Government not taking “appalling” harms from alcohol seriously enough

24 May 2023

Deaths rose 89% over last two decades and sharply since start of pandemic
Estimated £25 BN/year cost to NHS and wider society out of date and may not reflect full scale of harm
Alcohol linked to over 100 illnesses and 42% of violent crime but no strategy in place since 2012

An estimated 10 million people in England regularly exceed the Chief Medical Officers’ low-risk drinking guidelines, including 1.7 million who drink at higher risk and around 600,000 who are dependent on alcohol. But in a report today the Public Accounts Committee says a “staggering” 82% of those 600,000 dependent drinkers in England are not in treatment despite success rates of around 60% and evidence that, on average, every £1 spent on treatment immediately delivers £3 of benefit and significantly more in the longer term.

There has been an alarming increase in alcohol-related deaths, which rose by 89% over the past twenty years, with sharp rises since 2019. But the number of people receiving treatment for alcohol dependency has generally been falling. The Department for Health and Social Care’s understanding of the total cost of alcohol harm for the NHS and wider society is based on analysis dating back to 2012. That puts the estimate at £25 billion a year (adjusted for inflation) but the Committee is concerned that this more than decade-old analysis may not reflect the full scale of harm. The Committee is “surprised and disappointed” that the Department is not taking a more proportionate and serious approach to addressing the problem. Despite the widespread harm, there has been no alcohol-focused strategy since 2012 and the latest plans for one were abandoned in 2020.

Alcohol is linked to over 100 illnesses, can drive mental disorder, self-harm and suicide, and is a major cause of preventable death. In 2019-20 it was linked to 42% of all violent crime, up from 40% the previous year.

The Committee says DHSC must secure a consensus and act on the best available evidence on preventative measures around price, availability, and marketing. It must also address the key issues of funding uncertainty for local authorities; barriers to accessing treatment; local variations in outcomes and severe and worsening healthcare workforce shortages.

Chair's comments

Dame Meg Hillier MP, Chair of the Committee, said:

“The harms from alcohol are appalling and the benefits of every £1 spent on treatment are immediate and obvious. It is linked to over 100 illnesses, mental disorder and suicide and to 42% of violent crime. It also costs the NHS and wider society at least £25 billion a year with inflation – and possibly more. But the Government has had no alcohol strategy in place since 2012 and abandoned its latest effort 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? In doing so it 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.”

Lead PAC Member's comments

Lead PAC Member inquiry Dan Carden MP 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.

Alcohol harm is a deepening public health crisis that affects us all and it is wrong and unfair to believe that it is only alcohol dependent drinkers who are affected.

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.

In recent years, there has been a concerted and somewhat successful effort from the Government to implement strategies aimed to tackle obesity, gambling, tobacco, and illicit drugs. Arguably the most harmful and legal drug, alcohol, remains unchallenged. During the Public Accounts Inquiry, the Department provided no credible justification as to why alcohol remains a conspicuous outlier.

With thousands of families broken by alcohol, the highest alcohol-specific deaths on record, 84% of alcohol dependent people in need of treatment not receiving it and the enormous cost to the public purse, the Government must now remove the barriers of inaction and act on the recommendations set out in this report.”

Further information

Image: unsplash