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To ask Her Majesty’s Government what assessment they have made of changes in the number of deaths from heroin and morphine abuse over the first full year since they placed a financial incentive on the successful completion of drug treatment; and whether they have any plans to discontinue that policy...
To ask Her Majesty’s Government what assessment they have made of changes in the number of deaths from heroin and morphine abuse over the first full year since they placed a financial incentive on the successful completion of drug treatment; and whether they have any plans to discontinue that policy...
Whilst no conclusions can be drawn from one year’s data, Public Health England is analysing the drug misuse and treatment datasets to identify possible reasons for the change in drug misuse deaths reported in 2013. This analysis is due to be published in a statistical bulletin in 2015 and will help inform any possible future actions.
To ask Her Majesty’s Government whether draft regulations for making Naloxone more widely available will be published in draft ahead of the October 2015 implementation, to enable organisations including police, hostels and drugs misuse services to make advance plans.
To ask Her Majesty’s Government whether draft regulations for making Naloxone more widely available will be published in draft ahead of the October 2015 implementation, to enable organisations including police, hostels and drugs misuse services to make advance plans.
Naloxone has a vital role in saving lives and we are committed to widening its use in England. We have accepted the recommendation from the Advisory Council on the Misuse of Drugs to make this life-saving medicine available more widely and Departmental officials are drafting new regulations to give effect to this decision. This legislative change is due to commence in October 2015.
Public Health England has recently published advice for commissioners and providers on the provision of take-home naloxone for reversing overdose in people who use heroin and other opiates, so that commissioners and providers can take action, both now and following the October 2015 legislative change, to widen the supply of naloxone.
In addition, the issue of naloxone supply is also being considered by the independent expert group updating the 2007 drug misuse clinical guidelines, Drug Misuse and Dependence: UK Guidelines on Clinical Management.
As it is formulated as an injectable medicine, naloxone does not meet the criteria set out in legislation for classification as an over-the-counter medicine.
Amended regulations will be publicly available when they are laid before Parliament.
To ask Her Majesty’s Government what action they are taking to improve access to Naloxone in England.
To ask Her Majesty’s Government what action they are taking to improve access to Naloxone in England.
Naloxone has a vital role in saving lives and we are committed to widening its use in England. We have accepted the recommendation from the Advisory Council on the Misuse of Drugs to make this life-saving medicine available more widely and Departmental officials are drafting new regulations to give effect to this decision. This legislative change is due to commence in October 2015.
Public Health England has recently published advice for commissioners and providers on the provision of take-home naloxone for reversing overdose in people who use heroin and other opiates, so that commissioners and providers can take action, both now and following the October 2015 legislative change, to widen the supply of naloxone.
In addition, the issue of naloxone supply is also being considered by the independent expert group updating the 2007 drug misuse clinical guidelines, Drug Misuse and Dependence: UK Guidelines on Clinical Management.
As it is formulated as an injectable medicine, naloxone does not meet the criteria set out in legislation for classification as an over-the-counter medicine.
Amended regulations will be publicly available when they are laid before Parliament.
To ask Her Majesty’s Government whether they have given consideration to making Naloxone an over-the-counter drug in England.
To ask Her Majesty’s Government whether they have given consideration to making Naloxone an over-the-counter drug in England.
Naloxone has a vital role in saving lives and we are committed to widening its use in England. We have accepted the recommendation from the Advisory Council on the Misuse of Drugs to make this life-saving medicine available more widely and Departmental officials are drafting new regulations to give effect to this decision. This legislative change is due to commence in October 2015.
Public Health England has recently published advice for commissioners and providers on the provision of take-home naloxone for reversing overdose in people who use heroin and other opiates, so that commissioners and providers can take action, both now and following the October 2015 legislative change, to widen the supply of naloxone.
In addition, the issue of naloxone supply is also being considered by the independent expert group updating the 2007 drug misuse clinical guidelines, Drug Misuse and Dependence: UK Guidelines on Clinical Management.
As it is formulated as an injectable medicine, naloxone does not meet the criteria set out in legislation for classification as an over-the-counter medicine.
Amended regulations will be publicly available when they are laid before Parliament.
To ask Her Majesty’s Government what assessment they have made of the reasons for the 32 per cent rise in the number of deaths from heroin or morphine abuse between 2012 and 2013; and how many of the 765 people who died as a result of heroin or morphine abuse...
To ask Her Majesty’s Government what assessment they have made of the reasons for the 32 per cent rise in the number of deaths from heroin or morphine abuse between 2012 and 2013; and how many of the 765 people who died as a result of heroin or morphine abuse...
At this stage it is not possible to draw any definitive conclusions about a longer-term trend in deaths from one year’s data. Public Health England is currently analysing the data to better understand the reasons for the increase.
