmanship, has had a marked effect in this area. I understand that it has stimulated the Health and Safety Executive to look at codes of practice for problem drinkers. In fact, only last week in Cardiff Sir Bernard chaired a meeting of over 70 representatives from leading industrial firms and nationalised industries in Wales. Such a number would have been inconceivable 4½ years ago.

Mr. Ray Buckton, the General Secretary of ASLEF, speaking on behalf of the trades unions, said in February of this year to the National Council: The specialist statutory services are patchily distributed and poorly co-ordinated. If they were used by the majority of problem drinkers they could not possibly cope. Voluntary agencies have expanded to meet these unmet needs, and they do an excellent job. However, they are hampered by two factors, a shortage of funds and a lack of co-ordination with the statutory services. I cannot emphasise the deep concern felt by the trade union movement to improve the situation with regard to alcoholism at work. In order to assist management and trade unions in formulating a code of practice it will be absolutely essential to convince those ordinary working men who are problem drinkers, and their workmates, that they are going to be helped, not penalised. They must be encouraged to seek professional help with the certain knowledge that their job security and future career prospects are protected to the fullest possible extent. We are already pressing the HSC [the Health and Safety Council] to require employers to employ or to have on contract wide-ranging health and safety specialists. The relevant specialists would play a useful role in the early identification of the problem drinker. My Lords, I have covered most fields except the courts and prisons. The magistrates and the police must be better educated and informed. It is a waste of time and money putting alcoholics in prison.

No doubt the Government will say that taxes are not gathered for specific purposes, but there is a precedent for special levies. The Licensing Compensation Fund was set up in 1904 to curtail the renewal of certain licences in an attempt to lessen alcohol consumption. Do we not therefore have a strong case to do the same as is done in New Zealand where there is a levy for this purpose? I have said that a society must look after itself, and our society, which last year obtained £2,585 million revenue from drink, must, I maintain, spend a not inconsiderable proportion of this sum to reduce the consequences that the abuse of alcohol does to society.

The cost of alcohol cannot be quantified by the price of a pint of beer or a bottle of Scotch. We must add the human costs—the battered wife, the confused and disorientated child and the health and social wellbeing of a once productive human being. If we are to win this battle, the greatest stumbling block, the stigma, must be removed, for it is completely unjustified. While it remains it prevents the unfortunate sufferer from admitting his illness, let alone allowing him to consider getting help and treatment. We must remember that the drinking alcoholic is partially insane and is totally incapable of fighting his addiction alone. He is one of the more unfortunate and lonely characters in the world, despised by many and understood by few. He has reached a situation from which he can see no escape, and as such continues down this ever steeper and more slippery slope towards his ultimate and premature destruction. My Lords, I beg to move for Papers.

3.23 p.m.

The Lord Bishop of SOUTHWELL

My Lords, I am sure the House would feel it very remiss if there were no comment from these Benches in this debate. I speak not as one who has any personal responsibility within my Church or anywhere else for any of these matters; I speak as one who is concerned as a citizen, as a Christian, as a parent and as one who in his own diocese must have some responsibility for seeing that social problems of one kind or another are studied and worked at. I am sure the whole House will be grateful to the noble Earl, Lord Kimberley, for introducing this debate and for the way in which he did it, with such clarity and sympathy.

The picture which the noble Earl painted of the present situation is very disturbing. In my speech I shall concentrate on a few issues that might perhaps provide opportunities for action, but first I wish to make it clear that we are speaking about the abuse of alcohol. Like a great many things in life, what can be a joy and benefit can become a terrifyingly dangerous commodity, and some people, as a result, feel that the only solution in this kind of situation is that of total abstinence for themselves. I admire them. I do not myself abstain. But none of us can make people moral by legislation ; all we can do is to provide certain protections which make it difficult for people who are vulnerable to do what is unwise for themselves and their friends, for, as has been pointed out already, every alcoholic is a person who has a family, with many people around him, so the total numbers involved in this country are considerable.

