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Drink misuse ‘costs each Scot GBP900’

The impact of Scotland’s drink culture on the health service was laid bare yesterday when it emerged that the cost of treating only one person with a moderately severe alcohol-related head injury is more than £34,000.

The extraordinary figure was released by NHS Greater Glasgow and Clyde, Scotland’s biggest health board. The sum covers only acute care, and not costs associated with rehabilitation. NHS officials calculated the figure after an independent report suggested that alcohol misuse costs the Scottish economy up to £4.64 billion annually, more than double the £2.25 billion figure previously used by the government.

Alastair Ireland, NHS Greater Glasgow and Clyde’s clinical director for emergency medicine, said the cost of treating alcohol-related emergencies ranged from £800 for admitting a patient to hospital for a day or two, to more than £34,000 for complex head injuries. He also said that about 10 to 15 per cent of patients also had injuries that were so serious that they never recovered, and required round-the-clock nursing for life.

“I’d say that in 95 per cent of head injuries, alcohol is the significant factor, whether it is by a fall or assault,” he said. “There is obviously a cost to society, but for us as clinicians, we see first hand the cost to individuals in terms of suffering to them and their families.” Dr Ireland’s comments came as a report by economists at the University of York estimated that alcohol misuse in Scotland cost the public purse between £2.48 billion and £4.64 billion a year. According to the report, if the midpoint figure of £3.56 billion were used, alcohol abuse represents a cost to each adult north of the Border of £900 a year.

Nicola Sturgeon, the Scottish Health Secretary, said that the figures were frightening. She said the sharp rise was partly the result of different methodology, but said that the problems associated with alcohol abuse were increasing. “If you look at alcoholic liver disease statistics, they tell you it is getting worse … £3.5 billion is too high a cost to be paying for alcohol issues, and it reinforces the need to take action.”

Ms Sturgeon appealed to opposition parties to support the SNP’s proposals for minimum pricing. She is hopeful that a combination of public pressure, and support for the measure among experts, could lead to a change of heart. A broad coalition of health professionals and drinks industry figures now support the move.

“I think they are in party political positions, and this should be above party politics,” she said. “An analogy is the smoking ban. As [we were] the Opposition [when it was proposed], the easy thing would have been to oppose it, but we backed it, and I think that is what should be done now.” However, her Opposition colleagues at Holyrood rejected her appeal.

Jackie Baillie, the health spokeswoman for Scottish Labour, said that minimum pricing was untested and possibly illegal. She urged ministers to engage in a debate over alternatives. Robert Brown, justice spokesman for the Scottish Liberal Democrats, said that tackling irresponsible promotions and the sale of alcohol as a loss-leader would be more effective.

The University of York report used figures from 2007 to work out the cost of alcohol misuse across areas including healthcare, social care, crime, productivity and premature death. Under the £3.56 billion figure, healthcare costs were £268.8 million, 7.5 per cent of the total; crime costs were £727 million, or 20 per cent; and the loss of productivity was £865.7 million, or 24 per cent. The “human” cost of premature death, which was not included in previous estimates of alcohol misuse, accounted for £856.7 million.

John Neilson, Assistant Chief Constable of Strathclyde Police and a national anti-violence co-ordinator, said that minimum pricing would be the single most effective way of reducing alcohol-related crime. “We need to challenge the heavy binge-drinking culture in Scotland or we’re never going to move on as a country,” he said. Dr Ireland agreed that minimum pricing would be effective, saying that those without money in their pockets would stop.

Behind the story: A head injury

The first stop is the resuscitation department, at a cost of £1,000. Then a CT scan at £350. An ambulance to a specialist neurological unit is £75, three days in intensive care is £9,000, and further treatment on wards over the next three weeks is another £23,000.

By the time a patient with a complex alcohol-related head injury is discharged, the cost to taxpayers has risen to more than £34,000.

“The burden on the entire NHS system is enormous,” said Alistair Ireland, clinical director for emergency medicine at NHS Greater Glasgow and Clyde.

He said alcohol injuries were caused by falls, fights and chronic harmful drinking, creating long-term conditions such as liver disease.

The Royal Infirmary in Glasgow alone saw 5,000 alcohol-related head injuries, 1,000 of which required admission.

Dr Ireland said that the answer was better education and minimum pricing.

source: Times Online

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