UK: Time to Charge Binge Drinkers For Treatment

Hello ATS. As many here are aware the UK has a national health system called the NHS and people who have read my threads will no doubt know i am a very strong proponent of free health care for everyone as it has many benefits to a society. However like most systems, it is not perfect and i recently discovered something which utterly disgusted me. I am going to relate a story that happened to me and my family, i'll need to set up some background first. Warning, rant ahead

Ok i have mentioned on this website before that my father suffers from Motor Neurone Disease (this is pretty much identical to the condition Stephen Hawking has). It's a terminal condition and most sufferers die within 3-5 years of diagnosis. It's a rather nasty illness becaase right until the very end you are perfectly aware of what is going on, their is no mental degradation, just physical disability.

One of the leading causes of death among sufferes is pulmonary problems, this is because the chest muscles that help control breathing become very weak. My father was given two respirator machines so he can breath when he's asleep or if he's struggling during the day. These machines cost around 5000 pounds each, they have 4 hour batteries, basically very expensive kit.

As my fathers condition has gone on we have come to recognise certain problems and patterns. For example, three times he has been rushed into hospital with a dangerously high temperature as infections just take him over in a matter of hours (it might be four times my memory is playing up atm). To give you an idea how serious this is, the first time his temperature went from 37.2 celcius to 39.6 within 2 hours! The first time this happened we weren't sure what was going on and he ended up in the HDU (high dependency Unit) for two weeks as we didn't call an ambulance quick enough. It wasn't pleasant, his temperature went so high and his blood CO2 so high he began to hallucinate and become quite verbally abusive. Something which is shockingly out of character and very upsetting to see.

The system has treated him brilliantly, so much care has been provided without ever having to worry about paying bills and theres no way he could get private medical insurance with the conditions he already has. We would have simply had to sell our home which would have caused terrible stress to him and no doubt shortened his life further and knowing my father he would have felt guilty until his dying day for that.

So why am i angry? Well it's because of morons who get drunk out of their skulls. Let me explain.

It was a Friday when my dad said he felt very ill, around 9pm. So we checked his temperature every 15 minutes and watched it steadily climbing. We gave him paracetemol but it kept going up and once it went from 36.8 to 38.5 within a half an hour we knew what was happening (along with his other symptoms, mild shaking, dizziness etc).

So we called an ambulance and instead of getting one we were passed through to a nurse, she talked to us and passed us to a doctor, that doctor told us to wait an hour and see what happened. I took the phone from my mother and told the doctor we had seen it all before, we knew what this was, it's a consistent pattern. He repeated his comments and then i simply said "get an ambulance here now or i promise when my father ends up in hospital i will be contacting my MP and the local papers". The ambulance was sent and my father was taken to hospital but while talking to the ambulance crew i learned a couple of things.

1. The ambulance service works on an american style priority system, this is flawed because americans tend to call ambulances as a last resort becuase they often have to pay for them.

2. People who have drunk to much alcohol on a night out are given an "A" priority whereas my terminally ill father is only treated as a class "C" because he just has "breathing difficulties and a temperature" consistent with a cold or something similar.

How utterly disgusting is that. A terminally ill patient gets a lower rating than someone who has drunk to much! The ambulance guy realised we were not people who panic or waste the hospitals time. He took me aside as his partner was sorting my dad out and said "don't tell anyone i said this, but next time your dad gets like this, tell the people on the phone he has chest pains and they'll be right out". Of course i haven't told anyone this but we're on an anonymous online forum so it seems safe enough.

So anyway we got to the hospital and it's absolutely packed and i am willing to bet that 60% of these people were simply drunk or were injured by other drunk people. Many swayed in their seats, others vomited, one man was screaming in a nurses face and as worried as i was about my father i was about to walk over and smack him into the floor but security got there first. A drunk moron shouting at a nurse like that, i have a great deal of respect for nurses, they shouldn't have to put up with it.

Anyway getting a bed took a long time and this is where i'm just annoyed. It's time to start charging people who come into hospital drunk out of their skulls for the care they receive. This is self inflicted and maybe if they knew they would be paying for it they wouldn't get so damn drunk.

Ok yeah skydiving can result in injury but most skydivers don't get hurt, the whole point is not to get hurt. Drinking yourself into oblivion is really not the same thing. My fathers out of hospital now and doing ok again (within the constraints of his illness) and his stay in the hospital was fantastic. He was well looked after, he even got a private room with a nice view. The food is terrible of course but hey it's hospital food, we always make sure to bring some proper stuff in for him.

