Chamber
Plenary, 25 Oct 2007
25 Oct 2007 · S3 · Plenary
Item of business
Alcohol
We have heard and will hear more about the strategies that have been suggested for educating consumers on the dangers of excess alcohol consumption and about the justice system's role. I will say no more about those aspects of the alcohol challenge, except to make a plea to encourage licensed premises to make available a wide range of attractive non-alcoholic drinks at competitive prices. A glass of orange can occasionally cost more than a pint of beer, which is clearly wrong.
I draw the Parliament's attention to projects such as Albyn house in Aberdeen, to which people whom the police find to be drunken are taken for care and recovery. Regular attenders can be counselled and offered help, which is a far more humane and efficient way of tackling the problem than throwing someone into a police cell and giving them a criminal record the next day.
I will consider the part that the national health service can play in helping individuals who have an alcohol problem through providing appropriate treatment and support to those who wish to have help in giving up alcohol. In 2003, 42,000 people visited their general practitioners with an alcohol-related problem. In my practice, a patient survey some years ago showed that more than one in 10 men over the age of 45 who lived in a particular housing estate had an alcohol problem. There is no reason to believe that the situation is any better today, and the true picture is likely to be even worse, as that survey included only people whose problem was known to the GP, whereas many who have an alcohol problem hide the fact—it is a silent epidemic.
When we consider the ways in which we respond when someone with an alcohol problem seeks help, an immediate obstacle becomes apparent. The voluntary organisations and other organisations that offer help are often poorly co-ordinated and the quality of service varies greatly from one area to another. Unfortunately, the treatment service that the NHS offers is—like many others—top down rather than from the grass roots up. Typically, a huge population may be served by an alcohol problems consultant, who has perhaps a few hospital beds. Below that level will be a few psychiatric nurses who specialise in alcohol problems. A person who requests help wants it now, not after the many weeks that pass before a referral to the area community psychiatric nurse is rewarded by an appointment.
What is needed is a refocusing of our efforts so that plans are laid to respond immediately a person asks for help. In the health centre or surgery, receptionists, nurses and doctors must know the appropriate response and who to approach for further help. Doctors and nurse practitioners must acquire the knowledge and confidence to initiate brief pharmaceutical detoxification programmes. The specialist CPN can fulfil an educational role as well as providing a second specialist opinion when treatment problems arise. The alcoholic epidemic is too overwhelming for us to pretend any longer that we can rely on a highly specialist service to cope with the challenge unaided. Part of the knowledge that all need to acquire is of services that exist locally, such as Alcoholics Anonymous, and in which circumstances their skills can assist.
The urgency and size of the problem make it unfortunate that, although alcohol screening and brief interventions have been made one of the nine possible services for 2007 to 2009 that are listed in the recently announced Scottish enhanced services programme for primary and community care, health boards and community health partnerships have to choose only three of those services to implement. Furthermore, I gather that some organisations, including NHS Lothian, have chosen not to make alcohol services part of their enhanced services. I have no doubt that they have their reasons, but how they can ignore the most major health problem that faces us is beyond my comprehension.
All is not lost, however. NHS Health Scotland is funding a steering group to develop a co-ordinated national drugs and alcohol strategy. It aims to have an implementation plan in place by spring 2009 and the description that I have read suggests that that plan might achieve some or all of the desirable objectives that I have outlined. Those of us who have worked in the field are used to false dawns, but let us hope that the strategy will succeed—the health and happiness of many thousands of Scots and their hard-pressed families depends on it.
I draw the Parliament's attention to projects such as Albyn house in Aberdeen, to which people whom the police find to be drunken are taken for care and recovery. Regular attenders can be counselled and offered help, which is a far more humane and efficient way of tackling the problem than throwing someone into a police cell and giving them a criminal record the next day.
