The Cost of Alcohol on the NHS

Ever since its inauguration, the NHS has been a stalwart institution in the UK, offering health services free at the point of delivery for everyone, regardless of status or socioeconomic background. Over time, the pressure on the NHS has changed in various different ways. A growing and aging population mean that demands are different from what they were when the NHS came about. But what about the growing problem of alcohol, specifically alcohol abuse? What effect does this have on the NHS?

The Cost of Alcohol on the NHS

The cost of alcohol on the NHS has increased by approximately 19% in the last three decades alone. This is evidently due to the increase in affordability and availability of alcohol as well as the general increase in binge drinking. Recent reports have suggested that there are about 10.5 million adults in England alone that drink above what they should and there’s around 1.1 million who have some form of alcohol addiction or dependence. It’s actually the third leading cause of disease in the UK and, as a result, the costs of this are spiralling. If some sources are to be believed, the NHS will not be able to sustain the increases cost if this trend continues.

The latest figures estimate that alcohol costs the NHS around £3.5 billion each year, which is a staggering amount. This up from the estimates in 2006/7 which was around £2.7 billion. There are many difficulties in recording costs for alcohol-related harm and, as such, it would not be surprising if both of these figures were actually higher.

NHS Service

NHS

This increase in demand for NHS services has not always been met by an increase in the availability of appropriate services. The NHS is stretched to its limits without the added demands that increasing alcohol-related disease adds. Some statistics estimate that only around 1 in every 18 people who are alcohol-dependent actually receive treatment and the availability of such treatment varies massively across the different parts of the UK – another blip in the NHS’s ‘postcode lottery’.

How does Alcohol cost the NHS?

It isn’t just drunken admissions to A&E for excessive drinking that are costing the NHS so much, although this is undeniably one factor. Studies suggest that around 50% of violent assaults are related to alcohol and, as such, where the cause of the admission to hospital may be an injury, the primary cause of that injury is a direct link with alcohol consumption.

Other statistics show that, for rape victims requiring treatment, 58% of rapists had drunk alcohol before carrying out their attack. Alcohol is also a key player in accidental deaths, of which around a fifth are due to alcohol consumption. Suicides are also heavily related to alcohol consumption. We can see that these are just some of the reasons how alcohol can cost the NHS billions of pounds.

NHS Pressure and the Future

The pressure on the services provided by the NHS is mounting. Hospitals are left dealing with the majority of the problems related to alcohol with around 70% of all alcohol-related costs being spent in hospitals. More and more people are being admitted to hospital for alcohol-related harm than ever before too. But, are the hospitals the best places to deal with such pressure? Is this the most cost-effective way of managing alcohol-related harm. Perhaps other measures, such as preventative treatments could help hospitals cope with the demand as well as improving the health of the population too.

Hospitals particularly need to look nationally at best practices to see how other hospitals are managing such demands. Some areas have ‘alcohol buses’ with medical treatment provided near busy towns and cities in order to minimise hospital admissions related to single-session drinking. Likewise, most hospital admissions have not had any contact with primary care services for their drinking, and as such, perhaps the first point of contact should be elsewhere or perhaps GPs services could be doing more to minimise hospital demand. Alcohol services can have a massive impact on reducing the costs to Primary Care Trusts but, as mentioned above, these are dependent on the area in which you live. Whatever happens, it’s clear that something needs to be done to aid the NHS alcohol crisis that is looming.

How does the UK Compare to Europe in alcohol use?

It probably comes as no surprise that where you live, or where you are from, has a role to play in how much alcohol you drink. Most people today believe that the Northern European countries, such as the UK and Ireland, are the ‘worst’ drinkers in Europe; that we are prone to drinking to excess and bingeing. This is in contrast with the opinion that alcohol consumption in Southern Europe is much more moderate. However, it was not too long ago, in fact, that this view was inverted, with us Northern Europeans being considered as the more moderate drinkers.

If we compare today to the 1970s, there has been between a three and five fold increase in the amount of liver-related deaths in the UK whereas in Southern European countries such as Italy and France, this figure has decreased by three to five times. You can see that these changes have crossed over and gone in opposite directions. This shows us that our nations’ drinking cultures are not static but can change over time.

Changes in Southern Europe compared with changes in the UK

European drinking culture

So where has this change come from in Southern European countries? The belief about Southern Europe is that these countries often have the culture of having a little drink frequently as a part of everyday life. The changes have come about due to a wider societal change, with increased urbanisation and the subsequent changes in people’s working conditions. There’s also an increased awareness of drinking alcohol and health too.

In contrast, the Northern European countries, including the UK, have moved towards higher alcohol consumption and therefore an increase in alcohol-related harm, which has been explained by the increase in affordability and availability of alcohol. We’ve combined this with the culture of more episodic drinking associated with celebrations and weekends rather than the Southern Europeans who used to drink regularly but only in smaller quantities.

It’s evident that drinking to excess and bingeing is more harmful than the frequent, lighter drinking in the south and this readily explains why the northern countries, including the UK, have had such an increase in alcohol-related illnesses and deaths.

Comparing the UK with the Southern European countries in this way shows us that societal changes across Europe affect each country differently in terms of how much alcohol is consumed and it proves that there is not a direct link between drinking and an improvement in living and working conditions. It is, in fact, indirect, affected by the individual country’s cultural and historical background.

Underage Drinking Across Europe

A recent survey has shown that British children between the ages of 11 and 15 are more likely to have drunk alcohol on a weekly basis compared to the average taken of 36 countries in Europe. There’s also a higher percentage of 15-year-olds in England who first got drunk at 13 years old or before. This puts the UK in the top ten countries in Europe for early drunkenness.

Other surveys have also shown that there is an underage drinking problem in the UK compared with 36 other European countries. In fact, over half of 15-16 Brits said that they have been drunk on at least one occasion, with girls slightly more than boys. The only other countries to ‘beat’ us to the top of this underage-drinking table were Slovakia, Finland and Denmark.

Countries Similar to the UK in their Alcohol Consumption

We are by no means alone in our consumption of alcohol. While most of the Southern European countries drink less, we are actually similar drinkers to some of the Eastern European countries including Poland, Latvia, Slovakia and Hungary. Lithuania, Romania and the Czech Republic were at the top of the table, having approximately 3.2 drinks per day in Lithuania, with 2.4 drinks daily the other two countries mentioned. At the bottom of the list are Italy and Malta, whose inhabitants drink on average 1.3 drinks each day.

The Future

So, what now? The UK needs to drastically up its game in reducing the amount of alcohol we consume. Our current consumption levels are some of the most worrying in Europe meaning we have an awful lot of people who are greatly at risk of developing many related conditions and diseases. Let’s not forget that alcohol is a group 1 carcinogen! To change our habits may require cultural and societal changes and that is not going to happen overnight.