Britain is sitting on a boozequake, and what with cuts, austerity and Conservatism, GPs are going to see their workload rise even more as a result.
I had to visit my GP a few days before my recent BBC documentary on alcoholism was broadcast. I had a chest infection, but once the diagnosis was made, the doctor and I had a brief chat about Britain's relationship with booze.
He reckoned a good proportion of the people who came to see him, though reporting all manner of other things, were actually there because of drink problems they wouldn't confront. And here, the government cuts to the frontline were already having an effect. My surgery used to have an alcohol counsellor. The post has now gone.
There is something odd about seeing David Cameron and Andrew Lansley continuing loudly to claim that they are not cutting the frontline. If I had worries about my drinking, then yes, my GP is still there. But actually, that alcohol expert would have been part of my frontline. Were I to get into more serious difficulty, and require acute short-term residential care, two of the four places where I might get it in the Camden area are also gone. One of the arguments used for shutting them is that the beds were not always full. Sorry, but that was the point … there was always a spare bed, in case it was needed.
When I made a speech recently about this concept of ‘the frontline', Mark Brown, editor of One In Four, the mental health magazine, made a fascinating contribution on my website. He asked ‘what exactly is the frontline in mental health? Mental health inpatient wards? Community mental health teams? GPs surgeries? Social services departments? Community organisations? HR departments of companies? Consulting rooms of therapists or counsellors? The case work of advocates? Back to Work providers and JobCentres, benefit decision making bodies? Mental health charities? Advice and support helplines and websites? Accident and Emergency departments?'
The truth is it is all of these things. If my research for Panorama is anything to go by, GPs will be seeing more not less of patients because of drink, and as these other services come under pressure, the GP's share of the frontline will grow. Dr Nick Sheron, consultant hepatologist at Southampton General Hospital, reported that liver disease is the only major killer on the rise. The main smoking diseases have seen falls from between 20 and 70 per cent. In the same timeframe, mortality from liver disease has risen by more than 400 per cent. He also revealed that whereas once cirrhosis was a male-dominated illness, now his patients are evenly divided between men and women.
He reported changes in drinking patterns too. Only 5 per cent of his patients did most of their drinking in a pub. The rest – 95 per cent – mainly drank at home. That is why I called my programme ‘Britain's Hidden Alcoholics.' Middle class professionals who have good jobs, families, lots of consumer goods, nice holidays. But who drink too much and live in denial of that fact.
The government is currently devising a new strategy for alcohol. The signs are that they are looking mainly at the problem of young binge drinkers out at the weekend wrecking town centres. It is A problem. But is not in my view THE problem. THE problem is the huge rise of drinking at home, the power of the supermarkets and marketing, and the insight that wine ‘doesn't really count' as alcohol.
The best clip in my film came from Mark, a recovering alcoholic, who said: ‘I think people's perception of what is an alcoholic is interesting because actually, do you know what, it is not the guy with the brown paper bag and the strong cider or cheap vodka. It can be two glasses a night if that is what you need. I challenge anybody I know to stop for a month, to go the same places, do the same things, interact with the same people and just remove the alcohol from the equation and see how they feel.'
It is a challenge millions of Britons could not meet. The consequences are clear to GPs every day of the week and if the government fails to address the real issues surrounding alcohol, Britain's boozequake will reverberate through every surgery in Britain.
Alastair Campbell's film is available on BBC iplayer. His ebook, The Happy Depressive, is available now on all main platforms