The House of Commons Public Accounts Committee has produced a heavily critical report of the Department of Health's approach to alcohol-related harm. The report, 'Reducing Alcohol
Harm: health services
in England for alcohol misuse', examines how the Department of Health (DoH) responds to alcohol related harm through Primary Care Trusts, responsible for determining local priorities and spending. It states:
"Many PCTs, however, do not know what they spend on [alcohol] services and across England there is little correlation between need and expenditure. Where services are commissioned there is frequently a lack of performance monitoring and examination of whether what is provided represents value for money."
The report's 10 key conclusions and recommendations as summarised below:
- Alcohol misuse places a large and growing burden on local health services, in particular, accident and emergency departments.
- Some preventive services, such as ‘brief advice’... can be delivered effectively by...other officials outside the health service, but this requires effective partnership working at the local level. There is little evidence that this is happening.
- General Practitioners (GPs) have an important role to play... but are not doing so consistently. A new scheme [the DES] to encourage such work is likely to have only limited effects.
- Only around 1 in 18 people who are dependent on alcohol receive treatment and the availability of specialist services differs widely across England.
- ...there is frequently a lack of monitoring of whether what is provided by the public, private and voluntary sectors represents value for money.
- [Treatment] services are often not joined up, increasing the risk that people will simply relapse into their former drinking habits.
- The Department’s sensible drinking guidelines were changed from weekly to daily limits in 1995, but 11 years later almost two-fifths of people did not know the current recommended guidance.
- By July 2008, only 3% of alcoholic products had fully complied with the drinks industry voluntary labelling scheme.
- There is little evidence that Whitehall-wide action on other policies and regulations which affect alcohol consumption—such as licensing, taxation and glass sizes—is effectively coordinated.
- Alcohol has become steadily cheaper in relation to income; meanwhile, consumption and health damage have increased.
Last year the National Audit Office (NAO) produced a comprehensive review and recommendations for alcohol services, detailing issues, gaps and inconsistencies in PCTs alcohol provision.
However the DoH has recently published guidance for commissioning alcohol services, which highlights that ‘in 2008/9 roughly two thirds of PCTs’ had included Vital Signs Indicator 26 as a local priority to reduce hospital admissions. The DoH also have the Alcohol Improvement Programme and associated projects to support PCTs in reducing alcohol related harm. The AERC alcohol academy also provides support for local strategic alcohol leads.
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