Tuesday, 26 April 2011

Butt out Angela Merkel, Ireland is having another drink

Being Irish is becoming a by-word for a number of things these days, not all of them good.  Our reputation for extreme deference is now well enough established for protestors as far away as Egypt to hold banners aloft declaring ‘WE ARE NOT IRISH’ to convey their determination to stand up to bad government.  So we should look hard at how we got into our current difficulties and demand that our government sort it out? Apparently not. 

The recommended response to the Irish banking crisis, courtesy of the Irish Sunday Independent

Step forward the Independent on Sunday (24th April) with the startling news that we are already ‘sick of sackcloth and ashes; tired of being the sick men and women of Europe.  Let's party tonight, and tomorrow worry about the IMF and bitch about the bankers'.  Ah yes, the perfect solution to the long, booze-soaked disaster that was the banking-cum-property frenzy: a long, booze-soaked slide into chaos.  Don't think, don't protest, don't get organised: get sozzled.  And who cares about  ‘those still shaking a Teutonic fist and wagging a Gallic finger at our profligacy’.  As the Sindo continues so rightly 'In Greece, they rioted on the streets.  In Dublin, they are drinking and eating with renewed and refreshing vigour'.  So butt out Chancellor Merkel, we're having another drink.
Fair play of course to the Irish vintners and restaurateurs for doing their bit for tourism and the economy, as commended by new Transport & Tourism Minister, Leo Varadkar, at the Restaurants Association of Ireland Conference last week.  But the Minster’s  Road Traffic Bill  introducing mandatory breath tests for drivers involved in traffic accidents, while strongly supported in most quarters, raised carefully worded notes of caution from rural TDs - no doubt under pressure from publicans anxious about trade.  Longford TD James Bannon swore in the Dail for example that ‘I am in no way advocating or condoning drink driving’ (of course not) and made the cry, perhaps too floridly, ‘Let us bring in every imaginable regulation to prevent this abuse’.  But then, getting down to the real business, the Deputy mysteriously told us that ‘in the interests of balance...I must talk out of both sides of my mouth this evening’.  Brilliant. 

Drinking alcohol will help prevent suicide? 

Balance, it turns out, was weighing the deaths from drink-driving against those of ‘loneliness which is a major contributor to suicide and the destruction of the fabric of rural communities’ (meaning pubs).  Good argument, but the other rural killer, according to Bannon, is that being denied ‘a couple of pints owing to a lack of transport is a form of death’.  And if that doesn’t get you, a ‘lack of social contact for people in remote areas leads them to believe they would be better off dead’.  The spirit of Christy O’Sullivan lives on.  So, is Deputy Bannon suggesting that more people will die if Minister Varadkar makes it tougher for drunk drivers to avoid detection?  As Independent TD Finian McGrath pointed out in the same Dail debate, ‘while recognising that the solution is not drinking and driving’ we should be ‘coming up with other radical and sensible ideas’.

It's not restricting drink-driving that is a threat to Irish pubs it's the industry's own restrictive practices

Surely the most radical and sensible idea of them all is to ask why drinking to excess is the solution to every Irish problem?  Where in the rest of the world do we hear people even begin to argue that the cure for recession, loneliness, suicide, a banking crisis, tourism and economic collapse is a royal piss up?  To take the very reasonable argument that rural pubs are important to people, why are they not functioning like rural cafes and bars in the rest of Europe and selling a range of good quality,  soft drinks, coffee, tea and snacks - at any time and at affordable prices?  The answer is a surprising one when we look at the lengths TD’s have gone to, to debate the delcine of rural pubs without mentioning it.  As far back as 1998 the Competition Authority reached the conclusion that:

"All of the restrictions inherent in the system of licensing of pubs make it impossible for the market to function efficiently and in the best interests of the consumer."

Or to quote them in full:

"The effect of the liquor licensing regime has been to distort the retail drinks market. While Ireland has exported the Irish pub concept to the rest of the world, the licensing system here has actually destroyed many traditional pubs in Dublin. Meanwhile, Ireland is largely deprived of innovations like French-style cafes, which sell a broad range of products. Ultimately this restrictive system has imposed a huge cost on consumers in terms of high prices, poor quality, lack of choice and little innovation."

