Seanad Éireann - Volume 178 - 27 October, 2004
Report of Strategic Task Force on Alcohol: Statements.
An Cathaoirleach An Cathaoirleach
An Cathaoirleach: I welcome the Minister of State at the Department of Health and Children, Deputy Seán Power. I congratulate him on his appointment and wish him every success with that portfolio.
Mr. S. Power Mr. S. Power
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.
Mr. Browne Mr. Browne
Mr. Browne: I welcome the Minister of State and his officials to the House. It is good to have a discussion on alcohol and it is time to have a mature debate on it. There was much hysteria about banning alcohol and people being in bed by 10 p.m. This may sound great as a possible solution but it will not work. I am very encouraged by groups such as the Mature Enjoyment of Alcohol in Society because that is the core objective. The difficulty is that we cannot stop drinking. People in other European countries drink just as we do, but they stop. They can have one or two drinks and then go home. Unfortunately, we cannot do likewise. We have all been in situations where we have had one or two drinks and try to leave a group who react as if the night will collapse. When we tell them we are not having any more to drink, they look at us with complete incredulity. There is something wrong in a society where that happens. One should be able to say one does not want any more to drink and leave it at that.
This is a social issue. Much of this derives from parental example and guidance. If parents and other older relatives show good example, it follows that the children will drink modestly too. I was bemused to see on the day after the All-Ireland hurling final when Cork beat Kilkenny that TV3 was in a hotel in Dublin with the victorious team. They were in the bar and one of the  leading players was drinking pints of lager. The clear inference was that alcohol was in some way linked to the victory. It is anything but and the reality is that all those players probably were not drinking alcohol for weeks or months before the game.
We all accept that alcohol is detrimental to our health, which the Minister of State’s speech proved. It is unfortunate that the media did not interview that player either outside the pub or without a pint in his hand. That image sent out all the wrong signals. How can we be surprised here by young people drinking if they are bombarded with those images from an early age? There is an onus on advertisers and the media in that context to interview sportspeople away from a setting associated with alcohol. That image brought this home very clearly to me.
Many friends of mine have made the valid point that minerals cost almost as much as alcohol. Surely the Government has a clear role in this regard. It could reduce VAT on minerals or non-alcoholic beverages to ensure that people have at least the option and some incentive to save money, have a clear head in the morning and do not risk offending a friend. Instead, non-alcoholic drinks are as expensive as alcohol and there is no real incentive to choose those drinks. That is a practical area in which the Government can play a role and control prices.
When I started going to discos about ten years ago in Carlow, we were served dinner in the local nightclub. One paid an entry fee, received a ticket, had a few drinks and then went in to get a chicken breast and chips, or whatever was provided. At least it sobered one up a little. The difference now is that people go in and drink non-stop for the whole night. Unfortunately, they are also taking drugs with the drink, which is a lethal combination. I thought there was an onus on licensed premises which open late at night to provide some form of food. I have sought clarification on this and perhaps the Minister might know. It certainly was the case in the past, but it seems to have been abandoned recently. It might play some part in sobering people up as they are drinking on empty stomachs. On New Year’s Eve there will be people going into places at 8 p.m. and remaining there until 3 a.m. In a seven-hour period, they will have no food. Surely that is wrong and they should get some food to help them balance things up.
I am very concerned about the idea of a national ID card and why the Government is so lax in that regard. It makes common sense that everyone should have a national ID card. A friend of mine told me recently that her husband collapsed in Dublin after just two pints. It happened at night and most people would have assumed he had been drinking to excess, but he had not been doing so; he just felt unwell. In that case, it would make sense to have a national ID card so that someone could find out who he is because there would be basic information on his ID card, such as his blood group. At least that  information could be given to the emergency services.
God forbid that any of us might be beaten up and left in a heap on the street. It could happen easily if one met the wrong people at the wrong time. Surely it would make sense in that case to have a national ID card. I have not even mentioned the fact that it would eliminate the problem of under age people buying alcohol. They can alter some of the existing ID cards. They would not be able to do that to a national ID card.
I feel sorry for publicans and those who own off-licences who are convicted of selling alcohol to under age people. I saw a case in my own county where a girl went into an off-licence with an ID that had been clearly forged, yet which looked perfect to the person behind the counter. She produced the ID card which declared that she was over 18, so the person behind the counter had no choice but to serve alcohol to her. It then emerged that she was not over 18 and the off-licence was closed for a few days and its owner fined heavily. The irony of it was that the girl in question got away scot free, having deliberately tampered with an ID card. Surely that is wrong as it does not punish the person and make her responsible for her actions.
The Minister of State also referred to women drinkers. He stated that in Cork, drunkenness among girls was up 60% and that violence among this group was an additional phenomenon. That is unfortunately the case on every street in Ireland, yet it was certainly not the case in the past, which is very worrying. I am not too sure what the solution involves. However, some form of a breathalyser test should be introduced. If someone goes out with €150 in his or her pocket on a Saturday night, plans to drink that amount of money, gets exceptionally drunk and injures himself or herself, then that person should have some responsibility towards the cost of going to an accident and emergency unit. The whole purpose of such a unit is for genuine cases, such as someone at home who suffers a heart attack. It is terrible to see fully able people deliberately making themselves disabled. There should be some sanction in that regard. There should be an onus on all of us to know that if we hurt ourselves through being exceptionally drunk, then we have some responsibility. It is not good enough and they should not be clogging up accident and emergency units, depriving genuine patients of the care they deserve.
There are many recommendations in the interim report such as increasing taxes. However, I wonder whether that would drive people to drink more at home, which might not be good. At least a pub is a controlled environment. There is always a grave danger that people drinking at home might drink even more than they would in a pub. The establishment of a national ID card makes sense.
There are also recommendations to restrict greater availability on any new licence that meets specific criteria and to provide for health boards  to intervene in licensing systems. While that might make sense, I also have to question it. If one goes abroad to any EU country or even further afield, one will note that alcohol is freely available, even in ordinary shops, yet the local people are not drinking to excess. Prohibition, therefore, may not be the correct approach. A liberal market might actually have the opposite effect to what we envisage.
