Imagine summoning the courage to ask for support with your drinking. Imagine then being told you’re drinking too much to get mental health support, or that you’re not drinking enough to get alcohol support. Imagine trying to cut back on your drinking and finding it hard to access the right support or information.
Sadly, many people don’t need to imagine. 82% of people who need support can’t access it. And whilst many GPs and local health services genuinely want to see the best outcomes for patients, NHS systems have placed less emphasis on preventing harm. In fact, for every pound spent on community treatment services, £11 is spent on dealing with alcohol harm in ambulances or A&Es.
Done right, and through a genuinely powerful and cross-government approach led by the Health Mission Delivery Board, it could pave the way to creating good health through early intervention and prevention – not just when things go wrong. While genuine prevention means investing in alcohol treatment, the biggest opportunity lies in permanently transforming the environment surrounding alcohol, one that helps us to understand how the alcohol we drink might be impacting our health, wellbeing and quality of life, helping us make informed choices, while protecting us from efforts to get us to drink more – from pricing and availability of alcohol to how its marketed and advertised to us.
The scale of the UK’s underlying ill-health can feel overwhelming – particularly when it comes to alcohol harm. Last month’s news of record number of alcohol-specific deaths-specific deaths is only the tip of the iceberg: around three times as many deaths are linked to alcohol, particularly through cardiovascular disease. Alcohol also causes many other harms which threaten the Government’s ambitions – from reforming urgent and emergency care to enhancing access to dentists and reducing crime to cutting health-related economic inactivity.
These need concerted policy action – particularly Minimum Unit Pricing and proper controls on labelling and marketing – to shift the dial. This will require legislation, and the earlier the revamped Department of Health and Social Care (DHSC) starts, the sooner it will be able to demonstrate positive results. The good news is that there are also a range of proven policy measures, many of them almost free – and even revenue-raisers – to implement, that will kickstart that transformation:
- Firstly, at a community session Alcohol Change UK held last month as part of the 10 Year Health Plan, people told us that the guidance the NHS gives people on drinking doesn't fit with the digital age. We heard clearly that directing people not just to treatment services – but also to apps, podcasts, videos, and other forms of content – would help reach and support more people in ways that work for them.
- Secondly, we forget that the state is a massive employer. IPPR found that 24% of NHS staff were using alcohol or drugs as they thought it helped them with the pressure of their job – the equivalent of around 335,000 people. Sadly, alcohol can make stress and anxiety worse in the long run. Supporting public sector staff to cut back on drinking would improve their health and increase productivity in public services.
- Thirdly, the Government's new health and work plans offer a huge opportunity to address alcohol harm as part of its efforts to tackle economic inactivity. Research shows alcohol is leading cause of conditions like diabetes which are leading people to leave the workforce, while the biggest impact of alcohol on workplaces is lost productivity. Through missed work or reduced performance, this costs the economy over £5 billion each year in England alone. If more people were supported with compassion to improve their health and wellbeing, and reduce their risk of experiencing alcohol harm, this unlocks both health and wealth benefits for our nation.
- In the Spring Statement, the Government should also reintroduce the innovative and effective alcohol duty escalator that was introduced by the last Labour Government – this could raise £1.8bn a year by the end of this Parliament. Scrapping tax breaks for super-cheap cider would also bring in revenue, save lives, and reduce hospital admissions.
- Finally, to show the impact progress is having, the Government could start to publish data on what prevention means in terms of lives saved. This would drive change in DHSC. And by working with people affected by alcohol harm, the Government could start to communicate the human impact, too.
With Reform nipping at Labour's heels, the temptation might be to abandon public health commitments. But as research by the Health Foundation and Public First shows, we know serious action on prevention is popular with a majority of voters, including those in our most deprived areas.
Ultimately, voters value our NHS. They want to see a thriving, sustainable and future-proofed NHS – and as Wes Streeting has said, prevention is critical to achieving that aim. There are quick wins and savings to be made, and there’s a longer-term plan needed too. The sooner we start, the sooner we can help millions imagine a better future for themselves.
Ash Singleton is Director of Research and Public Affairs at Alcohol Change UK, an independent charity working to end alcohol harm.
