Oireachtas Joint and Select Committees
Thursday, 23 April 2015
Joint Oireachtas Committee on Health and Children
General Scheme of Public Health (Alcohol) Bill 2015: Discussion (Resumed)
I have received apologies from Deputies Ciara Conway and Robert Dowds, both of whom are attending a meeting of the Committee of Public Accounts. We also have apologies from Senator John Crown. I take this opportunity to congratulate the Senator and his wife, Orla, on the birth of their baby boy.
I welcome the Minister for Health, Deputy Leo Varadkar, Dr. Tony Holohan, chief medical officer, and Ms Geraldine Luddy, principal officer at the Department of Health, to our final session of pre-legislative scrutiny of the general scheme of the public health (alcohol) Bill 2015. The committee has had a very positive engagement with a range of delegate groups, who have presented disparate views on the proposals. I thank the Minister, the chief medical officer and Ms Luddy for their ongoing assistance to the committee.
We hope our work will contribute to the development of better regulation and measures to tackle the issue of alcohol misuse and reduce alcohol consumption.
I draw the attention of witnesses to the fact that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person, persons or entity by name or in such a way as to make him, her or it identifiable.
Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable.
I have received apologies from Senator Imelda Henry. I invite the Minister to make his opening remarks.
Good morning Chairman and members of the committee. I am pleased to be here today to bring these public hearings on the general scheme of a new public health (alcohol) Bill 2015 to a close. Before I start, I would like to remind the committee that at the start of the year the Minister of State, Deputy Lynch and I set out our 25 actions for the year and grouped them around five themes. First among those themes was Healthy Ireland, followed by patient outcomes and safety, the first steps towards universal health care, investment in infrastructure and facilities, and reform.
The reason we put Healthy Ireland at the top is that we strongly believe we need to improve our health as individuals and as a nation. If we do not do that we will never get on top of chronic disease problems and illnesses that we have and will certainly never get the health budget under control in the long term. This will involve a number of different actions. The Healthy Ireland survey is now under way and we will have the first figures in the summer. This is the first study of Ireland's health since Slán in 2007. We will repeat that study every year to see if our policies are working. There will also be specific actions on obesity and an event next Monday at Farmleigh to which I hope committee members are invited. The committee members will be familiar with the actions taken on tobacco already. There will also be a new sexual health strategy before the end of the year along with the national physical activity plan. Alcohol fits into all that as part of a general drive towards better public and individual health.
I commend the Chairman, Deputy Jerry Buttimer, the members of the committee, other members of the Oireachtas who participated in these hearings, and all the invited guests on the sensible and constructive approach that we have witnessed over the past few weeks. My officials and I have found the presentations and insights presented by the witnesses very useful. I am confident that these submissions and the report the committee will produce will greatly assist me and my officials in the drafting of the final legislation.
I am sure the committee members will agree that Ireland has a serious problem – we drink too much alcohol. The consumption of alcohol in Ireland increased by 192% between 1960 and 2001, from an average of 4.9 litres of pure alcohol per adult to 14.3 litres at peak. Even though this is a problem going back decades and centuries, it is much worse than it was before the 1960s. Since this peak in 2001, alcohol consumption has reduced and in 2013 alcohol consumption per adult was 10.64 litres. Ireland’s alcohol consumption remains in the top five among the EU 28 member states. The European region has the highest consumption in the world. Early statistics indicate that alcohol consumption increased in 2014 from 10.6 litres to 11 litres per person, which is worrying as it suggests that a feature of the recovering economy is going to be an increase in alcohol consumption as more people get back to work and have more money in their pockets. It is a certainty that alcohol consumption will continue to grow as the economy grows in the absence of any policy change and that is part of why these measures are so important.
As a country, when we drink, we tend to binge drink. I doubt many of us in this room are entirely innocent of that. It is very much part of our culture. Patterns of drinking, especially drinking to intoxication, play an important role in causing alcohol-related harm. The evidence suggests that a majority of Irish drinkers engage in excessive or problematic drinking behaviours and that Irish drinkers underestimate their alcohol intake. Ireland was second in the WHO European region in binge drinking with 39% of the population misusing alcohol in this manner at least monthly.
Our most recent national alcohol consumption survey was published by the Health Research Board last year. It found that 54% of drinkers were classified as harmful drinkers; 75% of all alcohol consumed was done as part of a binge drinking session; and Irish drinkers underestimate how much they drink by about 61%. The study also shows that more than half of adult drinkers in the population are classified as harmful drinkers, and this figure does not include 20.6% of the population who abstain. When the proportion of survey respondents who are classified as harmful drinkers is applied to the population, this equates with between 1.3 and 1.4 million harmful drinkers in the country.
Harmful drinking is more common among men than women, and most common among 18 to 24 year olds. In this category a staggering 75% drink in a harmful way. In addition, a considerable proportion of self-defined light, moderate or social drinkers drink six or more standard drinks on a typical drinking occasion. This is the equivalent of binge drinking. Even these light or social drinkers do not realise that they consume alcohol in an unhealthy manner.
The findings of this study lead to the conclusion that, among the drinking population, harmful drinking is the norm in Ireland, in particular for men and women under 35. I am aware that over the past weeks the committee has listened to numerous speakers who have presented on the kinds of damage that alcohol misuse of this magnitude does to the drinker, families, communities and society and the economy.
The general scheme of the Bill was published last February and my Department is now drafting the Bill. It is my intention to have the Bill ready before the summer recess and introduced in the Houses of the Oireachtas in autumn. This legislation is the most far-reaching proposed by any Irish Government, with alcohol being addressed for the first time as a public health measure. The significance of that might not have been fully understood by many people. This is health legislation, rather than justice or enterprise legislation, so the regulations will be signed by the Minister for Health and will come from a health point of view. The enterprise Minister would be coming from more of a consumer and competition point of view and the justice Minister from a criminal justice point of view.