Drink driving is a major issue that has been tackled very successfully in the past few years. There is a recommendation to introduce random breath testing, which is a welcome proposal. There is also a suggestion to lower the blood alcohol content to 0.5 mg per litre and lowering it to zero for provisional drivers. I agree with the second recommendation, but I have reservations about the first one. Lowering the blood alcohol level is fine in a city area because people have the choice of taxis, buses, the Luas, the DART, the Nitelink and so on. In a rural setting where people who work late and want to go to the local pub for one, two or three pints and can handle their drink, it is not such a good idea to close them down completely. In some respects, it would make people drink more.
The reality is that if people know that they can drive, they will go out for one or two drinks and drive the car home while under the current limit. However, if we lower the limit to an unrealistic level, such people will get a lift to the pub instead of driving and instead of staying out for a short while, they might stay out for a full night. They know they are not driving and will probably drink much more. It is an issue that should be examined and was raised in the last Dáil by former Deputy Austin Deasy. In the rural setting, draconian measures should not be brought in that would result in people not being able to go out for one or two drinks. We should be realistic and recognise that people do not all have the same transport facilities.
The section of the report on advertising and reducing exposure of alcohol marketing to children also makes sense, as does the encouragement of sports organisations to promote alcohol-free environments for children. It is also regrettable that when the under eight and under ten teams win something, invariably they all end up in the pub. Regrettably, all their parents are drinking and it is turned into a major drinking event, which gives a bad example to the younger children. At communion and confirmation time next year, parents, grandparents, uncles and aunts will invariably end up in hotels and pubs drinking, in some cases to excess.
The provision of information on education and services is a good point raised in the report. We clearly have to link alcohol consumption and poor health and get that message across. We must also provide proper sports facilities. This Government does not have a great record in that area. I am aware of one school in Donabate, County Dublin, that was told to divide its PE hall into  two classrooms, instead of being granted a new classroom. It means the children in that school will not even have a PE hall, even though PE is part of the national curriculum in primary school. That sends out a very bad message.
The collection, collation and proper interpretation of research and data on road fatalities and suicides is very important although I appreciate it is very hard to measure in some cases. I am also interested in the results of prosecutions for the sale of alcohol to minors. I reiterate that if a minor deliberately enters a pub or off-licence with false identification, there should be some onus on him or her to bear some responsibility for that. If I owned a pub or off-licence, I would feel very aggrieved if I discovered that an ID card which was presented to me was not valid, even though it looked as if it was. The sooner national ID cards are introduced, therefore, the better for everyone concerned.
The World Health Organisation has issued a declaration about young people and alcohol. I agree with most of the targets it hopes to meet by 2006, many of which are mentioned in the report under discussion by the House. How can the targets be achieved? That is the main question. Ultimately, we have to encourage the mature enjoyment of alcohol and introduce basic individual responsibility on the part of parents and juveniles. We would do quite well to follow the example of our European colleagues.
Mr. Glynn Mr. Glynn
Mr. Glynn: Cuirim fáilte roimh an Aire Stáit agus gabhaim comhghairdeas leis. I welcome the second report of the strategic task force on alcohol. The report’s recommendations aim to enhance society’s ability to prevent and respond to alcohol-related harm; to achieve the targets set out in the WHO declaration on young people and alcohol; to provide for early intervention to ensure effective treatments; and to increase the responsibility of the drinks industry in reducing alcohol problems.
We have to appreciate that alcohol is a socially acceptable drug. Contrary to common belief, it does have the same effect on everybody. The British Medical Association’s definition of an “alcoholic” was not an incorrect assessment. The World Health Organisation considers that a person whose drinking, or behaviour as a result of drinking, affects any of the three main areas of life — family, work and social activity — is an “alcoholic”. It might be appropriate to state that such a person certainly has a drink problem. It does not matter how much one drinks, but how alcohol affects one or how one behaves after one has been drinking.
The second report of the strategic task force discusses at length the various difficulties which can arise after people have been drinking. Alcohol is all the more dangerous, and all the more difficult to deal with, because it is a socially acceptable drug. The Minister, Deputy Martin, has pointed out that one of this country’s biggest problems with alcohol is one of cultural accept ance, although it might be more accurate to refer to it as cultural indifference. I do not doubt that there is a tolerant attitude to alcohol in this country. Nobody wants to be a killjoy, but it is evident that the pub forms a traditional centrepiece to Irish life. I am aware of that as somebody who goes to the pub from time to time. The atmosphere, music, song and craic found in pubs are intrinsic aspects of Ireland’s tourism industry. It is obvious today that Ireland may lack good weather, but we often compensate for that with conviviality. That does not need to change as long as we are responsible.
It is important to consider the difficulties caused by the abuse of alcohol. I refer not only to the number of working days lost as a result of alcohol abuse, when men or women do not turn up for work, but also to the resultant decrease in production. The Minister of State has mentioned that many workers have to do additional work to compensate for the absence of their colleagues.
Many organisations have been established to deal with alcohol problems. I acknowledge the great work done by Alcoholics Anonymous, Al-Anon and Alateen. The latter organisation has not been greatly successful, but attempts have been made to get it to work. INCA has also played a pivotal role in highlighting the dangers and attending difficulties of alcohol abuse.
Ireland should not be proud of its position in the alcohol league table of nations. There is stark evidence that a significant proportion of the population is not content merely to enjoy a drink. Ireland’s per capita alcohol consumption in 2001 was the second highest in the European Union, including the ten new member states which joined the Union in May 2004. Ireland’s per capita alcohol consumption peaked at 14.4 litres of pure alcohol per adult in 2001. The first fall in consumption for 16 years took place in 2003, when the relevant figure decreased to 13.5 litres per adult. While this decrease is welcome, there is a very long way to go.
