Nigel Hastilow asks would £50 fines sober up A&E drunks?

Attacks on staff and the verbal abuse of people dedicated to saving lives are disgusting. Especially as many of the offenders involved will be emergency service ‘regulars’.

From a close and enforced observation of how the system works, over several days, involving different patients, I have seen just how misused our health service has become.

My own health remains okay (touch wood) but unfortunately I have been involved in the hospitalisation of other people several times recently.

It’s allowed me to observe at close quarters how accident and emergency departments operate and listen to staff views on the failings in the system.

It is clear the single biggest problem facing hospitals is the need to admit into A&E the drunks and druggies who would once have been thrown into a police cell until they sobered up.

These days they are deposited by long-suffering ambulance crews at A&E where they disrupt proceedings, roar for attention when they are not throwing up on the floor or fall into deep, loudly-snoring sleep.

According to one paramedic crew, about 10 years ago the vast majority of their patients were genuine medical emergencies – car-crash victims or people having a heart attack.

These days they reckon more than half those they have to deal with are drunks and drug addicts who the police won’t touch with a bargepole.

As a result, patients queue for hours on stretchers in corridors while the one night doctor, who has a fairly shaky grasp of English, tries to deal with incoherent and insensible people.

In one case I saw, a drunk young woman had to be supervised by a member of staff full-time because she was liable to cause so much disruption through the hospital if she was left alone even for a few minutes.

Another drunk young man yelled at every passing nurse demanding pain-killers with menaces. The staff were surprisingly polite.

Then there are the people who, it seems, use A&E departments as late-night social clubs. There are so many regulars they know one another and spend their waiting time chatting and gossiping, for all the world as if there were nothing whatsoever wrong with them in the first place.

One drunk who had been sleeping it off for three hours was woken by a doctor and asked if he was in pain. At 4am it wasn’t surprising the medic was getting a little irritable.

This may explain why he stamped on the drunk’s feet, one at a time, to see if he had any sensation at all.

The only response was several grunts before this young, fit man wet himself.

At 11am another morning there were three young women in A&E, still drunk from the night before.They say it’s the old people who block hospital beds. This is plainly not true. Elderly people do not call out an ambulance unless they really need one.

The louts we witnessed one night were not, by any reasonable definition of the term, unwell apart from the fact that they had consumed so much booze they were incapable of functioning.

The other problem is the failure of family doctors to work out of hours. Thanks to their cushy contracts, the nine-to-five GP is far too important to visit someone’s home and see what the matter with them is.

Their default reaction to anyone who thinks they might need urgent treatment is to tell them to dial 999 and let the paramedics deal with it.

The ambulance crews do, admittedly, have better equipment but they do not have the same medical expertise – in theory, at least, though I reckon a paramedic’s advice is probably just as likely to be correct as the average doctor’s. If demands on the NHS is rising, it is, of course, partly explained because the population is growing and we all live longer. But a night or two in A&E reveals the real cause – too many people take the service for granted, treat it as a private drying-out clinic and should never be allowed over the threshold.

We ought to start charging people who call an ambulance and end up at A&E departments when there is nothing wrong with them that an ice-cold shower wouldn’t cure.

A £50 charge for a first unnecessary visit would reduce their drink money; a second of £100 would keep them sober for a day or two. Increasing the fines every time they turn up would quickly cut demand and leave doctors and nurses free to deal with real accident victims and genuine emergencies.

If they can afford the alcohol to get blind drunk, they can find the money to pay the fines.

Alternatively we can spending more and more money employing more doctors and nurses.

But if A&E departments are just drunk-tanks, the more capacity they have, the worse it will get.