Primary Health Care Trusts Face Court Action Over Alcohol Treatment Failings, UK

Main Category: Alcohol / Addiction / Illegal Drugs
Article Date: 08 Jul 2009 - 1:00 PDT

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Primary Health Care Trusts (PCTs) the length of England could soon find themselves in the High Court over the pitiful lack of appropriate treatment being offered to those with severe alcohol problems following an audit carried out by pressure group UK Advocates.

As part of its campaign to see successful abstinence-based treatment offered to all alcohol dependents who want it through the National Health Service (NHS), UK Advocates has conducted a sample survey of the provision, or lack of it, offered by a number of PCTs.

The results of the audit of PCTs across the East Midlands and Yorkshire reveal a picture that is reflected nationwide. It exposes a total lack of consistency from one PCT from another, with many offering no residential or intensive day abstinence treatment at all.

Access to this high-positive-outcome type of treatment, especially those based around the proven 12-step programme of Alcoholics Anonymous (AA), can effectively boil down to a postcode lottery according to which PCT the prospective patient falls under.

In many areas those suffering from alcohol dependence are instead offered only 'controlled drinking' programmes, often without appropriate prior tests to establish whether or not the person needs to stop drinking completely to avoid developing serious physical and mental health problems.

UK Advocates has sought a leading London counsel's opinion on possible action on the grounds of medical negligence regarding the lack of, or haphazard nature, of individual PCTs treatment provision and the legality of encouraging alcoholics or potential alcoholics to continue drinking, albeit at lower levels, without first undergoing a liver biopsy - the only truly effective way to establish if the individual has already sustained liver damage.

UK Advocates' counsel has also been asked for opinion on the possibility of administrative failure by PCTs on the grounds that they fail to offer general practioners abstinence-based treatment options, and also whether there is a basic abuse of individual human rights when alcohol dependents are denied access to appropriate, abstinence-centred care as recognised by the World Health Organisation and the United Nations.

UK Advocates' founder, Bob Beckett, says: "The disease of alcohol dependency, as defined by the World Health Authority (WHO) and other international governmental organizations, has simply been ignored for too long.

"Many of these PCT areas do not have any abstinence treatment for a disease that, for instance, is the biggest killer of women under 35 and is now believed to cause one in twenty deaths in Scotland.

"We are going down the legal road reluctantly, but our members and supporters feel strongly enough about the widespread neglect of providing alcohol dependents effective treatment that helps people stop drinking, and, crucially, helps them stay stopped, to challenge individual PCTs and the Secretary of State for Health in the courts.

"One million people every year are being admitted to hospital because of alcohol-related illnesses, costing the NHS £2.7bn in the middle of a crippling recession. The social and economic losses must triple this figure¹.

"The most expensive treatment is no treatment. Every one of these people, and their families, deserve the help they need to understand and arrest their illness and become healthy members of society again. At the moment they are simply not getting it."

While the inherent cost of intensive and residential treatment may appear high, statistics bear out that it actually saves taxpayer's money.

According to a 1996 National Treatment Agency report, for every £1 spent on treatment £5 is saved elsewhere². Many experts now believe that figure is far higher.

Although central government funded, local PCTs make autonomous decisions on how, and how much, money they allocate for alcohol treatment, with the result 'that treatment for alcohol misuse tends to be overshadowed by treatment for drug use, particularly in terms of funding arrangements.' ³

It means that the Department of Health is effectively powerless to force PCTs to implement its own targets for treatment set out in its 2006 'Models of care for alcohol misusers (MoCAM)', which states:

"Abstinence will be the preferred goal for many problem drinkers with moderate to severe levels of alcohol dependence, particularly for individuals whose organs have already been severely damaged through alcohol use.

"Commissioners should ensure local treatment systems are able to respond to severe and recurrent cases, ensuring that drinkers can, when appropriate, access alcohol treatment on multiple occasions, together with appropriate concurrent interventions from other services.

"This would include support from groups such as Alcoholics Anonymous (AA) or other available mutual support services (which may need to be commissioned to complement existing models such as AA)."

UK Advocates hope their campaign will lead to more PCTs following the example of Nottingham, which has long been held up as a beacon of good alcohol treatment practice and has been dubbed 'the recovery capital of Britain.'

NHS Nottingham City and Nottinghamshire Drug and Alcohol Team, in conjunction with the city's Alcohol Problems Advisory Service and treatment centre specialist Community Alcohol Services, opened a specialist six-week day care programme in January that is already delivering tangible results.

This follows a period of 18 years of successful outcomes at the original public/private treatment partnership scheme now known as the Nottingham Priory. During that time the number of meetings of AA in the Nottingham area has soared from just four to 64.

References

¹. The Lancet (June 2009). Estimates social cost of alcohol as approximately 1% per cent of GDP.

². National Treatment Agency (2006). Review of the Effectiveness of Treatment for Alcohol Problems

³. All Party Parliamentary Group on Alcohol Misuse (2009). The Future of Alcohol Treatment Services

Source
UK Advocates

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