Alcoholism, the NHS, and political hypocrisy

Politicians show sympathy for the sadly premature death of Charles Kennedy - but none for the ordinary alcoholic, facing cuts to services and threats of charges for A&E use.

Steve Topple
3 June 2015
charles kennedy.jpg

Charles Kennedy 1959-2015. Image: Wikipedia

The tragic death of Charles Kennedy this week, aged 55, is a sadly familiar story to many people who suffer with, or are close to, the illness that is addiction (yes – illness; you heard me right). Although the exact cause of death has not yet been identified, it is highly likely that it was, in some part, related to his drinking. To Kennedy’s credit, he openly admitted in a press conference in 2006 that he had a problem and that he had been seeking help for some time. A tough feat for any addict - and how much harder to do in full public gaze?

I’ve been an alcoholic for over a decade, since around 2004. “Why did you become addicted to alcohol?” people ask. Childhood trauma? Circumstance? Heredity? I don’t know; many struggle to resolve this for years. I admitted I had a problem in 2008.

I sought the help of my GP (who I had known for 7 years) after I was declared bankrupt, had my home repossessed and was sacked from my job – all in the space of two weeks.

He deemed me a “high-functioning alcoholic”. Fair enough, really – I’d held down my 80-hour a week job whilst downing the equivalent of 2 bottles of vodka a day. He discussed with me the pattern of my drinking, and what I would like to achieve. We agreed on referrals to two different services in my town – one run by the NHS, and one by a local charity - along with 4-weekly follow-up appointments with him for 6 months.  

Fast forward to March of this year.

I had been dry for 6 months, however for various reasons, I “picked up” again for around two weeks, at about the same levels I was at in 2008.

When I realised enough was enough, I went and saw a GP at a different surgery. I explained to the Doctor my history, what had happened, and he asked me what I wanted to do. I asked for a course of chlordiazepoxide (a tranquiliser which is administered to negate the effects of withdrawal), which he prescribed, and said to come back in a week.

I realised the dosage was wrong (only a quarter of what’s needed), so went back to sort that out – and saw a different doctor. I saw a different doctor again the next week for a follow up appointment, and a different one every time after that. One informed me he didn’t have time to discuss tertiary care. Another told me I knew more about the illness than him.

Times have drastically changed in 7 years. Funding for GPs was reduced in real terms by £450m between 2011 and 2014, whilst demand for appointments increased by 40 million a year.

Having a nominated GP who has time to listen to you is a thing of the past.

The two outreach services that were available in 2008 have both been closed, and replaced by one nationally-run charity centre, which has also taken on the catchment of two other parts of my county.

There is no longer any walk-in service available, and organised counselling sessions are only available three days a week – all of this following a “re-commissioning exercise”.

Ultimately, though – is any of this really important? Yes, treatment services are being scaled back - but if they are still there, and free on the NHS, what’s the problem?

We’ve all seen winos outside our local Coop at 7.55am, still addled from the previous night, waiting to buy 3.5 litres of cheap, strong cider. And if the NHS is still there to help them, then that’s fine, isn’t it?

This seems to be not only the attitude of a large section of our society, but also the Government.

Alcoholism is “that” problem.

You know! The one which the poor bring upon themselves (‘cause they spend all their dole money on Special Brew). If they stopped drinking for a few weeks, got off their backsides and got a job, then they wouldn’t need to drink; and as for the rich – well, it’s ‘cause they have all this money, and who wouldn’t get drunk all day, every day if they could?

As my original GP starkly enunciated to me: “Alcoholism is in some respects far harder to beat than heroin addiction, because you can never, in daily life, escape from it”. There is no “one size fits all” response – the key is to offer as many options to the sufferer as possible, as each person’s illness is individual to them. But with the continued assault on the NHS, the range of options available is visibly contracting.

Sadly one thing Kennedy’s death showed us was the political ignorance and classist attitude surrounding alcoholism. Former Deputy Leader of the Labour Party John Prescott tweeted that “History will be as kind to him as he was to others”. Last year he crudely wrote we “should charge the million people a year admitted to A&E with drink-related conditions”.

Alcoholism doesn’t care who you are – merely that someone has an open window in their character that it can sneak through while they are not looking.

The NHS estimates nine million of us drink more than the recommended daily limits. And there is no discernible moment at which a social drinker becomes an alcoholic. Anyone who has ever been to a “meeting” of some kind will know the feeling of relief when you hear people say they were an MD of a multinational company; a teacher; a housewife; an unemployed person – before they all became the same as each other – alcoholics.

I am yet to meet one person who has dealt with their addiction purely through private treatment, hasn’t been to A&E on more than one occasion, or whose illness has not had negative effects on everyone around them. My Mother is on anti-depressants because of anxiety and my former partner is battling addiction. Both due to my disease and both are relying on the NHS for support.

The Governments own research shows that for every £1 invested in specialist alcohol treatment, £5 is saved on health, welfare and crime costs. By crudely stripping back outreach services, and thus increasing the already gargantuan pressures on GPs and A&Es, it is creating a perfect storm for itself and us.

On the same day Charles Kennedy died, Public Health England released figures showing that 3 out of 5 authorities had seen an increase in hospital admissions relating to alcohol last year – which a leading psychiatrist summed up as pertaining to the UK’s “chronic drink problem”.

Whatever the Government is doing clearly isn’t working.

While marginalising the treatment for alcoholism may well prove to be the “thin end of the wedge” of NHS cuts, it could well be the slice which tips our already struggling health service over the brink.

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