Many things have been said during the debate on alcohol consumption. I do not think the demonisation of vintners during the debate has been fair. One is responsible for one’s own drinking and one’s own health. I will speak on the health aspects of alcohol consumption in a moment. Parents have a major responsibility to prevent under age drinking. It is regrettable that a sizeable number of parents seem to have abdicated their responsibilities in that regard.
I took a course in alcohol therapy and substance abuse some years ago when I worked in the psychiatric nursing profession. A 22 year old woman who was a reformed alcoholic was also taking the course. She was the only daughter of two doting parents. By the time they discovered their daughter had a problem, it was far too late and they eventually disowned her. The woman’s journey back from skid row was long, arduous and tedious, but she succeeded in making it. She was taking the alcohol therapy course with me and 13 other people at the age of 22. It is clear  that while alcohol might be a social drug, it has great dangers.
Senator Browne has asked why a national identity card has not been introduced. I understand that young people have a great talent for producing ID cards with the aid of personal computers. We have not yet come up with the ideal card. I agree with the Senator that some foolproof identity card would be most useful. There is evidence to suggest that such identity cards have been used and will continue to be used with particular effect, for example in off-licences.
Previous speakers have referred to the impact of the abuse of alcohol on the health service. People who have indulged in alcohol, or have been assaulted by people who have over-indulged in alcohol, for example in unprovoked attacks, contribute to inappropriate bed occupancy in accident and emergency units. It may not be the fault of such people that they have found themselves in accident and emergency departments. There is strong evidence to suggest that many people are creating mayhem in accident and emergency units because of their own wilful ingestion of alcohol. That should stop.
I wish to speak about a certain practice, often involving alcohol, which has affected psychiatric services in the past. I hope that it is no longer going on, since I have been out of that profession for several years. In acute units, people who had drunk a great deal would present themselves on the pretext that they wished to be admitted. The following morning, having had bed and breakfast provided, they would thumb their nose at the nursing and medical staff and go on their way until the next occasion. Hospitals have been used as hostels. This matter was previously raised by Senator Norris and perhaps also Senator Henry regarding the Eastern Health Board, when it was the subject of a special motion. What are we to do? Many recommendations in this report have been referred to, but when it comes to how we can take the drinks industry to task, we must address the manner in which alco-pops are pushed. They are designed for the young drinker. I agree with Senator Browne’s comment that the cost of soft drinks is extremely high. It is ludicrous. One can get bottles of sparkling water of various kinds for anything up to €2.50. That is absolute nonsense; one can buy alcohol for less.
Mortality on the roads as a result of drink driving needs special mention, as does the emergence of Mothers Against Drunk Drivers, or MADD. Perhaps there should be a DADD too. As a dad, I too am very much against such drivers. I am thankful that I have not yet lost a child to one. However, it is outrageous when a life is taken as a result of the abuse of alcohol. When we discuss the various problems that emanate from over-indulgence in alcohol, we must also mention the use and abuse of alcohol by pregnant women. It is absolutely unbelievable, and the report draws attention to what is clearly a major worry owing to the damage that can be done to the baby, especially  during the early stages of pregnancy when the central nervous system is developing. A recent study of women attending an Irish maternity hospital reported that 85% continued to drink during pregnancy. We should not be proud of that statistic. If men were the child-bearing part of the equation, I would say exactly the same thing. It is a great worry and it will cause problems in future.
Estimated alcohol-related costs to Irish society in 2003 were €2.65 billion, representing 2.6% of gross national product, a 12% increase on the previous estimate. High consumption combined with binge drinking has especially damaging effects. We all know that, apart from the conditions mentioned by the Minister of State, there is also the danger of brain damage. At a certain stage of alcoholism, when people get boozed up and go to sleep, a quantity of brain cells are killed before they wake up, and a further number damaged. That was very much brought to our notice when we attended that course. While alcohol is a very enjoyable social drug, it is also very dangerous when used in a certain way. One must remember that it is mood-altering. Some people can take a certain number of units without any great adverse effect. I pointed out in the early part of my comments when I referred to the terminology describing alcoholics that the issue is not what or how much people drink but what it does to them.
We must be responsible. MEAS is trying to achieve that in the manner in which it tackles the problem. Driving the problem underground is not the answer, since there would be an increased incidence of drinking at home. That is not welcome, given the presence of children in most homes. We must put area prevention programmes into operation. As I said, AA, Al-Anon, Alateen, INCA and other such organisations have a pivotal role. Crisis intervention must be introduced into the workplace, the home and society in general. People become alcoholics when they reach the stage of denial and delusion, at which point they do not appreciate their problem. Something must be done to get them to come to terms with it. Crisis intervention is known as the most effective policy in that regard.
Dr. Henry Dr. Henry
Dr. Henry: I welcome the Minister of State to the House. I am particularly glad that it is Deputy Batt O’Keeffe. When he was Chairman of the Joint Committee on Health and Children, of which I am a member, we spent a great deal of time on the issue. We both take it very seriously, as does everyone in the House.
The Tánaiste and Minister for Health and Children, Deputy Harney, has said that she is making it her priority to address the chaos in accident and emergency units and act to free up acute hospital beds. If she takes this report seriously, she will free up approximately 25% of acute hospital beds and make a significant difference regarding what is happening in accident and emergency depart ments. The Minister and many Members have already recounted what is going on in such units and what a serious effect on attendance the over-indulgence in alcohol is having.
In my juvenile career, I worked in accident and emergency departments. It was decades ago, and, while we had trouble with people who were drunk, it was nothing like what is happening nowadays. I occasionally visit accident and emergency units to see how they are getting on. I do not go as often as I should as the staff recognise me and give out to me in no uncertain manner about their claim that I am doing little or nothing to get the problem addressed. The problem is extremely serious; as stated in the report, 38% of people under 31 admitted to accident and emergency departments were drunk. They were out of their minds, and 25% of all admissions to hospital involve the abuse of alcohol. The number of beds involved is staggering, never mind the cost.
