NICE try

The best thing about the second NICE guidance on alcohol that has just been published is that it has put our alcohol consumption into the press again. As alcohol abuse is linked to over 60 health conditions (according to the BMA), £2.7Bn costs to the NHS, £7.3Bn costs to crime and public disorder, £6.4Bn to the workplace and tragic costs to children and families (all stats from Institute of Alcohol Studies Factsheet)this issue has to be taken seriously.

But the suggestion about raising the basic unit price is premature – we shouldn’t all be penalised when other interventions haven’t been tried. SoS Andrew Lansley has rejected the advice, yet when a commercial guru such as Sir Terry Leahy of Tescos agrees with a minimum pricing policy which would lose him millions, we can’t just dismiss it. We have to come up with alternatives. And the NICE report does make some sensible suggestions on licensing, advertising, availability etc. However we cannot and should not expect GPs to start policing alcohol consumption although it’s already a standard question during most medical encounters along with weight, smoking and exercise.

After a skim read through the guidance there is a significant omission. You and me. Holding us responsible. We enjoy the freedom to drink as we like in this country, but there have to be consequences to the abuse of that freedom. There should be standard fines for drunks (police discretion – remember that! – without cumbersome paperwork), frequent fliers in casualties, those consuming alcohol on public transport (it’s banned on the tube, it should be banned on buses and trains too). Bus conductors can stop and fine, so should the police and community wardens should be able to as well. Libertarians will argue that the NHS is there to treat us when we are drunk. The reality is that the NHS is not a Nanny-Help-Service, and unless we tackle the preventable demand giants (p42) at all levels, genuine needs will suffer. Forces amputees will get second-rate limbs, MS sufferers won’t get their drugs, your granny’s pain will be ignored and children won’t get mental health treatment. Oh, sorry, that’s all happening already. The message has to get through that we are already living in a way that is unsustainable to the NHS.

One last thought, NICE is turning into a health think tank. This is not its remit and we shouldn’t be paying for this activity. A review of its function at all levels is essential and we are keen to undertake this. Anyone want to support us?


About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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