We all know that some things might be good for us, others not. But being the person who puts a limit on things that are not good is not an easy job. In medicine, this is the job of our colleagues working in public health. They are the Fun Police, always trying to argue with health and safety in mind. So what have they come up with now? Minimum pricing for alcohol.
I am certain skiing would be made illegal in a matter of weeks if it were to be invented nowadays. But it is established as a great sport, or controlled self-harm for the middle classes, and we have to deal with the consequences. Prohibition does not work – not for skiing, and not for alcohol.
I am not going to examine in detail the evidence base for a minimum price for alcohol. I will leave this to researchers who are more eloquent at putting the case.
But my gut instinct, and my knowledge from years of working the field of primary care and alcohol misuse, tells me that this is good news. So I am surprised how many of my friends and colleagues don’t like it.
The arguments they use, however, are not surprising: minimum pricing does not help the alcoholics who need a drink, does not stop anyone dying of alcohol and it spoils the fun. And most of this is discussed with a pint, or – if you are a bit more sophisticated – a glass of Bordeaux in hand.
So I take a deep breath and try to stop myself lecturing. Like it or not, it will do exactly that – it will reduce the number of people drinking excessively and becoming a harmful or dependent drinker, and will therefore stop people dying prematurely. But it won’t spoil the fun in having a drink.
Let me use another analogy. Only a few people would argue that there is no need for speed limits on our roads. Nearly everybody thinks it should be a bit higher than it is, and we all have a laugh about Jeremy Clarkson being ridiculous on TV. But does anyone believe we should have no speed limits at all?
So why do we believe that buying six pints of cider in a supermarket for less than £3 is any good?
As we cannot limit the amount of alcohol people drink, the only way we can introduce an ‘alcohol speed limit’ is by making it more expensive.
Putting a minimum price to a harmful substance is a good thing. Making cigarettes more expensive was right – just travel to the Continent and see the number of smokers there compared with the UK – and it will work with alcohol too.
It has to be appropriate, so that we don’t create a black market for dodgy spirits like in some Eastern European countries, but enough that people feel it in their pocket when they drink too much. Just enough to make people stop early, before harm is done.
Making booze more expensive is not the only way to tackle alcohol-related harm. There are lots of examples where councils, police, probation and the NHS are working together to address this issue.
There are alcohol services, GPs with shared-care clinics, nurses working in A&E just to look after drink-related admissions, housing associations and last but not least the voluntary sector, with its invaluable input.
But we need more public health support – not to police our fun, but to deal with the mess we sometimes create when having a drink. And we need to support public health to make the case for more treatment, to the Government, to secondary care and to CCGs.
As alcohol is our society’s drug of choice, we will never overcome it – but we need to have an answer to the problems it creates. Minimum pricing is a step in the right direction.
Dr Carsten Grimm is a GP in Huddersfield, West Yorkshire, clinical lead for alcohol services for Locala CIC in Kirklees and the RCGP’s lead for the alcohol and gambling certificate. He is writing in a personal capacity.