May 24, 2023

expert reaction to Public Accounts Committee report on alcohol harms

The Fifty-Fourth Report of Session 2022–23’ on Alcohol treatment services has been published by the House of Commons Committee of Public Accounts.

Dr Sadie Boniface, Head of Research, Institute of Alcohol Studies; and Visiting Researcher, King’s College London, said:

“The Public Accounts Committee report on alcohol treatment services talks about wider aspects of alcohol harm in addition to alcohol treatment services.  Harms from alcohol are wide-ranging and occur on a continuum, and are not limited to people who drink at dependent levels.

“The statistics used in the report around alcohol use relate to high quality evidence from reputable sources such as NHS Digital and the Office for National Statistics.  Statements about estimates of the total cost of alcohol harm being very out of date are also correct.

“The report says that the right approach for addressing alcohol harms is contested.  It is not the public health science that is so contested, but this instead arises from the different interests of, for example, public health advocates compared with alcohol industry actors.

“The report says that DHSC said the results from minimum unit pricing in Scotland were unclear, whereas Alice Wiseman and Ian Gilmore said this evidence was convincing.  My assessment is the evidence is convincing, and since the evidence session in March, a major paper on minimum pricing has come out in The Lancet, with positive findings.  A final evaluation summary report is also expected at the end of June.”

Prof John Holmes, Professor of Alcohol Policy, University of Sheffield, said:

“The Public Accounts Committee report provides a good summary of the current state of play with regard to alcohol-related harm in England and the Government’s response to it.

“Deaths due to alcohol have risen gradually since the early 2000s despite alcohol consumption falling.  This is because the fall is driven primarily by less drinking among young people.  In contrast, people in middle- and older-age groups have continued to drink at the same or higher levels and it is these groups that are driving the increase in deaths.  The largest part of the increase in deaths occurred since 2019 and is due to the wider effects of the pandemic.  The precise reasons are unclear at this point but are likely to include (i) heavier drinkers increasing their consumption during lockdowns and not reducing it afterwards; (ii) people being less likely to seek or access help from general and specialist health services and (iii) alcohol problems combining with other problems that were exacerbated by the pandemic and people getting more ill as a result.

“The estimated £21bn per year cost of alcohol to society does need updating.  The estimate also has significant limitations and could be improved using new methods and data that were not available in earlier years.

“The evidence on key interventions that would help to prevent or reduce alcohol-related harm is also strong.  In particular, evidence from the evaluation of minimum unit pricing in Scotland now clearly suggests the policy has reduced alcohol consumption, including among those drinking above the Chief Medical Officers’ Guidelines, and then led to reduced deaths from alcohol.”

Report title: ‘House of Commons, Committee of Public Accounts: Alcohol treatment services, Fifty-Fourth Report of Session 2022–23’ by name of first author et al. was published by the House of Commons Committee of Public Accounts at 00:01 UK time on Wednesday 24 May 2023.

Declared interests

Dr Sadie Boniface: “I work at the Institute of Alcohol Studies which receives funding from the Alliance House Foundation.  My employer one of 60+ members of the Alcohol Health Alliance UK, which is chaired by Prof Sir Ian Gilmore, who gave evidence to this committee.”

Prof John Holmes: “No conflicts to declare.”