Smoking advice at routine smears prompts quitting
Open all hours . . .
Dealing with the fallout from the newly relaxed licensing laws is enough to drive GPs to drink
The Government is in the process of relaxing the licensing laws. From November, pubs and other licensed premises will be able to open for longer with local council permission. In reality, it seems few places are planning to extend their opening times for much longer. And many people are pleased that antiquated laws have been updated and believe market forces rather than a 24-hour drink culture are likely to dictate opening hours.
Who provided the medical consultation for this exercise? The buck stops with Sir Liam Donaldson, the Chief Medical Officer. But a quick review of alcohol statistics suggests some worrying trends. We have all seen the effects of alcohol in the consulting room (on patients, in the main) and know how difficult it is to engage these patients and get them help.
We Brits just don't behave like the Europeans. As a result the mortality from alcohol-related illness has risen by a staggering 18.4 per cent over the past four years. The Liberal Democrats, who pushed for the data to be published, commented that in some places we are literally drinking ourselves to death. GP colleagues in Yorkshire and the Humber have seen 46.5 per cent rises in alcohol-fuelled deaths.
Unbelievably, the number of children admitted to hospital after drinking alcohol has increased by 11 per cent in the past decade that's 13 children a day! A study in The Lancet has equated the global health burden due to alcohol to be as high as that of smoking. Social scientists reckon that a 10 per cent rise in the cost of alcohol could cut death from cirrhosis by up to 8 per cent.
Government alcohol strategy has been centred on education and information fluffy talk for not upsetting the drinks lobby or interrupting payments to the exchequer.
Treating alcohol abuse is difficult. It's hard to recognise. Few of us use rating scales at all, let alone routinely. Patients frequently do not attend. Alcohol services have been historically placed in distant addiction clinics.
Alcohol support, or a sick joke?
I'll paraphrase a letter I received recently: 'Thank you for your kind referral. We have not seen the patient but we phoned them and used our unvalidated alcohol scoring system. Unfortunately they have not been deemed enough of a risk to be seen anytime soon.
'We have sent them an information pack with some handy hints (presumably to read in the pub) and told them to sod off back to your care. If any problems should arise in the meantime we would rather they see you rather than contact us.
'We are hoping to run such a catastrophic waiting list that most of our referrals will have died, suffered medical complications, moved away or cured themselves. We may eventually get round to setting up some group therapy sessions in the next financial year.'
I'm off for a pint to calm down anyone got the telephone number for the minister in charge of joined-up thinking?
Dr Andy Jones is a GP in Stamford, Lincolnshire