As Senator Glynn pointed out, it is not simply a matter of the cost to the health service but to the economy. He is of course only too well aware that alcohol is the second most common cause of acute admissions to psychiatric institutions, depression being the only complaint with which patients are more likely to be admitted. I was interested to see the other day that €640 million is spent by the Department of Social and Family Affairs on long-term benefits for people with psychiatric illnesses, including those related to alcohol. At the same time, €500 million is spent on adult psychiatric services, including the upkeep of hospitals. There is something peculiar going on there. We will not even try to achieve a reversal of those figures, which might help to do something in this area.
We have concentrated a great deal on the problem but have not said too much about solutions. Many fellow members of the medical profession say we are not active enough in trying to deal with people whose main problem is obviously alcohol. We wring our hands about the situation but do little to find a solution. The statistics involved are shocking. The situation has been made clear regarding accidents, unintentional injuries and intentional injuries. The latter are important with regard to parasuicides, those brought to hospital with gastrointestinal upsets and those who proceed to more serious conditions such as cirrhosis and pancreatitis. We have also noted how many women are drinking much more, a most unwelcome development. The Minister of State may recall what Dr. Mary Holohan from the Rotunda’s sexual assault unit told the Joint Committee on Health and Children. She stated:
The pattern of ingestion of our clients has changed markedly since the middle of the 1990s. Spirits are being consumed at home before people go out. Younger clients are drinking in mixed sex groups, often in parks and abandoned buildings. While boys continue to drink beer, in the main girls are drinking undiluted spirits. Later, in clubs and bars, the  concentration of alcohol in the individual drinks being consumed is very high, often three or four units in a single drink, as the youngsters call it. Also worrying is the fact that the alcohol is mixed with stimulants. The median number of units of alcohol remembered by clients coming to us is eight, but 20% of our clients in the past three years remember ingesting 12 to 22 units of drink.
I will not query how any Member of this House might feel after such drinking, but these figures are unbelievable. Dr. Holohan went on to say that the drug Rohypnol is frequently referred to, with young people saying their drink must have been spiked. She said that the sexual assault unit does toxicology testing on all patients and has never had a positive for Rohypnol. She goes on to say, “However, the toxicology service has remarked to us that the levels of alcohol in the samples we send are only seen in one other service — the coroner’s office”. That is unbelievable and truly shocking. I have seen reports of cases of young girls with blood alcohol levels of 350 mg, a staggering amount when one considers what it must do to people.
Looking at this report one also sees that in the mortality figures for alcohol poisoning the percentage change from 1992 to 2002 has been nearly 100%. Those figures represent people who have died from drink, from acute poisoning, which is quite shocking. All the figures for alcohol-related mortality have risen enormously. The most important figure is for alcohol poisoning. The numbers suffering from chronic alcoholism have increased by over 60%, those from cirrhosis of the liver are up by nearly 80%, drink-related suicides are up nearly 20% and cancer deaths related to alcohol are up by about 10%.
Senator Glynn raised the issue of drinking by young pregnant women, which has serious effects on the foetus. There are suggestions that foetal alcohol syndrome, when the baby is born affected by alcohol to a serious extent, may be associated with attention deficit disorder later on. There may be long-term effects on the child.
We must take all this very seriously. The Minister of State will recall that numerous consultants from accident and emergency units around the country spoke to us about how bad the situation was. Dr. Luke from Cork spoke of the very significant increase in the level of domestic violence as a result of alcohol abuse. Dr. Martin from Galway spoke of the fights outside fast food units. Senators Browne and Glynn noted that those drinking too much late at night do not have access to food. Perhaps we should close down the fast food units before such people arrive because it seems that people will not queue when drunk, and get into the most appalling fights, sometimes killing each other. Some 25% of people brought to hospital accident and emergency units by ambulance following accidents are there because of the abuse of alcohol. How can we get a pre-hospital emergency service running if we are  going to have such abuse of the emergency services?
The recommendations made are very important. Moaning and groaning and wringing our hands is no good if we do not implement some of the recommendations. It is suggested on page 40 of the report that we should establish a national screening protocol for early identification of problem alcohol use for all relevant sectors of the health care system. That is very important. We must look at the totality of the situation. I recall people calling to me at 10 a.m. smelling like a Christmas pudding. One would need to talk to such people about what is going on. When it happened a second time I always asked, because while the incident might first have seemed frightening, the people would have got used to me on the second occasion.
The report recommends the establishment of an early intervention programme in primary care to introduce and establish brief intervention as standard practice to reduce high risk and harmful drinking patterns, in other words to get general practitioners involved in discussing alcohol problems with people whom they think have such a problem.
The report also recommends that for those presenting with alcohol-related problems in the emergency room and general hospital, someone should be present to address the issue. A specialist nurse is suggested so that people who are comatose on the ground will come round at some stage. One must remember that some of those comatose people will have head injuries. This is why the unfortunate accident and emergency staff must waste so much of their time taking these people’s blood pressure, checking their eyes and so on. The time consumption is appalling in such situations, so intervention is needed in the emergency room and general hospital for those presenting with alcohol-related problems. We need to address that issue immediately, not just in acute cases, but also in chronic ones. In health clinics, excess alcohol is noted as a contributory factor in presenting conditions. The report notes the connection in this area with emergency contraception, sexually transmitted diseases, parasuicide and mental illness.
The Minister of State may have seen in the newspapers that the Well Woman Clinic has decided to open at the weekends from 12 p.m. to 3 p.m. for emergency contraception when I presume people will have got out of bed and will attend for such contraception. In such cases it is likely that the girl and her partner may have had far more drink than was good for them, so that issue has to be addressed in such clinics and by those dealing with sexually transmitted diseases. The approach must be very broad.
We also need to intervene in the area of those convicted in court of alcohol-related offences involving public order, drink driving, etc. For those under 18, there is the Garda juvenile diversion programme, the Springboard initiative and other community-based interventions. It is also  recommended that all third-level colleges provide support services — perhaps brief intervention and counselling for students as outlined in the college alcohol policy framework document.
We should also require that as part of employee health and welfare considerations, there should be procedures in the workplace to address workplace alcohol-related problems. Senator Glynn mentioned absenteeism but there is also the problem of accidents in the workplace, which are frequently alcohol related.
