Tuesday, 23 July 2013

One step forward, two steps back...

You'll have noticed a reduced output on this blog of late as I have been experiencing a little "writer's block". I'm not sure I can pin down the reason, maybe it's because I've been busy on a couple of other projects, maybe due to the lethargy brought on by the inexorable rise of the mercury in thermometers across the land, or maybe I've realised the absurdities of 'the system' under which we all live. Whatever the reason, last night's thunderstorms have reduced the temperature and the rain has perked the garden and me up a little, so here goes with enough words to make up for my recent taciturnity.

Like a famous film poster read, "just when you thought it was safe to go back into the water", I read with dismay HMG's latest tortuous squirming in the wake of its decision to scrap minimum pricing for alcohol and the latest 'research' into the effects of alcohol on young women. The pub industry, on the one hand the cause celebre of MPs across the party divide, with a modest reduction in beer duty, a consultation into pubco reforms and the temporary abandonment of minimum pricing for alcohol, is yet again under headline grabbing attack from its new found friends in government and long-standing enemies in the 'health lobby'.

Firstly, in a ministerial statement to the House of Commons, Government Minister Jeremy Browne sets out HMG's position on minimum pricing but also took the opportunity of mentioning other measures which will be implemented and those that are under consideration:

Whilst minimum pricing will be kept under review it will not be implemented at present although the indication is that there will be a ban on alcohol sold for less than cost plus VAT. In addition, ‘multi packs' will not be banned. Although it's worth noting Kate Nicholls' (strategic affairs director at the Association of Licensed Multiple Retailers) comment:
"We are extremely disappointed that the Government has not grasped the nettle and taken meaningful action to stop the sale of pocket money priced alcohol and irresponsible promotions in the off trade which are together fuelling unsupervised consumption and contributing to alcohol related harms."
In line with there being no blanket minimum pricing per unit there will be a concentration of action in what the minister described as "high harm" areas of the country and an emphasis on giving more powers to enable "tougher action on irresponsible promotions in pubs and clubs"
Browne, the minister of state for crime prevention no less, also hinted at some areas of relaxation to alcohol retailing under the banner of reducing red tape and regulation:
  • making it easier for what are described as community premises to get a licence for low level alcohol sales
  • changes to the Temporary Event Notice restrictions to increase the numbers of Notices available
  • indication that the requirement to renew personal licences will be removed but also trailed for consultation is the possibility of the outright removal of the requirement for personal licences.
and secondly, the Glasgow Centre for Population Health in its research paper- "Alcohol-related mortality in deprived UK cities:worrying trends in young women challenge recent national downward trends", by Deborah Shipton, Bruce Whyte, David Walsh. (You can wade through the plethora of data and charts here.)

The latter is easier for me to deal with, as having no grounding in mortality statistics or public health the majority of this peer reviewed eight page paper, is somewhat lost on me. However, the abstract states:
"Glasgow, the largest city in Scotland, has high levels of deprivation and a poor health profile compared with other parts of Europe, which cannot be fully explained by the high levels of deprivation. The excess, premature mortality in Glasgow is now largely attributable to deaths from alcohol, drugs, suicide and violence."
You'll note the attribution to causes other than alcohol, yet when a layman such as myself attempts to make sense of the statistical data presented it seems strange the other causes of death mentioned above are not given the special emphasis the report gives to the 'demon drink'. 

Whilst I praise the authors for bringing to wider attention the apparent disparity in mortality rates for women born between 1970 and 1979 in not only Glasgow but also Manchester and Liverpool, which it seems to blame entirely on their drinking habits, from which the popular and trade press have drawn their headlines, I can't help but think they have been somewhat selective in what they choose to concentrate on. 

But if you dig a little deeper into the dry prose of this troika of public health analysts you'll come across this little gem:

"The shifting landscape of the excess mortality in Scotland, originally from cardiovascular disease and ischaemic heart disease and now to alcohol, drugs, suicide and violence, points to deep-rooted societal level factors driving the excess poor health in Scotland; the recent rise in alcohol-related deaths is likely to be a symptom of these wider societal-level influences. 