Anyway yes sorry this is a rant as i stated earlier. If you go out and drink so much you end up in hospital then

1. You're a moron
2. You should pay for your treatment
3. You're a complete and utter moron

Yeah ok i repeated myself but if you are one of these people just remember that you are holding up ambulance crews who are coming out to help terminally ill people like my father. And the treatment that is splashed upon you because of your own pathetic lack of self control means money that could help genuinely sick people is wasted.

Flame on!

Let me say that there are SMART people who binge drink - even if it is one time. That one time can kill you though.

Now, there are two points I want to make. A LOT of people have breathing problems, whether occasionally or frequently. You might have initially sounded "rhetorical" in your remarks. After further explaining though, you DID receive an ambulance.

People need to be served regardless of the issue, but I feel if drinking results in repeated visits to the ER, then after so many "marks" the patient has to foot the bill.

reply to post by FritosBBQTwist


I only received the ambulance because i told the doctor in no uncertain terms that i would be after him with every legal measure i could muster if he didn't send the ambulance. I was very calm and i explained in detail how his condition works and how many times we've seen it before. Before i took the phone from my mother she had explained the same details but he fobbed her off. I am sure people panic over a high temperature but you would think he'd take our word for it as it's happened 2 or 3 times before this one.

The first time it happened, because we didn't know what was going on and called the ambulance a bit late it resulted in his heart being damaged. Something i also explained.

The problems is the american style system they have implemented and the paramedic said that exact thing. Our local GP even said to lie if need be, although she suggested telling them he's hallucinating rather than chest pains. But the fact they are encouraging us to lie (off the record of course) shows something is very wrong.

A drunk should not get priority, they did it to themselves. Don't get me wrong, i'm not tea total but i don't drink until i'm barely standing, vomiting and crawling in the gutter. This country spends millions on police, medical treatment and legal costs because of these idiots drinking so much.

Ok i'm with you, one drinking session goes a bit wrong you shouldn't be charged because i suppose people often spike drinks and things. I know that happened on my brothers stag night, i didn't spike it but the rest of them slipped in extra stuff that made him really ill.

However after that one time we need to start charging them for costs. Because it will teach them a lesson if they get a 500 pound bill to pay and maybe curb their drinking habits. I have a real belief that some people have died waiting for an ambulance because of these people.

And yeah sorry i am annoyed about it as you can probably imagine considering the circumstances.

I want to agree with you here, but this could go down a slippery slope quite quickly. Should people who smoked all there lives and get lung cancer pay for their care? Should someone who eats fast food constantly and has a heart attack? (they do know what you buy at the grocery store if you use a rewards card) Or if you get into a car accident while speeding should you get free medical treatment? The truth is many medical emergencies can be prevented with a healthy lifestyle and diet. Where do you draw the line in regards to how much the public should pay for the stupidity of others?

This is something I feel very strongly about. If these idiots binge drinking hurt themselves through their own stupidity, then yes, they should be charged an amount for treatment. It all comes down to personal responsibility, which is sadly lacking as they expect everything for free.
It costs the NHS a huge amount every year just treating drunken fools - time to hit them in the wallet for it.

reply to post by oneinthesame


I think i draw the line at acute illness caused by a controllable factor, if the individual is not an addict. We're talking about people going out on a Friday and getting absolutely out of their tree drunk and then being pretty much sober the rest of the week. I am not speaking about alcoholics, drug addicts or others because those are long term conditions.

If someones liver fails then yes, get them to stop drinking and put them on the transplant list without charge. But the people who turn up at random intervals on a weekend need to be forced to pay for their drinknig and if we do it i am very sure it will encourage some of them to maybe stop drinking in that manner. I'm not a kill joy i am just tired of seeing hospitals cluttered on certain days of the weeks by idiots.

So smokers are of course inflicting it upon themselves, but it's long term and an addiction. Not great but they don't clog up the hospitals on a Friday if you see what i mean. The same with obese people, yes they get illnesses and diseases that cost money but they don't put incredible pressure on the A&E department and they don't scream in the face of nurses, (that's kind of a pet peeve of mine).

