Official approach to alcohol issues is needlessly divisive

The argument over plans for cafe bars reflects successive governments' failure to produce a clear national alcohol policy, writes…

The argument over plans for cafe bars reflects successive governments' failure to produce a clear national alcohol policy, writes Shane Butler.

Members of the public who have no particular interest in the detail of our liquor licensing system must be both amused and bemused by the intensity of the debate resulting from the recent publication of Minister for Justice Michael McDowell's draft proposals.

The debate, which has mainly been concentrated on the proposal to create new cafe bar licences, has been complicated by the opposition from existing licence holders who understandably are anxious to protect their current monopoly, but the real venom has emerged in the clash between the Minister and those who, on public health grounds, question the wisdom of these proposals.

Mr McDowell, acting upon the recommendation of the Commission on Liquor Licensing based in his own department, argues these cafe bars can play an important role in changing our drink culture by providing a moderating alternative to the so-called superpubs where frenzied binge drinking is thought to be the norm.

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Public health advocates are not convinced the cafe bar plan will transform us into continental-style drinkers and, drawing primarily on reports of the Strategic Task Force on Alcohol which was based in the Department of Health and Children, cite international research evidence that an increase in the number of retail outlets invariably leads to increased consumption, which in turn leads to an increased prevalence of an array of drink-related health and social problems.

Judging by the sharpness of its responses, the justice sector appears to be enraged by these public health criticisms; for example, Michael McGrath, who is legal consultant to the Department of Justice on this issue, commented in this newspaper (May 2nd) that "unless problem drinkers develop the gift of bilocation" the number of outlets was irrelevant since they could only be in one pub at a time, and the Minister (May 14th ) instantly dismissed the Irish Medical Organisation's objections to his proposals as "fanciful" and "the kind of over-blown argument which really doesn't do them any credit".

There is an obvious ideological dimension to this clash between two important sectors of government. Those on the health side believe that since alcohol is, in the words of the most recent World Health Organisation (WHO) report on this topic, "no ordinary commodity", public policy can justifiably use a range of regulatory measures to limit consumption; the justice side, however, sees this as smacking of the "nanny state" and, instead, emphasises the importance of individual responsibility and the further deregulation of the drinks industry. The justice position, particularly the views expressed by Mr McGrath on the futility of passing laws to "make people good", is not an ideologically consistent one, either for the justice sector in general or this minister in particular; one has only to think of Minister McDowell's hardline approach to the use of illicit drugs to see how selective his commitment is to the libertarian ideal.

The policy position advanced by public health advocates in this national debate is essentially that which the WHO has developed and refined over the past 30 years, based upon ongoing research by biomedical and social scientists. Although this emerging alcohol science is highly reputable and persuasive to all who might come to it with an open mind, it is easy to see why it is of doubtful popularity. Not only does it threaten the drinks industry, but it is also a source of discomfort to all of us who are alcohol consumers. Just as the road traffic regulations are applied broadly to all motorists and not just to dangerous drivers, drunk drivers, speeding drivers, young drivers or any other category that one can come up with, so too does the WHO policy perspective apply to all drinkers rather than to alcoholics, binge drinkers, alcohol abusers, young drinkers or problem drinkers.

From a broader public policy perspective, however, what the current dispute about cafe bars reveals is the failure of successive governments to draft and implement an integrated national alcohol policy. There have been token nods in this direction on several occasions, most explicitly perhaps in 1996 when Michael Noonan, then minister for health, launched National Alcohol Policy - Ireland, a policy document which made all the correct public health noises but has effectively gathered dust ever since.

It is instructive to compare our approach to alcohol policy with the approach which we have taken in recent years to policy on illicit drugs. In line with Strategic Management Initiative (SMI) views on how cross-cutting issues - policy issues which touch upon many sectors of government - should be managed, the National Drugs Strategy has now a formalised structure which includes: a Cabinet subcommittee, a "lead department", a Minister of State with clear responsibility for this area of policy, and a number of other dedicated structures.

In the absence of any such structures for alcohol policy, it is not surprising that we are now going through this rancorous debate on Mr McDowell's legislative proposals. Since both the health and justice ministries are currently occupied by PD politicians, it seems reasonable to assume that Mr McDowell will prevail. The cafe bars may not in themselves be all that important; they will not transform our drinking culture but neither, one hopes, will they do too much additional damage. A success for the justice sector in this particular battle will, however, symbolise and confirm our ongoing reluctance to take seriously the research evidence on what works and what does not work in relation to the prevention of alcohol-related problems.

Dr Shane Butler is director of the Addiction Research Centre, Trinity College Dublin, and author of Alcohol, Drugs and Health Promotion in Modern Ireland, published in 2002 by the Institute of Public Administration.