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Government not taking “appalling” harms from alcohol seriously enough - Public Accounts Committee Published Date: 25/05/2023

The Public Accounts Committee's "Alcohol treatment services" report has concluded that the Government is not taking “appalling” harms from alcohol seriously enough.

The Committee's Fifty-Fourth Report of Session 2022–23 focussed on alcohol treatment services found that:

  • 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  • Estimated £25 BN/year cost to NHS and wider society out of date and may not reflect full scale of harm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. 

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.”  

Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board said:

“This stark evidence shows a concerning increase in harmful alcohol dependency across the country since the pandemic, placing additional pressure on vital local council-commissioned alcohol treatment services.

“It is good that this report acknowledges that every £1 spent on alcohol treatment services provides a return of £3, with local addiction support services saving our overstretched health and social care system a staggering £2 billion every year.

“However, councils have seen £1 billion worth of cuts to their local public health grant over the last eight years, which goes to fund alcohol treatment services.

“To meet these increased pressures and transform the health chances of people in our local communities, councils need a long term increase in their public health grant.”