Tackling the alcohol-specific causes of the poor health in Glasgow, although important, alone is unlikely to improve the health of those in Glasgow"
It goes on, of course, to recommend minimum pricing and no doubt the statistical analysis and the "manipulated dataset" the authors used will bolster the Scottish government's ongoing experiment with minimum pricing. This despite finding:

"A marked increase in alcohol-related deaths, beginning in 1993, was seen in Glasgow, and to a lesser extent in other parts of Scotland. This stepped increase is in contrast with the picture in both Manchester and Liverpool where the increase was largely linear across the three decades. 

In all three cities, however, the alcohol-related death rate stabilised in the early 2000s, with some decrease seen in the late 2000s. In Glasgow this fall was greater, in absolute and relative terms, than in the other two cities"
It is only the "birth cohort" of women from 1970-1979 that buck the trend (also being experienced across the country) and cause the authors such concern to such an extent, that in all the eight pages of analysis the other causes of mortality in their abstract are mentioned a scant four times and always in the context of this being a more significant factor in mortality rates than alcohol.

So one question for all the media darlings and neo-prohibitionists out there who jumped on this latest tumbril - "Why not take up the scourge of drugs, violence and suicide that appears to be the real problem for the majority of the populations of Glasgow, Manchester and Liverpool?" Could it be, for the former, selling newspapers and filling column inches with sensational findings is a little easier than getting to the truth about greater societal ills; for the latter it's their usual tactic of selectively extracting "data" from others' work and spinning it to their relentless demonisation of social drinkers.

Either way, which bit didn't you get? I mean, the clue was in the title you dolts... "recent national downward trends" ! No trumpeting of flat-lining or reducing mortality rates attributed to alcohol then?

Now we can return to Mr Browne and his concentration on "high harm areas" of the country... here's a suggestion for a starting point... Glasgow, Manchester and Liverpool. But not for some localised version of minimum pricing but for some action on the societal results of deprivation brought on by drugs and the violence and suicides so prevalent in these cities. 

Oh and whilst you're at it how about including the off-trade in your promulgations from time to time, why are pubs and clubs singled out, yet again, for "tougher action on irresponsible promotions". Time and time again lazy politicians and their journalist friends trot out the same line "it's the pubs what's to blame governor" whilst conveniently forgetting the mayhem caused by 'pocket money pricing' in the off-trade.

As I've said before the current coalition administration seems to have developed a schizophrenic approach to its alcohol strategy, on the one hand a clampdown on the minority of irresponsible retailers in the on-trade, is coupled with turning a continued blind eye to the off-trade and is now compounded with proposals to relax how alcohol is sold.

Make your mind up man! How is making it easier to get premises licences for "low level alcohol sales" (whatever they're meant to be)  in "community premises" (village halls and the likes) are going to help tackle society's relationship with booze? So along with a two-tier health service we're now to have a two-tier licensed retail sector, with some operators constrained by increased regulation and scrutiny and others allowed to enter the market place with the minimum of fuss.

Whilst the on-trade will welcome the increase in the number of Temporary Event Notices it can serve on licensing authorities, how is increasing the number of potential events where alcohol can be served be reconciled with the usual mantra that "24 hour licensing" has been such a disaster for public health?

And the clincher? One of the most progressive measures introduced by the Licensing Act 2003 was to differentiate between the suitability of premises to have an alcohol licence (the premises licence) and the suitability of individuals to serve alcohol and run licensed premises (the personal licence). The former being a static licence which relevant authorities control by means of operating statements, licensing conditions etc hardwired into the way the premises are maintained and operated by their owners; the latter being a deminimus permit resulting from training, examination and certification designed to ensure professional standards in alcohol retailing.

So, Mr Browne, how does removing the necessity to renew ones personal licence or even the scrapping of the personal licence going to promote the responsible sale of alcohol and management of licensed premises? Instead of tinkering with the provisions of the Licensing Act, why not make sure local licensing authorities apply an even hand between on and off-trade and start reviewing the licences of those in the off-trade who continue to flout not only the spirit but the word of the law? 

And you wonder why I'm lost for words at times? Anyway I'll sign off with the tag-line from another favourite film... "in space no one can hear you scream"... nor in my little padded cell... 

Nurse! Meds! Stat!

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