Dáil debates

Thursday, 8 February 2018

Public Health (Alcohol) Bill 2015 [Seanad]: Second Stage (Resumed)

 

2:25 pm

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

3 o’clock

Ba mhaith liom a rá ar dtús go dtógaim deoch. Is maith liom é. Is maith liom dul isteach i dtithe tábhairne, is áiteanna sóisialta iad, agus is maith liom fíon le béilí. I take a drink, I enjoy it and I also enjoy going into many of the pubs because there is a very good atmosphere. I know the numbers employed in the drinks industry and I know the interest in the growing market in craft beers we have seen recently. Some areas of the country are producing their own spirits and this is having a positive impact on employment and the spirit in rural Ireland. I also know the numbers who visit the breweries and distilleries around the country, and the spin-off merchandising industry from that, as well as the visitors who come to enjoy the pub atmosphere and the music. However, there is no doubt but that we have a very unhealthy relationship with alcohol in Ireland. We know the damage it is doing to individuals, families and communities the length and breadth of Ireland. That damage is physical, mental and emotional, and it is because of the misuse and abuse of alcohol.

Apart from that physical and psychological cost, there is also a very serious financial cost to both individuals and society. We know figures of €1 billion to €3 billion have been quoted between health and justice because of the abuse of alcohol, which is a serious contributing factor in assaults, domestic violence and sexual assaults, as well as in self-harm, suicide and attempts at suicide. Child welfare concerns have also been articulated for those who are living in families with alcohol issues. Even for those young children who do not come to the attention of the child welfare agencies, the evidence is strong of the damage done to children and young people through living with excessive drinking. We also have figures on absenteeism from school and from the workplace. From my knowledge of prison and those in prison, I would venture to suggest that at least 50% of those who are in prison are there because of alcohol or drug issues. Into that mix come the illegal substances and drugs, and we see poly-drug use with alcohol, which is a lethal mix.

That is the damage from the misuse and abuse of alcohol that has been going on for generations. There is also the association of alcohol with every occasion from birth, when we have to wet the baby's head, to death and on all the occasions in between. There is a drink for every occasion and for every mood or feeling, whether one is sad, happy, lonely, depressed or celebrating. There is now a culture of normalising alcohol with everything that goes on in our lives. Another normalising aspect is that it is almost acceptable, if that is not too strong a word, to be drunk, to be over the limit or to have one too many. It is disheartening that, as a society, we are not shocked enough when we see such examples of excessive drinking.

We know the reports, the statistics and the surveys. I have looked at one from the Health Research Board on the per capitaalcohol consumption compared with other countries, and Ireland scores highly. The board then makes the point that if one fifth of the adult population is not taking alcohol, that puts the per capitafigures even higher.

When I was speaking on the Bill on removing the Good Friday ban, I made a point about St. Patrick's Day. I acknowledge what many cities and towns are trying to do to make it more family-friendly but there is no doubt that St. Patrick's Day - a public holiday as well as a day of religious significance - is a drinking day and, unfortunately, it is a drinking to excess day; it is drowning the shamrock. In parts of our cities, the late-night streets are just rivers of broken glass, urine and vomit and that is not just confined to St. Patrick's night but is also a feature on many weekends in the cities. Gardaí, members of the ambulance services and staff in accident and emergency are the ones who bear the brunt of that excessive drinking and drug taking.

That is an overview of the reality, the damage and the negatives from abuse and misuse of alcohol. If one turns to the new strategy, Reducing Harm, Supporting Recovery, I note the expert panel conducted a review of the previous drugs strategy and characterised alcohol as the elephant in the room. The question is how we are dealing with that elephant in the room, that is, with the damage, devastation and harm that is caused by abuse and misuse. This Bill is being presented as a way forward in addressing that and in responding to the damage. It is doing that through a new system of labelling, restrictions on advertising, structural separation of alcohol and measures on promotions and minimum pricing. I have to ask what difference those measures will make to the problem drinkers, to those who misuse and abuse. What difference will they make to excessive drinking and the drinking culture? Will this Bill have the effect it is claimed it will have? I have my doubts, in spite of the statements of welcome and optimism as to what it will do in raising awareness of the risks associated with alcohol and in reducing consumption. To me, this Bill is only a small part of a much bigger conversation. Although it has taken so much time and work, I feel the Bill is just scratching the surface of the issue. While it is about alcohol, the new strategy, Reducing Harm, Supporting Recovery, covers drug and alcohol use in Ireland, which is the much broader conversation we need to have.

When we look at the drug situation, we have legal and illegal drugs. There are frightening statistics on the increase in prescription drugs, such as oxycodone, fentanyl and codeine, with the numbers doubling, trebling and quadrupling. We also have the statistics on the increase in the use of sleeping tablets and antidepressants. These are statistics for medical cardholders, so we do not have the other statistics on drugs bought privately. Then there are the illegal drugs such as heroin, ecstasy and cocaine, as well as the proliferation of tablets on sale. I have to ask whether we are having the right conversation and how serious we are when it comes to tackling the misuse and abuse of alcohol and drugs.

There is a lot of dishonesty, contradiction and hypocrisy in the whole debate we have about alcohol. I see a positive move in the small craft beer cottage industry that is developing in rural Ireland and the employment it is bringing, and Deputy Catherine Connolly particularly wanted that point to be made. While it is a small but growing export business, however, the labels are now required to have health warnings, although this is not an EU regulation. That will be a serious cost for the small brewer but it will not be anything for the multinationals and the big companies which are producing other forms of alcohol. It will hit the small producer because those products will be on a shelf in European supermarkets with this health warning that if anyone drinks the beer, all these terrible things will happen, but they are side by side with beers from other countries with no health warning at all although they contain the same ingredients. That has to be looked at further.

