As the NHS becomes more stretched we can ill afford the drain on services caused by drinking to excess, writes Barbara O’Donnell
One of the key challenges confronting society today is how we can maintain a high-quality, responsive and publicly-funded health service. With an ageing population and more complex and costly medical treatments, it seems inescapable that the NHS will become increasingly stretched. However, not all pressures on the NHS are inevitable.
One of the biggest avoidable drains on NHS resources is alcohol.
From vomiting, unconsciousness, violence and injuries, to long-term, disabling illnesses including liver disease and cancer, alcohol puts a huge strain on all our frontline services. Last year there were more than 36,000 alcohol-related stays in Scottish hospitals and the vast majority of these resulted from an emergency admission.
Most NHS staff have a story to tell about how much more difficult their job becomes when dealing with people who have had too much to drink.
Emergency departments often bear the brunt of our excessive drinking, particularly at weekends. The disruptive behaviour of drunken patients doesn’t just affect the receptionists, porters, nurses and doctors who are trying to get on with their jobs, but also impacts on other patients waiting to be seen. Aggressive and irrational patients typically require more intensive staffing, diverting attention from others. In the Royal Infirmary of Edinburgh there is 24-hour police presence in reception to deal with the alcohol-fuelled disorder and aggression.
To ease the alcohol-related burden on emergency services, alternative facilities have been set up in some city centres. Edinburgh City Council recently announced that a SafeZone Bus will be a permanent weekend fixture in the city centre, offering support to people who become “vulnerable” while out at night. These facilities can certainly reduce the need for emergency services by helping people sober up and offering first aid, but for those who are more seriously ill or injured, hospital treatment is essential.
Better enforcement of the legislation relating to serving drunk customers may help reduce levels of intoxication. Staff in the licensed trade complete mandatory training covering alcohol awareness and the law, but the number of drunk people outside pubs and clubs at closing time suggests the law is not working that well in practice.
All drinkers have a responsibility not to drink so much that they can’t look after themselves properly and end up in hospital or a police cell. But individual restraint is difficult in an environment that promotes access and excess, where alcohol is available anytime, anywhere at pocket-money prices.
Rather than constantly mopping up the spills, it would be better for our health and the viability of our health service if we focused more on preventing harmful drinking.
By far the most effective way of reducing the harm caused by alcohol is to make it more expensive. Instead, alcohol duty was cut again in last month’s budget, allowing cheap alcohol to be sold even cheaper. “Penny off a pint” is the populist slogan that grabs the headlines, but tax cuts on alcohol benefit the alcohol industry not the NHS. Making alcohol more affordable condemns the NHS to additional unnecessary strain, whilst the loss of revenue from alcohol duty deprives public finances of much-needed funds. The money saved by global alcohol producers over the next five years through paying less alcohol tax could have funded 9,571 nurses, 5.7 million hospital bed days or more than 1.3 million emergency ambulance call-outs a year.
If politicians say they are committed to the NHS, then they need to listen to doctors and commit to addressing cheap alcohol. Minimum unit pricing, along with alcohol duty rates applied for public health purposes rather than short-term party political gain, will go some way to safeguarding the future of the NHS. Without this, alcohol-related illnesses and injuries will continue to place a huge avoidable burden on our public services and the people working for them.
• Barbara O’Donnell, acting chief executive, Alcohol Focus Scotland www.alcohol-focus-scotland.org.uk