Alcohol bill must be assessed for impacts, say Cork experts 

AN OPEN letter to the government is calling for a Health Impact Assessment (HIA) prior to the implementation of the Sale of Alcohol Bill.

One of the signatories told The Echo that if the bill is enacted, it will “increase alcohol-related harm to individuals, their families and, in particular, their children”.

Seventy-five health, social, and community organisations and advocates have come together to voice their strong opposition to proposed measures in the bill, which will dramatically increase the number of venues serving alcohol, as well as significantly extending the opening hours of pubs, bars and nightclubs.

“That this is being done without carrying out a Health Impact Assessment, as recommended by the Joint Oireachtas Committee for Justice who carried out pre-legislative scrutiny of the bill — and even by those who support the measures — is inexcusable,” they wrote.

One of the signatories, Mick Devine, who works in addiction services in Cork, said: “As an addiction treatment counsellor, the passing into law of the Public Health (Alcohol) Act in 2018 was seen as encouragement to professionals in the field of alcohol treatment.

“It indicated that, as a society, Ireland was becoming clearer about the need to acknowledge the serious extent of alcohol-related harm and to curb the consumption of alcohol and address serious health issues related to alcohol misuse.

“These issues impact thousands of Irish people directly on a daily basis. Alcohol misuse also impacts families, especially children, on a daily basis.

“The letter submitted by Alcohol Action Ireland to An Taoiseach gives information on how widespread these hidden harms to children are in our society.

Letter to Government 

“Now the proposed Sale of Alcohol Bill is discouraging to professionals in the field of alcohol treatment as it indicates our time-worn ambivalence about alcohol misuse in Irish society is still prevalent.”

The letter explained that a recent report by the World Health Organisation shows extending alcohol availability and trading hours increases crime, domestic and sexual violence, road deaths, and the burden on public services such as ambulance services, emergency departments, and gardaí.

“International evidence suggests that a one-hour extension of alcohol trading hours is likely to lead to a 16% increase in alcohol related crime, a 30% increase in traffic collisions in rural areas, and a 34% increase in alcohol-related injuries requiring hospital treatment,” the letter stated. “Furthermore, it does not solve the problem of crowds spilling onto the streets at closing time; it merely shifts the problem later into the night. These are some of the immediate consequences and do not consider other health harms from increased alcohol consumption such as cancer, heart and liver disease, and very substantial mental health problems.

“Children and families will also bear the brunt of this proposed bill —at least 200,000 children are currently growing up with problem alcohol use in the home and Ireland is estimated to have a prevalence rate of foetal alcohol spectrum disorder (FASD) of 2.8% to 7.4% of the population — the third highest rate in the world.”

They added: “Alcohol is an addictive, psychoactive, toxic, carcinogen which already causes four deaths every day, necessitates the use of 1,500 hospital beds daily, as well as bringing devastation to families, disruption to workplaces and places an enormous burden on our public services of at least €3.7bn annually.”

Bill will 'increase harm'

Mr Devine said passing the bill would be harmful.

“This ambivalence manifests in our glorification of alcohol on the one hand and, on the other hand, in the way we shame and stigmatise those who misuse alcohol and those family members impacted by it.

“The passing into law of this Sale of Alcohol Bill will increase alcohol- related harm to individuals, their families and, in particular, their children.”

Amongst those also calling on this Government “to do the right thing and carry out a Health Impact Assessment of this legislation without further delay”, were Gordon Kinsley, Cork and Kerry Alcohol Strategy Group, and Aaron O’Connell, the chair of Cork Local Drug and Alcohol Task Force.

University College Cork’s Dr Zubair Kabir, a senior lecturer in Public Health & Epidemiology; Prof Orla Crosbie, a consultant hepatologist, and Dr Monica O’Mullane of UCC's School of Public Health also signed the letter.

“Alcohol is not an ordinary commodity in Irish society,” Dr Kabir told The Echo.

He said that excessive alcohol consumption kills people, and four deaths a day in Ireland have been linked to alcohol.

“Ireland has one of the highest per-capita alcohol consumption patterns in OECD countries, which are disproportionately distributed,” he continued.

“These disproportionate harms of alcohol consumption impact the health and wellbeing of the Irish society, the underlying economic loss is equally significant.

“Ireland has just begun to make tentative progress towards the goal of reducing alcohol consumption, with drinking levels falling slowly on a population level thanks to the measures of the Public Health (Alcohol) Act, 2018 (PHAA), a suite of policy measures which, if fully implemented, will reduce alcohol-related harms in Ireland.

“However, any progress made is now under threat due to the Sale of Alcohol Bill, which proposes to increase alcohol licensing hours and the number of alcohol outlets for sale — increased alcohol availability leads to increased alcohol consumption with associated harms, and this will have impacts across multiple government departments with long lasting consequences.

“The proposed legislation is being promoted as a means of simplifying Ireland’s complex licensing laws and of enhancing the night-time economy.

“While no-one is arguing against the former reason, there is significant concern about the second.

“As a population health scientist and having seen the success of a comprehensive tobacco control policy in Ireland showing leadership to the global community, the PHAA is being closely observed internationally.

“Impactful research informs policymaking, which translates into societal and economic gains at the population level.

“The implementation of the Sale of Alcohol Bill is an anti-thesis to promoting wider population health and wellbeing, and will derail the prospect of another success story in Ireland if precautionary measures - such as a health impact assessment of this bill, are not undertaken,” he added.

Why experts are calling for a HIA

Dr O'Mullane, meanwhile, explained what a HIA is and why one is being called for.

“All public policies seek to enhance the health and wellbeing of the population,” said Dr O'Mullane.

“However, some can result in unintended negative impacts on health, which could potentially worsen health inequalities within population groups, particularly on vulnerable groups.

“One way to ensure a health lens, underpinned by health equity considerations, is applied to a policy in order to generate and collate evidence on the potential health impacts is a process called Health Impact Assessment.

“Endorsed by the World Health Organisation and the Institute of Public Health in Ireland, HIA is a systematic approach to assessing potential intended and unintended health impacts of a project, policy, programme, or proposal,” she said, citing one previously compiled on the night-time economy in Wales.

“HIA uses all types of evidence including health profile data, scientific evidence, policy analysis, and data gathered through public involvement, and HIAs result in measures or recommendations with policy decision-makers and stakeholders to maximise the policy’s positive health impacts and minimise negative health impacts.”

Dr O'Mullane concluded: “HIA is not about telling anyone what to do, nor is it a stick to beat policy-makers with - quite the opposite.

“It is about applying a health lens to a particular policy and collating robust evidence in an objective manner to support a strengthening of potential positive health impacts and minimising potential risks to population health.

“I signed the letter because I passionately believe that a HIA on the Sale of Alcohol Bill would strengthen the health impact of the policy’s implementation and minimise potential unintended negative health impacts.”