A and E admissions

Drinkers should pay for any treatment as a result of their bingeing. They've brought it on themselves and the fact that it makes many people violent should mean that the charge should be substantial. I'm fed up with more and more off licences opening. It's too tempting for many people. Round here they seem to come out of the job centre straight into the off licence.....

Yes, maybe the Department of Health have done that to make themselves appear more user-friendly.

I read DH as Dear Husband so I did wonder a bit at his "£740m revenue boost" Sorry, that was well off piste but couldn't help commenting.

"Unannounced £740m revenue boost shows DH was in 'desperate trouble'.

The Treasury has agreed an unannounced £740m increase to the health revenue budget for the current financial year, it has been confirmed to HSJ. The unusual move indicates the Department of Health would otherwise have been highly likely to overspend its revenue limit for 2014-15, health finance experts said. The revenue departmental expenditure limit increase was funded by an additional £250m from the Treasury, and a further £490m transfer from the DH’s own capital budget. King’s Fund policy director Richard Murray, a former senior analyst and economist for the DH and NHS England, said the moves were “both exceptional”. He told HSJ: “It looks like when the chancellor announced more money for the NHS for 2015-16 [in the autumn statement] what he omitted to say was he had already given them money this year.” The DH confirmed on Friday that the changes had been agreed with the Treasury. However, it declined to say when they were agreed, leaving it unclear whether they were known but not made public prior to the 3 December autumn statement. Mr Murray said being “allowed [by the Treasury] to raid the capital budget” indicated “the department was in desperate trouble on the revenue budget”. “It looks like they would have broken the [revenue] budget, it’s the only reason they would have [made the transfer from capital]”."

Interesting article in the HSJ, about the government giving the NHS money that has not been announced. Shame they took it away from the NHS in the first place and created this crisis. Not being a medical expert, I cannot read the rest of the article.

There aren't enough police officers or police cells to enable them to arrest all the drunk & disorderly people, which I suspect is why they get left to become sodden with alcohol, and then taken to hospital.

The buck stops with the government of the day.

This subject was back in the news because someone from one of the royal colleges of medicine thought that the police/politicians should address the issue of public drunken behaviour.

He was saying that if there was a concerted effort to arrest the drunk and disorderly, which is already an arrestable offence, then they wouldn't end up later in the night in A&E having got into drunken brawls, falling and injuring themselves, or being comatose in the street at risk of choking on their own vomit.

Rowdy drunks are a big problem to A&E staff and fellow patients, in a way that motocyclists, self-harmers, smokers, etc., are not.

Anyone who is ill, for whatever reason, is entitled to medical attention. I'm a self harmer. Usually I'm pretty lucky but on one occasion I cut in the wrong place and it wouldn't stop bleeding. I tried to treat it myself but after 12 hours the wound still hadn't sealed so I had to go to a and e.

Should I have been turned away because it was self inflicted? Should I have been put in a sin bin? Fortunately I was treated sympathetically and patched up.

I know some may say this was different but a binge drinker who has become ill is just as much in need of medical care. Like Nelliemoser I have tucked both my DDs and their friends up with buckets. I don't know about elsewhere but binge drinking has been a rite of passage here for generations. I don't think I was fully sober from the age of 17 to 21. I often got in around 3am and went to work at 8am so I must have still been drunk. My DDs also drank a lot in their teens. Now they hardly drink at all.

I'm not saying binge drinking is right, just that there is long tradition of it in some areas.

My DD who works in n ITU says they get a lot of people who have been binging as well as some long term alcoholics in and out.

One such was a first year University student in Freshers week who was unused to drinking much anyway and had been egged on by others. but got so much alcohol in him it was felt better to keep him in for the night to monitor his condition.

Having said that I have had to tuck my late teenage DD up in bed with a bucket by her side on more than one occasion and then pop in every so often to see how she was. You knew when she growled at you she was probably not too bad.

Partying binge drinkers should pay for their care. If they can afford to drink so much they can afford the consequences.

I have more sympathy for those with serious alcohol addiction.

A diabetic having a hypo can appear drunk, as Farnorth said, and can inflict damage on ambulance people and paramedics, as some of them know when attending to my husband. Not too often, I hasten to add.

What a good idea durhamjen. I can see both sides of this. A few years ago my husband was left sitting in A&E after triage with a suspected heart attack (with a history of heart problems) for far too long while drunks were wandering around clogging up the place.