The Bill is part of a comprehensive package of measures to reduce excessive patterns of alcohol consumption as set out in the steering group report on a national substance misuse strategy. It is also one of the measures being taken under the Healthy Ireland framework. The aim is to reduce alcohol consumption in Ireland to 9.1 litres per person per annum - the western world average - by 2020, to reduce binge drinking in particular and to reduce the harms associated with alcohol. I believe the legislative measures contained in the Bill are necessary if we are to achieve this aim and change our relationship with alcohol. The Bill includes provisions for minimum unit pricing to eliminate cheap alcohol from supermarkets; structural separation in shops to reduce availability and visibility; labelling on alcohol products; restrictions on the advertising and marketing of alcohol; regulation of sports sponsorship; and enforcement powers for environmental health officers.
Addressing the price of alcohol is an important component of any long-term approach to tackling alcohol misuse. The price of alcohol is linked to consumption levels and levels of alcohol-related harms. The World Health Organization states that there is “indisputable evidence that the price of alcohol matters. If the price of alcohol goes up, alcohol-related harm goes down.” Despite Ireland having relatively high excise duty, alcohol remains very affordable, particularly in supermarkets. A woman can reach her low-risk weekly drinking limit for just €6.30, while a man can reach this weekly limit for less than €10.
The public health (alcohol) Bill will make it illegal to sell or advertise for sale alcohol at a price below a set minimum price, essentially a floor price for alcohol. Minimum unit pricing, MUP, sets a minimum price per gram of alcohol. The minimum price of an alcohol product shall be based on the number of grams of alcohol in the product. I know that Dr. John Holmes and Dr. Colin Angus from the University of Sheffield delivered an excellent presentation on minimum unit pricing and the study they carried out in Ireland. Suffice to say that the study provided robust evidence that minimum unit pricing policies would be effective in reducing alcohol consumption, alcohol harms including alcohol-related deaths, hospitalisations, crimes and workplace absences and the costs associated with those harms.
The study also showed that minimum unit pricing would only have a small impact on alcohol consumption for low risk drinkers. Somewhat larger impacts would be experienced by increasing risk drinkers, with the most substantial effects being experienced by high risk drinkers. This is because minimum unit pricing is aimed at those who drink in a harmful and hazardous manner. Alcohol products which are strong and cheap are those favoured by the heaviest drinkers, who are most at risk of alcohol-related illness and death and young people who have the least disposable income. Minimum unit pricing is not expected to affect the price of alcohol in the on-trade in the main. However, it will prevent large multiple retailers from absorbing increases in excise rates and from using alcohol as a loss leader. Officials in my Department are also looking at possible mechanisms to ensure that some of the financial benefits of minimum unit pricing may flow back to the Exchequer, although if it succeeds in significantly reducing consumption, there may not be any financial benefit.
Some members have been calling for a ban on below-cost selling instead of minimum unit pricing. I would like to take the opportunity to clarify why minimum unit pricing is more effective than a ban on below-cost selling. First of all, there is no agreed definition of below-cost selling in Ireland or how it could be calculated. If it is interpreted as alcohol being sold below VAT and excise duty then very little alcohol is sold at this price in Ireland. The University of Sheffield study found that a ban on below-cost selling would have a negligible impact on alcohol consumption and related harms. Working out a cost price that incorporates other costs such as manufacturing, transportation and retailing is a complex, expensive and perhaps inaccurate exercise. Banning below-cost selling would be difficult to implement, monitor and enforce. MUP is easier to understand, measure and enforce than a ban on below cost selling
Others have been calling for a general increase in excise rates. However, further increases in excise rates would render premium and higher-priced alcohol more expensive, which is unnecessary for the purpose of targeting hazardous and harmful drinkers, who purchase larger quantities of cheap alcohol. It would be just another tax. A tax increase would not necessarily have the same effect as a compulsory minimum price, because of the risk that taxes would not be passed on in full. However, minimum unit pricing prevents large multiple retailers, or any retailers, from absorbing increases in excise rates and from using alcohol as a loss leader.
The appropriate minimum unit pricing will be chosen taking into account estimates from the report of the University of Sheffield and in consultation with the relevant Departments. The price needs to be set at a level the evidence indicates will reduce the burden of harm from alcohol use. In short, it needs to be high enough to eliminate very cheap alcohol but not so high that it affects the price of a glass of wine in the pizzeria.
We must also take into account what Northern Ireland does, so that we do not create a new issue around cross-Border trade. I know that many members are concerned about the impact that MUP might have on cross-border trade. The Minister for Health in Northern Ireland, Jim Wells, MLA, has also announced plans to introduce minimum unit pricing for alcohol. My officials are in contact with their counterparts in the Department of Health, Social Services and Public Safety on the matter and we are cognisant of the requirement to work together with the North on the implementation of minimum unit pricing.
Finally, I will give the committee an update on the current European court case regarding minimum unit pricing. Last February, the Scottish Inner Court of Sessions, Scotland’s highest court, referred a number of questions on minimum unit pricing to the European Court of Justice. The court is due to hold a hearing on this case on 6 May and we expect a judgment by the end of the year. We intervened in this case and the relevant officials will be attending the hearing in Luxembourg. We are hopeful that minimum unit pricing will be found to be compatible with EU treaties and rules and it is therefore important that all the necessary steps have been put in place to commence the legislation, if enacted. However, it is a risk and the court will have to decide which is more important: public health or eliminating barriers to free trade. It is noteworthy that the EU was initially established as a common market, the European Economic Community, a trade-based organisation, rather than one based on public health. We will fight as hard as we can to ensure the court makes the right decision.
Moving on to the regulation of marketing and advertising, protecting children from exposure to alcohol marketing is an important public health goal. There is a compelling body of research which shows that exposure to alcohol marketing, whether it is on TV, in movies, in public places or through alcohol branded sponsorship, predicts future youth drinking. Numerous longitudinal studies have found that young people who are exposed to alcohol marketing are more likely to start drinking, or if already drinking, to drink more. Research also shows that self-regulation is not able to protect young people from exposure to large volumes of alcohol marketing and appealing alcohol advertising.
