Professor Ian Gilmore - Royal College of Physicians

Question: You are holding a conference on alcohol this week - what is it going to focus on and why is there a need for the conference?

Prof Ian Gilmore: It is now a year since the government produced its long-awaited alcohol harm reduction strategy, and more recently its public health white paper "Choosing health".

However, the recommendations and policy measures promoted in these two documents concentrate too heavily on the aspects of drinking most closely related to law and order issues at the expense of health, and fall short of meeting the concerns of the medical profession.We are using this conference to put the health consequences of alcohol misuse back on the agenda.

Question: In your opinion is the government taking alcohol related harm seriously?

Prof Ian Gilmore: I think the government is taking alcohol related harm seriously, however I believe they are working under considerable constraints due to the massive force of the drinks industry lobby.

I think the government finds it easier to tackle the law and order aspects of alcohol misuse, as they are politically attractive.It may be true that it is only a small minority who are creating havoc in our inner cities and making them no go areas at night.

However, 25 per cent of the population are drinking at potentially harmful levels and five million people in the population are alcohol dependent.So we are not talking about small numbers.

We are talking about immediate health risks which are linked to binge drinking; like getting a glass in the face, unwanted pregnancies, but we are also talking about the long term consequences like cirrhosis of the liver.

Cirrhosis of the liver has gone up 900 per cent since the 1970s during which time our alcohol consumption as a country has gone up 50 per cent.We are drinking more and more as alcohol is getting cheaper year on year and we fear that a change to the licensing laws is about to make alcohol more available than it has ever been.

Question: Should the government be doing more considering the effects on health, work, anti-social behaviour?

Prof Ian Gilmore: The alcohol harm reduction strategy as produced by the Cabinet Office was cross cutting but since then I think the focus on alcohol related harm has been lost to some extent.The Home Office was given the responsibility of pulling the strategy together but the Home Office inevitably has a much more law and order focus.

Question: Is the drinks industry taking alcohol related harm seriously?

Prof Ian Gilmore:I believe that this drinks industry isbeing vocal on the issues of binge drinking and I believe that they want to see law and order problems sorted out as currently it gives them a bad name; I do not believe that they wish to see the nation drinking less.

The industry has a £30 billion annual turnover, they have some social responsibility programmes, however at the end of the day they have a responsibility to the shareholders.

I am not blaming the drinks industry for the problems that we have now, but I am concerned the government wants to work alongside the industry and I am doubtful that this will be effective.

For example, in the public health white paper one of the government’s recommendations is that there should be a public information campaign in partnership with the Portman Group.We do not think that is the right partnership for a public information campaign when there are other independent bodies like Royal College of Physicians or Alcohol Concern who could and would be much better placed to work to publicise this information.

Question: What are your views on the new licensing laws – will we be able to adopt a continental style of drinking or do you think it will simply encourage binge drinking?

Prof Ian Gilmore:It is very unlikely that the single act of extending licensing laws will turn us into a wine sipping continental culture.We may be able to move in that direction in the longer term but the timing of this change, when we are in the middle of an epidemic of alcohol related problems, seems to be inappropriate.

International evidence suggests that extending licensing laws increases the amount of alcohol drunk and in turn the amount of alcohol related harm including violence and Accident and Emergency attendances.

Question: Can we learn from other countries? For example, in Iceland extended drinking hours led to an increase in road accidents.

Prof Ian Gilmore: I think we should learn from these other countries; they are more relevant to us than Spain and Italy.Looking closer to home in Dublin they have had terrible problems related to the relaxation of closing times.

Question: What would you like to see done?

Prof Ian Gilmore:It is a complex area and there is no one single answer.

The Department of Culture, Media and Sport tells us that they are putting together other measures to tackle alcohol misuse, e.g. strengthening policing and stronger controls on licensees - this is to be applauded.I believe that we should take these measures first to ensure it has an effect on stemming the rise of alcohol related harm, measures to relax the licensing laws can then follow.

The evidence we have already from other parts of the world shows clearly that alcohol-related harm is closely linked to the nation’s overall consumption, and this is best controlled by price and availability.The mushrooming of retail outlets, for instance in petrol stations, needs to be urgently addressed, as does the sale of cheap alcohol as a loss leader or special offer.There are no Government plans to address availability or price.

We need more research into the causes of our present culture and patterns of alcohol consumption in the UK and how it could be changed.The roles of public information and education, encouraged in "Choosing health" are poorly understood, as are the ways in which alcohol damages the body.

A one per cent levy on the industry would allow an independent national institute to drive this forward.There is no government commitment to funding research of this kind.Public information campaigns on the dangers of alcohol are to be led by the industry, in direct contrast to those on tobacco.

The advertising regulations continue to be ambiguous and difficult to implement, even after Ofcom’s proposed changes. "Choosing health" offers options for restricting junk food advertising to children including a possible 9.00pm watershed, yet no such restrictions are suggested for alcohol.

There is surely an obligation that advertisers make clear the contents and risks in understandable language.The new Ofcom rules on alcohol are weak compared to those proposed for unhealthy foods.

Question: Would you like to see more activities made available for young people so they don’t get bored and start drinking at an earlier age?

Prof Ian Gilmore:We do not know why there is a culture in this country that sees high levels of drinking among young people; we need more research so we can understand it.There is evidence that people who start drinking at an earlier age run more risks of having alcohol dependence and alcohol related problems in later life, so it does make sense to target the young.

It is not just young people; it is 25 per cent of the population who are drinking quietly at home and who are drinking at dangerous levels.

Question: What is your message to the government?

Prof Ian Gilmore:The Royal College of Physicians and the British Society of Gastroenterology are not ‘anti-drink’ and accept that alcohol is part of our society with some positive benefits.However patient care comes first, and we are keen to work with the government to help halt the rising tide of physical, mental and social harm that is accompanying the nation’s escalating drinking.

Question: What is your message to the industry?

Prof Ian Gilmore:We would like to see thevoluntary partnerships agreed between the industry and the government work and for this to happen as soon as possible.

The industry needs to look very hard at reducing the number of two for one offers, happy hours and knock down prices on alcohol in off-licenses.