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#ChangeTheWorld

While we're all responsible for our own health, it's important that laws, policies, organisational structures and our culture supports health too. It's challenging to make changes is these areas.

As part of our #ChangeTheWorld series we focus on Trinity people who have achieved political change to make it easy to be healthy.

How Professor Joe Barry worked with partners to pass the Alcohol Bill

Professor Joe Barry worked with the Alcohol Alliance to bring in Ireland's Alcohol Bill which is some of the strongest alcohol legislation in the world. While legislation to increase the price of alcohol isn't always popular with students, alcohol is responsible for 10 premature deaths a week in Ireland. To learn from Joe's experience of changing policy to effect lasting change, read on.

"I think we just said, 'This is what we believe.' And like, initially you get people saying, 'I don't believe that.' Then you give them some information, and people do change their mind."

Written by Shreya Shreekant Pattar

Some of the headlines in the media over the past months include:

"Would the new alcohol bill ban the Guinness Christmas ad?"

"Decision to not include cancer warnings on alcohol products an 'insult to those who have suffered from cancer’"

"After 1,000 days of debate, the government's landmark alcohol legislation has been passed"

These are the headlines in the alcohol and public health sectors since the past many months. First published in 2015 and finally passed and enacted in November 2018, the Alcohol Act is meant to bring about significant changes to Ireland’s consumption of alcohol. 

The goal of the Alcohol Act is simple: to reduce our per capita alcohol consumption in Ireland from 11 litres to 9.1 litres for every person aged 15 and over and to reduce alcohol harm. The Act provides for changes such as advertising restrictions especially near schools, revised prices especially minimum unit pricing and warning labels on alcohol. 

In a country with one of the highest rates of binge drinking in the world, this Act was not an easy one to bring into effect. It involved a lot of people and a lot of time to change the mindset of the public and the decision-makers, and to take a step towards what is best for the country. 

One person who had an influential position in passing the Public Health Alcohol Act was Professor Joseph Barry. In his research, he takes a programmatic and thematic approach into problem substance use and addiction, and uses a mixture of quantitative and qualitative techniques. 

Read on for Prof. Joseph Barry’s interview conducted by the Health Promotion Officer, Martina Mullin:

What drove you to work on Public Health and Alcohol?

Well I was working with the HSE Drugs Service from 1991. In 2002, the Minister for Health, Micheál Martin set up a strategic task force on alcohol, and I was nominated onto that task force from the HSE.

And you brought in the Public Health Alcohol Bill which was a big deal. How did you achieve that?

Well, it wasn't just me. It was lots of people; it was an alliance. We had an Alcohol Health Alliance which comprised Alcohol Action Ireland  and I'm a board member of that and I am a Fellow of the Royal College of Physicians of Ireland. So those two bodies came together and set up a coalition with lots of other agencies.

That alliance was persistent. We did lots of media work, we did lots of radio and television; you know, fairly simple messages about the bill were needed. And we persevered and persuaded the Government to publish the Bill. Before that, in 2012, they published a National Substance Misuse Strategy that became a Bill. And then the Bill was passed in 2018.

And did you persuade them with stats and stories?
Stats and stories and personal stuff. And obviously the fact that it was such a big issue for the  Health services. You know, that helped.  The Minister for Health  was Leo Varadkar, a medical doctor.

How did you persuade him? He'd be a data person would he?

Well, he was interested in business initially. But then he did realise that there was a lot of benefits for the country in having a better public health response to alcohol. And he became a champion for that then.

In what form did the opposition come?

The biggest opposition came from the alcohol industry, because they are very powerful. And of course, our message would mean that they would have less profits. So they lobbied very intensely to prevent the bill from being passed. They lobbied very hard to water down the National Substance Misuse Strategy. They employed as many PR firms as they could so that we couldn’t have any. Well, normally when a PR firm that’s on one side of an argument then they don’t take money from the other side. So if they bought up as much of the PR expertise as they could… that’s what big corporations do. 

So we just presented our case, and ultimately, the government brought in the Act because they realised that it was the right thing to do. But the opposition was mostly from the alcohol industry, which was not surprising.

No, it wasn’t surprising. They did it through lobbying?

Through lobbying, and through influencing, and through trying to basically rubbish what we were trying to do. They said they were in favour of the bill except for all the recommendations of it… so that’s a tactic.  And that's not just in Ireland, that's everywhere. So that's how these corporations operate. There's a limited amount of parliamentary time. So there were a lot of TDs who were ambivalent. There were some TDs right at the very end who didn't want it brought in. However, they were defeated by those who did.

How did you get around the ambivalent people?

We didn’t… we don't mention any individual people. Like there are TDs who are climate change deniers...

There must've been some who you brought along. How did you do that?

Well, I mean the way the Parliament works is that ultimately the government party and the main opposition party [and most of the opposition party agreed on what we were doing] agreed with us. 
There was sort of a rump of 10 TDs who opposed it right to the end. And there were people in the Seanad equally who were opposed to it. Ultimately, we wore them down.

You wore who down? The nay-sayers?

Yeah because the votes for exceeded those against.  I was at the Dáil for the last two sessions; and it was all the same 10 people who were opposing it.

From your point of view: let's say you're a student who wants to affect climate change. What would you do? Just persevere?

Yes, I think it's always good to persevere. When you have this 16 year old Swedish girl who's leading the charge on climate change… I mean people are authentic and they believe in something and if you look for it, it doesn't mean it'll happen straight away. And facts are never enough. You need emotion as well and you need stories.

And you spoke with that before and the story of a family who lost… you were telling me?

Yeah. The father of that family is a very good friend and he is a very rare man, and he put his voice and his family story in the public domain. And he got an award  last year for his work. Because, you know he lost a child to suicide, which was very tough. It isn't easy ever. But he also wanted to play his part in trying to bring in this Act, as did lots of people who were victims in other ways.

So ye had multiple stories…?

Well, not too many in public. What's happening now is that the Alcohol Action Ireland has an initiative called ‘Silent Voices’ for people who have grown up in a house where one or both parents have alcohol problems or had it. It is really getting people to share their experiences because that's quite common in Ireland. 

How did you sway non-believers?

I think we just said, “This is what we believe.” And like, initially you get people saying, “I don't believe that.” Then you give them some information, and people do change their mind. I mean you can think of abortion; Irish people have changed their views on that. Same sex marriage; people have changed their mind. There were multiple public opinion surveys carried out obviously by the State, and they showed a shift in attitudes. The same thing happened with regard to say drink driving; that didn't come in straight away. But the majority of the public wanted the Government to do something about alcohol. And ultimately the Government said yes and we the Public Health (Alcohol) Act now.

Lastly, what advice would you give to others who want to make a change happen?

There's a few things. First of all, be prepared for the long haul. Be positive. Be optimistic. You’ve got to believe in yourself. If you don't believe that, people won't buy into it. You've to be reasonable: know what you're talking about. Say it simply. And build up an alliance.

Want to know more? Details of the Alcohol Bill are here.