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Government 'Not Taking Alcohol Harms Seriously Enough'

Editor's note: We have updated this article with a quote from the BMA

A new report by the House of Commons Committee on Public Accounts has concluded that the Department of Health and Social care (DHSC) "is not taking alcohol harm sufficiently seriously".

The report follows an inquiry into alcohol treatment services by the Public Accounts Committee (PAC) that concluded earlier this year, which noted that harmful drinking appeared to be increasing, with an "upward trend in alcohol-related death and hospital admissions" that accelerated sharply since the COVID-19 pandemic lockdowns in 2019.

"The costs of this to drinkers, their families and society are significant," the inquiry said, adding that alcohol costs the NHS an estimated £3.5 billion per year in England, and costs an estimated £21 billion per year to society.

The PAC report added that the DHSC's estimated £25 billion per year total cost to NHS and wider society was an "out of date" figure based on a decade-old 2012 analysis that "may not reflect full scale of harm". It said that alcohol-related deaths rose 89% over the last two decades, that alcohol was linked to over 100 illnesses, can drive mental disorder, self-harm, and suicide, and is "a major cause of preventable death". In 2019-20, alcohol was linked to 42% of all reported cases of violent crime, up from 40% the previous year. 

'Unacceptable Toll' of Alcohol Deaths

PAC Chair Dame Meg Hillier MP said: "The harms from alcohol are appalling, and the benefits of every £1 spent on treatment are immediate and obvious."

Yet, the Government abandoned its latest effort towards an alcohol strategy in 2020, "just as deaths from alcohol began to rise sharply over the terrible, unacceptable toll it was already taking". 

"What more does DHSC need to see to act decisively on this most harmful intoxicant?" Dame Meg asked. The Government "must give local authorities the certainty and stability over funding to maintain and improve the treatment programmes that are proven to work, and stop dithering over the evidence on industry reforms", she urged.

The Committee was "surprised and disappointed" that the Department was not taking "a more proportionate and serious approach to addressing the problem". Despite the widespread harm, there had been no alcohol-focused strategy in place since 2012, the report said.

Estimates suggested that 1.7 million people in England drink at levels posing a higher risk, with around 600,000 dependent on alcohol. "While most adults do not regularly drink to excess", an estimated 21% drink "in a way that could risk their long-term health", the report said.

However local authority spending on alcohol services, and the number of people going through treatment, have both decreased since responsibility for public health moved from the NHS to local authorities in 2012. Since local authorities have been responsible for commissioning treatment services, most provision has moved from separate alcohol and drug services to one integrated service. In tandem, the number of people receiving treatment for alcohol dependency has been falling. 

Local authorities reported spending £637 million on alcohol and drug services in 2021-22, which represented a real-term spending fall of 27% compared with 2014-15.

11 Years Since Last Alcohol Strategy

Lead PAC member Dan Carden, Labour MP for Liverpool, Walton, said: "Today’s report lays bare the lack of political will to address alcohol harm. The Government’s record on alcohol harm is one of policies scrapped and promises broken.

Mr Carden described alcohol harm as "a deepening public health crisis" and contrasted the Government's stance with its efforts to tackle obesity, gambling, tobacco, and illicit drugs, albeit that these had been only "somewhat successful". Yet alcohol was arguably the most harmful and legal drug.

"Shamefully, it has been 11 years since the last Government UK alcohol strategy. The measures set out in the 2012 strategy were, and remain, effective evidence-led health policies that prevent death, improve public health and alleviate pressures on our public services. The abject failure to deliver on promised initiatives has certainly contributed to tragic yet preventable levels of alcohol harm felt across the UK."

Commenting on the report, John Holmes, professor of alcohol policy at the University of Sheffield, said it provided "a good summary of the current state of play with regard to alcohol-related harm in England and the Government's response to it".

He noted that the rise in alcohol-related deaths was despite alcohol consumption generally falling. "This is because the fall is driven primarily by less drinking among young people. In contrast, people in middle- and older-age groups have continued to drink at the same or higher levels and it is these groups that are driving the increase in deaths. 

Pandemic Measures Responsible for Largest Increase in Deaths

"The largest part of the increase in deaths occurred since 2019 and is due to the wider effects of the pandemic. The precise reasons are unclear at this point but are likely to include (i) heavier drinkers increasing their consumption during lockdowns and not reducing it afterwards; (ii) people being less likely to seek or access help from general and specialist health services and (iii) alcohol problems combining with other problems that were exacerbated by the pandemic and people getting more ill as a result."

Also commenting, Dr Emily Finch, chair of the Addictions Faculty at the Royal College of Psychiatrists said in a statement: "Today’s report makes it abundantly clear we need a strategy that cuts across multiple sectors including health and criminal justice, and it must be backed by adequate funding.

"A key focus of the strategy must be prevention. We know strong evidence exists that interventions like minimum unit pricing, alcohol duty, and restricting alcohol availability can reduce alcohol misuse.

"Government must listen to today's recommendations so more lives are not needlessly lost to alcohol."

In a statement released by the British Medical Association (BMA), Professor David Strain, chair of the BMA board of science committee, said: "There were almost a million alcohol-related hospital admissions last year alone, contributing to the hospital bed crisis and increasing stress on the already over-burdened workforce.

"What we need to see is a comprehensive alcohol strategy from the Government that tackles the problem at both ends: preventing harmful drinking through improving the conditions in which people live and work, funding for community mental health support, and ensuring timely and effective treatment for those who are already living with an alcohol problem."