The public health (alcohol) Bill will make it illegal to market or advertise alcohol in a manner that is appealing to children. It provides for the making of regulations on the marketing and advertising of alcohol and includes provisions for restrictions on broadcast marketing and advertising, cinema advertising, outdoor advertising, print media and the regulation of sponsorship by alcohol companies. This will encompass major sporting events for the first time by putting the existing code of practice for sponsorship by drinks companies on a legal footing with enforcement powers and penalties. The legislation will contain a commitment that the provisions on marketing and advertising will be reviewed after three years.
On labelling, research shows that accurate information on the alcohol content of specific beverages is essential to promote awareness of alcohol intake. However, "standard drink" units are widely misunderstood by the general public. In order to address this, the Bill will provide that labels on alcohol products will contain health warnings, including for pregnancy; the amount of pure alcohol as measured in grams; and the calorie count. Under the Bill, pubs and restaurants will also be obliged to provide this information to customers for alcohol products sold on draught or in measures, e.g. pints, glasses of wine and measures of spirits. Finally, health warnings will also have to be included on all promotional material.
From a merchandising perspective, at the moment the Minister for Justice and Equality and I are examining the best way to implement the separation of alcohol products from other products in mixed trading premises. Our aim is to ensure that alcohol products cannot be displayed like ordinary grocery products, but will be subject to strict merchandising requirements. We want to do it in a manner that is not too onerous on retailers and that will not impose excessive cost on them in order to comply.
The public health (alcohol) Bill will be enforced by environmental health officers. Provisions to be enforced include minimum unit pricing; health labelling; the control of marketing and advertising; structural separation of alcohol from other products; and regulations relating to the sale, supply and consumption of alcohol products under section 16 of the Intoxicating Liquor Act 2008. These pertain to restrictions on advertising, promoting, selling or supplying alcohol at reduced prices or free of charge.
To conclude, I believe that the public health (alcohol) Bill will act as a powerful enabler for a healthier relationship with alcohol in Ireland. I know some people believe the measures do not go far enough, but I am confident that it is a bold and major step in the right direction. As I said earlier, I will seek Government approval to publish the Bill before the summer recess and plan to initiate it in the Houses of the Oireachtas in the autumn.
I thank the Chairman and all of those who have participated in these public hearings for the valuable contribution they have made to this issue and for the assistance they have provided to me and my officials in the work that lies ahead. I look forward to receiving the committee's report and reflecting it in the legislation as published.
I thank the Minister. I should at this juncture welcome to our meeting our guests for the second part of our presentation, namely Mr. Ian O'Sullivan and Ms Eimear Murphy from Coláiste Treasa in Kanturk, who are the BT Young Scientists of the Year 2015. They will be contributing to the second part of our meeting. We also welcome their families and school community to the meeting and thank them for being here this morning. As members know, their study for the Young Scientist exhibition dealt with the impact of parental alcohol consumption on the drinking behaviour of children and adolescents, which makes it appropriate for what we are discussing this morning.
I am of the view that every one of us as legislators has a common goal in addressing this issue, namely, to secure a significant reduction in the use of alcohol across the population and want every effort to be employed to create a greater knowledge and awareness, particularly among the younger cohort in the population, of the dangers that alcohol abuse presents in the life of any citizen. The Minister referred to the fact that some of us are arguing for this or for that. I just want to state that the difference in terms of approach and ideas does not indicate on any of our parts, the Minister's included, any lack of resolve. It is about what we think may work best.
I give the Minister the assurance that, even without sight of the legislation, which the Minister has yet to publish, I am not going to be an obstacle to the passage of this legislation, although I am not sold on the certainty of the introduction of minimum unit pricing. As legislators, we have a job of work to do on this matter, and my colleagues and I will be full participants in seeking to arrive at the best position. We will not be an obstacle to any address going forward.
The Minister spoke about different studies and figures. He mentioned the 20.6% of the population who abstain, but are not included in the Health Research Board's figures which show that more than half of adult drinkers in the population are classified as harmful drinkers. Can the Minister indicate whether the consumption figures of 10.6 litres per adult in 2013 and 11 litres per adult in 2014 include abstainers, and that the figures are for the general adult population? It is my observation as a citizen that figures for average consumption fall far short of the reality for so many of our people. I believe it would be staggering for many if the real picture was exposed. It is way up the scale from 11 litres per person, for those who are using alcohol as part of their weekly practices. Just to be absolutely clear, I include myself in that. Could the Minister comment on that? It is important to point out that Irish drinkers underestimate their alcohol intake and it would be helpful if we could all be exposed to the true facts. It might also be of help in winning greater public acceptance of the need to address this very serious matter. The Minister makes the point that drinkers underestimate their alcohol intake by 61%. That may be, and it may be much more than that.
The Minister said the Bill would be ready before the summer recess. Will the Minister clarify whether individual Members will have sight of it, and does "ready" mean "published"? He talks about the Bill being addressed in the Houses in the autumn, but will Members have sight of it before the recess? The Bill includes provisions for minimum unit pricing, structural separation in shops, health labelling on alcohol products, restrictions on advertising, regulations on sports sponsorship and enforcement powers for environmental health officers. There are other views, but I am concerned that the minimum unit pricing approach is not the panacea. I know it is one of a number of items, and of course there has to be a package - I fully support that - but when the Minister makes the point-----
I ask for a wee bit of leniency from the Chairman. The Minister makes the point that minimum unit pricing is aimed at those who drink in a harmful and hazardous manner. I do not believe that will necessarily be the result. My assessment is that it will mostly affect those on lower income levels. If one looks at the current cost versus the suggested minimum unit pricing which will result from this legislation, one can see that it most certainly targets drink products which are used mostly by people on low to medium incomes. Maybe some of those are people who depend on social protection, but I do not believe that the issue of alcohol misuse, and all the terrible negatives that come from it, are confined to one social class. I fear we are not addressing this in the most holistic way. I will be addressing the issue through regulation of below-cost selling, which was rejected by the Minister. I do believe it has to be based on the invoice price, and I believe it is absolutely a sustainable solution that should be part of the overall approach. I have had negative reactions to my arguments for considering increased excise duties on alcohol, and I know it is not popular. We need to ring-fence money to address the serious social problems in our communities - to educate people and provide supports for those who are wrestling with serious alcohol abuse and those who are the victims of family members' abuse of alcohol - irrespective of where we are from or where we live. It is right across the board. Although I am mindful of what the reaction would be, I make no apology for suggesting increases in excise duties. It is not for the sole purpose of making alcohol more expensive, but to utilise the additional revenue in the most focused way. I believe this is essential, and it needs to be confirmed in this legislation.
