Dr. John Holmes:

I will answer some of the questions that have been asked. My colleague, Mr. Colin Angus, will respond to some of them as well. An overarching point that applies to pretty much everything that has been said is that there is no perfect alcohol policy. Minimum pricing is not going to solve every problem. When I read through the heads of the proposed public health (alcohol) Bill, I was encouraged to see that the Government is taking quite a comprehensive approach. Something similar was done with the alcohol strategy in the UK, although it was eventually gutted. Not much that was effective was left in the end. The key thing is that minimum pricing should not be considered on its own. The question of what minimum pricing will do should be considered alongside the question of what other policies will do. What does the Government's policy strategy as a whole achieve? Does it hit all the different things the Government wants to hit? Deputy Ó Caoláin made the point that minimum pricing is particularly effective because it targets the very high levels of consumption of very cheap alcohol among low-income, high-risk drinkers. We need to be very precise here. We have examined this issue in the UK. We had a paper published in The Lancetlast year looking at this in particular. We need to be careful not to make sweeping statements. It is not that minimum pricing will target the poor - it is that it will target low-income drinkers who are consuming at very high levels. Low-income drinkers who are consuming at low levels will be largely unaffected because they are simply not buying much of the cheap alcohol that the policy affects.

Deputy Ó Caoláin made the relevant point that low-income drinkers who drink at high levels are still low-income drinkers, or people who are financially constrained. I would respond to that by mentioning that the evidence we have on how alcohol harm occurs suggests that a person with a low income or of a low socioeconomic status suffers a greater risk of harm for each drink he or she consumes than an equivalent person of higher socioeconomic status. A low-income person who drinks 30 units, or standard drinks, per week is at greater risk than a high-income person who drinks the same amount. If we want to tackle the harm caused by alcohol, to a certain extent we have to target the low-income heavy drinkers because they are the people who are experiencing a lot of the harm. We need to ensure we go about that in an equitable way that does not aggravate other problems. We would argue, on the basis of the evidence we have gathered, that minimum pricing seems to do that. It seems that people would respond to these price increases not by spending a greater percentage of the family budget on alcohol but by reducing their spending on alcohol, reducing their alcohol consumption and improving their health as a result. I agree with the suggestion that has been made that this improves the well-being of those around these people as well. I guess that is my main response to that.

The question of how people are affected by this is a little more complex than it might come across in the service level and in my short presentation.

While people from all social backgrounds are likely to be buying some alcohol affected by this measure, not all alcohol products are affected equally. There is a threshold and some alcohol products will be a little below the threshold, while some will be a long way below it. Lower risk drinkers tend to drink a little of this alcohol. The higher risk drinkers are the ones who are buying this alcohol which is very cheap. They will experience some big price increases. This has to do with how alcohol is sold because if one is buying large quantities, one can buy it at much cheaper prices per standard drink. The same applies if one is buying cheap spirits which is only bought regularly by heavy drinkers. They buy certain products which are only bought regularly by those drinking at risky levels.

Tax was raised as an issue. A key point is that tax should not be seen as an alternative to minimum pricing. They should be seen as complementary strategies. If members want to tackle heavy drinking among higher income groups - they should want to do this - tax may be a better targeted option. However, there are some problems with it. The way alcohol is taxed is not fully within the Government's control; it is partly under the control of the European Union. For example, a bottle of 10% strength wine will cost less per unit than a bottle of 14% strength wine. This is because the European Union specifies that wine must be taxed by volume, not by alcohol content. The same applies to cider. One of the reasons we have very cheap high strength cider in the United Kingdom is we have very low taxes on it and also the tax rate does not increase as the alcohol gets stronger. One of the recommendations I make to the committee in the long term is that the Government make the case in Europe for alcohol to be taxed based on the strength of all products. This would allow a much more rational and health-focused taxation system. The UK Government is also looking at this issue.

Mr. Angus will talk about price distribution.