The statistics published in the Home Office pamphlet Offences of Drunkenness, England and Wales, 1978 reveal the fact that prosecutions for drunkenness reach their peak among young people at the age of 18. The real worry today is that that problem is on the increase, and on the increase among young wage-earners, perhaps an increasingly affluent section of the population, and it is in that section that perhaps the problem is greatest. I am sure that problem drinking is the result of a whole complex of anxieties. I am told that mothers with young children are particularly vulnerable in this field, and of course this is a problem in all classes of society; what is drunk may be different in different areas of society, but I am alarmed at how much of what is called the hard stuff is drunk by the young.

As a country we are drinking far more alcohol, and it is therefore inevitable that there should be an increase in the problems that arise from it. I am told that 1969 was a significant year in our country in respect of this problem; there was a vast increase in the consumption of alcohol because at about that time it became very much easier to buy alcoholic drinks in the shops, and this leads me to one of the main suggestions I have to make. In this country there are very different policies about how alcohol is allowed to be sold. In the City of Nottingham, which is in the area from which I come, a very real effort is made to ensure that in large shops the sale of alcoholic drinks is confined to a particular part of the shop where it is enclosed and steps are taken to see that payment is made separately from other times; and this controlled sale outlet provides a much greater chance of being able to ensure that alcohol is sold to the right people. Indeed, many stores have expressed gratitude at the tough line which has been taken in this matter, feeling themselves that they can be much happier about the control of their sales in consequence. I am sure we must do all we can to help in this way so that the sale of alcohol through the shops is rather better controlled.

One factor in the increase in the sale of alcohol, as has already been pointed out, is the price. Twenty years ago the young could not afford to drink. At that time drugs were a greater problem than alcohol. Today, though many people may disagree with me, alcohol is relatively cheap; at any rate it is cheap enough to make it an increasing temptation for us all. I know that fiscal measures—increasing the price of drink—have been considered, and in the light of the problem we are facing today it may be that the cost of alcohol should be increased as a deterrent. The fact that the sale of alcohol is big business is evident by the amount of advertising that supports it, and I am told that even in magistrates' courts Queen's Counsel are employed to support applications for licences.

In the end, problem drinking is a personal problem on which an individual has to make a decision. As a parent I have always regarded it as a duty to teach my children how to drink so that they can cope with the temptation to drink too much, but parental responsibility is not at its highest in the country at the moment, and indeed it is well known that the children of alcoholics are more likely than any other children to become alcoholics. We need to maintain and increase educational programmes in schools and other places. This is part of the exceptional work of the National Council on Alcoholism, which has already been mentioned by the noble Earl and which, as your Lordships have heard, has over the years been trying to set up local branches. Many of these are voluntarily based, and the tragedy is that a considerable number of them may well come under threat of extinction because of a cut-back in local government financial support. In all cut-backs the voluntary field is beginning to feel the pinch, and I would plead for a recognition of the work which volunteers are doing and that it shall not be lost in an indiscriminate cut-back which disregards the quality of that work.

One interesting piece of work, which is quite local to me in Derbyshire, is that conducted by one of the Bishop's advisers who is himself concerned with educating those who are seeking to educate others—social workers, teachers and clergy. He is concerned about how to provide the knowledge and support that they need in educating and counselling those who are in a vulnerable position. I believe that one of the recommendations of the Government Advisory Committee on Alcoholism—which was quoted by the noble Earl—is very important: that anyone who is in need of help should be able to find someone to help. This requires publicity. It requires an adequate provision of help locally.

Several suggestions which will affect the availability of alcohol are being mooted at this time. One is the Bill—I think not yet published—which will be presented in another place and which will affect licensing hours. Another is the suggestion that there should be more adequate provision for children at public houses, so that they are not left at home, on the streets or in the car while their parents drink. I am sure that this has much to commend it. But the plain fact is that if the constant consumption of alcohol is made easier, the problems are bound to increase.