To ask Her Majesty’s Government what discussions they have had with the drinks industry about contributing to National Health Service accident and emergency costs.
To ask Her Majesty’s Government what discussions they have had with the drinks industry about contributing to National Health Service accident and emergency costs.
My Lords, the alcohol industry has responsibilities to reduce harm caused by its products. We have challenged the industry to deliver action through the responsibility deal. It is important to recognise that individuals also have responsibility
for their behaviour. The Government set the legislative framework, and the United Kingdom has relatively high taxes on alcohol, which are the main way to compensate society for its costs. Our alcohol strategy seeks to prevent and reduce harm from alcohol.
My Lords, the alcohol industry has responsibilities to reduce harm caused by its products. We have challenged the industry to deliver action through the responsibility deal. It is important to recognise that individuals also have responsibility
for their behaviour. The Government set the legislative framework, and the United Kingdom has relatively high taxes on alcohol, which are the main way to compensate society for its costs. Our alcohol strategy seeks to prevent and reduce harm from alcohol.
My Lords, the alcohol industry has responsibilities to reduce harm caused by its products. We have challenged the industry to deliver action through the responsibility deal. It is important to recognise that individuals also have responsibility
for their behaviour. The Government set the legislative framework, and the United Kingdom has relatively high taxes on alcohol, which are the main way to compensate society for its costs. Our alcohol strategy seeks to prevent and reduce harm from alcohol.
To ask Her Majesty’s Government what discussions they have had with the drinks industry about contributing to National Health Service accident and emergency costs.
My Lords, alcohol-related attendances at A&E are certainly a matter of concern; we fully recognise that. Having said that, there is no evidence to suggest that current pressures in A&E departments are related to trends in alcohol-related attendances. We are taking a range of actions to prevent and reduce harm both nationally and in many local areas. We are certainly not just treating this as a financial issue. This is an issue to do with people’s health, and it is important. The industry is playing its part through the responsibility deal, which is already yielding some encouraging results.
My Lords, alcohol-related attendances at A&E are certainly a matter of concern; we fully recognise that. Having said that, there is no evidence to suggest that current pressures in A&E departments are related to trends in alcohol-related attendances. We are taking a range of actions to prevent and reduce harm both nationally and in many local areas. We are certainly not just treating this as a financial issue. This is an issue to do with people’s health, and it is important. The industry is playing its part through the responsibility deal, which is already yielding some encouraging results.
My Lords, I am grateful for the pleasant words from the Minister, but I omitted to pick up on just what action the Government intend to take. Does he share the concern of his new CEO for the NHS, Sir Simon Stevens, that more than 1 million people are now presenting at A&E each year with alcohol problems? Not only that, but they are in the main accompanied by their friends and often family, who swell the numbers and are equally intoxicated. They are creating great difficulties for nurses, doctors and other A&E patients. Many of those people do not come from their home; they come from drinking establishments from which some of them have been ejected. Many of those establishments have personnel there looking after security for the protection of the interests of the drinks industry. If the drinks industry can pay for those people to protect its interests, why cannot it be required to pay to protect the interests of nurses, doctors and other people in A&E who are intimidated by people who are drunk?
My Lords, we are keeping the developing evidence on a minimum unit price under review. It has only ever been part of our alcohol strategy—which, as I said, includes a range of actions. We acknowledge the need to give careful consideration to any possible unintended consequences of MUP, such as its potential to impact on the cost of living, the economic impact of the policy and, importantly, a possible increase in illicit alcohol sales that could ensue.
My Lords, we are keeping the developing evidence on a minimum unit price under review. It has only ever been part of our alcohol strategy—which, as I said, includes a range of actions. We acknowledge the need to give careful consideration to any possible unintended consequences of MUP, such as its potential to impact on the cost of living, the economic impact of the policy and, importantly, a possible increase in illicit alcohol sales that could ensue.
Do the Government accept that currently, the cost to the NHS of these attendances is about £120 per taxpayer for England? The arguments for minimum unit pricing are very strong, given that the attendance range peaks between the ages of 35 and 55 and yet, in that age group, you can drink your whole maximum weekly recommended amount of alcohol for less than £10 with the current pricing system. Minimum unit pricing might bring in more money to cover the cost to the NHS.
My Lords, we have taken a strong policy on taxation in recent years, particularly to reduce the availability of cheap, strong alcohol. Since the 2010 general election, duties on spirits have risen by more than 18%, which is well above RPI, and on wine by more than 21%, again well above RPI. We have also introduced a ban on the sale of below-cost alcohol, which should stop the worst cases of cheap and discounted alcohol sales.