I will consider the part that the national health service can play in helping individuals who have an alcohol problem through providing appropriate treatment and support to those who wish to have help in giving up alcohol. In 2003, 42,000 people visited their general practitioners with an alcohol-related problem. In my practice, a patient survey some years ago showed that more than one in 10 men over the age of 45 who lived in a particular housing estate had an alcohol problem. There is no reason to believe that the situation is any better today, and the true picture is likely to be even worse, as that survey included only people whose problem was known to the GP, whereas many who have an alcohol problem hide the fact—it is a silent epidemic.
When we consider the ways in which we respond when someone with an alcohol problem seeks help, an immediate obstacle becomes apparent. The voluntary organisations and other organisations that offer help are often poorly co-ordinated and the quality of service varies greatly from one area to another. Unfortunately, the treatment service that the NHS offers is—like many others—top down rather than from the grass roots up. Typically, a huge population may be served by an alcohol problems consultant, who has perhaps a few hospital beds. Below that level will be a few psychiatric nurses who specialise in alcohol problems. A person who requests help wants it now, not after the many weeks that pass before a referral to the area community psychiatric nurse is rewarded by an appointment.
What is needed is a refocusing of our efforts so that plans are laid to respond immediately a person asks for help. In the health centre or surgery, receptionists, nurses and doctors must know the appropriate response and who to approach for further help. Doctors and nurse practitioners must acquire the knowledge and confidence to initiate brief pharmaceutical detoxification programmes. The specialist CPN can fulfil an educational role as well as providing a second specialist opinion when treatment problems arise. The alcoholic epidemic is too overwhelming for us to pretend any longer that we can rely on a highly specialist service to cope with the challenge unaided. Part of the knowledge that all need to acquire is of services that exist locally, such as Alcoholics Anonymous, and in which circumstances their skills can assist.
The urgency and size of the problem make it unfortunate that, although alcohol screening and brief interventions have been made one of the nine possible services for 2007 to 2009 that are listed in the recently announced Scottish enhanced services programme for primary and community care, health boards and community health partnerships have to choose only three of those services to implement. Furthermore, I gather that some organisations, including NHS Lothian, have chosen not to make alcohol services part of their enhanced services. I have no doubt that they have their reasons, but how they can ignore the most major health problem that faces us is beyond my comprehension.
All is not lost, however. NHS Health Scotland is funding a steering group to develop a co-ordinated national drugs and alcohol strategy. It aims to have an implementation plan in place by spring 2009 and the description that I have read suggests that that plan might achieve some or all of the desirable objectives that I have outlined. Those of us who have worked in the field are used to false dawns, but let us hope that the strategy will succeed—the health and happiness of many thousands of Scots and their hard-pressed families depends on it.
In the same item of business
The Presiding Officer (Alex Fergusson):
NPA
The next item of business is a debate on motion S3M-681, in the name of Kenny MacAskill, on alcohol. I invite members who wish to take part in the debate to ...
The Cabinet Secretary for Justice (Kenny MacAskill):
SNP
I say at the outset that I will be happy to accept Pauline McNeill's amendment. We are seeking to address underage drinking and although we have laws, they m...
David Whitton (Strathkelvin and Bearsden) (Lab):
Lab
Does the cabinet secretary share my concern that alcohol can be bought in garages and chip shops? Surely making it so easy to purchase alcohol increases the ...
Kenny MacAskill:
SNP
Absolutely. The matter was flagged up by the previous Executive, and this Government will continue to move in the same direction.The fact is that we have to ...
Margo MacDonald (Lothians) (Ind):
Ind
Should we infer from the tenor of the cabinet secretary's comments that the Government wants the whole Parliament to urge the Chancellor of the Exchequer to ...
Kenny MacAskill:
SNP
This Government feels that we should have those powers because they are, after all, powers that any normal independent nation has that allow it to act approp...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
I am not sure that every member does agree. In other European Union countries, such as Italy, people spend a lot of money on alcohol and wine, and beer and s...
