Seán Power (Kildare South, Fianna Fail)

I am delighted to introduce the second report of the strategic task force on alcohol. This report addresses what many regard as one of the most serious threats to public health in Ireland, that of the excessive consumption of alcohol by society and its related harm. It provides a comprehensive review of alcohol trends, both in terms of use and consequences, in an Irish and European context. The report's recommendations are based on internationally proven measures which are evidence-based and are appropriate to Ireland's complex alcohol problems.

The strategic task force on alcohol was established in January 2002 by the then Minister for Health and Children, Deputy Martin, under the chairmanship of the Department's chief medical officer, Dr. Jim Kiely. Its remit is to recommend specific evidence-based measures to Government to prevent and reduce alcohol-related harm. Membership of the task force is broadly based and comprises public health experts, non-governmental organisations, the drinks industry, representatives from the Garda Síochána and Departments. This comprehensive report includes a list of recommendations, the purpose of which is to enhance society's capacity to prevent and respond to alcohol-related harm; to achieve the targets set out in the World Health Organisation declaration on young people and alcohol; and to provide for early intervention to ensure effective treatments. This wide-ranging report, which the Tánaiste and Minister for Health and Children will bring to Government shortly, contains recommendations relevant to many different sectors in society.

In the past decade, Ireland has seen many changes which have influenced the context and nature of drinking and have in turn increased alcohol-related harm. Against the backdrop of the fastest growing economy in Europe, Ireland has seen the highest increase in alcohol consumption among European countries. Between 1990 and 2002, alcohol consumption per capita in Ireland increased by 41%. Irish people continue to be some of the highest consumers of alcohol in the world. In EU terms, Ireland ranked second per capita in terms of alcohol consumption in 2001. Among adults, the consumption level was 14.4 litres of pure alcohol per adult. A recent European study shows that in 2002 adults in Ireland had the highest reported consumption per drinker and the highest level of binge drinkers in comparison to other European countries. This study shows that binge drinking is the norm among Irish men with every 58 of 100 drinking occasions ending in binge drinking while the figure among women is 30 occasions out of 100.

There is a tendency to believe that alcohol-related harm occurs only to the heavy drinker or alcoholic. However, it affects those who do not drink, those who drink small amounts but in risky situations, those who sometimes drink to excess and those who regularly abuse alcohol. There is also a tendency to focus on under age drinkers as the main problem group. While cases involving young people are the ones that hit the headlines, the majority of alcohol-related harm happens in the adult population.

Excessive alcohol consumption is a significant contributory factor in personal harms, including accidents, injury, unprotected sex, aggressive behaviour and depression. It is a contributory factor in social harms including fights, assaults, violence, drink driving, relationship and marital difficulties and poor work and school performances. Mortality caused by cirrhosis, cancers, suicide, homicide, alcohol dependency and alcohol poisoning are results of excessive alcohol consumption. It is the combination of high consumption levels and the high rate of binge drinking that leads to greater alcohol-related harm. Alcohol-related deaths have increased over the past decade. Chronic conditions specific to alcohol rose by 61% and acute conditions rose by a staggering 90%, which contrasts sharply with a decrease in the overall number of deaths, 14% for all cause mortality.

The global burden of disease study, sponsored by the World Health Organisation and the World Bank, found that alcohol was the third most detrimental risk factor for European ill health and premature death. In 2002, alcohol-related death and disability accounted for 9.2% of all burden of disease, with only tobacco at 12.2% and high blood pressure at 10.9% causing more harm. Between 1992 and 2002, 14,223 people died in Ireland from five of the main alcohol-related mortality causes, namely suicide, cancers, alcohol poisoning, liver cirrhosis and alcohol abuse. That statistic excludes road deaths and drownings caused by alcohol consumption.

Alcohol continues to be a major contributor to the workload of those working in the health service. I am aware, as I am sure are most Senators, of the high number of alcohol-related incidents that accident and emergency services in hospitals throughout the country have to treat, especially late at night and at weekends. The current pressures on accident and emergency departments are exacerbated by these preventable injuries and accidents.

International research has demonstrated the involvement of alcohol in injuries. Several studies conducted in Ireland have shown the high level of alcohol involvement in accident and emergency attendances. Alcohol-related accident and emergency admissions have been monitored in Cork University Hospital and the increased demands on accident and emergency services can be linked directly with an increase in drunkenness in the city. Drunkenness among girls in Cork city is up by 60% and violence among this group is an additional phenomenon.

A North Eastern Health Board study found there was an 80% increase from 1997 to 2001 in acute alcohol intoxication admissions. Over half these admissions were at the weekend with the average length of stay being 2.7 days while just under a quarter were discharged on the same day. Neither a rise in population nor changes in demographics accounts for the phenomenon.

In a study of alcohol and drug use among young attendees to accident and emergency services, alcohol was identified as a significant problem among the young population in north Dublin where over 38% of those under 31 years of age in attendance in the emergency room were there primarily due to alcohol.