Any initiatives we introduce should be considered on an EU basis. When alcohol abuse advertising campaigns are running it is important that they do so on an all-island basis, with advertisements perhaps being shown on UTV as well as RTE, since one cannot rely on people to watch only the national channel. We must ensure good value for our advertising.
The time for moaning and groaning is over. We must ask the Minister to consider what has been recommended. If she wants to resolve the problems with accident and emergency services and acute beds, the people to whom I refer are not elderly and they will not be transferred to nursing homes. They are young people who will leave hospital and who will be in a position to return home. They are occupying beds which are desperately needed for other people. We must not forget that elective operations are frequently postponed. The first thing the Minister could do to solve the problems with accident and emergency services and improve the position as regards acute beds is to address the recommendations in the report.
Ms Feeney Ms Feeney
Ms Feeney: I warmly welcome the Minister of State, Deputy Batt O’Keeffe, who previously served as Chairman of the Joint Committee on Health and Children. I am aware of his great interest in and in-depth knowledge of alcohol and the problems relating thereto.
I welcome the report, which is a great read. Since I became a Member of the Seanad, the House has discussed alcohol on more occasions than I can remember. When I pointed this out to a colleague who contributed earlier in the debate, the reply I received was that we have spoken on it so often that it would nearly drive one to drink. I do not intend to make light of a serious issue. The more we discuss this matter, the more we will highlight it.
I congratulate the authors of the report, one of whom comes from my health board area, on presenting us with such a detailed and good report. I was particularly impressed by the public health approach taken. It is the first occasion of which I am aware that the authors of a report on alcohol were aware they have the support of the WHO, which recognises the range of health, social and behavioural problems caused by alcohol consumption. The best and most effective alcohol policy must take into account the total amount of alcohol consumed by a community,  while bearing in mind the needs of high-risk groups and individual high-risk drinkers.
My local health board, the North Western Health Board — I will not use all of my allotted time referring to it — seems to be well on the road in terms of reports on alcohol. Last week or perhaps the previous week, the health board’s CEO, Mr. Pat Harvey, and the independent chair of the North West Alcohol Forum, Mr. Denis Bradley, who is also vice-chair of the PSNI and an alcohol addiction counsellor, visited the Houses of the Oireachtas where he met the Minister of State, Deputy Tim O’Malley, and presented him with a report from the board. I am a member of the Oireachtas Joint Committee on Health and Children which, headed up by the Minister of State, Deputy Batt O’Keeffe, issued a report just before the summer recess on young people and drinking. The recommendations of both reports are extremely similar. I do not know if the health board copied us or vice versa. However, our report went to print before the board’s.
The North Western Health Board’s forum on alcohol came about following the first report of the Commission on Liquor Licensing. The forum came together with interested groups in the north west such as those involved in education, the Garda, the vintners and, in order to get their message across, the local radio station, and has drawn up a plan for 2005. It wants to move into primary care units and discuss issues such as detoxing in-community as opposed to doing so in hospital settings, away from which people tend to shy. Those involved want help to be given to people with acute problems. If a person has an acute problem on a Friday evening, there is nowhere for him or her to detox other than in a mental hospital. The position must change in this regard because using mental hospitals or institutions involves a particular set of problems.
The forum also wants brief interventions and wants people to discuss their drinking habits. For example, a GP should be prepared to discuss with patients how much they are drinking, whether their drinking is causing arguments at home and if they are missing half or entire days at work as a result of drinking the previous night. GPs, nurses and counsellors should also be able to talk to younger people about alcohol and pregnancy. I refer here not only to young girls but also to their male counterparts. As everyone is aware, it takes a man to make a woman pregnant. I was intrigued to hear Senator Glynn state that such a high percentage of women drink when they are pregnant. I did not realise the figure was that high. As a woman, I would have thought people, particularly when they are pregnant, would be more responsible. He stated his views would be similar if men were able to carry children.
The Sligo group also referred to liaison nurses being appointed in acute hospitals. This recommendation is also contained in the national report. It asked the Minister of State’s colleague to establish the north-west group as a pilot group.  The Minister of State is aware that I will push the interests of my local group as much as possible but I must reiterate that the North Western Health Board is ahead of the posse. The group is already in place and has an agreed understanding of the problem and the project on hand. The liaison nurse in accident and emergency is part of its plan for 2005. She will deal with issues surrounding mental health such as self-harm — which will be followed up on — and also alcohol problems. She will also deal with the general hospital in terms of how it deals with problems that arise each week.
The group has a major understanding of what is involved and has identified areas to which reference has already been made during this debate. One of these concerns the difficulties involving early school leavers. There are strong indications that such young people are more likely to become involved not only with alcohol but also drugs. In my opinion we should group the two together because they are both addictive and equally harmful. Female early school leavers are probably more likely to become pregnant than their counterparts who remain in education. The group also identified the fact that early school leavers will become involved in crime, either early or later on in their lives. Major emphasis should be placed on retaining people in education. The group to which I refer has had involvement from educators, parents and other interested bodies.
Other people referred to the fact that those most at risk — this message should be driven home to parents — are the under 15s. We must face the fact that society has changed since we were young. We did not drink before 15 years of age. When one approached the legal age for drinking, one would certainly indulge. However, one would not dare go home afterwards. The position now is different. Parents should consider that perhaps under 15s should not be allowed to work. I do not wish to deny anybody pocket money, babysitting money or whatever. However, the fact that people have too much money is only fuelling the problem. Everyone is aware of the huge risks to the health of those of 15 years of age or younger if they are constantly drinking.
The task force’s report highlights the fact that the main problem is the conflict between Departments, a matter which has often been discussed here. The House has frequently discussed the need to gel Departments for the betterment of society. Regardless of whether the issue is under age drinking or drinking among adults, we must knock our heads together and get on with dealing with it. Given the goodwill among the public in this respect, we must get the show on the road.
