Easy access to cheap alcohol is “killing us as never before” and must be curbed with tough licensing laws, price rises and a shift in public opinion that makes being drunk as unacceptable as smoking, the Chief Medical Officer has warned.

Setting out his public health report, Sir Liam Donaldson said the nation was blighted by “passive drinking” – with innocent bystanders the collateral damage of drunk drivers, domestic violence and antisocial behaviour.

Sir Liam said that licensing laws should be tightened to reflect the full impact of drinking in each region – with fewer bars allowed to open in areas where there were high rates of alcohol-related health problems. A minimum price on alcohol should also be introduced because the Government had “no Plan B” to address the fact that the average adult was consuming the equivalent of 120 bottles of wine a year.

“There’s no doubt in my mind that in this country we have a drinking problem,” he said as he presented the 150th annual report of the Chief Medical Officer. “The whole of society bears the burden. The passive effects of heavy drinking on innocent parties are easily underestimated and frequently ignored,” he said.

Expert View

Sanitation may have improved around London, but Westminster has acquired its own peculiar stench

Sam Lister

• More

• Post a comment

Times Archive, 1859: Mr. Simon's report on the public health

There are 100,000 deaths every year that ought not fairly to take place

• Public health: Registrar General's weekly return

• Public health: The quarterly return

Related Links

• Something stinks in this put-down of Sir Liam

• Medical chief backs Wii for obesity fight

• Pioneer kicked up stink 150 years ago

“The concept of passive drinking and the devastating collateral effect that alcohol can have on others must be addressed on a national scale. Cheap alcohol is killing us as never before. The quality of life of families and in cities and towns up and down the country is being eroded by the effects of excessive drinking.”

Sir Liam said that he would push forward proposals on price rises – which could lead to minimum cost of £1 for a can of beer and £4 for a bottle of wine – despite a rejection from Gordon Brown before the report had been published.

Responding to comments from Downing Street that the majority of sensible drinkers should not have to pay for the excessive drinking of the minority, Sir Liam said: “I take a different view as to whether heavy drinking is a minor and insignificant problem.”

He recommended that a minimum price of 50p per unit of alcohol is introduced to reduce consumption. He said that substantial effects would be seen immediately from this policy alone, including 3,393 fewer deaths each year, 97,900 fewer hospital admissions and 45,800 fewer crimes.

Describing his irritation at the leak of his report – blamed widely on Downing Street – Sir Liam said that he would have preferred to present it in his own way for measured debate rather than have it relayed in a partial, “heat of the moment” fashion.

In what might be considered a thinly veiled dig at the Government, he added that the damage of deregulation in the financial sector had been clear to all, and that such an attitude should not be repeated with alcohol consumption and licensing. “Selective tough regulation is going to help solve this problem,” he said. He said that the benefits of a minimum price of 50p per unit on alcohol was supported by evidence. Pubs would benefit because less cheap alcohol would be drunk at home, he said.

Sir Liam said that the full scope of passive drinking had not been recognised and he likened the problem to that caused by passive smoking. “[My plan] will upset people, [they] will not see immediately why they should participate in it, but we need to face up to this as a country.”

The measures were welcomed by health leaders, although politicians reiterated that there were no plans to penalise the majority of drinkers. “We have taken action to tackle binge and underage drinking and it’s right that we do so,” the Prime Minister said. “But . . . it’s also right that we do not want the responsible sensible majority of moderate drinkers to have to pay more or suffer as a result of the excess-es of a small minority.”

David Cameron, the Conservative leader, said that he also opposed Sir Liam’s proposals and that tax increases should instead be targeted at the high-alcohol drinks favoured by binge drinkers. “It seems to me that what we should do is what we suggested before the last Budget, which is to try to target the problem drinkers and the problem drinks,” he said.

What the doctor orders

Prostate cancer

The Chief Medical Officer’s report calls for more research into the treatment of prostate cancer – in particular which tumours require radical therapy and which may be better left, avoiding the side-effects of treatment – as improved diagnosis identifies an ever-greater number of patients. In England, one man has prostate cancer diagnosed every 18 minutes and it is second only to lung cancer as the most common male cancer. A prostate cancer cell, below right, can form into two types of tumour, known as “pussycats” and “tigers”. The slow-growing “pussycats” can often have no symptoms and may not shorten life, while the rapidly growing “tigers” can spread quickly.

The report calls for:

— Increased efforts to identify whether patients have the “pussycat” or “tiger” form of prostate cancer

— Better counselling before diagnostic tests

— More research into treatments for localised prostate cancer

Pain

The concerns of 7.8 million people living with chronic pain are not being addressed adequately, the report concludes. With better disease survival and longevity, sufferers of pain are far more common now than 40 years ago, especially women. A third of these patients reported inadequate control of pain, while only 14 per cent of people suffering pain have access to a pain specialist.

The report calls for:

— Training in chronic pain to be included in the curriculums of all healthcare professionals

— Consideration given to a national network of rapid-access pain clinics

— A pain score for hospital patients, that should become part of the signs that are monitored routinely (such as pulse and blood pressure)

Antibiotic resistance

The report says that antibiotics have been successful at treating infectious disease and saving lives over the past 60 years, but it warns that inappropriate and unnecessary use has reduced their effectiveness. In some diseases, because of resistance, the last line of defence has been reached.

The report calls for:

— Public education campaigns about responsible use of antibiotics to be given greater prominence

— Antibiotic packaging to carry a warning, reminding people to take them responsibly and appropriately

— No further classes of antibiotics to be made available over the counter without careful consideration of public health consequences

Safer medical practice

A greater use of simulation training – from machines as sophisticated as those used for training airline pilots to simple dexterity exercise involving mannequins – is advised.

Studies of simulation training for surgical skills have shown that surgeons trained in this way make fewer errors and carry out technically more advanced procedures.

Explore Health

• Expert Advice

• Health Features

• Mental Health

• Alternative Medicine

• Child Health

• Health Club