Daily Archives: 06/02/2015

Sneaking one more post in before Recovery 2.0 4th conference ;)

So the conference starts today but will be on Pacific Time (PT) so 8 hours behind us.  I consider that a whole day so I’m sneaking one more post in before the Recovery 2.0 4th online conference begins.  Me – addicted to my blog?  cough cough 😀

There is a big debate for many about lifestyle choices and whether the NHS should pick up the health cost tab.  Interestingly it’s normally skewed to perceived negative behaviours not positive ones – so ill-health due to smoking and obesity that’s ‘your’ fault whereas ill-health due to an injury while playing rugby that’s an ‘accident’.

I’m with Nye Bevan’s original vision for the NHS in that all citizens should be protected from illness and pain, so that even the most disadvantaged in society would have “freedom from fear”.  And to me that means physical or mental pain irrespective of what caused it.  PS You could pay us nurses that work within the NHS more though 😉

This was in The Guardian in early January – always a good time for headline grabbing stories as the winter bed crisis starts in earnest.

Alcohol abuse: it’s not a doctor’s job to decide who ‘deserves’ treatment

Who are the “more deserving” patients being prevented getting speedy access to A&E because of the undeserving drunks (“Arrest drunks who clog up A&E wards – medical chief”, News)? Are they the speeding motorist, the heart-attack victims who smoked 40 a day? I think it becomes problematic if we start making moralistic judgments about who deserves help and don’t just treat them regardless of the cause.

Drinking to excess is a problem, but there are multiple reasons why people drink. It might be partying, depression or a whole host of reasons. I recently saw a 70-year-old man who had been banned from local pubs for drinking to excess and was being treated for liver damage. His wife had died and he had few other places to find company. I think helping him with his grief and finding other places to be less lonely is a better solution to arresting in his case. Two possible solutions spring to mind:

1. Drink-awareness courses offered instead of arrest and paid for by the individual. They could be run by drug and alcohol services/charities and make people aware of the dangers of excess drinking and for those with more long-term problems be an access point to get help.

2. Increasing the price of alcohol. Smoking has decreased as its cost and the services to help quit have increased. We need the same two-pronged approach to alcohol.

Dr Chris Allen

Consultant clinical psychologist


“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community,” said Nye Bevan in 1951.

I doubt very much that he would have seen an inexorable influx of the legless into A&E as the responsibility of his embryonic NHS, which Dr Cliff Mann rightly questions more than 60 years later.

Clearly it is debatable as to whether this amounts to a legal offence as he suggests but it does highlight the increasing demands of lifestyle illness on the NHS. The charity Alcohol Concern recently reported that in-patient admissions entirely attributable to alcohol cost the NHS £518m per annum and partly attributable cost £1.3bn.

Surely this money would be more appropriately spent reversing the cutback of nursing numbers or funding better care for chronic illnesses and for the elderly.

Patients’ rights and expectations are repeatedly sounded but perhaps there needs to be an equal emphasis on the public’s responsibility to look after their own health and to use the precious NHS resources judiciously. I, for one, would drink to that.

Dr John Trounce


East Sussex

While sympathising with Dr Cliff Mann there is little chance of police enthusiasm for his suggestion. A much more effective policy may lie with the enforcement of existing legislation that involves the removal of licences from premises serving alcohol to the intoxicated. As with the drink-driving laws – once somebody you know has spent a night in the cells and lost their licence the temptation to flout the law lessens considerably.

Perhaps those doctors so exercised by cigarette packaging could now turn their attentions to alcohol as I am still seeing advertisements for alcohol on television, one featuring the clean-cut Mr Beckham, who should know better.

Anna Farlow

London NW2

Dr Mann should be reminded that it is not the job of NHS staff to assert that one patient (or group of patients) is more deserving than another.

He would do better to join with other NHS workers and public servants, including police officers, in demanding that the government provides them with sufficient resources to do their respective jobs in the way that is most appropriate.

Francis Prideaux

London W9

Hear hear to all of those thoughts.  What are yours?