Train wreck avoidance: a radical 3 strikes policy for NHS abusers

There are twin debates going on at the moment that have some overlap:-
1. The bill to “Reform” the NHS
2. The cost to us all of drunk drinkers
The first is based on keeping down the costs of the NHS and the 2nd is based on
…keeping down the costs of the NHS.

As a worker within the health & Social Care system I have some views on the NHS bill that I won’t go into – but as a contributor to the money that funds the NHS and an occasional user of its services, I am appalled at the way the drinking public ignore the issue of how their irresponsible behaviour is costing us all money that could, “save the NHS”, and save my NHS colleagues benevolence-fatigue and genuine physical harm.

Twice I have had the misfortune to have to attend A&E units on a Saturday night, and witnessed first hand what is almost a repeat of that town’s nightclub queues but in a post war state of a mixture of blooded unconsciousness and occasional violent aggression.
I sat there and heard nurse after nurse repeatedly asking semi-comatose young people,
“Hello… Hello?.. John… have you taken anything else besides the alcohol..?”

On one occasion the jam up in A&E meant my hemorrhaging nose had to carry on bleeding unattended for 4 hours (since I was capable of holding a bowl and tissues whilst staying upright in a wheelchair) while they attended to these largely self inflicted injuries.
There are no easy solutions to this problem. Members of parliament drink, the vast majority of people enjoy a drink, we have no collective desire to become Islamic over this issue. (Some Muslims though, must take an awful lot of encouragement for their extreme views on the subject when they witness this weekly ritual of waste, violence and abuse).

I have a solution.
Yes, unlike many other folk sitting on their hands and moaning, I have a workable (if complex to implement) answer to this problem.

The government propose to make alcohol more expensive to purchase, as is planned for Scotland. This has some merit based on research that shows that drinking levels increase with the affordability of alcohol.
The NHS reform bill proposes to introduce competition in a manner that has people very upset that we will attempt to save money by introducing privatised health services through the back door. I agree this is a bad idea.

My proposal will undoubtedly not please those who think no one should ever pay money for NHS services – without realising that this is exactly what we already do – through our taxes, but not only through out taxes, through our motor insurance policies.
Road Traffic Accidents can lead to ambulance trips and the negligent party has to pay

What I am seeking is a way to increase the costs to negligent drinkers (who clearly have money to burn) and at the same time prevent and repay costs to the NHS accident and emergency services.

The nature of repeated drunkenness means that people take for granted that the NHS will pick up the pieces and, mostly, the worst this leads to (apart from the regular deaths) is a lot of “joking” at work the next week, “Man! he was so out of it!, covered in puke and blood, hahahahaaa”.

Of course you can be in A&E at blood alcohol levels double those allowed for driving and it not be your fault at all:- you fell/ got in a fight/ got hit by a car jaywalking. This is why my proposal for the “negligent party pays” includes a 3 strikes element.

  • 1st time in A&E with double legal driving limit of blood alcohol – a written notice explaining scheme and signature of understanding
  • 2nd time – a compulsory alcohol awareness course in lieu of £60 fine (as per speeding drivers option) including a mocked up bill for what you have cost the NHS so far from the 2 visits to A&E.
  • 3rd time – you are now liable as a negligent abuser of the NHS for all costs of all your incidents (ambulance, doctors, nurses, medication, orderlies, overheads, everything, for all three visits). That’s a big bill.
  • There will be issues, including those who are broke and alcoholic – sorry to be ruthless but that might mean community service for non payment of fine.
    The way this is designed to work includes, as its dominant purpose, to become a severe deterrent to “being drunk and abusing doctors and nurses” being an habitual fun occupation.
    I commend this proposal to parliamentary committee…

    Update 13th March 2013

    Gove and others on the cream (rich & thick) of the right, are very quick to defend poor people’s right to cheap alcohol just as they also decide they should have less access to benefits – but they ignore the real issues of the harm drunkenness does.
    For those who would wish to dilute my argument by saying, “Ahh but where would you stop? – dangerous sports injuries? smokers?”
    my point is this,
    – those people do not assault ambulance and A&E staff
    and as far as “paying for NHS services is wrong” goes, People who cause Traffic accidents ALREADY pay for the ambulance services that take them to hospital, see the link above – their insurance company does the actual paying if they are the guilty party – I am only seeking parity with this arrangement, and Smokers actually pay enough tax to cover their health care costs already…

    I actually believe dangerous organised sports clubs, (Rugby, Soccer, Boxing) should have an insurance scheme as part of their membership and then the sports injuries that clog up the A&E on a Saturday afternoon can also be funded by insurance and not the general tax payer. Again – it might be complex to work out the detail, but we may save the NHS by doing this, so It’s at least worth a serious bit of research into viability.

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