Wednesday, 6 January 2016

More anti-booze propaganda

Just before Christmas I mentioned the 'error' in an academic study which led the press to report that 70 per cent of A & E attendances are due to alcohol consumption; the real figure in this study of A & E departments in Newcastle was 12-15 per cent. If there is a news story here, it is that.

It seems unlikely that this mistake happened by accident since the same error appears twice in the text of the study and was repeated in the headline of the press release. More likely it was a deliberate (and successful) attempt to keep the narrative of 'binge Britain' rolling in order to promote higher taxes, shorter opening hours and minimum pricing.

This theory is supported by an accompanying editorial by Clifford Mann. Clifford is the person the media go to whenever they want someone to predict that the NHS will 'collapse' due to cold weather or under-funding. His latest editorial resembles a clearing house for every tired old trope and debunked factoid about drinking in Britain in the last fifteen years. Virtually every sentence contains an exaggeration, misrepresentation or outright lie. Here are a few...

Almost 1 in 6 emergency department attenders in this study presented following significant alcohol consumption. This in itself is a cause for concern. However, the prevalence rises to almost 3 in 4 four attendances during the late evening and early hours of weekends.

This statistic is less misleading than the study's press release but it is still wrong. It doesn't rise to almost 3 in 4 'during the late evening'. It only approaches that rate for two hours between 2am and 4am when there is hardly anybody awake who would pass a breathalyser test. How many people are out and about at 3 o'clock in the morning in Newcastle at the weekend who have not had 'significant alcohol consumption'?

The real question is how many A & E attendances are due to alcohol consumption? The NHS, the government and the 'public health' lobby claim 35 per cent. This study—in one of the country's premier party towns—says 12 to 15 per cent.

This study, in an inner city emergency department, best reflects the case load and case mix of other metropolitan and urban centres...

Not necessarily. We don't know how transferable data from Newcastle are to other cities.

...but the key messages are relevant to all emergency departments in countries where alcohol is readily available.

The key message is that A & E departments are not 'swamped with drunks' to anywhere near the extent suggested by the media and pretend public health groups.

Current national and international data describing the financial burden of alcohol are dramatic, yet the response of governments has been woefully inadequate.

Cost-of-alcohol estimates are 'dramatic' because they massively inflate the cost to the public purse by relying on shoddy evidence (such as the 35 per cent figure) and including non-financial intangible, emotional and internal costs without including any savings or benefits. The government makes at least three times more from alcohol duty than it spends on externalities - see Alcohol and the Public Purse for evidence.

In England alone, the National Health Service (NHS) estimates that there are 1 million hospital admissions annually as a direct result of acute or chronic alcohol ingestion.

No it doesn't. The NHS estimates that the figure is around a fifth of that. The Department of Health stopped using the broad measure that allowed an estimate of 1 million admissions to be claimed because its methodology is prone to huge numbers of false positives.

The financial cost to the NHS is £3.5 billion.

No it isn't.

The pattern of alcohol intoxication has changed significantly in the past 10 years. 

People are drinking less and getting drunk less. Could that be what Clifford means?

No longer do people set out sober, in the early evening, to attend licensed establishments where they consume alcohol. 

I do it all the time and so do most people I know.

Instead the phenomenon of ‘preloading’ has become endemic.

Firstly, people have every right to drink alcohol in their own home. Secondly, if home-drinking has become more common, it is principally due to extortionate alcohol taxes and the smoking ban.

In 2005 the licensing laws for England and Wales were ‘relaxed’. The arguments made at the time to amend the legislation emphasised the benefits of the ‘cafe society’.

That was never the main rationale for making licensing laws more civilised. It was done to allow consumers more freedom, to diversify the nighttime economy and to alleviate the problems that came with pubs kicking everybody onto the street at the same time. It achieved all three of these objectives. It was a success.

Since then, accident and emergency departments in the UK have seen ever greater numbers of patients whose presentations are linked to acute or chronic alcohol ingestion. 

Rubbish. There are no national statistics on this whatsoever but studies that looked at A & E attendances before and after the introduction of the Licensing Act mostly found no change or a decline in alcohol-related cases.

Official statistics for England show that hospital admissions for alcohol related diseases or injuries rose 100% between 2003 and 2013.

Wholly attributable alcohol-related admissions have actually risen by a third which is roughly in line with the general increase in hospital admissions for all causes. They represent a mere one per cent of all admissions.

Although the number of licensed premises has risen dramatically in the UK over the past decade...

I haven't got figures for the last five years but there was certainly no surge after the licensing laws were reformed:

Currently it is perfectly feasible to purchase a volume of alcohol that represents a safe weekly maximum for less than £10. 

You can buy more than a 'safe' number of calories for less than £5. So what? It doesn't mean you have to do it.

Alcohol at this price is cheaper than bottled water.

Still using the old chestnut about the most expensive bottled water being cheaper than the weakest, least popular, supermarket own-brand lager, Clifford? What is it supposed to tell us? That people who buy bottled water are being ripped off?

Profit margins may be very slim but the intention is clearly to encourage alcohol consumption with little regard for the notion of responsible drinking.

This fellow seems to genuinely believe that drinks companies are more interested in encouraging irresponsible alcohol consumption than in making a profit. I thought they were supposed to be ruthlessly profit driven?

By contrast, where prices reflect true costs plus the necessary profit margin—for example, traditional restaurants and cafes—the marginal difference between the cost of a soft drink and alcohol again encourages consumption of the latter.

Alcoholic drinks are almost invariably more expensive than soft drinks. You can't just keep making things up, Cliff. We go to cafes and restaurants too. We know how it works.

A recent Canadian study highlighted the correlation between raising the minimum unit price and a consequent reduction in crimes against the person.

It was a laughable piece of junk science.

Public Health England estimates the total annual cost to society of alcohol related harm to be £21 billion. 

That estimate was devised in 2003. Public Health England was formed in 2013. They're just parroting an outdated number from research that doesn't stand up against the facts.

To put this in context, the annual aggregated running cost of every accident and emergency department in the UK is £2 billion.

£2 billion is less than two per cent of the NHS budget and the 'context' is totally inappropriate. The £21 billion is mostly made up of intangible, emotional and internal costs such as lost productivity and premature mortality. The cost of running A & E departments, by contrast, is a real monetary cost to the taxpayer. You cannot compare the two.

Is it any wonder that newspaper editorials about alcohol are so factually incorrect when editorials in peer-reviewed journals are filled with bollocks like this?

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