'Should we call last orders on drunks and traffic cones in A&E?'
I have never been very good with drunks. They are often earnest and inarticulate and, if you are both of those things at the same time, you just sound like John Prescott.
Sometimes they shout or sing really badly and they make poor relationship choices - I once saw a very drunken man lay down in the street, wrap himself tightly round a traffic cone and fall asleep. I felt the traffic cone could have done better but you don’t like to say anything do you?
Anyway I mention this because of a call this week for drunks to pay a contribution toward the cost of their treatment in accident and emergency departments. Proponents say that charges would act as a deterrent to binge drinkers who cause delays to treatment given to patients who are genuinely ill - sometimes for hours. This position was lent poignancy by a bereaved husband who spoke out last month about his wife, a mother of two, dying after being kept waiting in A&E as a succession of drunks were seen before her.
The Patients Association and members of parliament have spoken in support of the idea and, given the underpinning health service principle of trying to incentivise good public health, it has some logic doesn’t it?
But I suspect it makes a lot of nurses uncomfortable. In part maybe it’s because it lacks sympathy? But perhaps it’s also partly because if we introduce charging to the NHS - particularly with this type of government in power - we will find ourselves rushing toward a tariff that charges smokers and doughnut lovers for treatment for heart disease and anyone injured playing sport for bone repair and physiotherapy.
However I am no fan of the “slippery slope argument”. It is lazy and belligerent; relying on it is something like using logic as a baseball bat to hit complex dilemmas over the head with.
It seems we have a strange relationship with alcohol. Men measure themselves according to how many beers they can drink, and young people choose to celebrate anything from passing their A-levels to getting rid of a persistent spot by drinking until they fall over and wet themselves, then sobering up and texting everyone they know exclaiming: “I was so blathered last night I was sick in my own ear. I had to be resuscitated on the bus. Same again next week.”
Of course it’s sad and ugly and I understand that it is some sort of expression of youth, freedom, disaffection, self loathing or whatever you feel like calling it. But it is also expensive, time consuming and it does have an impact on other people. Surely in these times of austerity, where important services are being cut, behaviour that is destructive - and I don’t mean to the individual here, I mean to the ability of a health service to function adequately - really does need to be addressed.
Perhaps doing so is a bit of an unsavoury idea because it smacks of social manipulation? Who are we to tell people how they should live their lives? Who are we to punish them for wanting to have a good time or developing feelings for a traffic cone?
But perhaps we might look at it another way; perhaps we should entertain the idea that sharing a health service demands something like a collective responsibility to the resources that we require? And I think if that idea is worth exploring, a good place to start is with the good time drunks treating A&E visits as routine party stops.