On the other hand, on one occasion I tried desperately to get help for a young man I came across in the street who was almost comatose. The paramedic came to him and left, apparently happy to leave him lying on the street in subzero temperatures and unable to get himself home or even remember where he lived. All I could think was 'it might be my son'.

That does sound like a good idea. People who appear drunk, and ask for help, do need to be checked in case their slurred speech etc is actually caused by something else (and presumably they would be checked, by the medics at this unit.)
I don't think the issue of the condition being self-inflicted is the important one, it is that drunks can endanger others, whether directly by their own actions or indirectly by causing medical staff to waste time dealing with out-of-control drunken behaviour.
Those things don't apply to the other examples of self-inflicted conditions that were given.

This is Middlesborough's answer.

www.thenorthernecho.co.uk/news/11664993.Safe_Haven_for_drunks_in_Middlesbrough/

I think it is a good idea. The policeman who was interviewed about it had the right idea, though. It's a problem of lack of resources in A&E and the police force. Until that is dealt with, we will always have too many drunks and too few people to deal with them.

Good post absent.

Yes, the whole culture of drinking to oblivion needs to be turned round, but until that happens the A&E units are flooded with people who really mostly need a safe place to sober up enough to go home, and someone to separate those who need more active treatment and give it to them. Meanwhile the other, sober, patients need a better atmosphere to wait in than a roomful of drunks.

Perhaps a separate area for the drunks would be a good idea?

I think as things stand at the moment all that can be done is to shift the problem to the sort of service I was outlining above. Stopping it happening in the first place is a long term project of some complexity! - the priority is to find some way of keeping them from filling up A&E and stopping then staff getting on with their jobs.

A & E departments have a triage nurse who prioritises patients. If an alcohol abuser is severely injured and at risk of bleeding to death, he/she will take precedence over someone with a broken wrist. If, on the other hand, he or she is suffering from such symptoms as a raised pulse, dizziness, nausea, slurred speech, then the patient with the broken wrist will take precedence unless a heart attach or stroke is suspected.

Self-inflicted injury may be very annoying for the holier-than-thou brigade but drunks, smokers, druggies, bulimics, over-eaters, self-harmers, failed suicides, etc. all pay taxes and are all entitled to treatment. If they also break the law in some way, they may be prosecuted. The police service and NHS have different functions.

I don't think they should be penalised. It should be shock and awe tactics to dissuade them from repeating said behaviour. These are not people with sickness and problems. They are out of control young people with too much money and no scruples. Heavens, you see them sitting in the gutter urinating. Being carried off for a gang bang (I kid you not). Arguing aggresively with police. Clogging up A&E. I was in early hours Sat/Sun with suspected heart attack. Loads of young people needing attention. Earlier this year. Make sure they're safe. Put them off this behaviour. I have no sympathy with the drunken young masses. But, those who need attention should be separated.

It goes beyond this problem ... the question that needs to be answered is why is there a culture amongst certain groups in this country of drinking unto oblivion on a regular basis.

Anything else is just a band aid approach and shifting the problem elsewhere.

And the police think the idea is nonsense. I think the idea of some kind of base is a better idea.

There's something on the news at the moment - a suggestion that drunks should be arrested rather than accepted into A&E.

I was in A&E a few weeks ago and was pushed through as I was temporarily quite poorly - it was a Saturday night and the nurses said they wanted to get me onto a ward as quickly as possible before the drunks arrived as they did not want me to have to endure it. I do not want them to have to endure it either! It is a total waste of resources and an insult to the dedicated nurses.

In our nearest city they have a voluntary service which trawls the city with police on a Friday and Saturday night and has a base where they take people to dry out to try and keep them out of A&E.

Should someone who has a ski injury be penalised for having engaged in a risky activity? Or smokers be refused treatment for lung cancer? Where do you draw the line? The key word in what you said was "treated". I'm not in favour of abusive drunks clogging up A&E, but if they are there because they need medical attention, then they should get it. And then they should get help for their drink problem, but that is not very easy. There is no point in criminalising people for drinking. We have an offence of "drunk and disorderly" but the fines are negligible and in any case fines are no use in stopping someone's drinking.

Its been a long term problem for A and E staff I'm not sure how you could penalise these people.. and I don't think it would change their behaviour whatever was done..