I congratulate my hon. Friend Dr Wollaston on securing this important debate. I should like to take a slightly different track and speak briefly about alcoholism. I am motivated to do so because a friend of mine died recently of alcoholism. I surveyed his circumstances and wondered what conceivably could have been done to prevent his early death—he died at a younger age than I am now.
I looked back at my friend’s history in some depth, trying to find out how it all started. It started, as it does for many people who take to drink, with other psychological problems: a lack of self-esteem, to some extent prompted by his family upbringing. It was accentuated by losing his job as a civil servant—he took early retirement—and then by the loss of his marriage due to the strain induced by alcoholism. I followed his whole history from that stage on. There were periods of abstinence, where he thought he had licked the problem. There were periods of very aberrant behaviour that sometimes involved the police, but often strange and gratuitous acts of mad generosity. There were periods of treatment when he went in for detox, somewhat ineffectively, and came out and resumed previous behaviour.
There was a period when my friend found that Librium worked in discouraging him from drinking, but he could not be given the amount he needed, so I made an arrangement with his doctor to provide him with the drug. For the first time in my life, I became a drug dealer. He could not receive it himself, simply because it was feared that he would take an overdose. Then there were periods of real sickness when he was losing weight rapidly. He was hospitalised frequently. He had blood transfusions and other forms of hospital treatment for a disease that I fundamentally believed to be, at root, of a mental rather than physical kind. Throughout it all, there were long periods of solitary drinking, punctuated by phone conversations to his friends. Those conversations were not always welcome; any drunken conversation tends to be very repetitive and goes nowhere. Ultimately, this was followed by a phone call saying that he had been found dead alone in his flat.
I reflected on this. I believe that, at root, the cause is psychological, but I had seen my friend struggling when applying for NHS services to get any psychological treatment, because most psychiatrists do not want to mess around with alcoholics. They regard them as a complete waste of time. In some cases, their criteria for treating people exclude alcoholics. I was a member of the Public Bill Committee that considered the Mental Health Act 2007, when it was expressly stated that people could not be sectioned for alcoholism—it was not regarded as the kind of disease that fell under that banner.
My friend phoned me on many occasions and pleaded with me to find some sort of mechanism so that he could be sectioned, because he knew that he could not stop himself drinking. Towards the end of the time when I was trying to help him, I found something that I thought might work. It was a treatment that other alcoholics I had known had benefited from. It was a process of very robust detoxification, followed by rehab, and was clearly producing results. It took place outside the primary care trust area in which he lived and was going to cost £10,000. However, I am sure that the total cost to the NHS of his treatment in all those years was much more than £10,000. I could not, in all honestly, believe that the PCT would respond very positively, given its other priorities, to a case that stated, “This man has had a lifetime’s history of alcoholism. Now, will you spend £10,000 in getting him out of this fix?”
I am concerned about what we do for alcoholics under the current regime. Having had to look into it, I found that a lot of them go through procedures that are, in a sense, futile—they do not actually take things a great deal further. They detox people and turn them around again, so they go back to the habits that they had before. Unless there is detox plus rehab, this is not a workable solution. This is a big problem for many families and communities, so it is surprising that so many organisations out there take so much money out of the NHS to so little effect. The NHS needs to drill down and support only those therapies that genuinely work. In the short term, they may be very expensive, but in the long term, they will repay the investment.
On the voluntary consumption of alcohol, there are a couple of factors that can precipitate people along the route that my friend followed: a cultural permissiveness about excessive drinking and a mishandling of how, culturally, we deal with alcohol. At root, that is our problem. Recent licensing law reforms have been an ineffectual attempt to change the culture into a French or continental system where we can manage our alcohol a little better. Certainly, one of the bedevilling features that impact on how society handles alcohol is its cheap and plentiful supply.
Frankly, I am agnostic—I am not sure whether my hon. Friend is right. Doctors are arguing very forcibly for minimum pricing, and I think that the Government are committed to banning below-cost pricing. Both are helpful, but probably neither are sufficient because in themselves neither will guarantee cultural change. As a former teacher, I am agnostic about what education can do. Asking 14-year-olds to forswear a life of alcoholic indulgence is not an easy task, particularly as most of them have not really engaged much in that direction.
We have to accept that alcohol consumption is always regulated in some form or other, but its long history shows that we do not always get it correct and that no system is flawless. We need to look at good practice and at what works—my hon. Friend Stephen Gilbert has some good examples—and roll them out right across the piece. We do not have many good models to imitate in the control of either alcohol or alcoholism, but evidence-led policy is clearly the way forward.