My Lords, we have taken a strong policy on taxation in recent years, particularly to reduce the availability of cheap, strong alcohol. Since the 2010 general election, duties on spirits have risen by more than 18%, which is well above RPI, and on wine by more than 21%, again well above RPI. We have also introduced a ban on the sale of below-cost alcohol, which should stop the worst cases of cheap and discounted alcohol sales.
My Lords, is it necessary to refer to the alcohol industry for measures to alleviate the £21 billion-worth of harm that it causes? Should my noble friend not instead refer to the calculations by
the University of Sheffield showing the amount by which alcohol harm can be reduced by increases in taxation?
Not at all, my Lords. As I explained the last time the noble Lord asked that question, the reasons were purely technical and nothing to do with a disagreement. The CMO is overseeing a review of the alcohol guidelines so that we can ensure that people make better-informed choices. That is now under way and in its second phase. During the review we will look at any significant new evidence that relates to pregnancy, in particular, to consider whether our advice needs to be updated. We expect to consult on new guidelines by the middle of this year.
Not at all, my Lords. As I explained the last time the noble Lord asked that question, the reasons were purely technical and nothing to do with a disagreement. The CMO is overseeing a review of the alcohol guidelines so that we can ensure that people make better-informed choices. That is now under way and in its second phase. During the review we will look at any significant new evidence that relates to pregnancy, in particular, to consider whether our advice needs to be updated. We expect to consult on new guidelines by the middle of this year.
My Lords, can I ask the noble Earl about the attitude of the drinks industry? He said that it is responsible but can he confirm that the long delay in the publication of new guidelines from the Chief Medical Officer on safe drinking levels is because she wants to reduce those levels but the drinks industry objects, and the Government have given in to it?
My Lords, again, there has been a great deal of progress in alcohol labelling. Independent research published in November showed that just under 80% of bottles and cans of alcohol on shelves now have the correct health labelling: a clear unit content, the CMO’s lower-risk drinking guidelines and a warning about drinking when pregnant. That fulfils an industry-wide responsibility deal pledge.
My Lords, again, there has been a great deal of progress in alcohol labelling. Independent research published in November showed that just under 80% of bottles and cans of alcohol on shelves now have the correct health labelling: a clear unit content, the CMO’s lower-risk drinking guidelines and a warning about drinking when pregnant. That fulfils an industry-wide responsibility deal pledge.
Would my noble friend consider obliging the purveyors of this habit-forming, hallucinatory drug to place a government health warning on their products?
My Lords, as I said earlier, there is actually no evidence that the A&E pressures we are now seeing are attributable to trends in alcohol-related attendances, and we have a mechanism through duties on alcohol to compensate society for the harms that alcohol causes.
My Lords, as I said earlier, there is actually no evidence that the A&E pressures we are now seeing are attributable to trends in alcohol-related attendances, and we have a mechanism through duties on alcohol to compensate society for the harms that alcohol causes.
My Lords, does the Minister agree that the drinks industry should bear the cost of treating people with alcohol-related sickness and illness who end up in A&E that is proportionate to their number? For example, it is 80% in some hospitals on a Saturday evening.
To ask Her Majesty’s Government what are Public Health England’s plans for combatting alcohol addiction.
To ask Her Majesty’s Government what are Public Health England’s plans for combatting alcohol addiction.
My Lords, Public Health England recognises that the harmful use of alcohol is a major health risk. The harm from alcohol is preventable; alcohol is one of seven key priorities that PHE is focusing on. It is implementing a programme to support national and local government, the NHS and partners to implement evidence-based policies and interventions. Included in this work is the reduction of alcohol addiction.
My Lords, Public Health England recognises that the harmful use of alcohol is a major health risk. The harm from alcohol is preventable; alcohol is one of seven key priorities that PHE is focusing on. It is implementing a programme to support national and local government, the NHS and partners to implement evidence-based policies and interventions. Included in this work is the reduction of alcohol addiction.
My Lords, Public Health England recognises that the harmful use of alcohol is a major health risk. The harm from alcohol is preventable; alcohol is one of seven key priorities that PHE is focusing on. It is implementing a programme to support national and local government, the NHS and partners to implement evidence-based policies and interventions. Included in this work is the reduction of alcohol addiction.
To ask Her Majesty’s Government what are Public Health England’s plans for combatting alcohol addiction.
My Lords, my noble friend was kind enough to give me advance warning of those questions. I have to say to him that we do not recognise the figures he quotes; nor do we think that the comparison he makes is like for like. In 2007, an estimated 1.6 million people had some degree of alcohol dependence, including those with a slight dependence. Of those, some 250,000 were believed to be moderately or severely dependent. The specialist treatment centre system continues to work well for many people. Many of the trends in terms of treatment are positive. As regards supportive relationships, I fully agree with what he said; they are a vital element in helping individuals build their own recovery. In October 2013, Public Health England produced a strategic action plan for supporting the treatment sector to strengthen its links with mutual aid organisations to ensure that everyone in treatment can benefit from that support.
