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

by Stephen Tall on September 14, 2007

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 BBC.co.uk – 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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12 comments

Surely this (charging drunks) undermines one of the fundamentals principles of the NHS – namely that it is free at the point of treatment.
Not just that, but those who have to pay in A&E are effectively being charged twice – once as a taxpayer, then again when they seek treatment.

by Gavin Whenman on September 14, 2007 at 2:00 pm. Reply #

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

by Stuart on September 14, 2007 at 7:07 pm. Reply #

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

by Mike Cox on September 14, 2007 at 10:35 pm. Reply #

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?

by MatGB on September 14, 2007 at 11:39 pm. Reply #

“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.

by Rory Cox on September 15, 2007 at 3:54 pm. Reply #

Its an interesting question Norman raises, should drunk and disorderly people in hospitals have to pay their medical bills. No, i think is the resounding answer from most liberal democrats, because it contravenes the fundamental principles of the NHS. but what about fines for the drunk and disorderly who take up hospital time or cause trouble? That might be an acceptable policy, changing drinking legislation is how Norman should really be tackling this problem rather than focusing on the ends, after all, people don’t aim to drink themselves to death and when they do I don’t think medical bills are really going to change their minds as they have far bigger problems.

by a radical writes on September 16, 2007 at 12:03 am. Reply #

I like the “bill the rat-arsed” suggestion. ISTR as a student that one would get billed if an ambulance were called for you while drunk and unconscious.

If people are spending their disposable income getting very drunk, any hefty medical bills will probably do them more good than the actual treatment.

by Joe Otten on September 16, 2007 at 12:15 am. Reply #

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

Problem is given the timing and physical appearance of the paper you end up with press reports like http://www.mirror.co.uk/news/topstories/2007/09/15/drunks-to-pay-a-e-89520-19793818/
“Drunks should pay for their own treatment if they end up in hospital, say the Liberal Democrats.”
You can’t blame the press for that!

by Duncan Borrowman on September 16, 2007 at 10:00 am. Reply #

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.

by tony hill on September 16, 2007 at 6:00 pm. Reply #

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).

by Matt on September 24, 2007 at 9:09 pm. Reply #

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.

by Meral Ece on September 24, 2007 at 10:12 pm. Reply #

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