No one wants to deprive anyone of the pleasure of drinking, or of drinking in comfort, but I do not think that at this time we can as a nation afford to turn a blind eye to the danger signals in our society; and problem drinking is certainly throwing up a great many danger signals. I am told that addiction is much more likely among young people than it is among older people. That may be a comfort to me, my Lords, but it is not a comfort so far as the whole country is concerned. I am grateful to the noble Earl for giving us the opportunity to debate this subject. It is a matter which must not be left at the level of debate, but supported by wise legislation.

3.34 p.m.


My Lords, I am grateful, as the House will be, to the noble Earl for reintroducing this topic. I reflect that many years ago it was my privilege so to introduce it, and I remember repeating myself on a number of occasions when I ask the question, to which I find the answer perhaps more obvious now than heretofore, as to why it is that a problem of this size and gravity should require the constant attention of your Lordships' House, as if it has been under-valued, under-rated, and not understood. I suggest that there are probably two reasons. One is that alcoholism is an uncomfortable and unpopular topic, and suffers for the same kind of inhibition which I remember Calverley recorded in his poem about smoking: Tobacco is a filthy weed, I like it. There must be a large element of secretiveness, some induced, some voluntary, on the question of whether or not this is a problem which needs the close scrutiny of such a debate as this.

The second reason is perhaps that there is a confusion among those who now belong to a group concerned with alcoholism, as if we are the residual legatees of the teetotal lobby, and this causes quite a number of otherwise wellwishers to suspect an extravagance in our claims today, as I think I must admit, as a life-long teetotaller, that I belong to the Band of Hope in which I was reared. It is not true that alcohol is the devil in solution, and if I may offer some slight comfort to your Lordships' House, it is my theological proposition that when the Kingdom of God comes, light wines will be permitted.

But the problem, as it now faces those who look out upon the social effects of the consumption of alcohol, altogether overshadows the personal concerns as to the probability of Hell for those who imbibe the alcohol itself. It is in this social context that I would seek to reinforce what the noble Earl has already said so cogently. This is a monster evil, and by any calculable determination it is the kind of evil which is tending to grow, and it is the kind of evil of which there is a form of geometric progression.

I shall confine myself to one or two additions to the statistics so economically presented by the noble Earl. It is true that over the last 10 years there has been an 87 per cent. increase in the total consumption of alcohol. It is also true that from 1955 to 1977 there has been an increase of 17,000 in the number of youngsters under 21 who have been convicted of drunkenness. I am careful to read these figures because, although generally I am not addicted to notes, I do not want anybody to get the impression that I am speaking vaguely or generally. These are attested statistics and should, I suggest, be accepted as such. Drinking and driving offences have doubled over the last seven years. What is more sinister is that there has been a progressive increase in the consumption of alcohol because of its availability and its relative cheapness, as my noble friend has already stated.

What brings many of these points to focus is the situation that now I endeavour to understand from the Government, though I find it confusing. So far as I am aware this is the position. Whereas up to 1973 the responsibility for custodial and other services for alcoholics was a matter for the Home Office, in 1973 it was passed over to the DHSS, which in turn passed it on to local authorities, though at the same time the department was prepared to make subventions to the local authorities in order that the services might be maintained. The decision has been taken to cease in a year's time, or in less than a year—and I read with great care—the funding responsibility for hostels in their areas by no less than 11 local authorities when the effects of circular 21/73 on funding will come to an end next year. Eleven local authorities have already indicated that they will no longer be able to support such institutions and services, and I suspect that over the next few months the number will tend to increase. It is known that there are 2,000 beds required, and I would beg to delay your Lordships by saying a little about the consequence of this particular situation as it affects those beds. According to the present calculations, the expiry of Government funding will mean that instead of the required 2,000 beds, no greater number than, say, 600 w ill be available.

I speak with personal knowledge of these matters, having been responsible for setting up one of the complete alcoholic services in London. I look with despair, almost, on what will happen when these services are no longer funded and, in most cases, have to cease. Two services—the Leeds detoxification service and the South-east London service—have already been declared to be no longer available for the allocation of resources. My Lords, if you are going to do anything at all for the alcoholic then it must be upon a three-tier system: first of all, there is the necessity for detoxification; secondly, there is the requirement for rehabilitation; and, thirdly, there is the need for the kind of protective housing which in normal circumstances will prevent the relapse of the man who recovers from an alcoholic condition but is never more than a permanent convalescent. There is no complete and final recovery from alcoholism to which any doctor would put his name.