The Joint Committee on Health and Children, of which I am a member, issued fantastic recommendations on the issue of alcohol consumption. These should be considered alongside those of the report of the national task force on alcohol, some of which overlap. Among our recommendations was the establishment of a central control agency to co-ordinate Departments such as  Health and Children, Justice, Equality and Law Reform and the Environment, Heritage and Local Government.
We need to discuss with the new Minister for Finance the possibility of increasing the price of alco-pops by as much as 100%.
An Cathaoirleach An Cathaoirleach
An Cathaoirleach: The Senator’s time has concluded.
Ms Feeney Ms Feeney
Ms Feeney: The Cathaoirleach is a hard man.
An Cathaoirleach An Cathaoirleach
An Cathaoirleach: The Senator may speak for another 30 seconds.
Ms Feeney Ms Feeney
Ms Feeney: The Leas-Chathaoirleach is more generous than the Cathaoirleach.
An Cathaoirleach An Cathaoirleach
An Cathaoirleach: The Senator should not make comparisons. The Cathaoirleach must do his job.
Ms Feeney Ms Feeney
Ms Feeney: I withdraw my remark. The Cathaoirleach is more than generous and kind to me on all occasions. We need to stop what is known as hedge drinking and address the problem of young people drinking at home. Parents must become more vigilant and we should introduce bar coding and traceability for off licences. I will not test the Cathaoirleach’s patience any further.
Mr. B. Hayes Mr. B. Hayes
Mr. B. Hayes: I welcome this debate which concentrates on the second alcohol task force report. It is important that the House regularly inform itself about Government policy and the progress being made in this area. I welcome the Minister of State at the Department of the Environment, Heritage and Local Government, Deputy Batt O’Keeffe, and thank him for attending this important debate. It is easier to have a rational, thought-out debate on matters of this nature in this House than in the other House given the political argy-bargy which takes place in the latter on regular occasions. The Seanad is a particularly useful and adept forum for dealing with the issue.
Senator Feeney raised the issue of providing a multi-faceted response to the problem. She is correct that it concerns more than one Department. Given the range of Departments involved, a number of Ministers should sit in on future debates, where possible, because one Department cannot take a lead role in this area.
It is staggering that Ireland has recorded the highest increase in alcohol consumption among European Union countries and that, as the Minister of State noted, per capita alcohol consumption increased by 41% over the period between 1990 and 2002. We have the second highest per capita consumption of alcohol in the EU. Why are more and more people drinking greater volumes of alcohol? It does not matter how many strategic task forces are in place or how many Departments respond in their functionalist way  to the problem, society must address the reasons people are drinking more.
People are using alcohol to fill gaps in their lives which did not exist in the past. The increase in alcohol consumption is not only fuelled by much greater purchasing power but by real needs, which may be psychiatric, the result of a missing link or the loss of certain characteristics of society. We must address the reasons an increasing number of younger people are drinking large amounts of alcohol. As the Minister of State said, a large proportion of total alcohol consumption occurs as a result of binge drinking.
The effects of alcohol consumption are well known. As a constituency representative, one of the issues I encounter, which has not been raised but needs to be addressed, is domestic violence. We do not speak loudly enough about domestic violence which is fuelled by drink and is causing untold havoc in many families from various income brackets. On the Order of Business, Senator Terry referred to the considerable increase in the number of women calling the Women’s Aid helpline. The reason is the rising incidence of domestic violence, an issue we must place at the top of our priorities.
Another issue we need to address, one on which many people have a view, is the crisis in the accident and emergency departments of our acute hospitals in Dublin and other cities. The pilot study carried out by the Mater Hospital in 2002, to which the Minister of State also referred, showed that alcohol was a contributory factor in one in four patients attending accident and emergency departments. This matter must be addressed.
As the Minister of State noted, the research in question indicated that 30% of male admissions, 10% of female admissions and almost 25% of accident and emergency attendees met the diagnostic criteria for alcohol misuse or dependency. I hold the old-fashioned and perhaps unattractive view that those who attend accident and emergency wards in acute hospitals because they are drunk should not be given priority when it is necessary to attend to other patients. It is a scandal that frequently those attended to first are raucous patients who continually put pressure on staff and other patients. One need only attend any accident and emergency department in this city at any time on a Friday or Saturday night to see that large numbers of people are in attendance because of a form of self-abuse, namely, getting out of their heads with drink. It is not right or proper that other people attending hospital because they are sick should have to wait in a queue while such people are dealt with first.
Some form of financial penalty should be imposed on those who regularly attend accident and emergency departments while drunk. It is a disgrace that they put so much pressure on our medical services and security personnel. A large number of people are lying on trolleys in our accident and emergency departments, many of them  acutely sick, who must put up with mayhem on the wards on a nightly basis. This is unsustainable and wrong and society must take a firm position on the issue.
We cannot continue to tell people that such problems can be sorted out by task force reports. They must be sorted out by ensuring people take responsibility for their actions. I ask the Minister of State, Deputy Seán Power, in consultation with his colleagues in the Department of Health and Children, to ensure that patients attending accident and emergency wards because they are sick rather than drunk are prioritised. We have a responsibility to develop measures for those in real need of support.
I agree with other Senators that it will be necessary to implement the recommendation in the first and second task force reports to raise awareness of the problems associated with drunkenness and drunken behaviour by introducing a targeted marketing campaign. This public health issue needs to be addressed at all levels of society. I support the Government’s amendments to the Road Traffic (Amendment) Bill to enable much harsher penalties to be imposed on those driving at night while drunk. We must be strong in this area. I strongly support the recommendation that we deal with the issue of alcohol marketing and take a strong stance with sports organisations that seek funding exclusively in this area. The progress made in recent years is worthwhile.
This is a much wider problem than simply implementing a number of recommendations. People must take responsibility for their actions. It does not matter how many fine reports are produced because unless we can inculcate personal responsibility into people’s behaviour, we will not secure a change of attitude to alcohol. I compliment the Government on its work so far in this area but more needs to be done. This House has a pivotal role in terms of surveying that work on a constant basis.