My Lords, my noble friend was kind enough to give me advance warning of those questions. I have to say to him that we do not recognise the figures he quotes; nor do we think that the comparison he makes is like for like. In 2007, an estimated 1.6 million people had some degree of alcohol dependence, including those with a slight dependence. Of those, some 250,000 were believed to be moderately or severely dependent. The specialist treatment centre system continues to work well for many people. Many of the trends in terms of treatment are positive. As regards supportive relationships, I fully agree with what he said; they are a vital element in helping individuals build their own recovery. In October 2013, Public Health England produced a strategic action plan for supporting the treatment sector to strengthen its links with mutual aid organisations to ensure that everyone in treatment can benefit from that support.
Considering that three years ago, there were 1.1 million alcohol addicts in England and that abuse of alcohol was costing the nation £21 billion—and probably much more than that today—how can the Minister reconcile the fact that we spend only one-tenth as much on treating alcohol addiction as we do on patients suffering from drug addiction? Why is it taking until 2016 to update the guidance on access to mutual aid fellowships such as Alcoholics Anonymous, when the ACMD has shown that there are effective ways of combatting the addiction?
No, my Lords, they are not. The Government have regular dialogue with the industry, but the industry does not formulate policy and never will do. There has been a delay on the new guidelines; the consultation on them had been planned for December last year but will not now happen until shortly after the general election. That is simply due to problems with Public Health England commissioning expert advice on guideline methodologies, which took longer than intended. The academic body that PHE wanted to do the work decided that it did not have the capacity to do so. A tender exercise was therefore necessary and the work is being carried out by a team from Sheffield University.
No, my Lords, they are not. The Government have regular dialogue with the industry, but the industry does not formulate policy and never will do. There has been a delay on the new guidelines; the consultation on them had been planned for December last year but will not now happen until shortly after the general election. That is simply due to problems with Public Health England commissioning expert advice on guideline methodologies, which took longer than intended. The academic body that PHE wanted to do the work decided that it did not have the capacity to do so. A tender exercise was therefore necessary and the work is being carried out by a team from Sheffield University.
My Lords, how many meetings have been held between Ministers and representatives of the alcohol industry since the last election? Why are the Government delaying the publication of the Chief Medical Officer’s review of safe drinking levels until after the election? Are the two connected?
My Lords, the Royal College of GPs has a special focus at the moment on giving advice to GPs. We are also dramatically increasing the number of health visitors, who are, of course, highly instrumental in influencing the behaviours of mothers-to-be and young mothers.
My Lords, the Royal College of GPs has a special focus at the moment on giving advice to GPs. We are also dramatically increasing the number of health visitors, who are, of course, highly instrumental in influencing the behaviours of mothers-to-be and young mothers.
My Lords, the Minister is well aware of the effect of alcohol on unborn children. What are the Government doing for young mothers who are either addicted to drink or unaware of the difficulties that alcohol creates for their children in terms of education both through the health service and the education system?
My noble friend is absolutely right. More than 90% of liver disease is due to three main, preventable and treatable risk factors—alcohol, hepatitis B and C, and obesity. Alcohol accounts for 37% of liver disease deaths, but obesity is indeed a major factor in this.
My noble friend is absolutely right. More than 90% of liver disease is due to three main, preventable and treatable risk factors—alcohol, hepatitis B and C, and obesity. Alcohol accounts for 37% of liver disease deaths, but obesity is indeed a major factor in this.
My Lords, does the Minister accept that although alcohol was until recently the commonest cause of liver disease, the commonest cause is now the obesity epidemic, which is killing millions of people? Some 13 million people in this country are suffering from obesity—far more than are suffering from alcohol problems.
My Lords, Public Health England has a programme of work to ensure that all the bases are covered. It is producing a report for government that will be published later this year. Over the next 18 months,
there will be a longer programme of work on such things as a framework for liver disease, setting out the evidence base for the introduction of a minimum unit price for alcohol and using alcohol as the trail-blazer for a new whole-system approach that establishes what works and is clear on the return on investment, to enable government to take action based on evidence.
My Lords, Public Health England has a programme of work to ensure that all the bases are covered. It is producing a report for government that will be published later this year. Over the next 18 months,
there will be a longer programme of work on such things as a framework for liver disease, setting out the evidence base for the introduction of a minimum unit price for alcohol and using alcohol as the trail-blazer for a new whole-system approach that establishes what works and is clear on the return on investment, to enable government to take action based on evidence.
Will the Minister explain to the House why, when his Government came to power, they tore up the draft strategy on liver disease that had been prepared by the previous Government? What are they going to do to put one in place and, given the complaints we have heard, make sure that the growth in the number of deaths is reversed?