Pub doors are reopening – and hospitals are preparing like it’s New Year’s Eve

Barely a month has lapsed since we were clapping every Thursday evening showing how much we valued the NHS and its staff. Demonstrating how fickle some of us are, that same NHS is now instructed to prepare for a huge surge in demand due to alcohol-related injuries and poisonings resulting from pubs and bars opening after months of closure. All NHS trusts have been warned to expect levels of attendance usually seen during new year celebrations, and have been asked to prepare their A&E departments and free up bed capacity in their hospitals to manage the increase.

A pattern is developing here, as with those of us too lazy to pick up our own litter, leaving beaches and parks strewn with rubbish for others to clear up. This same mindset lies behind the lack of thought that will see pressure being placed on health services due to alcohol intoxication.

How can our binge drinking square with our apparent shared belief that those staffing the NHS are our “heroes”? Believing we have a right to harm ourselves by drinking too much, and then expecting NHS staff and resources to rescue us, signifies a selfish and entitled culture.

We can narrow down who will be most likely to be calling on the services of A&E staff and needing hospital admission. The NHS routinely collects data on alcohol-related A&E attendances and hospital admissions, and a clear and consistent demographic picture emerges. Significantly more men than women, and in particular men on low incomes, are creating this demand. Contrary to popular belief, it’s not the young who make up the highest proportion of alcohol admissions, but those aged between 55 and 64.

There are regional variations too: those drinking the most alcohol, and therefore at increased risk of alcohol-related harm or injury, are in the northeast, northwest and the Midlands. Those drinking the least are from the southeast and London.

Most of these admissions are avoidable – if people are willing to change their behaviour. Although Covid-19 has prompted some to do just that – recent surveys show a significant proportion of the population have become abstinent or reduced their alcohol consumption – a smaller significant proportion who were already drinking at hazardous levels have actually increased their consumption since the start of the pandemic.

A clear correlation exists between alcohol dose and risk of harm through injury or poisoning. The reopening of pubs and bars facilitates excess drinking, due to the “group effect” that has been absent during lockdown. This effect is unlikely to be curtailed by the planned Covid-19 safety measures that establishments are legally required to put in place in order to reopen their doors; if anything they will serve to encourage excess consumption, as queues will be minimised and the staff-to-customer ratio improved.

As a society we might be excused for celebrating the reopening of bars and restaurants as the only public messaging around alcohol we hear has been based on how the government will provide access to alcohol. Not wishing to be seen as spoiling people’s fun or freedom, the announcements and messaging from government signal only the pleasure of drinking and, by inference, deny any problems with the drug.

Reducing these anticipated alcohol-related admissions would obviously reduce individual suffering but it would also have an economic benefit at a time when our economy is already taking a hit. This week the prime minister announced that £1.5bn would be allocated to NHS hospitals. Unfortunately alcohol-related admissions are estimated to cost the NHS at least £3bn annually. The government knows this but remains silent. Not once has it spoken about our collective unhealthy relationship with alcohol. The only time alcohol features is when the government ensures we have unfettered access to the drug by deeming off-licences as essential services – or good news press conferences over the latest announcement that pubs will be opening again.

In the UK we have been developing significant problems with alcohol for more than a decade. This weekend’s demand on health services, as a result of excess consumption, is yet another manifestation of how embedded this disease is in our society.

More will follow unless we are willing to move from a state of denial to one of acceptance that we have a problem – the first step in our collective recovery.