When the government’s 10-year health plan is published in July, prevention is expected to get a promotion. This won’t be the first time that ministers will have stressed the importance of healthy lifestyles. But nine months after Wes Streeting announced that a shift from treatment to prevention would be one of the principles governing Labour’s stewardship of the NHS, we are just a few weeks away from knowing how the idea will be put into practice, and turned into a narrative for voters.
In recent years, obesity has dominated discussions of the rising burden of chronic illness. But alcohol, too, is expected to feature in sections of the plan dealing with public health. Alcohol-related deaths in the UK reached a record high of 10,473 in 2023, with men more than twice as likely to die as women, and over-55s drinking far more than younger adults. The highest death rates are in Scotland and Northern Ireland.
In his review of the crisis facing the NHS, Lord Darzi highlighted that the rise in deaths in England coincided with alcohol’s increasing affordability. By contrast, in Scotland, research suggests – though it does not definitively prove – that the introduction of minimum unit pricing has led to fewer deaths and hospitalisations.
Pressure for a tougher approach from policymakers to alcohol is also growing internationally. Two years ago the World Health Organization (WHO) made a public statement that there is no safe amount of alcohol. Last month, in Amsterdam, a new European Health Alliance on Alcohol was launched. It plans to campaign for the reduction of alcohol-related injuries and illnesses. Later this year, a UN general assembly meeting on non-communicable diseases is expected to include discussion of alcohol-related illness.
If governments decide to act in response to such pressure, the options open to them include minimum pricing, taxes, advertising restrictions and stricter guidelines (in the UK, adults are recommended not to exceed 14 units a week, while pregnant women are advised not to drink at all). Other public health interventions include specialist clinics and other local services for those who are already addicted or ill.
Before last year’s election, Labour ruled out minimum unit pricing in England, although this was introduced by a Labour administration in Wales. If this decision has not already been reviewed in connection with the 10-year health plan, then it should be.
But lobbyists will ensure that this and other challenges to the industry won’t be easy. Last month, the Guardian reported on how new restrictions on ultra-processed foods were watered down under pressure from the Food and Drink Federation. While the guidance to retailers was softened under the last government, these changes have not been reversed by Labour. Unsurprisingly, a government that has staked its reputation on economic growth is a good listener to businesses.
Rules and regulations are not the only factor shaping habits and behaviour. The drinks industry is also pushing back with advertising campaigns that reach over politicians’ heads and seek to influence the public directly. Central to these efforts is a message that moderate drinking is not harmful. While this is in direct contradiction to the WHO’s stance, it may appeal to a public that enjoys drinking. Ministers must ensure that accurate information about risks is out there, too, and that government decisions are guided by health, not lobbying.
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