Agenda item

Briefing Note of the Director of Public Health, Durham County Council.

The Board received a Briefing Note from the Director of Public Health, in reference to ‘Reducing Alcohol Harm - A Blueprint for National Action’ a document from BALANCE, presented by the Public Health Advanced Practitioner, Rachel Osbaldeston (for copy see file of minutes).

The Public Health Advanced Practitioner noted that the launch had been yesterday, 23 September 2024, with the aim of influencing politicians within the region and nationally to prioritise action on alcohol harm.  She highlighted this was timely in terms of the new Government following national elections, and the utilisation of real people’s stories within the document helped to reinforce what the impact of alcohol harms meant to people affected.  She noted key elements included: national strategy, to follow the progress in respect of tackling tobacco harm; to note that every drink of alcohol was a health harm; minimum unit pricing (MUP), which had seen successes in Scotland, though had failed to be implemented in England; marketing restrictions; looking at licensing objectives, where health was not currently an objective; early intervention; and prohibiting the alcohol industry from influencing policy noting much of the associated alcohol research and many charities were industry funded.  She concluded noting the continuing work in County Durham through the County Durham and Darlington Combatting Drug and Alcohol Strategic Partnership as well as through the work of the Health and Wellbeing Board.

Councillor R Bell noted the information was very positive and noted a few points, firstly that supermarkets were a large part of total alcohol sales, not just what many would consider licensed premises, such as pubs.  He noted that the volume and strength of alcohol readily available via supermarkets was an issue.  He noted the implications of alcohol consumption and healthy weight, adding many were unaware of the calories within alcoholic drinks.  Councillor R Bell noted the reference to alcohol as toxic and noted concern that anything that could be seen to be akin to the temperance movement in the nineteenth century may in fact lead to a backlash against any positive health message.  The Public Health Advanced Practitioner noted that BALANCE had campaigned with the message that alcohol was toxic as a shock tactic, as many people did not associate alcohol consumption with cancer.  Dr D Dwarakanath emphasised there had been an explosion of alcohol related deaths over the last 30 years.  He noted an example of 60 gastroenterology beds within his Trust, with around 35-40 of those being occupied by people with issues as a result of excessive alcohol consumption.  He noted there was an increase in alcohol consumption in certain groups, including young women aged 25-35.  He noted that there was also a need to educate as regards ‘safe drinking levels’, with many still believing outdated figures of 28 units for men and 21 units for women per week.  He suggested that members of the Board could look to have ‘quizzes’ within their organisations that included questions on those types of misconceptions.  Dr D Dwarakanath added that another important issue to highlight was the link of alcohol to dementia and Korsakoff's syndrome.  He added that it had been a travesty that England had not followed Scotland in introducing MUP, adding that those working in Accident and Emergency Departments, along with those Neighbourhood Wardens and Police in our town centres, would be able to point to the harms caused by alcohol.

The Interim Corporate Director of Adult and Health Services noted there was an impact from alcohol in terms of anti-social behaviour, domestic violence and arson, in addition to well documented health harms. 

The Corporate Director of Children and Young People noted that while articles and campaigns were clearly highlighting the dangers of alcohol harm, one of the issues was that people were not equating the consequences with their own experience.  He added that another element was that alcohol alternatives were not pushed very hard, with many being as expensive or more expensive than alcohol itself.  Dr J Wistow noted the use of alcohol as a means of altering their state, to change how they were feeling, adding that understanding the reasons why people were choosing to drink alcohol to excess, as well as societal pressures associated with alcohol.  The Public Health Advanced Practitioner noted that locally it was found that alcohol misuse was often used as a coping mechanism for other issues.

T Murphy noted the comments as regards the increase in young women 25-35 with alcohol harm related problems, with the details as regards young people with serious liver conditions being particularly frightening.  He noted from his own experience many younger people were not drinking as much in traditional settings, and asked whether the Licensing Act had an impact, in terms of so-called ‘pre-loading’.  The Public Health Advanced Practitioner noted that indeed more and more young people were choosing not to drink alcohol at all, however, those that were drinking were drinking to excess.  She added that it was true there was a reduction in on-trade sales and an increase in off-trade sales.  She noted there were elements of culture shift, however, one of the main reasons was the ‘always available’ nature of on-trade sales.

The Director of Public Health thanked colleagues for their useful comments.  She noted that the endgame with alcohol was different to that of tobacco, however, the Chief Medical Officer understood the need to have alcohol alternatives at a lower cost, to compete against alcohol.  She noted the debate as regards the framing of alcohol as toxic and noted that the Board’s support for BALANCE had been excellent over the years.  Dr D Dwarakanath asked if the Council had an alcohol education policy, he noted that his Trust were in the process of developing one.  The Director of Public Health noted that, at the ICB level, there were alcohol leads, and noted that while there may not be a specific policy at DCC there were elements within specific areas, such as training for drivers of council vehicles.  She added it was an area that could be beneficial in looking at, including where staff may be at greater risk due to significant life event, such as bereavement or divorce.

Resolved:

That the briefing note and update be noted.