The government has recently proposed liberalising Britain's licensing laws, potentially paving the way for 24-hour alcohol consumption in public places. The BMA, together with the Royal College of Physicians and the Royal College of General Practitioners, has rightly criticised this, based on evidence that this will increase the already considerable cost to individuals and society caused by heavy alcohol consumption, especially binge drinking. Perhaps the government genuinely believes that the rise in cirrhosis rates in geometric tandem with consumption is a coincidence. Maybe they reason that the young people who are responsible for the pools of urine, vomit, blood and other detritus that blight our cities and towns every Friday and Saturday night may become quite civilised, given even more time to drink alcohol.
A more likely explanation for this enthusiasm is that the drinks industry is powerful and has influenced policy in its favour. If recent history is the best predictor, this, and the liberalised gambling legislation, will go ahead without public debate or consensus. The public will be presented with a fâit accompli, couched in the velvety language of consumerism, of ‘choice’ and ‘change’ to use Tony Blair's favourite words. Should the pessimists be proved right, it will fall upon the already hard-pressed public sector, particularly the NHS, the police and the judiciary, to sweep up the mess caused by private self-indulgence. This well-established trend must cause grave concern to anybody who values democracy or cares for the environment. Moreover, the examples cited are a microcosm of worrying trends that adversely affect public health in subtle ways that front-line clinicians will nonetheless recognise.
Despite its Socialist roots, New Labour is the government that has forged the closest links ever with big industry. The public face of the liberalisation of gambling and licensing is the Culture Secretary Tessa Jowell. The job description suggests that she ought to spend her energy increasing interest in (and access to) museums and theatres. But no, that is ‘elitist’. In their peculiarly inverted snobbery, the current elite class has decided the populace are better served by having something profoundly cultureless, vacuous and meretricious foisted upon them. Thus, we have the blueprint for policy: a fusion of liberal-left social values and right-wing economics. Woe betide anyone who questions this prevailing orthodoxy, be they a learned professional body or an individual whose ‘choice’ is not to have a lap-dancing club in the neighbourhood. Any government, particularly one that has enjoyed power for a long time and with a large majority, should feel comfortable with a consensual democracy, where major legislation is debated with voters and professionals. But no, it seems that the global capitalists must always win; a fact that ironically confirms the decline of the real power for politicians, whose role seems to be merely to ratify the demands of big industry.
Quite apart from its fundamental unfairness, I believe that such crass materialism and short-termism is damaging people's health as these values have spread to wider society. The rise of corporate power over the last 2 decades has spawned a super-rich ‘overclass’ who are far more ostentatious than any preceding elites, certainly in recent history. With the media stoking the pleasures of conspicuous consumption, many more have tried to emulate this beguiling lifestyle by gargantuan personal borrowing above their real means. The government has no choice but to encourage this, for they preside over an economy that is virtually a one-trick pony: debt-fuelled consumer spending. This gamble is risky and stressful, with the number of individuals and families whose lives are blighted by bankruptcy steadily rising. For them, the suffering is silent, with no glossy magazines invited to share their beautiful homes and lives. At best they might be advised to consult their doctor. Would that the government did the same.
- © British Journal of General Practice, 2005.