A pilot study carried out in the Mater Hospital in 2001 showed that alcohol was a contributory factor for one in four patients attending the accident and emergency department. The research showed that 30% of male admissions, 10% of female admissions and almost 25% of total accident and emergency attendances met diagnostic criteria for alcohol misuse or dependency. This study, using a WHO protocol, was expanded nationwide to include six major hospitals: Beaumont and the Mater hospitals, and hospitals in Waterford, Galway, Sligo and Letterkenny. The data is currently being analysed and should be available before the end of the year.

A study in treatment service demand in the Southern Health Board and South Eastern Health Board regions showed that over 70% of those treated reported alcohol as their main problem drug. Alcohol use during pregnancy is also a growing concern.

As I already stated, Irish people continue to be one of the highest consumers of alcohol in the world, which comes at a cost. The harm experienced as a result of excessive drinking has personal, economic and social consequences. This harm is not limited to the individual drinker but also to those around him or her and to society.

On a purely financial level, nearly €6 billion of personal income was spent on alcohol in Ireland in 2002. That represents €1,942 for every adult over 15 years of age. It is estimated that alcohol-related harm cost Irish society €2.65 billion in 2003, which is 2.6% of GNP, an increase of 12% from the last estimate. Therefore, we are all paying for something which, for the most part, we believe to be someone else's problem.

The sum of €2.65 billion is just the economic cost. Employees pay when a colleague fails to turn up for work, when a driver gets into a car having consumed alcohol and cannot take a sharp corner on the way home and families pay when a member is aggressive or abusive.

The strategic task force published an interim report in 2002 and since then some progress has been made in tackling the problem. An important marker, that of overall consumption, fell last year for the first time in over 16 years. This was as a result of the implementation of one of the STFA's recommendations from the interim report of May 2002 which called for increased taxes on alcohol products. This change must be preserved and built upon and, in tandem with the implementation of other recommendations, in time we will see a reduction in alcohol-related harm.

Progress has also been made in several areas based on the measures recommended in the first task force report. This includes a three-year alcohol awareness campaign which raised public awareness of alcohol as a public health issue. In addition, the Road Traffic Act extended the grounds for requesting a breath specimen and represents a move to random breath testing. The Government has also strengthened the licensing laws through the Intoxicating Liquor Act 2003, which contains measures to counter drunkenness and disorderly conduct, and to combat under age drinking, including the prohibition on happy hours and the prohibition on persons under 18 years of age from being in the bars of licensed premises after 9 p.m. The Act also prohibits the supply of intoxicating liquor to drunken persons on licensed premises and licensees may not permit drunkenness in the bar of licensed premises.

The parliamentary draftsman is drafting legislation which aims to reduce the exposure of children to alcohol marketing. Several research projects have been undertaken to monitor and inform alcohol policy decision-making. The Irish Sports Council's code of ethics and good practice for children's sport has been instrumental in encouraging national sporting organisations to promote alcohol-free sporting environments. This code contains several recommendations. To date, 62 of 67 governing bodies of sport have signed up to the code and appointed national children's officers to implement the guidelines at local level.

The Health Promotion Unit produced a framework for the development of a college alcohol policy in association with the heads of colleges and the Union of Students in Ireland. The framework provides guidelines for a comprehensive approach, which includes measures on controlling promotion, sponsorship and marketing on the college campus, providing education and support services as well as alternatives and limiting harm in the drinking environment. The responsible server training programme, developed by the Department of Health and Children and the drinks industry, is now being delivered nationwide by Fáilte Ireland. However, while there is an improvement, it is only the beginning and much more needs to be done.

It is appropriate that the responses in this report are many and varied to reflect the nature of the harm and the costs to society. The recommendations in this report incorporate the community, the workplace, parents, the drinks industry, youth organisations and the health service and the breadth of the recommendations reflect our responsibility as a society. The recommendations include building community action projects to enable communities to address alcohol-related problems in their areas, providing support for families and providing professional training for those in contact with alcohol problems through their work. It also recommends that employers put in place guidelines for alcohol policies; restricting any further increase in the physical availability of alcohol; that national sporting bodies with high youth participation develop a proactive strategy to find an alternative to alcohol sponsorship; and increasing alcohol-free alternatives. It recommends putting in place early interventions in a variety of settings — primary care, hospitals, health clinics, courts, colleges and juvenile programmes. It recommends the development of responsible serving practices which discourage high-risk drinking.

There are 78 recommendations based on international research evidence of what works in reducing alcohol-related harm. We can therefore say with certainty that the measures recommended in this report, if implemented, will be effective in addressing the problems associated with excessive consumption of alcohol. The task ahead of us as a Government and as a society must not be underestimated. Introducing a climate where a cultural change can take place is a considerable challenge, but the task force has made a very important start towards bringing about that change. The members of the task force worked hard to provide the Department of Health and Children and the Government with tangible plans. We have two reports from the task force, which together contain a comprehensive range of effective recommendations and provide a blueprint for a co-ordinated framework going forward to tackle alcohol problems at national, regional and local levels.

The Tánaiste and Minister for Health and Children intends to bring this report to Government to seek approval for the implementation of its recommendations. The Government is committed to tackling the problem as evidenced by alcohol being listed as one of the special initiatives of the Sustaining Progress social partnership agreement. The task force has produced a comprehensive, robust report which I urge every public representative, public servant and medical expert, every relevant organisation and institution to examine with a view to working towards the implementation of its recommendations.