The Department of Health describes as “significant” the level of recent lobbying by the alcohol industry against the Public Health (Alcohol) Bill.
“However, the Public Health (Alcohol) Bill continues to be a priority for Government as set out in the Programme for a Partnership Government,” a spokesperson for the Department insisted to the <strong><em>Medical Independent</em></strong> (<strong><em>MI</em></strong>).
“The Bill did not complete Committee stage in the time allocated in the Seanad and will be rescheduled in the next session.”
Asked if the Government was “split” on whether the proposed legislation would pass in its current form, the spokesperson responded by saying that enacting the Bill “is a commitment in the Programme for a Partnership Government and a priority for Government”.
Nevertheless, the spokesperson said that before it resumes Committee stage “consideration will be given to examine how best this important measure can be brought forward”.
The Bill is primed to introduce a number of provisions including minimum unit pricing and health labelling of alcohol products (<strong>see panel</strong>).
<div style=”background: #e8edf0; padding: 10px 15px; margin-bottom: 15px;”> <h3><strong>A debated Bill</strong></h3>
The Public Health (Alcohol) Bill 2015 was approved by Government in December 2015.
The Bill aims to reduce alcohol consumption in Ireland and to reduce the harms associated with alcohol.
Supporters of the Bill say its provisions such as minimum unit pricing, health labelling of alcohol products, the regulation of advertising and sponsorship of alcohol products, and structural separation of alcohol products in mixed trading outlets, will lead to a decrease in alcohol consumption and thus improve public health.
The requirement for storeowners to segregate alcohol and non-alcohol products has caused some concerns within the alcohol industry.
Mr Mac Mathúna from ABFI insists that the “drinks industry is in favour of the policy objectives” behind the Public Health (Alcohol) Bill.
“We fully agree that legislation is needed to tackle the problem of excessive drinking, an issue which is in nobody’s best interests. Our concerns are that certain proposals are not supported by evidence with regard to decreasing misuse. The facts tell us that they will not reduce misuse, but that they will have unintended negative consequences on jobs and business affecting the 200,000 people employed in the drinks and hospitality sector across Ireland.
“In Ireland we pay 175 per cent of the EU average price for alcohol, so if price alone was the silver bullet we would have solved the problem of misuse years ago.”
He added that “we must be aware of the implications of the border with Northern Ireland where alcohol is significantly cheaper to buy due to lower taxes and the drop in the value of sterling”.
However, Prof Barry says he doubts any claims that the hospitality industry “will collapse” if the price of alcohol increases.
He would like to see more political leadership in the face of lobbying.
“I would expect the Minister of Health and the Department to stand up to it. We need to hear from the Department that this Bill is on track and is going to happen.”
Prof Barry adds that alcohol misuse impacts a wide variety of areas.
“The devastation that homeless people feel, there is an alcohol issue there that gets swept aside,” he says. “There is a lot of talk about suicide prevention, [and] reducing alcohol consumption would help with those figures.”
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<h3><strong>‘Horrified’</strong></h3>
Independent Senator Frances Black said she was “shocked” by the lobbying she witnessed around this piece of proposed legislation. On 17 November she provided the Seanad with a rather colourful account.
“I saw seven people from the industry standing around one Deputy in the coffee dock some days ago and I was absolutely horrified. I bumped into one Deputy who told me he had been lobbied five times in one day.”
Leading public health figures who spoke to <strong><em>MI</em></strong> echoed these concerns.
RCPI President Prof Frank Murray is an ardent supporter of the Bill. He says the “intensity of the lobbying is almost unprecedented in terms of its scale”.
Prof Murray is also Chair of the RCPI Policy Group on Alcohol and a Consultant Physician/Gastroenterologist at Beaumont Hospital, Dublin.
<img src=”../attachments/496fb63b-e34f-4a08-9d74-323757b16851.JPG” alt=”” />
<strong>Prof Frank Murray, RCPI President</strong>
“Alcohol has a huge impact on everyone that needs access to healthcare because it drains the resources of the State and the healthcare system,” he tells <strong><em>MI</em></strong>. “There are consequences every single day that we don’t implement [the Bill]. It’s over a year now since Minister [Leo] Varadkar published it.
“An enormous amount of lobbying is taking place by the alcohol industry. It is because they are making such profits. Unfortunately, most alcohol is being sold to people who are drinking excessively and most people in Ireland drink more than is recommended.”
Prof Joe Barry is Chair of Population Health Medicine at the Trinity College Centre for Health Sciences. He says the lobbying has been “unprecedented”.
“The health lobby has been muscled out of it by this industry,” he tells <strong><em>MI</em></strong>.
“I think this is wrong. It is up to the politicians. They have to make a choice. They can’t have it both ways, saying they want the Bill to come in, but at the same time not bringing it in.