On the same subject Forfas reported to the Consumer Strategy Group in 2004 that Ireland is world-class again, this time as 'the most expensive country in the Eurozone to purchase soft drinks'.  It additionally and uniquely applies the same full rate of VAT to soft drinks as it does alcohol.  Further, "an analysis of the retail prices of 13 individual brands of soft drinks across the EU15 reveals that 12 out of 13 soft drinks are more expensive in Ireland even when price-adjusted for VAT".  And a straw poll will tell you that these over-priced soft drinks are also very poor quality and come in very small measures. The industry seems to want us to drink nothing but alcoholic drinks when we visit a pub. 

When I asked Gerry Mellett, the President of the Vintners' Federation of Ireland, on Dublin CityFM why pubs don’t sell a better range of non-alcoholic drinks, he rightly said pubs would like to, but the distributors won’t let them.  We are, as the Consumer Association report says, once again in the grip of big business.  'Five manufacturers / distributors dominate the Irish market: Diageo Ireland Ltd, Heineken, Beamish & Crawford, Irish Distillers (IDL) and Dillon & Co Ltd' and the soft drinks trade is dominated by Coca Cola Ireland and C & C, who between them have created a situation where the big money is in  ensuring that Irish pubs remain the home of large measures of addictive, alcoholic drinks.  The restrictive practice referred to in the Forfas report limits not only the range and price of the drinks pubs can sell but the number of pubs who can sell them.  That has been known to be the cause since 1998, in spite of what Deputy Bannon is arguing, of the decline in rural pubs - not a restriction on drunken drivers roaming country roads. And since Deputy Bannon invokes the subject in this context, the causative link between alcohol and suicide is well documented.

When the Independent on Sunday recommends that we drink our way out of the recession, in fact they are, knowingly or not, helping only one industry get out of the recession: the drinks industry.  And while that industry contributes to our economy in taxes and jobs, the EU has calculated that for every Euro it contributes we are paying out up to 100 Euro to repair the damage alcohol causes, including costs for absenteeism, social break-down, crime and ill-health.    

Tuesday, 19 April 2011

Why Mayor Bloomberg and Jessie J are right: the business and reputational cost of alcohol to Ireland

Okay, so we are 9 billion in credit, and there are jobs too?   Not necessarily . "Current evidence from alcohol and other sectors suggests that declining consumption may not necessarily lead to job losses in the economy as a whole".  Chielfy of course, because money spent on alcohol is disposable income that people will then spend on other goods, creating other markets and other jobs.   And what of the cost of alcohol in terms of working days lost, health service costs and crime ? The European Union rates that at a staggering figure of up to €1,000 bn.  Not much of a return on the investment, then.

"Based on a review of existing studies, the total tangible cost of alcohol to EU society in 2003 was estimated to be between €79bn and €220bn, equivalent to 1.3% GDP, which is roughly the same value as that found recently for tobacco. The intangible costs show the value people place on pain, suffering and lost life that occurs due to the criminal, social and health harms caused by alcohol. In 2003 these were estimated to be between €150bn and €760bn".

So the cost to the European economy of alcohol is potentially over 100 times higher than its economic benefit.  And the cost to Ireland, where drinking is proportionally 20% above the european average, is arguably greater still.  As Alcohol Action Ireland put it, "it’s worth remembering that these costs are avoidable costs. According to the Chief Medical Officer of Ireland, a 30% reduction in alcohol-related harm would result in a cost saving to the Exchequer of €1billion. Meanwhile, alcohol-related harms cost each tax payer in Ireland an estimated €3,318 a year. Cheap alcohol in Ireland is fuelling a growing health and crime crisis that is costing us an estimated €3.7billion* a year in health, crime/public order and other ancillary costs, such as work-place absenteeism."

We could of course look at it much more cynically, as the RAND report to the EU did.  Noting that  "Population ageing is the main threat to the sustainability of European pension funds...a future reduction in the harmful effects of alcohol consumption may lower premature mortality and increase the number of people that reach retirement age. Alcohol users who die prematurely contribute to pensions funds but do not draw a pension." 