The Minister is very welcome to the committee. I have written two European papers on alcohol-related harm. I was asked to do one of them by the Swedish Presidency of the Council of the European Union. It gave me an opportunity to present to the then Minister, whom I could not meet in my role at the time as chief executive of the Children's Rights Alliance. I am delighted this is being framed as a public health issue. I believe it is critically important. There is really strong support for this Bill. Most contact I have with individuals and organisations is about how we can go further and what more we can do. We have had too much talk about alcohol and we now need to ensure there is legislative change.
I differ from my colleague Deputy Ó Caoláin on minimum unit pricing, but I do respect his views and we have had our discussions. We have listed to impressive presentations by Dr. John Holmes and Mr. Colin Angus from the University of Sheffield. I am convinced on the issue so I will not use my time today on that.
I am concerned that the plan to place the voluntary code for sports sponsorship onto a legal footing is not strong enough. Let us look back at how the voluntary code came into place. In 2003, draft legislation had been prepared by the Government and had gone to Cabinet for approval, when all of a sudden the voluntary code was brought in. The Children's Rights Alliance submission to this committee states: "It is worth noting that the text of the voluntary code mirrors exactly that produced by the industry, including grammatical errors." I hope the industry does not have the same influence now. The committee has had presentations on the issue of the voluntary code. I draw the Minister's attention to audience profiling. An example was given to the committee about a rugby match and the 25% rule. I suggest to the Minister that it could be reduced to 10%. Obviously I would prefer stronger enforcement, or that it was not in the way, but if we are going to do something then we should make it 10%.
Children are clearly being targeted with that 25%. We should remove it as much as possible.
We must also consider digital and online marketing, which seem absent from this proposal. A few years ago, Diageo announced that 21% of its marketing budget was going towards online marketing. Recently, Finland introduced legislation banning alcohol apps that contained games, location settings and information on where the nearest place to drink was. Clearly, these are targeted at children. It is social engagement. A young person who visits Youtube sees advertisements for alcohol that I do not see. I know this from when my nephews and nieces show me clips on Youtube or other social media. Children are being targeted. I do not get the same advertisements. I tend to get the weight loss ones and so forth that seem to target my age demographic. Children get the alcohol ones. This is telling and we should be well aware of it.
Who will carry out the regulation of alcohol marketing and enforcement of penalties? Will it continue to be the Alcohol Marketing Communications Monitoring Body, AMCMB? Will the Minister discuss section 16 of the Intoxicating Liquor Act with the Department of Justice and Equality? It relates to the making of regulations on advertising and promoting. Perhaps we could commence the section immediately.
An issue is absent from the Bill that many presentations raised with us, namely, sports sponsorship. I do not understand why we do not simply set a date. It is inevitable. It is telling that neither sports organisations nor the drinks industry will give us figures for sports sponsorship. Yesterday morning, I attended an interesting briefing given by Ms Katherine Brown of the Institute of Alcohol Studies, IAS, and organised by Alcohol Action Ireland. She stated, "Alcohol sponsorship of sport is a gateway to children's bedroom doors". She referred to the posters of our sporting heroes on bedroom doors. It is a child protection issue.
What the Minister is doing in respect of labelling is welcome. At a conference organised by Alcohol Action Ireland on Tuesday, there was an interesting presentation on whether the health warnings should include cancer warnings. Clear evidence was given in a similar fashion to that in respect of tobacco. Is this something that the Minister should consider?
The issue of section 9 of the Intoxicating Liquor Act also arose. It relates to the separation of alcohol products. The National Off-Licence Association, NOFFLA, outlined an easy way of doing this. It provided an architect's diagrams and the like. It is not as great a difficulty as one might believe. Why can we not commence this section immediately?
I was concerned by the emphasis placed on the role of education in some of the submissions to the committee. They tended to be those linked to the drinks industry. Education informs our behaviour, but it does not change it. I cited the example of picking up our mobile telephones while driving. In the Minister's previous role, he introduced a law and we changed behaviour because people did not want to get caught. I know that I should not pick up my telephone, but I swear at the Minister at least once per day when I go to pick it up, only to stop because I do not want to get caught. I know it is wrong, but legislation is necessary.
I do not even look at it. It is in the boot. I am concerned about Drink Aware advertising for an education programme manager to visit our schools. It is an issue for the Department of Education and Skills, but it is also an issue for the Department of Health, which is helping with the SPHE programme. The HSE has done good work in this regard. Drink Aware and the drinks industry have no role in our schools.
On a personal note and in front of the Minister for Health, I wish to put on record my thanks to the Tullamore regional hospital for the care and attention it has given me after a serious hip operation. I offer many thanks to Mr. John Lunn, an orthopaedic surgeon, and his staff. It is important to put on record the great services provided by hospitals.
The Minister mentioned that his counterparts in Northern Ireland were planning to introduce minimum unit prices for alcohol. Have they given him a firm commitment that these will be introduced? Has he or his officials discussed at what level the minimum prices will be set in Northern Ireland? My constituency of Louth borders Northern Ireland. It is important that the regions' minimum unit prices be set at comparable levels.
Proper labelling regarding the health effects of alcohol is vital. The Minister plans to introduce three pieces of labelling to alcohol products, namely, health warnings, the amount of pure alcohol as measured in grams and the calorie count. I agree with this plan. As the Minister rightly pointed out, standard units are widely misunderstood. If information was displayed on labelling, it would go a long way towards helping consumers make informed decisions on their alcohol consumption.