Kenny MacAskill:
SNP
We said at the outset that although price is not the only issue, it is a pivotal factor. We want to address the culture of price promotion and a variety of o...
The Presiding Officer:
NPA
I should have said that we will be extremely tight for time if we are to fit everyone in, so I ask members to watch their time.
Paul Martin (Glasgow Springburn) (Lab):
Lab
The Executive is to be commended for having a debate on alcohol during alcohol awareness week. It is important that members put on record our appreciation of...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
The most recent "Scottish Schools Adolescent Lifestyle and Substance Use Survey National Report"—a survey of schoolchildren aged 13 and 15, which is conducte...
Paul Martin:
Lab
I thank Richard Simpson, who made—as always—a well-informed intervention. I will talk about underage consumption.On the proposal to ban certain drinks promot...
Bill Aitken (Glasgow) (Con):
Con
The debate is on a reasonably consensual matter; indeed, the Conservatives find the Labour Party and Liberal Democrat amendments acceptable. There is also mu...
The Minister for Public Health (Shona Robison):
SNP
Does Bill Aitken not accept that the whole point of alcohol awareness week is that people should know their own drinking limits? Surely each person should as...
Bill Aitken:
Con
The words to stress are "their own". We are talking about individual levels. That is the way forward, but we have to recognise that each individual has a dif...
Shona Robison:
SNP
Does the member agree that the evidence clearly shows that rates of consumption have gone up? Where young people are concerned, there is a direct correlation...
Bill Aitken:
Con
I will explain where my concern lies. Suppose a supermarket does a deal that involves selling 12 cans of lager for the price of six. If an old-age pensioner ...
Ross Finnie (West of Scotland) (LD):
LD
I welcome the cabinet secretary's securing of this debate on alcohol. I also welcome many of his remarks, particularly those on the importance, difficulties ...
Kenny MacAskill:
SNP
Is the member suggesting that the ways in which alcohol is promoted that I mentioned in my speech are acceptable? Is it acceptable that beer is displayed wit...
Ross Finnie:
LD
That is not the point that I am making, although I can see where the cabinet secretary is coming from. History shows that there is a danger in the sort of wo...
The Presiding Officer:
NPA
We move to the open debate, with speeches of a tight six minutes, please.
Ian McKee (Lothians) (SNP):
SNP
We have heard and will hear more about the strategies that have been suggested for educating consumers on the dangers of excess alcohol consumption and about...
Trish Godman (West Renfrewshire) (Lab):
Lab
One of the most harrowing experiences I had as a social worker was taking into care, in the early hours of a morning, a young baby of about six months whose ...
Kenneth Gibson (Cunninghame North) (SNP):
SNP
In August 1994, while I was on holiday in Austria, I got the phone call that no one wants to receive. My mother called me to tell me that my father had died....
Claire Baker (Mid Scotland and Fife) (Lab):
Lab
I welcome alcohol awareness week and its efforts to encourage sensible drinking. However, as other members highlighted, an unhealthy attitude towards alcohol...
John Lamont (Roxburgh and Berwickshire) (Con):
Con
Excessive alcohol consumption is a growing problem throughout Scotland, including in my constituency in the Borders. Lifestyles and the way in which alcohol ...
Dr Simpson:
Lab
The member makes an important point, but the early stages of alcohol-related brain damage result in repeated admissions, so the important point is not just t...
John Lamont:
Con
Indeed. I agree.Men and women in Scotland drink more frequently than men and women in England. Men and women in Scotland are also more likely to exceed the d...
Hugh O'Donnell (Central Scotland) (LD):
LD
Scotland's somewhat unhealthy relationship with alcohol is nothing new, as most of us know. The scale of the problem is obvious; it is growing and has been f...
Kenny MacAskill:
SNP
Will the member explain what he believes are the extreme legal interventions that the Government is proposing? I view our regulations on liquor licensing as ...