NEWS FOCUS
OUT OF COMMISSION
With the government’s long-awaited alcohol strategy showing
no signs of materialising any time soon, the newly launched
Commission on Alcohol Harm is hoping to fill in some of the gaps
I
t’s estimated that alcohol
harm costs the NHS around
£3.5bn a year, with alcohol-
related hospital admissions
up 20 per cent in a decade
(see news, page 5). The cost
to the wider economy, meanwhile,
is thought to be anything up to
£21bn, all of which makes it odd
that we’ve had no new alcohol
strategy since 2012 (DDN, April
2012, page 4).
In response to this, a new
Commission on Alcohol Harm
has been launched by the Alcohol
Health Alliance (AHA) (see news,
page 4). The commission will
hold three oral evidence sessions
across the country, with these and
submitted written evidence feeding
into a wide-ranging report.
‘I think it’s time to re-focus
the public’s attention,’ AHA chair
Professor Sir Ian Gilmore tells DDN.
‘The lack of a strategy is really
harming the nation, and it’s timely
in terms of the pressures on the
NHS.’ While A&E departments used
to feel the impact on Saturday
nights, it’s now every night of the
week, he says. ‘Then there are the
chronic conditions and the links
to cancer that maybe weren’t so
evident when the evidence was last
reviewed. I think the spotlight also
needs to be put more on areas that
are traditionally less well known,
like domestic violence, children of
alcohol-dependent parents, and
foetal alcohol spectrum disorder. I
think it’s time to look beyond the
usual harms.’
The commission will make
recommendations across the board,
and not just about prevention –
its scope also includes treatment
services, which are ‘of major
concern’, he says. ‘But in terms of
prevention we wish to be evidence-
based, and the evidence is around
price, availability and marketing.’
When it comes to marketing,
two areas that are perhaps ripe
for reform are social media and
the current system of self-
regulation around labelling. ‘While
the government hasn’t been
receptive to regulation I think
they are concerned about digital
marketing and protecting children,
and alcohol falls very much into
that category – so we’ll certainly
be making the case around the
digital world,’ he says. ‘But also
self-regulation doesn’t seem to
work, and I think that’s something
that’s likely to come out of the
commission.’
Any effective alcohol strategy
will need to address price, and one
thing it’s easy to forget it is that the
2012 strategy did actually contain
a commitment to minimum unit
pricing (MUP). While that’s now
in place in Scotland – albeit after
a lengthy battle – and Wales,
we’re still yet to see it in England.
Gilmore believes the introduction
of some sort of floor price is only a
matter of time, however.
‘I think the evidence is
overwhelming that price is the
single biggest determinant of how
much communities drink,’ he says.
‘There isn’t just one mechanism of
tackling price, and I think the huge
benefit of MUP is that it hits the
cheapest drinks. Products like white
cider have almost disappeared in
Scotland since MUP, and very few
moderate drinkers drink white
cider – it tends to be the most
vulnerable. So minimum unit price
is certainly on our agenda as an
important priority, in partnership
with duty.’
The drinks industry’s first
response ‘is always, “It’s nothing to
do with price, we need to change
the culture”’, he says. ‘But my
response to that is the biggest
change in culture in the last 20
years has been going from a country
that drinks in pubs and bars to a
country that drinks at home. About
eighty per cent of alcoholic drinks
except beer are drunk at home, and
even beer is 50-50 whereas it used
to be consumed overwhelmingly in
pubs. That’s been driven by cheap
supermarket drink.’
Access to treatment, meanwhile,
is ‘worryingly inadequate’, he
says, ‘and our impression is that
The government estimates that
alcohol-related harm currently
costs the NHS £3.5bn every year
(equal to £120 for every tax payer)
and the wider UK economy £21bn
– more than double the £10bn
revenue generated from alcohol
taxes.
6 • DRINK AND DRUGS NEWS • MARCH 2020
‘It’s time to re-
focus the public’s
attention. The
lack of a strategy
is really harming
the nation, and it’s
timely in terms of
the pressures on
the NHS.’
PROF SIR IAN GILMORE
it’s getting worse rather than
better. Services are getting more
fragmented and often put out
to the lowest tender, and while I
understand the reasons for moving
public health into local government
there have been casualties from
that in funding terms.’
So what are his hopes for
the commission? ‘What will we
achieve? I don’t know. But we know
from experience that we won’t
achieve anything if we don’t try,
and we think the time is right. The
lack of government commitment,
the evidence of real progress in
Scotland, the pressures on the NHS
– they all make the commission a
timely exercise.’ DDN
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