The lack of mention of the NHS from the Budget statement is a worrying sign. We know all parts of the health service are struggling to meet demand and maintain quality under the financial strain of the last five years.
This Budget does not give patients and NHS staff any certainty about wider funding plans up to 2020. Yet that is the timescale on which NHS England, rightly, thinks spending must be committed in order to drive improvement and maintain quality.
There was some extra funding announced - but unfortunately it is mostly likely to go not to the NHS but rather to the growing number of companies and social enterprises feeding off it.
Impact of alcohol misuse is huge
For me, the most damaging announcement in the budget for the NHS was the proposed cut of duty on beer for third year in a row with another penny coming off the pint. Cider duty will be reduced by 2% as will the duty on whisky and other spirits. Wine duty is frozen.
The impact of alcohol misuse across the rest of the NHS, in hospitals and in our communities is huge. More than 10m adults in England now drink more than the recommended daily limit, with 2.6m drinking more than twice that. As a GP for 30 years, I have witnessed first-hand how alcohol destroys lives. I have seen people who had cirrhosis of the liver or another alcohol-related illness, such as heart disease, as well as those who were injured or assaulted while drunk.
My colleagues working in A&E departments tell me that every weekend they see children who have been found unconscious through drink on the street and brought to hospital by the police or the ambulance service.
Alcohol misuse costs the NHS and the justice system about £25bn every year. That figure covers the cost of healthcare, crime, social disorder and lack of productivity at work attributable to alcohol, including the £2.7bn the NHS spends treating the chronic and acute effects of drinking. The total number of alcohol-related NHS admissions hit almost 10m in England during 2012/13 with almost 600,000 in Greater Manchester.
Successive governments have been too complacent about the problem of alcohol abuse, particularly among young people. The WHO says that Europe has the highest proportion in the world of total ill health and premature death due to alcohol. More than one in five people across the whole of Europe admits to heavy drinking at least once a week.
The cost of tax giveaways to the alcohol industry in the last three budgets now totals £690m annually. While, in real term the NHS budget been squeezed every year. Reducing duty on beer, cider, spirits and wine would do nothing to address the economic and health impacts caused by alcohol abuse. Is the government not concerned to tackle alcohol-related harm and its implications for the cost and workload on the NHS? Politicians may have been tapping into populist sentiments of a booze-loving nation, but they are also playing with lives. Once again, the government in England is bowing down to big business. Ministers now are doing what ministers in the past have done with these public health measures – kicking them into the long grass.
The short-term revenue gains from alcohol advertising do not tell the full story of how much social, financial and medical misery alcohol abuse causes.
Dr Chand is BMA deputy chairman but is writing here in a personal capacity.