We could put health warnings on so many things in our supermarkets and shops because most things we eat should carry a health warning in some way. There was a dishonesty in the previous debate on the Good Friday ban. Leaving aside the tradition and religious aspect of it, we were told it was all about tourists but we were not telling the truth. It was not about tourists; it was really about the vintners and what they were losing because of the Good Friday ban.

Part of this Bill relates to young people. The Minister wants to create an environment in which our children are not exposed to alcohol products or advertising of such products daily. Short of putting all the children in Ireland on a desert island with no alcohol, I really have to ask about the practicality of this. I accept the arguments being made about advertising but, to my mind, it is about education and awareness-raising among young people on how to cope and deal with alcohol. It is also about raising their critical awareness of what the advertising industry is about, the work it does in targeting an audience's fears and expectations, the hopes it plays on in order to sell a product, as well as the techniques and the strategies. Whether it is a caption or a jingle, using a famous person or using a whole psychology of colour, young people need to understand that. Such critical awareness would be much more beneficial and effective.

There are mixed views among young people when it comes to advertising being an incentive to drink. I refer to work I did with transition year and fifth year students in second level schools in the north-east and north-west inner city, where we got them to look at the advertising around alcohol and drugs. They made the point forcefully that the lifestyle that was being portrayed was a partying one, with money and celebrations. However, they found the lifestyle portrayed in the advertisements to be totally unrealistic in the context of their lives and they did not see it as portraying something they would achieve because they knew what life was about and they knew what having too much drink was about. They also saw the irony in banning alcohol sponsorship of sports when the pub is often the norm as the place to watch these sports. They were not into who exactly was the sponsor. They also saw the irony in the contradiction of sport and alcohol in the same advertisement because they know that sport is about a healthy lifestyle whereas too much alcohol can be unhealthy. They were very aware of what the advertisements were doing.

They discussed their reasons for drinking.

It was to boost confidence and help them relax and have fun. How do we address that? How do we give them the opportunities to celebrate, relax and have fun that do not involve alcohol and drugs? We know confidence comes from a sense of self and self-esteem. That requires joined-up thinking between schools and the communities which have the programmes to work with young people.

I know the argument that the advertising and drinks companies would not spend so much on advertising if it did not have an effect. The 400 young people who were asked over four different events were not taken in by advertising. We need to go beyond that debate and look at the advertising and marketing that encourages young people to stop and think. I want to make the point strongly that the voices of young people should be heard. The work must be done with them, rather than assume that we know what is affecting them, or what works or does not in relation to them. They would be empowered to make the informed choices when they make decisions on alcohol and drugs.

On pricing, no doubt others will have been to supermarkets and hypermarkets in France, Spain, Italy and Portugal where alcohol is often cheaper than alcohol here in Ireland. While those countries have problem drinkers, they do not have the same visible, excessive, out of control drinking that we have here. I am not sure this Bill will make a difference to that excessive drinking. Similarly, regarding on-street drinking, while it can be very nice to sit in the sun at an outdoor café or pub with a drink, whether alcoholic or otherwise, the problem lies where it gets out of hand and that happens because of the culture we have. While each of us is responsible for our drinking, there are irresponsible owners and workers in pubs and clubs who serve those who are clearly drunk. Pubs provide a social atmosphere but they are affected by cheap alcohol and the offers which encourage people to drink at home, where they drink more than they would if they were out. The other side of that is that if no one goes to the pubs, particularly on Monday, they will come up with offers and promotions. I can imagine the offers that we will see this Good Friday.

Another important part of the conversation that we are not having is the services available in Ireland for problem drinkers and drug users, especially for those who do not have private health insurance. We know of the chaos in emergency departments when those presenting with alcohol and drug issues are in the same space as those presenting with coronaries, broken limbs or strokes, for instance. While they are all health matters, there is a need for a separate space. That is not to stigmatise those who are coming in with alcohol and drug issues, but rather a practical suggestion.

I am very struck by all the work that went into the Bill by so many organisations and the Oireachtas staff who were involved in its drafting, along with the extensive lobbying. However, I feel it skirts the real issues. I think of those who are working on the front line in the addiction area and the many projects which have faced so many cuts in recent years but are there for those who want to start a recovery journey, a person in addiction and those affected by the addiction who have a different expectation of what we mean by a public health alcohol Bill. That is the debate we really need.

If one goes to the emergency department drunk, there is an opportunity to sober up before being put out, but at least one project I know takes referrals from emergency departments which gives people the option of recovery. That saves lives. That project has no guarantee of continued funding. There is a lack of residential places for those who do not have private health insurance. I acknowledge the work of Sister Consilio and the opportunities her centres give to those who do not have private health insurance. I also acknowledge the 12-step programmes and the voluntary and community organisations throughout the country which struggle between cuts and the uncertainty of continued funding.

Many people go into prison and get sober and drug-free while they are inside, yet they are then released into the chaos which got them into addiction in the first place. We do not seem to care about that and the revolving door continues to operate.

I also refer to the work of the Recovery Academy Ireland and the number of recovery coaches and the work they do in raising awareness of recovery and providing training and support. They make the point that recovery is possible and achievable.

Overall, I support the Bill and what it is trying to do but there are areas that need further scrutiny, particularly with the unintended consequences of some of its measures. It is disappointing that having taken so long, it only deals with a small part of the problem and what is needed to resolve it.

We need up-to-date, reliable, evidence-based reports. Too many contradictory reports are being published. We also need the same space to be given to young people and those who work directly in areas affected by this in discussing this issue as has been given to the lobbying groups for the drinks industry by Ministers and their officials.

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