Mr. MacSharry Mr. MacSharry
Mr. MacSharry: I wish to share my time with Senator White.
An Cathaoirleach An Cathaoirleach
An Cathaoirleach: Is that agreed? Agreed.
Mr. MacSharry Mr. MacSharry
Mr. MacSharry: I congratulate the Minister of State on his appointment and I look forward to working with him over the coming years. We had the opportunity to speak on alcohol-related issues last week during the debate on the intoxicating liquor legislation. I wish to reiterate some of the points that were made.
I commend the strategic task force on alcohol. It has made great progress in recent years and in this report has made a number of tangible recommendations which we should embrace and seek to implement at the earliest opportunity. This nation and consecutive Administrations, regardless of party composition, have failed miserably in tackling this issue over the years. Successive Administrations might have believed they were doing their best to deal with the issues but they have  consistently tried to deal with the symptoms rather than the bigger issue, which is culture. I am glad there are strategic task forces on alcohol to facilitate us examining the issues until we get to the root causes of the culture and seek ways to reverse the desperate things it does to society.
With regard to dealing with the symptoms, we persist in looking at opening times, closing times and accessibility to alcohol. While the task force recommendations include reducing accessibility to alcohol, I am unsure if this is the correct way to proceed. One tends to want what one cannot have. The report contains comparisons to the Continent where alcohol is consumed more slowly, in smaller quantities and generally with a meal. We aspire to that but I do not believe our culture is ready for it. In our culture drink is to be hidden away and children are not to be let anywhere near it. It should be made less accessible. I am concerned about that because I fear it could increase the mystique associated with alcohol and, therefore, enhance its attraction for young people who will want to try it at an early age. We are aware of the damaging effects in that regard.
Changes to licensing laws to create a café culture is another instance of looking at the continental model. That model would be fantastic but I do not believe Ireland is ready for it. In fact, we might abuse it. A total of 14,000 licences in the country is more than enough. If we want to tweak the system while keeping accessibility to a reasonable limit, we should encourage those licensees to carry out their business in a different way, perhaps, and try to lead it towards a café type culture.
With regard to a national identification card, in my maiden speech in the House I called for the introduction of such a card. It should be introduced as soon as possible. There would be many other benefits associated with it, not least in terms of age and identification checks when entering licensed premises. It should be the same as the system in the United States where the checks are random. Whether one is 60 or 16 years of age, one can be asked on a random basis for identification. That reduces any embarrassment or stigma attached to being asked for identification, regardless of one’s age.
An interesting suggestion which should be considered is the introduction of legislation to dictate the potency of alcoholic beverages in this country, whereby they need not necessarily be 4% or 5% pure alcohol. There might be merit in considering a basic maximum. The alcohol content of beers is 5% and 6%, while it is 12% for wine and up to 40% for brandy. Perhaps we have alcoholic beverages on the market that are much too potent. It would be innovative at least to look at this area.
With regard to dealing with the culture for young people, it must begin with education. There are many beneficial schemes in place to educate young people about the harmful effects of alcohol. However, what is needed is an aggressive advertising campaign which would  demonstrate the sheer chaos endemic in society at present. It could show the utter destruction it causes to families, the hopelessness of young people who have been subjected to or fallen into the trap of alcohol abuse and the desolation it brings to families and the tragic consequences. The “Prime Time” programme on this subject and on the hidden Ireland left parents bewildered, young people embarrassed and the drinks industry exposed. It is a sorry saga.
The highest level of binge drinking in Europe is among young people in Ireland. It was mentioned earlier that one in four people attending accident and emergency departments throughout the country do so as a result of alcohol. I believe the number is higher. The cost of dealing with alcohol related illness is €2.4 billion per annum. What would that money do for the schools building programme, for example, or in providing more sports facilities for young people?
There is an onus on everybody, particularly parents, to offer alternative night life activities to children, whether that is through sporting organisations or otherwise, and to glamorise them so young people will want to go to them. These should not be about alcohol and getting drunk. Parents need to incentivise children along this route. They need to de-glamorise alcohol while glamorising what is alcohol free. There should be an onus on movie producers, entertainment celebrities, actors and so forth in this regard. In films we watch fictional characters who are healthy, athletic, good looking, courageous and talented, yet they are addicted to alcohol or nicotine. That is not possible in the real world but these are the characters that are displayed. I am grateful for the opportunity to make those points.
Ms White Ms White
Ms White: I congratulate the Minister of State on his appointment. I am delighted for him. It is well deserved and a great honour for him and his constituents in north Kildare.
A recent study showed that adults in Ireland had the highest reported consumption per drinker and the highest level of binge drinking in comparison to adults in other European countries. One of the consequences of this, which I intend to discuss, is alcohol-related mortality. In the past ten years in Ireland, alcohol-related mortality has increased. Over that time, 14,233 people have died from six main alcohol related causes, which included cancers related to alcohol, chronic alcohol conditions, alcohol dependency, chronic liver disease and cirrhosis, alcohol poisoning and suicide. The Irish water safety organisation says that 30% of all deaths from drowning were alcohol related.
Alcohol use during pregnancy is a growing concern because of the damage that can be done to the baby, especially during the early stages of pregnancy when the central nervous system is developing. A recent study of women attending an Irish maternity hospital reported that 85% of the women continued to drink during pregnancy.
 The report of the strategic task force on alcohol spells out the recommendations. However, as the Minister stated in his contribution:
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. . .
I would like the Government to do what the former Minister for Health and Children did in regard to smoking. It is a pleasure for me to go into the Dáil bar to have a cup of tea and a sandwich. Previously, I could only get as far as the door due to the wave of smoke. While I gave up smoking 20 years ago, I have sympathy for those who smoke but find it difficult to give up. However, I am glad I can now enjoy the benefit of an extra refreshment area in the Houses. Despite the fact that sales in public houses have dropped, the industry has a chance to develop a nice environment where people can go for coffee or a meal.