So we could work by day, get pissed by night and die conveniently young.  Or we could add up the reputational damage, the social cost and the huge drain of billions from our economy and grow up.

Monday, 11 April 2011

Message on a bottle: can Minister Reilly's health warning survive Ireland's alcohol industry lobby?

As Bertie Ahern memorably said of Lehman's Bank, 'they had testicles everywhere'.  So it is with the alcohol industry.  A cautious welcome then for Minister for Health James Reilly's announcement last week in the Dail that: “My Department is developing legislative proposals to provide for the inclusion of health advice/warnings on alcohol drink containers (bottles, cans) and on promotional materials”. A GP himself, the Minister must be aware of the consequences of alcohol consumption in the world's third biggest consumer per capita - both in human terms and in the emormous cost to a creaking and underfunded health service.

Research confirms that warnings on bottles and cans do influence people's buying and drinking habits as long as they are specific and serious.  Warnings that 'smoking may harm your health' were seen to be weak, for example, and were replaced by the far more effective 'Smoking Kills' campaign which made a real impact on tobacco sales and, in turn, smoking related deaths.  Now the Minister intends “to warn pregnant women on the dangers of consuming alcohol during pregnancy”.  But will the wording be clear about the risks of foetal alcohol syndrome?  And on other risks James Reilly intends, he says, to “inform the consumer about the dangers associated with the alcohol product being consumed”.

So who will advise the Minister in drafting the legislation and the wording of the warnings?  It will, the Minister announced, be the National Substance Misuse Strategy (NSMS) Steering Group due to report later this year. When that group published its National Drug Strategy (NDS) for 2009-16 it did, for the first time, recommend that alcohol be included as a harmful substance alongside heroin, opiates et al.  A welcome step given that alcohol is responsible for more crime, hardship and deaths than all those drugs put together.  But the inclusion of alcohol in the strategy, while very welcome, is carefully managed so that it is treated with more deference and respect than its bad-boy illegal cousins.

Alcohol is not clearly recognised as a problem drug in its own right in the NDS. Rather it is contextualised mainly as a problem "in association with illicit drug use"...or as "a gateway to illicit drug use” and “poly - drug use which very often includes alcohol - is now the norm among illicit drug users”.   After a very thorough but separate examinaton of the risks and costs of alcohol use, there is a disappointingly hurried and undeveloped commitment “to address broader issues around the supply and availability of alcohol, pricing, marketing, promotion and sponsorship etc”. Alcohol is then left to one side while the strategy gets down to the real busness “as outlined in the Introduction...to the primary focus of this Report, illicit drug use”.  A gaping hole in the data is the lack of comparative information that could only show that it is alcohol in its own right that should have been the primary focus of the strategy. 

So it remains to be seen how strong any advice on alcohol from this Steering Group will be. What we already know is that, unlike tobacco, the intended warnings will not be on every bottle, because pubs, hotels and restaurants are to be exempted from the legislation for the time being. And while the number of licenced premises has grown by 150% since 2000 (pubs declining by 14%), off-licences still acccount for less than 40% of sales (government figures), meaning that over half of all drinks sold will be without the new health warnings.

Some already see that as a warning sign that this government initiative will attempt the impossible: to limit alcohol related harm while not actually upsetting the powerful industry itself, particularly the publicans who have succesfully lobbied for a soft-pedalling on legislation in the past . As John Lee writes in the Irish Mail on Sunday “Sources indicated publicans would welcome the warnings as they may help reverse the trend towards cheap alcohol from off-licences and supermarkets”. Or as you might say, it's those damned industry testicles again.

Wednesday, 6 April 2011

Accident & Emergency: Alcohol and Ireland

This post continues the Gargle Nation report into teenagers and alcohol.
Following the January high of 569 patients on trolleys in hospital A & E departments, new Health Minister James Reilly recently promised 'action to ensure that the issue of overcrowding in hospital emergency departments would not occur again'.

