Martin Daly warns of Christmas spike in alcohol harm

Thank you very much for coming in here today, I really appreciate it. We're entering the festive season of Christmas and I have to say as a GP and I know that many GPs, healthcare workers, Gardaí, social workers, people who are involved with TUSLA and other organisations that are concerned with the welfare of both adults and children will testify that this is the most dangerous time of the year in relation to alcohol consumption and whilst many people will take moderate amounts of alcohol to enjoy company of other people, there is a huge spike at Christmas time in domestic violence, in children going hungry, children being abused, children being neglected and an increase in accidental deaths and injuries both in cars and in domestic things. I think we need to recognise the very significant health issues, especially at this time of the year in relation to alcohol and I suppose the real regret is that as much as the department will do and the representative bodies here in relation to alcohol will do, the industry is extremely powerful and the industry has expended enormous energy and expenditure on defending its position. Going so far, and I've just read an article in the journal, using much the same playbook that was used with smoking, with fossil fuels and other industries that were a risk to health. And I think as a state, you know, we're talking about spending £170 million on drug and alcohol services, but the cost in terms of health costs are enormous. Have we any quantifiable, in a monetary term, the cost of alcohol to health in Ireland? DEPUTY, HICWA currently, I suppose, that's the job that they have been given, which is to analyse the cost to the health service and extrapolate from that. That work commenced in this summer, so we would expect that it would take a number of months to complete, obviously, but we've asked them to, as I referenced in my opening statement, we have asked them to study the risk of alcohol-related mortality and hospital admission associated with different levels of alcohol use. So I would expect they're really good at that sort of work and I expect we'd have a very good idea from that of an up-to-date position in relation to possibly Mary Gillian too. Yeah, HICWA are doing that body of work alongside new guidelines on alcohol use, low level of alcohol use. We expect it to be available in the second quarter of 2026 is what they're indicating. But it's likely to be enormous if you take into fact it's the leading cause of liver failure in women. It is the fetal alcohol syndrome is a lifelong affliction that someone, a child, is going to have to live with. Head and spinal injuries are, you know, my experience as a GP, every so often you call someone falling down the stairs with alcohol, breaking their neck, having an acquired brain injury. These are lifelong hugely, whilst a personal tragedy for that person and their families, a huge cost on our health service. And it really, we should need, we do need these type of facts in order to counter the narrative from the drinks industry. Now, I'm not someone who's a killjoy. I enjoy a drink. I put my hand up. But I think the tactics from the drinks industry in relation to, for example, the labelling of alcohol quite recently, and the deferral of that, shows the power that it has over government, in terms of making the case about jobs, talking spiritually about an EU-wide approach. Everything to deflect away from what was going to be a very reasonable proposal under legislation to have alcohol labelling. And certainly when it comes back on the range in 2028, we must pursue it. But, I mean, how do we counter that type of narrative? I might ask Dr Sheehan to get a question. Yes, thank you. Just to add, in addition to that study that HICWA are doing to inform the lower drinking guidelines, it's also an additional study the Department of Health are funding around the cost benefit of alcohol. And I think you're right, it's really important that we have up-to-date figures, some of the figures that we're reliant on for looking at the costs and impact on alcohol are quite old. So this will provide us with up-to-date figures, both on the economic benefits and harms. So I think that will be really important to put those figures side by side to show the differential that's there. And looking at that whole range of costs that you've outlined, the hidden harm, the cost to all different aspects of society. But I absolutely agree with you that it's really important that we have up-to-date data on that to inform our policy, for sure. Do you think that, I see here there's a plethora of organisations, 366 service providers to treat alcohol and other drugs, 11 services providing alcohol-only services. Do you think that having such a plethora of people is actually effective in the delivery of alcohol services or should we have a more refined approach? So I'd say it's a twin-track approach. So it's good to have community-based services. They're accessible, they're local, people can identify them. So over 80% of our services, drug and alcohol, offer alcohol services. So I think that's a positive thing. But I think the second element then is we need a more strategic approach. And that's why we've funded the national rollout of the Integrated Community Alcohol Service, which is a HSE-led service. It is a very particular model which is integrated into community care. We've invested in that to make sure that every health region has that service. I think that is a breakthrough in how we approach the issue of alcohol. And Aisling here is very much leading out on the rollout of this new model. So it's that combination of kind of locally accessible services, community-based responses and a HSE-led initiative at the health region. I think that's the good combination. But we're not there yet. Right. And in delivery of residential alcohol treatment beds, how much of that is delivered directly by the HSE and how much is contracted out to voluntary organisations? The vast majority is contracted out to Section 39. But the HSE today fund a new facility in Coondara for medically complex cases with drug and alcohol addiction. A new facility currently at 12 beds. That will rise to 30 beds next year. And that will operate and provide a national service for very complex cases for the first time. So it's great to see the HSE showing the leadership and mobilising resources to provide this critically important service for complex cases, including women who are pregnant with drug addiction. It's a hugely important breakthrough. So it's great to see that growing in terms of service model. But are we actually, and I welcome that, and I also want to recognise the work of many of the voluntary organisations who treat addiction and also the HSE, the community addiction officers, alcohol officers, and also, but many of the voluntary organisations provide residential care and do make an impact for people who have committed to giving up alcohol. And, you know, it's not a binary, you don't give it up once, you may have to do it a couple of times to get there and people hit. But again, coming back to the investment in the education and, and, and, and advocacy piece from the state's perspective, in order to counter the narrative from the drinks industry. Like, are we, are we investing enough in that, in telling people the level of health risk and social risk that's associated with alcohol abuse? I suppose, you might ask. Yes? I suppose first, I think that stem, question stems in a way from your, your earlier comments about what you read in the journal in relation to the, the sheer weight of skill and resource that the alcohol industry gives. And spurious, and spurious research being, using certain researchers to give them the narrative they want. Yeah, and it is the narrative that we live in. We, we live in a narrative where we think of Ireland as a country that likes alcohol. Ireland is part of our culture. I was born in the 1960s. We had less than five litres of alcohol per person in Ireland. We're now almost 10. We used to be relatively low compared to France and countries that we're now up there and above them. You know, Italy's at seven to eight, so is Greece. Norway's at five. So we're actually a culture that traditionally did not have high alcohol, that as we got wealthy, and as there was a really well-developed and superb industry, have shifted to being a culture of heavy drinking across the population. And like there is that reality. The only way for us to get the health we want is to get down to sort of levels of six, like the HSE say, which isn't a strange level. On average in the world, that's the level. You know, Europe is at the top of the world above America and far above everywhere else. Ireland is in the top quarter of Europe now. It never was. And that's the direct result of the commercial context that we've lived in and would have to accept that we would lose a third of the income for the alcohol industry if we were to choose health over that. And it is a direct choice. Thanks very much, Tuffy.