Lighten CBD booze controls at your peril!

Chalk and cheese. That's the common response from frontline doctors and nurses at St Vincent's Hospital when asked about life before and after the introduction of Sydney's lock-out laws.

Since the NSW Government began to limit alcohol availability in key inner-Sydney areas early last year, the volume and severity of alcohol-related trauma presentations to the hospital has changed dramatically. 

The difference is both stark and very human.

Alcohol-fuelled violence: Thomas Kelly, 18, was killed in an unprovoked attack in Kings Cross.

Talk to the on-call neurosurgical registrar who finds himself constantly checking his phone because he hasn't had a single contact on a Saturday night; or the Intensive Care Unit social worker who for months hasn't had to make a devastating call to the parents of a young reveller undergoing surgery to remove glass shards from his face after a severe assault. 

Australia's problems with alcohol obviously transcend hospitalisations; alcohol-related harm and violence affect all parts of our society.

Yet hospitals are often at the pointy end of this problematic relationship and the volume and types of alcohol-related presentations often serve as a gauge of how we are tracking in relation to alcohol's impact.

Teenager Daniel Christie died after a 'one-punch' attack in Kings Cross on New Year's Eve 2013.

Ominously, a recent national snapshot of emergency departments throughout Australia showed that alcohol-related presentations continue to account for a sizeable  number of patients overall.

Bucking this trend is St Vincent's; a hospital with a catchment area that includes the Sydney CBD, Kings Cross and Oxford Street – an area with the greatest concentration of licensed premises in Australia – and which has largely been subject to the new lock-out laws. 

Don't get me wrong, the number of alcohol-related presentations within our emergency department remains disproportionately high. However, for the first time in years, our alcohol-related patient numbers are declining. 

On New Year's Eve, emergency staff spoke of lower levels of intoxication and violence in the patients they saw, with not a single person admitted to intensive care.

It appears the government's initiatives to limit alcohol trading in hot-spot areas of Sydney are working.

From a public health perspective, they are akin to seat belts in cars and the NSW Government should be applauded for its courage in seeing them through.

However, there are those – including most recently the Sydney Morning Herald – who now argue for the laws to be reassessed on the basis of their impact on late-night trade and the curbing of personal freedoms.

As a community, we need to take a long-term view about what type of society we want; what types of harm we are willing to tolerate; and what laws we're happy to adopt to deliver safety and a sense of balance for the benefit of the entire community.

There is no silver bullet to address our society's difficult relationship with alcohol – one that is far greater than what happens in Kings Cross on a Saturday night.

Sadly, drinking is a national sport in Australia – drinking to excess even more so. Our young people regularly drink themselves into oblivion as a rite of passage. Alcohol's misuse is accepted – almost unquestioningly – at all levels of our society.

In that context, we see Sydney's lock-out laws as an uncommon achievement. 

While we wait for the NSW Bureau of Crime Statistics and Research's confirmation in a few months, certainly from our perspective they show all the signs of being a runaway success. 

We cannot tackle anti-social behaviour and violence in Sydney's CBD and entertainment district without limiting access to alcohol; be it through pricing, trading hours or promotion.

We may be sympathetic to the businesses that have seen a decline in patronage as a result of these laws. But, as a community, we simply cannot have it both ways.

The lock-out laws are ultimately about saving lives, which surely trumps any passing commercial irritation?

Arguments that the laws have gone too far in restricting young people and their enjoyment of the city's night culture pale against their success in preventing alcohol harm and signs we are beginning to inherit a more civilised – and safe – community as a result, particularly after the sun goes down.

A case in point being the multitude of Sydneysiders who enjoyed New Year's Eve without having their civil liberties infringed upon by the anti-social and violent drunks of previous years.

Chalk and cheese indeed.

Toby Hall is the chief executive of St Vincent's Hospital, Darlinghurst

SMH 12th January 2014