<img src=”../attachments/aee3d5b8-b820-4869-a54d-2b87a40afd56.JPG” alt=”” />
<strong>Prof Joe Barry, Chair of Population Health medicine, Trinity College</strong>
“The industry has the upper hand and they seem to have a lot of willing ears in Leinster House. In 2017 hopefully things will be better. The health service is under massive pressure, partly because of many alcohol-related problems. But that all seems to get forgotten when they sit down to try and pass this legislation.”
Not surprisingly, the alcohol industry defends its conduct.
“It is entirely appropriate as part of the democratic process for stakeholders to communicate their positions on the Bill to politicians who are charged with scrutinising its provisions before its enactment,” Mr Ross Mac Mathúna, Director of Alcohol Beverage Federation of Ireland (ABFI), tells <strong><em>MI</em></strong>.
ABFI is part of the Irish Business and Employers Confederation (IBEC).
“As an industry that makes a significant contribution to the economy, we have made our views to elected representatives known and have actively engaged in the policy-making process to ensure we have legislation that is fit-for-purpose, in a similar fashion to efforts carried out by those who support the Bill,” says Mr Mac Mathúna.
“Our activities in this regard remain completely open and transparent and are publicly available to view on the Lobbying Register.”
<h3><strong>Health policy </strong></h3>
Lobbying is regarded by many as part and parcel of the political process. However, new rules have come in following the establishment of the Register of Lobbying in September 2015 (<strong>see panel</strong>). The Register is designed to provide information to the public about who is lobbying, about what, and on whose behalf. It is maintained by the Standards in Public Office Commission.
Health is the public policy area with easily the most amount of lobbying, according to the most recent figures from the Register of Lobbying. The Register is continually updated at www.lobbying.ie.
As of Wednesday 4 January, health had 990 examples of lobbying returns. Justice and Equality was second with less than half of this (433).
The Department of Health was the third most lobbied public body, according to the Register, with 622 returns. It only trailed the Dáil (2,044) and the Seanad (634).
IBEC is the lobbying organisation which had registered the highest number of returns with 300. The Irish Farmers’ Association (IFA) was second at 267. In terms of the major medical representative bodies, the IMO had 58, the NAGP 12, and the IPHA and IHCA nine apiece.
But behind the cold figures there is often a searing lobbying battle, as with the Public Health (Alcohol) Bill.
“This is completely David versus Goliath. They are big corporations with huge profits,” says Prof Barry.
“Our resources are tiny. In fact I work at a full-time job doing other stuff. [Prof] Frank Murray is President of the College [RCPI] and a full-time gastroenterologist as well. We don’t have professional lobbyists. We have to do it ourselves.
“This is an open democracy, obviously it is perfectly legal what they [alcohol industry] are doing. That is no problem, [but] we just cannot out-lobby them, we just don’t have the resources to do that. Our biggest strength is our arguments.
“But it doesn’t seem to be cutting ice, the Government seems to be running scared at what’s being said to them in terms of loss of jobs and corner shops closing. That won’t happen of course. The very same arguments were made at the time of the smoking ban,” outlines Prof Barry.
Prof Murray warns against any ‘false equivalence’ between both sides.
“We are not paid lobbyists. I’d call it more advocacy for health and wellbeing rather than lobbying,” he says.
“Why do we do it? We think it is a public health issue. We can’t afford cheap alcohol in Ireland.
“The WHO made a statement that said the alcohol industry should have no role in the formulation of policy in terms of alcohol, because alcohol is a health issue.
“Now the wonderful thing about this Bill is that it makes alcohol a health issue in Ireland rather than an economic one and that is one of the tremendous steps forward in the Bill.
“I am concerned about the delay in the implementation because of the direct consequences on health and I am concerned with the delay because it reflects, I think, the success of the lobbying on behalf of the alcohol companies.”
<div style=”background: #e8edf0; padding: 10px 15px; margin-bottom: 15px;”> <h3><strong>A new era for lobbying?</strong></h3>
“I suppose lobbying works,” says Prof Joe Barry, when he looks at the current lack of progress with the Public Health (Alcohol) Bill.
“The lobbying register will at least expose more of the reality.”
The Register of Lobbying (www.lobbying.ie) has been in place since September 2015. Recently the Standards in Public Office Commission said that from this year on, fines of up to €2,500 will be levied on organisations and individuals who breach lobbying regulations.
Ms Nuala Haughey is a policy analyst with TASC (Think Tank for Action on Social Change) and has researched the area of lobbying in Ireland.
“While overall the register is working fairly well, I’d be concerned that not all lobbying activities are being self-reported and even when communications are reported on, it is not always clear from the register what lobbyists actually want,” Ms Haughey tells <strong><em>MI</em></strong>.
“Thankfully the law had a one-year review built into it – this is currently underway and it is a really important opportunity to plug the various loopholes in the legislation that are facilitating secretive lobbying lacking in transparency.
“It is obvious that much more than a lobbying transparency register is needed if we are to protect the public interest in policy-making and guard against deal-making behind closed doors and the ‘capture’ of policy makers by powerful interests.”