I thank the Minister for his comprehensive presentation. I will focus on one or two points. A recent publication by Dr. Orla Crosbie of Cork University Hospital addressed liver damage and cirrhosis of the liver and how the situation had changed in the past 20 years. Approximately 40% of patients in these categories now are female whereas there would have been few or no female patients 20 years ago. A frightening finding in the study is that many of these females are young mothers with young children.
I will focus on section 9 of the Intoxicating Liquor Act, to which my colleague, Senator van Turnhout, referred. I raised it as a Commencement matter in the Seanad this week. If we publish legislation at the end of July, it will have gone through the process by November or December. Implementation will take a further six to 12 months. Why can we not consider section 9 of the 2008 Act, which clearly set out the question of the segregation of alcohol products? According to the Minister's submission, there is an ongoing discussion with the Minister for Justice and Equality. Can we not implement section 9? The legislation is already in place. Section 9 could be implemented by 1 January of next year. If we go through this legislative process, however, it will take at least a further 12 months. Why can we not agree what needs to be done in respect of section 9 so that the industry can prepare for it and there can be a clear timeline? Currently, there is no timeline or any guarantee that we will have passed this legislation by December. The structures that we have discussed establishing will not be in place by the time the next general election comes around. As such, there is no guarantee that the legislation will not be changed immediately afterwards. Section 9 already exists. We can implement it. If we put a timeline up to 1 January in place, we will have implemented some change instead of living with the current ifs and buts. Will the Minister's Department and the Department of Justice and Equality consider my suggestion?
I thank the Minister for his presentation. I have two questions. Are there plans for the regulation of the proximity of off-licences to schools, crèches, youth clubs and resource centres? I believe the current requirement is 100 m. I will cite an example of a school in Youghal. People can come out the front gate, walk across the zebra crossing and go straight through the door of an off-licence. This situation needs to be addressed.
Will the Minister consider raising the age for purchasing alcohol to 21 years in off-licences while leaving it at 18 years where people can drink responsibly in pubs? It is less likely that 21, 22 and 23 year olds will purchase alcohol for 16 and 17 year olds. This suggestion widens the age gap.
I welcome the Minister's presentation. The proposed legislation is also welcome and the feedback on it has been positive, but perhaps it does not go far enough. I will air two issues.
Obviously, they have been raised previously. We must grasp the nettle of sports sponsorship as it relates to this area and at least start the process of stopping that area of sports sponsorship. The other issue, mentioned by Senator van Turnhout, is online advertising. These are two important aspects. The proposed legislation needs to be strengthened to take account of these two areas.
I am not a member of the committee but I did not want to miss the opportunity to comment on the proposed legislation. I commend the Minister on what is probably one of the most progressive pieces of public health legislation, certainly in the lifetime of the Government. In conjunction with the Public Health (Standardised Packaging of Tobacco) Act 2015, it is up there with the previous legislation on the smoking ban in public houses. In years to come, we will be able to measure the public health dividend from legislation such as this. We are certainly trespassing on powerful commercial vested interests in the drinks sector and retail outlets for alcohol.
I wanted to raise specifically the issue of sports sponsorship to which Deputy Healy and others have alluded. I have spoken to the Minister about this and written to him on it as well after the Government decision to proceed with the legislation. Is there something slightly contradictory in the proposed legislation as envisaged not dealing with the issue of sports sponsorship? In his speech the Minister stated, "There is a compelling body of research which shows that exposure to alcohol marketing, whether it is on TV, in movies, in public places or alcohol branded sponsorship, predicts future youth drinking." There is a lot of funding in advertising. Senator van Turnhout referred to the online marketing budget making up 21% of Diageo's total marketing budget. I have heard the Minister rail against the criticism of one specific aspect, which criticism blindly ignores the many progressive areas the legislation deals with. Is there a danger that as we close off a number of avenues for advertising in particular areas, the closing off of which is welcome, this budget will find its way in greater volumes into sports sponsorship? If the Minister closes off advertising in cinemas, on billboards and on television at particular times, this money will seek an outlet elsewhere. It is like the laws of gravity. It will find an outlet somewhere else. There is a danger that greater sums of money will be poured into sports sponsorship. It is not a benevolent gesture by the drinks sector to sponsor sports. It does it because it recognises there is a return on such investment. This is the Achilles heel of this progressive legislation. I would like the Minister to consider that, and while I do not expect a definitive answer on it now, I am aware he is open to further consideration of the issue.
On the argument of minimum unit pricing versus below-cost selling, Senator Colm Burke referred to the fact that with the best will in the world, passing the proposed legislation through the Houses of the Oireachtas and producing the various regulations that will follow mean it is likely to be two years before we will have some gain from it. Is there a case to be made for banning below-cost selling of alcohol under the groceries order or the legislation that banned below-cost selling as an interim measure while we await legal clarity from the European courts on minimum unit pricing, the concept of which I support? It would be quite easy for us to take such an interim measure.
I congratulate the Minister on what he has done. I want to raise one issue. I want to highlight the importance of this in another area, that is, mental illness. Alcohol affects those who have some form of mental illness and it compounds the situation. Alcohol damages the brain cells and is a cause of certain mental illnesses. A recent study in one of our counties found that 36% had consumed alcohol at the time they had taken their life. Another study found that half of those under 35 who committed suicide in three countries had alcohol in their bloodstream as well. It is accepted internationally that alcohol plays a role in the area of self-harm and suicide. The World Health Organization states that a person who is currently abusing alcohol is eight times more likely to die by suicide than if he or she was not.
Mental ill health is a vast area, especially in young people. For example, the brains of those in their teens are developing and alcohol inhibits or affects that. There can be life-lasting effects if there is a high consumption of alcohol by young people whose bodies are in the development stage, and their brain is part of their bodies. That has been well researched internationally.
