Lamb: “rat-arsed drunks” should pay A&E bills

You can’t accuse Norman Lamb, Lib Dem shadow secretary of state for health, of slipping out gently his policy proposal that patients needing emergency NHS treatment after becoming drunk or incapacitated by drugs should be charged:

“If you get rat-arsed on a Friday night and get taken to A&E where you are foul and abusive to staff, is it right for the taxpayers to fund your life-saving treatment?”

Though this is perhaps the most eye-catching proposal from Norman – gathering headlines in The Guardian, The Times and – it is by no means the only one.

His paper – not Lib Dem policy, but his contribution to the party’s health policy working group – proposes:

• An elected Local Health Board: putting people in charge of decisions about their local health services.
• A local health contribution: offset by cuts in national income tax, this would allow communities to raise extra money for their local health services.
• A Patient Adviser: a universal information service accessible via the GP surgery, guiding the patient through the full range of health, social care and other support services.
• A ‘Patient’s Contract’: a declaration of entitlements that every citizen has of right, wherever they live.
• Empowering patients: exploring introducing more direct payments and personal budgets.

Here’s what Norman says about his paper:

“The Liberal Democrats are committed to an NHS which delivers high quality health services to all, irrespective of income.

“As Derek Wanless recently said, this can only be achieved by getting better value for money, but it is crucial to recognise that not every area has the same priorities. In today’s highly centralised NHS there is a real ‘democratic deficit’, with too many decisions made in Whitehall.

“Protests against hospital closures and cuts to services, up and down the country, show that local people do not feel their voices are being heard.

“Liberal Democrats think the status quo is unacceptable. The key is creating real accountability to local communities, where they have the power to make decisions on how money is spent on their NHS. Patients would be genuinely empowered to take control of their own healthcare through better information and a ‘patient contract’.

“My paper will help inform the debate on how the Liberal Democrats can genuinely give people a say in their local health service.”

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  • I don’t like this either, but I do love that he said, “rat-arsed”.

  • I normally have a lot of time for what Norman has to say and I can understand why he wants to do something about the friday and saturday night louts BUT how do you distinguish between the occasional lout and someone who is an alcoholic

    I have had indirect experience of the latter condition and it is a disease which needs treatment not fines

  • I agree with Duncan as laid out in his post.

    Besides, they’re paying enough in excise tax to get drunk, that’ll help cover the costs anyway, right?

  • “If you get rat-arsed on a Friday night and get taken to A&E where you are foul and abusive to staff, is it right for the taxpayers to fund your life-saving treatment?”

    Since they will most likely be tax-payers themselves i would say yes. I would also agree with Gavin, that being free at the point of need is one of the most essential founding principles of the N.H.S.

  • People being foul and abusive to medical staff is a problem best dealt with by security staff and the police. The principle of charging people if they are foul and abusive is unworkable and a gimmick, just like Tony Blair’s suggestions of marching yobs to cashpoints to pay spot fines. In any case, if we are going to start charging people who find themselves with medical problems as a consequence of their actions, where do we stop? Should we charge smokers? Rugby players? Drivers? It’s a daft idea.

  • How about keeping the free treatment – as any form of introduction will merely be opening Pandora’s Box (i.e. where will it stop?) – but instead charge abusive patients the cost (or more) of their treatment – and then put that money directly into the NHS.

    This covers all points: the lowlives who think it’s acceptable to abuse people who have taken an oath to help them get hit in the pocket, the NHS gets a helping hand that it needs, the NHS keeps its “free for all” badge, and the government’s piggy bank doesn’t get income from another new tax (after all, this problem is an epidemic).

  • Norman is rightly raising a thorny issue thats been debated in the NHS for some time. Go to any A&E on a Friday night, and the amount of time, effort and medical resources going into treating drunks who have got into fights or had accidents is staggering. They are usually weekly attenders at A&E and well known to staff. Its truly awful to have to wait in a crowded waiting room if you or a member of your family need treatment, with a foul-mouthed abusive drunk staggering around, or falling at your feet.
    Most NHS Trusts now employ their own security staff, and its the policy of all Trusts to call in the Police to deal with violent and abusive patients. Safety of A&E staff has rightly been high up on the NHS agenda for a decade. I think it is right to have a debate as to whether significant resources spent on this problem is sustainable or desirable.

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