Originally posted by Britguy
It costs the NHS a huge amount every year just treating drunken fools - time to hit them in the wallet for it.

It's not so much about the cost (although that is a big issue and not one i'm ignoring), it's more about the sharp end of care suffering. When paramedics are occupied by these idiots, when nurses and doctors can't care for those who are ill for reasons which aren't their fault because of these drunken slobs then we need to find a way to make them think twice about heavy drinking.

A massive fine may just do that, we're not talking 50 quid, at least 500, maybe a grand.

There is nothing wrong with alcohol, there is nothing wrong with drinking a little to much every now and then, but drinking a little to much is quite different from drinking until you pass out, need hospital treatment and then expecting everyone else to pay for your excesses, espeicially if you do it often.

If these people work then it's also doubtful they'll be going back to work Monday, so that's then more lost money in taxes and cost to business.

I see your point and I agree with you. A small fine, I'm thinking 200 pounds would work wonders to keep people like that from taking up valuable resources from the health system. My only fear is that it won't stop there. As soon as the NHS sees the savings from this act it would stop paying for the care of smokers, the obese, people that own fast cars, athletes, construction workers, etc. Once small freedoms are given away more and more are taken. What if one day NHS only covered people in approved careers who only ate certain foods and didn't engage in anything that the government considered reckless endangerment?

Once again I want to point out that my sympothies go out to you on this matter. I have been in a similar situation with my grandmother unable to get a bed in a hospital on a Friday night due, in no small part, to the amount of people with alcohol poisoning on IV drips. My only fear is where is the line drawn?

reply to post by oneinthesame


Yes i agree with you and in the past i have also disagreed with peopel who are saying what i am here because i saw that slippery slope. However the NHS already doesn't treat people for certain things or puts restrictions on stuff.

For example if you want a new hip/knee and you are obese they will often ask you to lose the weight, not simply because it makes surgery safer but because they don't want to waste the replacement joint. They have followups for such people with dieticians to help them keep the weight off.

Alcoholics are the same, if they want a new liver/kidney/heart then they have to quit alcohol and prove they're off it long term before they get a transplant.

So we have already started on that slope and it's been happening for years but it hasn't gone further because tight guidelines were built in and that's what we need. Tight guidelines for how this would be applied. Wording it as only acute episodes of illness, brought on by self harming behavior which doesn't have a major underlying psychological component, would be open to being fined. And it would have to be a repeat instance of this not simply a one off because that would be unfair in case someone has their drink spiked.

This would exclude smokers, the obese and general addicts, it would also exclude suicide attempts, half hearted suicides (cries for help) and extreme sports.

It could be done, but the wording would be important and need to be hammered out to provide a long term piece of legislation. However i disagree with you on the amount, 200 pounds is not enough. At least 500 should do it and they must be forced to pay. If they're on benefits then dock their benefits.

reply to post by ImaginaryReality1984


As a Paramedic in the U.S I can honestly tell you drunks do not get priority over chronically ill patients because they are drunk. The priority disp system triages calls based on chief complaints and conditions.

This is how the system I work in works.

Our system is

Priority 1 or echo (lights and sirens) response = pulseless non breathing, uncontrolled airway and cardiac complaints

Priority 2 (lights and sirens) Difficulty breathing, seizures, unresponsive, Motor vehicle accidents, altered patients,unstable vitals. Any complaints that could lead to the above,

Priority 3 drunks without other complaints basic first aid type calls.


Anytime there is doubt units are sent lights and siren.

Ambulance dispatchers in the US do not diagnose callers, they triage based on the chief complaint and in some area's they provide the caller with step by step instruction on what they can do to help the patient until help arrives.




[edit on 5-7-2010 by rbilly001]

reply to post by rbilly001


He stated it was an american system, the doctor stated it was an american system so it most certainly is american. However maybe it's different where you are. I never said the doctor talking on the phone was part of that system, only the priority codes. The doctor talking to us was part of the NHS direct system. NHS direct isn't actually a bad idea and we've used it for other things and it's been very helpful. The first operator heard "high temperature" and so it goes right down the list and she handed us off to a doctor.

However the system you quoted is open to interpretation. A drunk can easily become a life threatening case as i am sure you know. Of course most don't die but people still call ambulances because their friends is vomiting on the pavement. I know americans think they drink a lot but i'm afraid you haven't seen anything. When americans come to the UK and stay for a while they are shocked by our drinking habits a great deal of the time.