One issue urgently waiting to be addressed by the new government is the contribution of alcohol to those A&E figures, which according to Alcohol Action Ireland make up a quarter of admissions, 50% of them being injuries to young people under 30. The problem can be traced to what the National Youth Council of Ireland (NYCI) has called 'questionable policy decisions' made after lobbying by the alcohol industry.

In the UK, despite the recent flurry of publicity for its new tough action on alcohol, the Government has lost the backing of The Royal College of Physicians and major health organisations. The College reports that 'Six health organisations have decided not to sign up to the...Public Health Responsibility Deal because of serious reservations about the proposed alcohol pledges.' Three of those six pledges relate to a failure effectively to regulate advertising.

In the words of Alcohol Concern CEO Don Shenker: "This is the worst possible deal for everyone who wants to see alcohol harm reduced. There are no firm targets or any sanctions if the drinks industry fails to fulfil its pledges. It's all carrot and no stick for the drinks industry and supermarkets. The deal on alcohol is clearly the result of determined drinks industry lobbying coupled with a coalition government in thrall to business".

This is also an accurate summary of the position in Ireland, confirming the power of the industry-led lobby in the two countries, led by leading companies such as Diageo, Heineken and Irish Distiller's. The resulting self-regulation of advertising to young people agreed between industry and government has clearly failed on two levels: advertising continues to reach young people, and drinking amongst young people continues to be problematic.

Regulation of advertising in Ireland chiefly relies on a 'quota' system monitored by the industry's own Central Copy Clearance Ireland Ltd and the industry/government-run Alcohol Marketing Communications Monitoring Body. The industry agrees not to run advertisements for alcohol during programmes or in publications thought to have a child/teenage audience of greater than 25% (down from 33% in 2008). Where advertising is permitted, alcohol advertisements will be limited to 25% of the available space. Though the industry called these measures 'tough', they read more like a memo-to self- by marketing managers to remember to place alcohol advertising in 25% of the major media outlets.

On the restricted programming Alcohol Action Ireland have observed:

"Reliance on audience profiling allows alcohol marketing to continue to reach a significant number of children and young people. For example, according to 2008 television viewer figures programmes such as Coronation Street, EastEnders and Fair City attracted some 600,000 to 700,000 viewers with major sports events attracting around the same figures. Applying the 25% rule, it means that up to 150,000 children and young people could be watching these programmes featuring alcohol advertising...Children and young people are bombarded with positive images of alcohol through marketing of the product - in effect, the alcohol industry is a child’s primary educator on alcohol".

And as Professor Gerard Hastings has written, other less regulated means of marketing such as sponsorship are just as effective to the industry. "Although sponsorship is not specifically included in the advertising code, it is a large and powerful part of alcohol promotion. Sponsorship is a way of raising brand awareness, creating positive brand attitudes, and building emotional connections with consumers".

In it's 2009 research report Get 'em Young, the NYCI reports how, despite six years of regulation, young people continue to be reached and influenced by advertising. The report describes how the industry reinforces its message using multiple media, and adopts styles designed to attract them, using "the elements of the alcohol marketing practices that particularly appealed to young people...ads that use humour, are clever, offer cheap/free alcohol and are attractive".

Get 'em Young concludes that "the science is clear as to what works in reducing alcohol harm, which includes high taxation, strict controls on availability, marketing and random breath testing". However, the Irish Government has done the opposite - imposing "no tax increases during economic boom, longer opening hours, free movement of licences, below cost selling of alcohol...and pursued policies that have been shown not to work: information campaigns, education, individual responsibility and self regulation".

And for all the scrutiny of bodies like AMCMB, they fail to monitor the one thing that matters - the rising tide of alcoholism amongst teenagers. After nearly ten years of self-regulation it is painfully clear that it has not impacted a problem that is growing year by year. As reported in the Irish Times in January, a survey of 15- and 16-year-olds showed that "44 per cent of Irish girls and 42 per cent of Irish boys reported binge-drinking in the last month and over half reported being drunk at least once by the age of 16".

And getting back to those hospital waiting rooms, 13 children a day are now hospitalised as a result of alcohol misuse (Alcohol Concern Ireland).