Seòmar agus comataidhean

What I have said is that we need to drill further into the statistics that we have from the first year of the pandemic. We need to understand those figures. The big picture is that the population drank less, yet we know that we saw the highest level of alcohol deaths—a 17 per cent increase on the year before, which is tragic. Some people must have been drinking more and we think that that is a pandemic impact, which we think is largely explained by the fact that people who were drinking heavily before the pandemic drank more during it.

We need to understand that better, and to understand whether that was a one-off change in response to an emergency situation or whether that trend has persisted. However, we do not yet quite have the understanding of what happened, and I will certainly be keen to see this year’s data to see whether that trend has stuck or whether it is just a one-off that is related to the initial lockdown particularly, during which the pandemic so seriously impacted healthcare services.

I will bring Amy Kirkpatrick in to see whether she can add a little more detail or clarity to the issue. My understanding is that MUP was a whole-population measure, which was not targeted just at people who were drinking heavily but also particularly at children and young people who were buying very cheap alcohol.

The WHO talks about the three best buys, one of which is affordability. We expected that a general shift would take place across the population if we made alcohol less affordable. My understanding, from my time working in mental health, is that heavy alcohol drinking is on a spectrum—some people are completely abstinent, some drink very little and some drink more and more heavily, until it gets to problem drinking. The MUP policy shifted our drinking to a safer point on that spectrum.

I firmly believe that fewer people will run into the problem of alcohol dependence in the future because we introduced MUP in the past. The challenge is that, when we look back, we see that there have been a number of changes, which I do not think have been entirely down to MUP. We are seeing children drink less; children and young people are less likely to drink and they drink fewer units of alcohol than they did even in our quite recent history. Our policies are having an impact both on the population and on the problem drinkers.

I will ask Amy to come in and see whether she can add more clarity to the issue.

When I first came across the MUP policy, I was slightly sceptical about whether it would reduce the amount that is drunk by people who are seriously addicted to alcohol and whose lives revolve around it . However, when we brought in the policy, evidence suggested that even the people who were more seriously addicted to alcohol reduced the amount that they were drinking.

We are talking about 23 deaths and more than 600 admissions to hospital every single week in Scotland this past year. We have to tackle that.

Scottish Women’s Football is a shining light in this area. It has a very responsible policy. It is sponsored by SHAAP, I think, and it does not accept alcohol sponsorship. That is a great thing, and it would be great if all sports were like that.

I think that the World Health Organization is reasonably clear that voluntary codes do not work and that legislation is needed. Other countries have brought in legislation. France certainly has, although we have seen examples of how the industry cleverly gets round the measures there. We are mindful of that when we consider any legislation here. I think that Ireland either has legislated or is in the process of legislating on the matter.

We have spoken before about the study that looked at the six nations and showed that children were exposed to the highest level of alcohol advertising and promotion in the Scotland-England match, because many of the other countries, including France and Ireland, already have measures in place to protect children from advertising during sporting events.

You are absolutely right that it is an area of growth, and the pandemic has shifted our behaviour at population level in a way that we would not have imagined. That has happened with food as well. We are consuming in a different way to the way in which we consumed before.

Premises such as pubs that are selling alcohol online have to have a licence and they have to get a premises licence through the licensing board in the area where the premises are located, so they still have to go through a licensing process. I agree that we need to consider and understand how much alcohol is being bought from large national retailers such as Amazon. Much of the regulation of the online world is reserved to Westminster.

During the passage of the recent legislation—I will ask Amy Kirkpatrick to come in on that—we carefully went over whether online sales of alcohol could be considered a public health issue rather than an online sales issue. The UK Government was keen to consider it an online sales issue rather than a public health issue. We will continue to consider that.

We need a bit more understanding of exactly how consumer habits changed over the course of the first year of the pandemic in order to ensure that the strategy of reduced availability is not completely undone by online sales and being able to order something from Amazon in the morning and get it delivered to your house in the evening.

I am not sure whether Amy has anything more to say on that. Most of the discussion on that legislation was around online sales rather than alcohol online sales, but it is a growing trend across the board.

Absolutely. I will bring in Amy Kirkpatrick to supplement what I say. As a Government, we are always looking around the world to get ideas and to see how to solve problems.