I regularly visit Northern Ireland. It fascinates me that, in the North, one is offered a cup of tea whereas at a meeting or social occasion in the Republic, drink is offered. There is an acceptance of alcohol and the figures from the task force suggest we have a serious problem.
Last week, a relation of mine attended a football match in Greece involving an English team. Following the match, the Greeks drank cups of coffee but the English drank beer. We must deal with this issue and the need to have drink on every occasion. Given the vision shown by the previous Minister for Health and Children, Deputy Martin, the current Minister, Deputy Harney, should tackle this issue and try to change the cultural acceptance of alcohol. As Senator MacSharry noted, drinkers in other countries sip their drinks and enjoy them while those in Ireland drink very quickly. The point is not that we intend to be spoilsports but that alcohol is a dangerous drug.
Mr. Quinn Mr. Quinn
Mr. Quinn: I welcome the Minister of State, Deputy Seán Power, to the House and welcome the enthusiasm I am sure he will show in this portfolio, as he has on other matters. I wholeheartedly endorse the recommendations of the task force and urge the Government to give priority to implementing them. However, I urge this without much hope it will actually happen. My pessimism springs from an examination of the recommendations contained in the task force’s first report of over two years ago. The Government increased alcohol prices but many of the other recommendations have still to be implemented. In particular, the three key recommendations in regard to road safety have been completely ignored.
Ms White Ms White
Ms White: That is true.
Mr. Quinn Mr. Quinn
 Mr. Quinn: They were to introduce random breath testing, to reduce the blood alcohol limit to the European norm and to reduce that limit to zero in the case of drivers with a provisional licence. That none of those recommendations have been implemented is a scandal. No doubt, we will hear again in this debate ministerial promises that random breath testing is on the way. My response is that I will believe it when I see it in action. It is almost three years since I devoted my Private Members’ time on 21 November 2001 to a motion calling on the Government to introduce random breath testing without further delay. I thought I received a positive response but, three years later, we are still in the realm of promises.
With regard to one of the task force’s recommendations, which concerns controlling the promotion of alcohol, the report rightly points out: “Alcohol advertising promotes and reinforces positive attitudes about drinking and portrays drinking as fun, glamorous and risk free.” In Ireland, research showed that children were strongly attracted to alcohol advertising and that young people believed advertisements were targeted at their age group. The report also stated: “More recent research reports that alcohol sports sponsorship has an effect similar to alcohol advertising.” While large sums were mentioned by Senator MacSharry, according to the report, in 2002 no less than €43.2 million was spent in Ireland on alcohol advertising and God knows how much more on sponsorship.
I have a specific proposal in regard to spending on advertising and sponsorship. I suggest that the Government impose a 100% levy on all spending by alcohol producers on advertising and sponsorship and that it ring-fences the yield from that levy for spending on advertising and educational initiatives that highlight the dangers of excessive drinking and the attractions of a lifestyle that avoids it.
We are engaged in a battle for the hearts and minds of the people in an effort to change what are now deeply ingrained patterns in how we live. How we change attitudes is in our own hands but it cannot all be done by law. We need a focused marketing campaign. I suggest this be undertaken with the money gained if we impose a 100% levy on the advertising of alcohol. We should then ring-fence that money and use it to promote the benefits of healthy, alcohol-free living. The least we can do in this battle is meet the promotional force of the alcohol producers on equal terms. Under my proposal, doing so would cost the State nothing whatsoever.
Other proposals have been made during the debate. It was suggested that every unit sold from an off-licence should be labelled with the name and address of the off-licence. This should not be considered because it is not possible to prove an off-licence sold the alcohol to a young person. If young people were found with labelled alcohol, it could have been stolen from home or an adult might have bought it. Such a measure would be difficult to prove and would not have much  benefit. In saying that, I declare an interest as the owner of a number of off-licences in supermarkets.
Some matters cannot be solved by legislation, as was mentioned when the Minister for Justice, Equality and Law Reform was in the House last week. In that debate, I referred to a visit to Salt Lake City in Utah, where my wife and I joined another couple for a meal in a restaurant. When I ordered white wine and my wife ordered red wine, my host told me this was awkward because the law in Utah states that one cannot have two bottles of alcohol on a table at one time in a restaurant. I had not known this but, being a gentleman, I switched to red wine. When we finished that, we switched to white wine. I mention this to illustrate my point that we should not try to solve every matter by legislation. Let us find a way to persuade the population of the benefits of being free of drink.
The report is quite right on the figures. We have the second highest consumption of alcohol in Europe, Luxembourg being the only country with a higher rate. However, an interesting statistic is that we have more teetotallers and Pioneers.
Ms White Ms White
Ms White: Some 22%.
Mr. Quinn Mr. Quinn
Mr. Quinn: Therefore, when we measure per head of population we are in second place, but, if we measure per amount of alcohol per drinker, we jump into first place with a far higher consumption rate than others. The average rate of consumption per person is approximately nine litres. However, if Pioneers and total abstainers, who represent a sizeable group in Ireland, are removed, the rate of consumption is much higher. The Pioneers among us will understand this point.
A challenge faces us. While we should not assume all aspects of it will be dealt with by law, some issues can be dealt with by law. The report contains recommendations which can be acted upon, for example, in regard to random testing. We must also work to persuade the nation, particularly the young, of the disadvantages and dangers of using alcohol. My proposal is for a 100% levy on all alcohol advertising, with the funds raised being ring-fenced and invested in promoting the benefits of not using alcohol. This would produce a win-win situation. It would cost the State nothing. It would diminish the amount of money spent on advertising and promoting alcohol and would give us an equal amount of money, one for one, for those who are promoting a better lifestyle.
Mr. Moylan Mr. Moylan
Mr. Moylan: I welcome the Minister of State at the Department of Health and Children, Deputy Seán Power, to the House. I congratulate him on his promotion and wish him well.
When somebody like me says anything about alcohol it is pointed out that I have a Pioneer pin and must therefore be anti this, that and the other  and certainly anti-alcohol. I welcome this very detailed and in-depth report.
Seanad Éireann 178 Report of Strategic Task Force on Alcohol: Statements.