The area of those who have suicidal ideation but are inhibited in taking their lives is also well researched internationally. Taking alcohol can remove that inhibition. We often hear of persons who were in great form at a disco and they were never seen in better form, and they have drink taken. After a certain amount of drink, they look at taking their own lives and they are less inhibited. Often they go home and take their lives. We all are aware of such cases. People are very confused about why something like that would happen but a lot of it has to do with alcohol consumption by those who have a level of mental unwellness. There is a continuum of what constitutes mental illness. Not all mental unwellness is mental illness. This is an area in which we can help in assisting the work of suicide prevention organisations and the office of suicide prevention of the HSE. The Minister can, through this proposed legislation, contribute to assisting such work in trying to reduce the levels of suicide, self-harming and suicide ideation.
I apologise for having to leave earlier for a while. I thank the Minister, Dr. Holohan and Ms Luddy for attending. I thank the Minister for his speech. I wholeheartedly support minimum unit pricing. One of my questions, which has already been asked, was how long it would take to put this in place.
I have two other questions. The first relates to the structural separation in shops and supermarkets and, I hope, in petrol stations. Who will supervise and monitor the visible availability of alcohol? How will it be put in place? The Minister stated that business would not be put under any extreme pressure if there were costs involved in making a separate area in a supermarket or petrol station. One of the drawbacks, even in supermarkets and shops I have been in, is that there is a separate area for alcohol which used be at the back but which seems to be creeping up to the front where the service desk is.
How young people view alcohol is a result of the pressure on them which is caused by being unable to cope with many of the difficulties they face.
There is no mention of education in the report. Maybe it will appear in another report. I have heard people saying that education does not make any difference to people who want to drink. As a mother, I have always spoken to my children about the ill effects of drink, drugs and smoking. I have achieved some of my goals with them but not all. If we are going to educate young people about the consumption of alcohol and drug addiction, it starts in the home but it must continue into school. Is there anything in the Bill for schools and colleges? I know from my children about the consumption of alcohol on so-called "cheap nights" where the price is a lot lower than it should be. What about the sale and marketing of alcohol?
Education should take place as early as primary school. I met a little fellow a number of years ago. He visited me in the youth club one night and I could see he was not in a nice place. He had drunk a half a bottle of vodka before he came in and he should have been carted off in an ambulance. Alcohol is readily available. I welcome the introduction of minimum unit prices but I want to know how it is going to be monitored, particularly in stores, supermarkets and petrol stations. If businesses are not prepared to pay the cost of moving drink in the aisles, how will it be tackled?
I hope I have jotted down all the questions and I am sorry if I miss any. The analysis of Deputy Ó Caoláin is totally correct. It is 11 litres per person, but that includes the whole population, including the 20% of people who are teetotallers. That brings the average down. We have a higher proportion of teetotallers than other countries. The intention is that the Bill will be published before the summer recess so that Members will be able to consider it over the recess and propose amendments, but that is not 100% under my control. Things can get held up at the Office of the Attorney General or the Office of the Parliamentary Counsel, meaning that it has to go back to Cabinet and committee, so I cannot promise it, but that is what we are working towards. I want it to go through before this Dáil and Seanad end. A lot of work has been put into it and it would be a real shame if it fell to the next Dáil to start from scratch or look at it again.
Deputy Ó Caoláin made the point that a minimum unit price, MUP, may affect those on lowest incomes the most. There is a grain of truth in that because people on lower incomes are more likely to buy low-cost alcohol and are therefore more likely to be affected by this measure, though that depends on how much they drink. If they do not drink at all it does not affect them at all and if they drink a small amount it is only going to affect them to a small extent. The corollary of that, however, is that people on low incomes are more likely to abuse alcohol and there is a correlation between social class and alcohol abuse. Those on lower incomes and who are poorer are more likely to abuse alcohol. In many ways, alcohol contributes to poverty and poverty contributes to alcohol. Poverty might drive some people to alcohol and alcohol might cause poverty for others, because if one grows up in a household where one's parents abuse alcohol, surely one is much less likely to get a good start in life. If one drinks heavily in school or college one is not going to do as well. If one drinks as an adult one is going to miss work and is less likely to get promoted. There probably is a correlation between poverty and alcohol and between inequality and alcohol, so the fact that it may affect that group more in some ways strengthens the argument for it, not from the point of view of disposable income but from the point of view of public health.
Among the groups that can be counted as low income are students and children. Students and children do not have a lot of disposable cash and they buy really cheap alcohol with it, so it will affect them more, but it is kind of supposed to, as they are the ones who are most at risk of damaging their health, their mental health and everything else from alcohol consumption.
Senator van Turnhout and others asked about the code of conduct. At the moment the code of conduct is voluntary and not legally enforceable. That will be replaced by regulations, by statutory instruments, by law. It is not that we are going to put the code on a statutory footing, which, as the Senator will know from her experience with Children First, does not necessarily work anyway. It will be done by regulation and by law. It will not then be voluntary but will be legally enforceable, and there will be penalties. Even if the code is not changed - and I am not saying it cannot be strengthened - it will make a difference, because the current code is widely flouted. For example, one is not supposed to associate alcohol advertising with speed but that is done all the time. I am ashamed to admit I was at the Bavaria City Racing event. How could one associate alcohol with high speed to a greater extent than that? Some of the advertisements associate alcohol with sporting prowess - one drinks a certain beer and can throw a rugby ball or hit a light switch. That is a total violation of the code. A similar case is where a player is heading for the try line and the Guinness turns into a ball; he catches it and scores a try. If he has had that many pints he is not going to be good at the violin or score a try. In fact, he is more likely to drop the ball.
We will certainly examine the possibility of using online advertising and apps, and I would be interested if the Senator could give me more information on what they have done in Finland in that regard. I have a sense, though, that when it comes to online advertising we will only be able to deal with it on a European or an international level. It is, after all, the World Wide Web.
