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Re: EMJ August 2007 Licensing Act & Emergency Hosiptal Attendances

In the report, the Licensing Act is described as "permitting 24-hour drinking". While this is true, it belies the practical reality of gaining local authority permission for such hours. Across the country, a mere 200 pubs have been granted permission to open for 24 hours and, as the Home Office will confirm, none do. The most relevant licensing authority to this particular study, Westminster City Council (which has the highest concentration of hospitality venues in the country), has adopted the most restrictive approach and granted virtually no additional hours to pubs and bars. It is, therefore, disappointing that no attempt appears to have been made to verify the assumption that forms the basis for much of this study. Specifically, whether or not such a change of pub opening hours has taken place with the A & E catchment area of St Thomas's Hospital, or indeed, whether there were any other factors that might have affected the results between March 2004 and 2006.

As far as alcohol related admissions are concerned, given the relatively small absolute numbers in such a limited study, the number of people in central London in a given period may have been a more significant factor in influencing the results of the study. A massive demonstration in Central London in March 2006, for example, may have been a significant determinant in increased admissions, as might have been the recent rapid growth in annual St Patrick's Day celebrations in and around Trafalgar Square, or indeed the England versus Ireland rugby match that month.

I would make (what you may consider as) the possibly slightly surprising observation from an industry association that in this paper the percentages of admissions relating to alcohol are probably the lowest that I have ever seen in any study of A & E. This would, therefore, also call the analysis into question.

While we have concerns about the study, we particularly hope you would share our issues about the news release promoting this report. The heading "UK licensing law changes have trebled overnight alcohol related visits to emergency care" is a sweeping generalisation. An assertion that is not sustainable on the basis of this study, particularly when the word used in the study in relation to the effect of the Licensing Act is 'may', not 'have'. The release does not state clearly that the survey relates to a comparison of just two one-month periods in one hospital - this is stated only later. It goes on to state that: "The new licensing law, which allows alcohol to be available around the clock, took effect in November 2005. All subsequent matters highlighted in the release are based on the implicit assumption that alcohol is newly available from licensed premises in the area "around the clock" when, as I have already indicated, this is not the case.