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 is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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