TASC is an independently-funded research organisation, which is itself registered with the lobbying register.
The Annual Report of the Standards in Public Office Commission for 2015, in regard to the administration of the Regulation of Lobbying Act 2015, notes that “any informal encounter” on a street or at a social occasion, for example, could possibly be considered lobbying. In certain circumstances a message sent directly to a Minister or a Department official via Twitter, phone or Facebook should also be registered.
How confident is the Standards in Public Office Commission that these types of incidences are being registered by people/organisations?
A spokesperson for the Commission tells <strong><em>MI</em></strong> it is “confident that awareness and understanding of how the Act’s provisions apply will continue to grow over time”.
“The Act provides that a relevant communication made by a person within the scope of the Act is lobbying and must be registered.
“The Act is silent on the format and venue of such communications, and any communication – regardless of where or however it is made – that meets the criteria of the Act should be included in a person’s return of lobbying activities.”
There are calls for greater transparency in the area.
“Industry ties to TDs should be exposed and conflicts of interest (made) clear,” People Before Profit health policy advisor and Consultant Child and Adolescent Psychiatrist Dr Peadar O’Grady tells <strong><em>MI</em></strong>.
In addition, Ms Haughey says “robust reforms to our ethics laws are by now long overdue”.
“It is disappointing from an anti-corruption perspective that the Public Sector Standards Bill 2015 does not include an outright ban on all public officials accepting significant gifts, which are a particular risk when it comes to corruption or the appearance of corruption in public procurement and policy-making in all sectors, including health,” notes Ms Haughey.
But what of the experiences of organisations trying to work within the system and get their perspective across to politicians and others?
The IPHA says its experience of the new lobbying system has been good.
“On the whole, our view would be that that the Act works well in terms of scope and offers a transparent mechanism to reflect legitimate interaction with politicians and relevant public officials,” a spokesperson for the IPHA tells <strong><em>MI</em></strong>.
“There has been no negative feedback from members or concerns raised.”
Vape Business Ireland (VBI) is a smaller organisation than the IPHA. It has been lobbying on the issue of e-cigarettes in recent months. However, Mr Michael Kenneally, spokesperson for VBI, tells <strong><em>MI</em></strong> that it has been unable to arrange a meeting with Minister for Health Simon Harris on the issue.
“After much effort, we did manage to meet with Minister [Marcella] Corcoran Kennedy, Minister of State for Health Promotion, and an official from the Department of Health, in November 2016. However, we still await to see if Minister Harris will agree to meet with our alliance. VBI believe that the lack of engagement could prove to be detrimental to the sector.”
As a result of VBI’s experience in the area, Mr Kenneally thinks “it would be beneficial if Government departments and State agencies were to be under a statutory obligation to update the listings of designated public officials each quarter.
“This would ensure that lobbying organisations are kept up-to-date [regarding] which Department official needs to be contacted and it further ensures that public officials as well as lobbyists are compliant.”
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<h3><strong>‘Strange’ meeting</strong></h3>
In December, a delegation of doctors spoke to a Fine Gael parliamentary party meeting. Prof Barry could not attend, but what he has heard about the meeting concerns him.
“The doctors had a very strange meeting,” he tells <strong><em>MI</em></strong>. “A lot of the arguments by a vocal minority [of Fine Gael representatives] were taking the line of the alcohol industry, questioning why the doctors were there. In fact they were trying to paint the public health side as doing more [of the] lobbying.”
<blockquote> <div> <p class=”QUOTEtextalignedrightMIstyles”>‘As an industry that makes a significant contribution to the economy, we have made our views to elected representatives known’
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Prof Barry says he believes that the lobbying is “fairly intense”.
“Even politicians are saying they have never seen this lobbying, even during the abortion debates. The alcohol industry seems to have set up camp in Leinster House. They have retained some of the blue chip PR companies and they seem to have a heavy permanent presence in Leinster House.
“When the Bill came to the Seanad first we got word that they were lobbying the Fianna Fáil senators fairly hard. But in fact they have lobbied the Fine Gael people even harder.”
Prof Murray did attend the Fine Gael meeting and when <strong><em>MI</em></strong> asks him about it, he points to past examples of public health legislation where politicians also came under lobbying pressure.
“I think it has been very disappointing that it didn’t make more progress before Christmas,” he says.
“The thing about the Bill, if you look at all the opposition to it, what does it remind you of? It reminds me of the opposition to the tobacco legislation that introduced the smoking ban. Organisations lobbied very hard at that stage saying effectively the world would stop spinning.
“Yet we wouldn’t think of going back to the days before the ban now. Look at what we did in relation to plastic bags and look at what we did in relation to smokeless fuels. We have made very big decisions and implemented very big decisions here in Ireland.
“So we need to take that as an example. These previous initiatives were introduced in the face of huge lobbying from vested interests. We need to act in the interest of the Irish people and society. The responsibility of our elected officials is to do the best for the most people in Ireland and I think the Bill is a great opportunity for that.”