These are conditions which I will not harass this House by repeating or by excoriating. It is my intention, rather, in the time which is available to me, to say something about what appear to be possible and sensible plans which can be put into operation to abate this scourge. The first is that the DHSS should take active and overall responsibility for the maintenance of those hostels which are efficiently run and those hostels which have demonstrated their ability to curb this evil. Secondly, that there should be a recognition on the part of those who took drunkenness out of the criminal law that they should reflect upon what they have done. Instead of sending the drunk to prison they imposed upon him a sentence of fine—which he was totally incapable of paying. Therefore he ended up in prison by a more circuitous route, but almost inevitably. It is a sheer waste of time to apply the fining principle to the drunk, who is totally incapable of paying it and, therefore, as I say, in fact ends up in prison.

As to the realm of advertisement, if it is good enough to attach in writing or script to a packet of cigarettes that smoking is a dangerous habit and can cause damage to health, then I would say that it is overwhelmingly important that every advertisement for the imbibing of alcohol should be accompanied by the statement—which every doctor would subserve and our experience would confirm—that alcohol is a dangerous drug and can cause damage to those who do not know how to use it moderately. I wonder what would be the effect on the innumerable and, to me, nauseating advertisements on television after nine o'clock at night, which seem to encourage the belief that if you desire virility then you must top it up with constant and copious draughts of alcohol. I find this ridiculous, I find it nauseating; and I should like to see those who participate in this particular exercise being required to say as part of their advertisement that of course the intake of alcohol will be dangerous if it is taken in immoderate amounts. It is as reasonable as the somewhat ineffective but at least well-intended attempt to curb the habit of smoking, and I believe it would be an excellent way of at least calling attention to the immoderate and, in my judgement, insufferable kind of greed which is stimulated by the kinds of advertisement which appeal, as it seems to me, to most of the seven deadly sins.

There is, my Lords, a sum—it is over £4 million in amount—which was part of the Licensing Compensation Fund. There are some who would regard this as tainted money and who would not like to touch it; but, strictly speaking, there are only two kinds of tainted money—that which is improperly minted and that which is illegally possessed. It may indeed be unregenerate cash, but I would offer it, shall we say? a second birth. If you will give it to me, I will baptise it, because I believe that this £4 million could be excellently used in the retention of the services which are now imperilled and which are a recognition that we live in a society in which the Muslim argument in the matter of alcohol is a lot stronger than most of us are prepared to admit.

May I, then, in conclusion, say a little about society. We are told that alcoholism is a stress complaint; that it is an accompaniment of "the rat race" I find it intensely disagreeable to contemplate the kind of attitude which is prevalent today that the end purpose of one's activity should be an enlightened self-interest, for in such days as these such enlightened self-interest is a stressful occupation, to be unfavourably compared, as I see it, with the community which I hope to serve. Secondly, it was said in the early days of the Industrial Revolution that two penn'orth of gin was the quickest way out of Manchester. Those who, in the last century, talked of religion as the opium of the people would, I think, have been much more accurate if they had talked about alcohol as being the opium of the people. It is my experience as a social worker that the attitude to alcohol is very often that it is a means of escape from a world in which people, especially young ones, find it pretty difficult to live, and in which many of them are denied the opportunity to make any contribution to the society in which they live.

Alongside all the efforts which decentminded people should make in the name of Christianity, in the name of humanity, for a curbing of this particular vice—this vice and this disease of alcoholism— it is at the same time not part of a Marxist doctrine but of a very sensible Christian one to suggest that, if you create a society in which there is less stress and less encouragement to opium, you will have created a society in which alcoholism will diminish. It is that hope which I cherish, and it may be that our discussion this afternoon may move in that direction.