Thursday, 17 December 2015
Public Health (Alcohol) Bill 2015: Second Stage
I welcome the Minister to the House. I am sure the points I make will be duplicative. I have been asked by the Royal College of Physicians in Ireland and others who are the experts in the area to make a few points. The following is the fantasy scenario that would happen if everybody in Ireland stopped drinking alcohol completely tomorrow. There would be a colossal decline in the incidence of liver disease, although there would still be some non-alcoholic liver disease. There would be a major decrease in the incidence of cancers of the head, neck, throat, oesophagus, pancreas and breast, as well as cancer of the liver. There would also be a decrease in domestic violence and violence in general. There would be a decrease in child neglect. There would be an increase in the disposable income available to families to spend on their children's food, clothing, shelter, health care, education and other requirements. There would be a major decrease in assaults of all kinds and a decrease in rape. There would be a decrease in unwanted pregnancies and a decrease in foetal abnormalities. Road deaths would decline and the burden faced by accident and emergency departments would go down. Waiting lists in our hospitals would decline quite dramatically. In addition, we would have increased productivity at work and decreased absenteeism. These are all the things which would happen if everybody stopped drinking completely tomorrow morning. Obviously, that is not going to happen.
Most of us here, myself included, enjoy a drink. It is part of our culture, part of the personal reward we give ourselves and part of our social system. In trying to formulate policy, however, it is important to realise what would happen if everybody simply stopped. One often hears the argument advanced that a certain amount of alcohol is better than no alcohol in terms of cardiovascular risk and, of course, both are substantially worse than excessive alcohol. While that is all well and good, the minute one has that first drink, one does not know whether one will be the person who is a moderate, temperate, non-addicted drinker. The problem is that a substantial percentage of those who start to drink will become unhealthy drinkers. I am afraid that the proportion in Ireland is relatively high. It may be true that if everybody in the country had one glass of nice red wine a day and no one had more and no one had less, we would be healthier than if we had none. It is an interesting hypothesis but it would be difficult to test in the context of a prospective random assignment trial. In practical terms, however, it is a fantasy. When one has that first drink, one does not know what is going to happen.
I must join in the praise most of us have for Senator Barrett, who has been, over the course of my single term in Seanad Éireann, one of the most consistently effective and serious legislators in the House. As an individual, he has contributed more to enriching and improving the Bills that have come from the Dáil than any other Senator or indeed most of us put together. However, I disagree with him on this. I also disagree with some of his facts. In reality, there has been something of a downward blip in alcohol consumption over the last few years, which related to economic forces. If one actually looks at alcohol consumption in Ireland in terms of litres of pure alcohol per adult per year, one can see the trend. In 1965, we consumed fewer than 5 litres each. At the peak of our economic activity, we got up to approximately 13 to 14 litres. While the amount has since decreased somewhat, it is still two and a half times higher per person than it was in the 1960s. If one compares the recession we had in 1982 to the one that some would argue we are still in - I do not know, and I will not go into it today - one finds that alcohol consumption in the latter period was still one and three quarter times higher than in 1982. Thus, the relentless pressure appears to be upwards. As such, it is important for us to understand that while asking everyone to completely stop drinking alcohol, myself included, would be unwelcome, it is our national goal.
Our ambition for the tobacco industry is bankruptcy. We want it either to stop selling tobacco or to become bankrupt. We have no other ambition for it. Our ambition for alcohol consumption is a substantial decline in the unit consumption of alcohol per head of population. If anyone thinks that any part of the alcohol industry is our partner in this, that person is deluded. The industry has one ambition, which is to sell more alcohol. From retailers to manufacturers to distributors, the industry is not our partner in public health on this. It should not be part of the equation whatsoever. The measures the Minister and his predecessors have put forward will have the support of most who worry about the consumption of alcohol in this country.