Enforcement will be carried out by environmental health officers. They are people who work for the HSE and are part of the health family. They go into restaurants and shut them down when there are hygiene issues and they are very effective. They go into the pubs and enforce the smoking ban, at which they are also pretty effective, and they also enforce the regulations around sunbeds. They will be given this additional, very important role on alcohol. They will need to be supported and to get an increase in resources. They are a good bunch of people. I do not think a lot of people around the country know what an environmental health officer is, but the job they do is enormously important and very valuable.
My understanding is that health labels will be dealt with by regulation and signed off by me as Minister in the same way as the Minister for Transport, Tourism and Sport, Deputy Paschal Donohoe, signs off on road signs. I agree that they should probably include a warning about cancer, because alcohol is a major contributory factor in liver cancer, oesophageal cancer and so many other cancers.
Deputy Neville and Senator van Turnhout asked about the commencement of the existing section 9 of the Intoxicating Liquor Act 2008. That is legislation that belongs to the Department of Justice and Equality, so it would fall to the Minister for Justice and Equality to enact it. There are two reasons it has not been enacted six or seven years later. First, it is very onerous and requires a separate till and walls, which is perhaps is a little bit too onerous on some retail outlets. Second and more significantly, there is no enforcement mechanism. Even though it is a law, there are no powers to enforce it nor any penalties if it is breached, so it is an ineffectual piece of legislation and that is why it has not been commenced to date. We will either have to bring in a mechanism to enforce it or just replace it with a new piece of legislation.
Deputy Fitzpatrick asked about the cross-Border issue, about which I am very aware. We have a North-South sectoral meeting every four to six months with me, the Minister for Health, Mr. Jim Wells MLA and the Minister for Children and Youth Affairs, Deputy James Reilly. It is a standing item on the agenda. We always ask how we are getting on with minimum unit pricing and we then have a discussion about it. We have discussed the price but have not agreed one.
Deputy McLellan asked about off-licences and their proximity to schools and crèches. That also falls under the Department of Justice and Equality and would be relevant to the sale of alcohol Bill and to licensing generally. I think it would be a difficult thing to do. I come from a very urban constituency and there is virtually nowhere that is not 100 m or 200 m from a crèche or a school. I would perhaps have to go to County Meath to buy a bottle of wine. One could put it at 50 m or maybe 60 m. One thing we will look at in that context, however, is whether we will allow advertising within a certain radius of a school. Again, that will be tricky.
In urban west Dublin and in many urban areas, schools and crèches are very numerous.
Changing the age of purchase to 21 would fall under the Department of Justice and Equality legislation. I would not be convinced as to whether raising the age to 21 would be a good idea and would have to see evidence to support it.
Deputy Creed spoke about sports sponsorship. The legislation deals with sports sponsorship by regulating and restricting it very heavily. However, we decided not to go for an outright ban for numerous reasons, most particularly that as no alternative funding source was identified, it would lead to a loss of income for sport which would then percolate down to local levels.
One potentially could, but it was not agreed. That is the bottom line. Some people assume that minimum unit pricing will result in a revenue boost for the Exchequer. I hope there will not be; I hope minimum unit pricing works to bring down consumption and therefore there is not an increase in revenue. I actually hope the revenue goes down because if we get alcohol consumption down from 11 litres to 9 litres, that is 20% less alcohol sold so there will be a cost in pure accounting terms. Obviously, there will be a longer-term gain from better health.
In the committee's first term we held hearings on the issue of alcohol. We did not submit a recommendation on sports sponsorship because there was not consensus in the committee. However, it is the Achilles heel in the Bill. Those of us involved in sport recognise the importance. My club in Bishopstown has a bar that helps to fund the activities. However, at one level it sends the wrong message. At one level it is promoting public health which is very positive. However, at the same time we are saying to the sporting organisations, albeit with modifications, that they can continue to get money from these people. I know it is not the perfect answer.
I see the Chairman's point. Until recently one of my local clubs was sponsored by a nightclub and it is not unusual for a club to be sponsored by a local bar, so I see the contradiction.
Even to put it out further to 2025 would give the beneficiaries of the current sponsorship contracts time to reposition themselves. It may not be the drinks industry; it could be an insurance company, a food company or whatever. However, there are alternatives.
By the same token I wish to raise a personal hobby horse. The Minister was previously Minister for Transport, Tourism and Sport. If one looks at the iconic images of the visits of President Obama or Queen Elizabeth, they were taken with alcohol involved, which is a mistake. At one level we are promoting public health. However, we have issues with Arthur's Day and the emergency departments of our hospitals being full. In my club, for example, the bar gives us revenue we could not get otherwise. As a society we need to have a conversation about the message given by the association of alcohol with sport and young people.
That is a debate we will have for a long time. I do not get all that upset over seeing President Obama having a pint of Guinness. It is not the pint of Guinness that is causing our problems, but it is the excessive numbers of pint of Guinness.
I get the point. I just wonder if there is a risk of going too far into a nanny state space in some of these things. I will not rubbish the Chairman. This legislation was bandied about Government for three or four years and it was not possible to get agreement on it. We are in year five of the Parliament and I wanted to get good stuff done. As I have said before, and I really mean it, the perfect is often the enemy of the good. When people are willing to sign up for 85% of what we want we take the 85% and come back for the 15% later. We will write into the legislation a review after three years. It is a legislative requirement that the Minister three years after enactment will need to look at the issue and all these issues again.
Changes to the groceries order would need to be done by the Minister for Jobs, Enterprise and Innovation. I would not have any objection to using it if that were agreed. However, our concern is that it would not be effective for the reasons I outlined earlier. It could also be challenged under competition law and consumer law. It is a very old order and I am not sure if the primary legislation underpinning it has policies and principles and all the rest of it.
Deputy Catherine Byrne and some of the other contributors mentioned education. I think there is a very strong role for education. I am convinced that education on its own does not work, but as part of the package education is very important. We have seen that with smoking and other things. There have been very effective education approaches to that. Perhaps officials from the health and well-being section of the HSE should talk to officials in the Department of Education and Skills about it to see if we can carry out a schools programme. That would be a good idea.