Things that happen in Scotland are rarely unique to Scotland. However, it is clear that Scotland has a troubled relationship with alcohol, and we have had that for some time. If you think back to the discussion about the introduction of minimum unit pricing, it was clear that we had more of a problem than most other countries, which is one of the reasons why we were able to safely chart our way through the various legal challenges of that policy. We have to understand that context. We probably need to do more than most other countries in the world to get our relationship with alcohol on a healthy footing.

Alcohol consumption is cultural, and it is interesting to look at different countries. Alcohol is much more available in Italy, for example, where it is more common to have a drink with food; however, people often drink smaller quantities and almost always with food. The way that we drink in Scotland is quite different. Equally, Scandinavian countries have a difficult relationship with alcohol, and those countries brought in quite serious legislation on licensing and availability: people have to go to a specific shop to buy alcohol there. We have all heard stories about just how expensive a pint of beer is in Norway, although people who live there are paid well. That shows you the issue of affordability.

We are—absolutely—happy to look at other countries, but it is quite a complex picture. We have to be careful not to just think, “Oh, that’s an easy solution,” or, “That’s an easy win.” We need to think about the Scottish context and how it would apply. We are looking very carefully at the issue of alcohol marketing and sport and at what happened in France, because it is clear that some alcohol companies are getting around the legislation that was brought in there. For example, in their advertising at stadiums, companies are not displaying the brand of the alcohol but they are using the font that is closely associated with it. Everyone sees it. It is not an advert for the alcohol, but it makes you think about the brand—the connection is there in your head. We are looking carefully at how the legislation has landed in France and what we might need to do to close that loophole before it is exploited.

It is complicated and cultural, and it will take some time for us to unpick it. We have a long way to go, but, for some years now, we have been heading in the right direction—until the pandemic hit.

The minimum unit price of alcohol was the route that we went down. I know that there was a lot of discussion at the time about the tax aspect of it and whether that money should come back to be spent on treatment and prevention. The policy landed well partly because it did not affect the livelihoods of people who sell alcohol and did not impact the alcohol industry, of which there is a lot in Scotland. Decreasing affordability without impacting the wider economy is quite a sophisticated way to tackle the problem.

We need to understand the impact of minimum unit pricing and how it has changed behaviour. We will have to wait a little longer for the full evaluation of that, but I will definitely keep the possibility of a social responsibility levy under review. I am interested in anything and everything that I can do to tackle the challenge. I do not think that this is about affordability; I think that we need a better understanding of the impact of minimum unit pricing, which acts in the same way. The two strands will be to look at whether it works and to review the unit price, before we consider introducing different approaches to taxation to tackle the same issue.

To be honest, we do not know about the effect—the most recent year that we have data available for is 2019-20, which was just before the pandemic hit. There were 75,616 ABIs in that year, which was 23 per cent more than the standard that we asked people to aim for.

We need a fuller picture of what has happened with ABIs over the pandemic. The committee knows from previous evidence sessions that I am a huge fan of Near Me, and there is an opportunity to use that technology. If ABIs can be a useful tool virtually as well as in person, we will try to get the evidence to support that going forward.

The work that is going on with Public Health Scotland to review ABIs began before the Covid pandemic. It will reflect on the experience of the pandemic across Scotland, and the actions are well under way, so I expect the strategy group to be convened in the summer.

It is difficult to have immediate actions to take and levers to pull, because we do not quite understand what happened or what the barriers were. We need to understand what led to the increase in deaths, which occurred across the UK, before we know what will be effective at reducing deaths in the future. We also need to understand whether such an increase will be repeated—whether it was the result of a consistent behaviour change or a one-off.

The situation is frustrating. I am desperate to solve the problem and I am keen to do what we can—the need is urgent. Every single one of these deaths is a tragedy, but we need to understand the situation better before charting our way forward.

I am satisfied that an effective process is in place. I hope that we do not reach the point of triggering it. For all that the impression that is given is that we are regularly in conflict with one another in the four nations, we actually work together closely on a number of issues across the board in health, and we have strong working relationships, particularly in my portfolio. Therefore, I expect us to be able to avoid triggering that conflict resolution process.

I will bring in Jennifer Howie to talk a little bit more about the detail of how the process will work should it be triggered.

Although the act was passed in 2020, it is still bedding in. We are still trying to understand the impact of that piece of legislation on our public health decisions, and I cannot at the moment think of an area in which we would be looking for exclusions.

The framework allows for divergence and respects the devolution settlements. For public health reasons, and all reasons, we prefer that mechanism for resolving issues of divergence.