As the comedian Rich Hall (an american) says "You brits drink like americans eat".

The other problem aside from the ambulances is simply the number of people that stream into A&E on a Friday and Saturday night. Some hospitals have entire departments dedicated to this problem.

I understand what the OP is frustrated about, i have seen many people have to wait with serious injuries when others that just get wrecked for the fun of it take up valuable services.

However i think if this were to come into effect, we would then see other charges for injuries sustained through other "dangerous" activities.

Driving a car is dangerous.

Any sport can be dangerous.

Using a knife in the kitchen could be dangerous.

Need i go on?

So whilst i agree with the OP in some part, i think it would open a can of worms, and more income for the government.

CX.

reply to post by CX


A government gaining income is neither here nor there as a criticism to this idea. As stated this would need a proper, well written piece of legislation, not simply a quick policy. If done correctly it could easily protect the other groups, in fact it would have to be written that way otherwise i wouldn't support the idea as it would no doubt lead to the extension of fines for other things as you point out.

The NHS was started to treat people who were unwell because of accidents, disease, psychological problems or simply old age. It was not built to pander to people who deliberately drink to get out of their skulls, knowing they will likely end up in hospital.

First time it happens, let it slide, second time, maybe let that one slide but the individual should be required to do community service or something, third time you start paying.

No arrests or criminal records of course, that would be a little much.

reply to post by ImaginaryReality1984


For the most part I agree.

I hate getting up at 3am to take a drunk to the hospital. I also agree the system sucks.

But I also believe everyone deserves help when needed and that help should not be decided by someone over the phone who doesn't like your lifestyle choices.
The issue you ran into can be blamed on alot of things. It sounds like the community you live in doesn't have enough resources to handle the load placed on it. We have the same problems were I work.
Are the ambulance providers in your area private or government?

I think the whole problem with emergency medical services in the US is that its a for profit buisness. Prevention and education results in profit loss.


I hope your father is feeling better.

Just like to put my point of view and opinion across on this matter.

Firstly i completely agree with the OP and I think that binge drinkers etc. should have to pay for their NHS treatment depending on the care they recieve and also the cause for their condition...what i mean is if you pass out drunk and require stomach pumping etc. or treatment for alcohol poisoning or something similar because you've been out on the lash then you should be sent the bill after treatment, this means you get treated, but will think twice about it once you are sober.

Secondly, if you need treatment because of a drunken fight etc. then the above should also apply...if you were attacked then you should have reported this to the police and it will have been assigned a crime number...the bill can then be passed on to the guilty party instead.

Thirdly...and this will get some flack i expect...If you are obese or a smoker and require treatment for conditions related to either of these then you should ALSO have to pay for your treatment...don't like it, then lose weight or quit smoking....and i don't care if it's hard, or you are an addict...for every person who claims they can't quit or drop the flab, there are people who can and do succesfully.

Before anyone criticises me for being anti-smoker or anti-fat, then go ahead, but why should it be tolerated?...both are lifestyle choices and both have many solutions....also, i have direct family members who fit into both these categories and i've told them the same...

Get a Nicotene patch, see a doctor about quitting, eat less and move more...it's not bloody rocket science!

But drinkers and smokers will argue that they already pay extra due to the ridicously high taxes they pay on the products they use.

reply to post by Freeborn


Then stop doing both and they save double then!

reply to post by uptheirons!


How do you know I do?

If I do why should I?

And who the hell do you think you are to tell me or anyone else what to do?

reply to post by Freeborn


I wasn't saying you do....and i don't care if you do or not....but if someone smokes or drinks or does anything that is bad for them and can impact the health care system provided to all of us then i just believe they should pay!...

If someone doesn't like the concewuences they shouldn't carry out the activity that leads to those consequences.

reply to post by uptheirons!


But smokers and drinkers do pay more than those who don't drink or smoke because of the extraordinary level of tax they pay to the government on the products they use.

So why should they pay even more?

What about people who eat unhealthy diets and are prone to heart diseases etc?

Or what about those who are unfit though lack of excercise etc, should we charge them more for any health issues that may be attributable to their life style?

Or is it just those that fit into your own brand of abusers who deserve all they get?

I wonder if one of your own little peccadillo's ever comes to cause you harm then you will still be so bitter and self-righteous.