The Minister turns my concerns into what he would describe as a positive in terms of the Bill's impact on low-income families and students. That is not what the Bill should be about because it misses the point. Students by and large have no or very little disposable income. Drink abuse among low-income families and students is more in evidence because it happens in a more public way. People are going from their homes to a pub. That would be the case with students. They are not buying in drink to drink in their homes. They are not having the negative impact on dependants, young children and older children, and what they are exposed to.
Those who may well have the greatest problem in all this are those who can afford the more expensive alcohol products. The Minister is not seeing the reality of the lives that they lead and the impact that their problems have on those who are dependent on them. We need to recognise the raft of different social issues that require address in terms of people on low income and even the student population. However, it is not about making their access to alcohol more expensive or even in some cases prohibitive. That is not what the Bill is about. It may be part of it, but there are many other measures that would make a difference to the lives of people in those circumstances. We need to look at the issue holistically and not to take our eye off the biggest problem and that is the one that is least exposed in terms of alcohol.
I ask about the timeframe. The Minister has said that section 9 of the 2008 Act cannot be implemented. My understanding is that section 9 is quite specific and that the Act contains provisions whereby if there is any breach of the legislation, fines can be imposed. I do not understand why it cannot be implemented. It may be looking for too much from retail outlets. However, if we get the legislation published and passed by December it could still take a further 12 months for that part of the legislation to be put in place, resulting in a delayed process again. That is why I am raising section 9. Why can it not be considered? We could use section 9 to set out clearly that segregation will come into place by a certain date even at this stage if the new legislation does not go through. I am concerned about the timeframe issue.
Senator Burke, may I correct what I said earlier? There are penalties in the Intoxicating Liquor Act; however, there are no enforcement powers. There is nobody who can enforce it, so we could commence it but it could not be enforced, which seems pretty pointless. What would happen is that all the retailers would say they would wait until the new legislation comes through to see what they will have to do. The timeline will be around 12 months. One has to give reasonable notice to people to comply with the legislation. If we can enact the legislation by the end of the year, giving people about one year's notice to comply with it, that would bring us up to the end of 2016, which is not all that far away.
That is in the detail of the legislation and the regulations. I would be interested in seeing the suggestions the committee will make in its report on how to deal with this issue. I personally think that requiring a brick wall and a separate till is too onerous, particularly for very small shops, but one does not want to make rubbish of the new provisions. The current retail code is rubbish, as it qualifies the provision by stating "as far as is practicable," and that is not enough.
-----and one should not be walking through and past it. It should not be behind the till. What really bothers me is the display of alcohol right behind the till in the small stores around town. One sees the vodka and one starts to think about buying it, but obviously I never do.
To deal with the point raised by Deputy Ó Caoláin, the only purpose and intention behind this Bill is one of public health. I might ask the chief medical officer to comment on this, because he would be able to put across the research better that I would. My understanding is that it is not only an issue of visibility, but the research does show that the low-income groups spend a higher proportion of their income on alcohol and drink more heavily. It is not just that it is more visible, or that there are large numbers of wealthy people secretly drinking huge amounts of expensive alcohol. The research does actually show that those on the lowest incomes are the ones who consume the most alcohol. Unfortunately, that is so often true in health - it is known as the inverse care law. Those who need the most health care get the least, and they are the people who always put themselves at the most risk as well.
Dr. Tony Holohan:
We are talking about the health risk associated with alcohol. It is a reality that the distribution across society of the burden of alcohol consumption is not even and falls disproportionately on lower social classes. It is exactly the same as for all the major lifestyle-related risks, such as tobacco consumption, physical activity and obesity. That then finds expression in patterns that we are all too familiar with. We see that the burden of chronic disease falls disproportionately on people in lower social classes. That is a result of the way in which alcohol consumption is distributed.
The other point that is relevant in the context of consumption patterns is that, of our figure of approximately 11 litres of alcohol purchased per year, which comes from Revenue statistics, the greater portion is purchased in off-licences rather than the on-trade. Most alcohol that is consumed in this population is purchased in the off-trade. The pattern of drinking among young people, with their limited income, is significantly facilitated by having access to cheap alcohol and their pattern of purchasing is to buy cheap alcohol from large multiples rather than in pubs.
Dr. Tony Holohan:
Overwhelmingly our concern is in relation to mixed trading. The standalone off-licences are in a different situation because alcohol is their primary business. In the mixed trading environment, particularly in large multiples, the ability of people to have access to large volumes of alcohol at very cheap prices is driving a significant pattern of consumption, which has resulted in an enormous shift in the pattern of consumption of alcohol over a decade or two. The vast majority of alcohol consumption happened in the pub environment when we were younger. The off-licence or off-trade was not a significant component of our lives. Most people got off-trade purchases in over-the-counter transactions in on-trade environments, in contrast to the current reality whereby the majority of alcohol consumed in this country is purchased in the off-trade. In that sense, something that is discriminatory in the sense of targeting more off-trade rather than on-trade purchasing is consistent with our policy objective to reduce the sale of alcohol.
I have two short questions. In regard to imposing extra costs on businesses, the Minister did not address the question of businesses that say they cannot afford to create a separate area for the sale of alcohol. What will happen to them?
How many environmental health officers are employed? If the Minister does not have the information, will he find out?
Dr. Tony Holohan:
The figure is in the hundreds, but we will get a precise figure for Deputy Byrne. As late as yesterday we were having discussions with the Department about the planned expansion of that service, in line with what the Minister said. We know we will need to invest in both the number and the capacity of environmental health officers, as well as training. They will be instrumental in enforcing this legislation.
On the issue of structural separation, we need to work it out. We will work it out in consultation with retailers as to how it can best be done without imposing enormous capital costs on them. It needs to be done for real. It has to result in reduced visibility and reduced availability, with alcohol perhaps being kept behind a screen or in cabinets. There are many ways in which it could be done. It might be the case that some retailers decide that they do not make all that much money out of the alcohol anyway and it is not worthwhile continuing to stock it. If that is the case, that is not necessarily a bad thing.