Martin Samuel
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Remember that obesity crisis? It turned out that ganging up on fat folk was the thin end of the wedge.
Now they are coming for you. Oh dear. Didn’t see that happening. And it is too late to wind the clock back now, of course. Too late to start quoting live and let live and why can’t we just get along and let he who is without sin, and all the various little mantras and sermons of tolerance that stop the human race from tearing itself apart like weasels in a sack. Now that we have evolved into a nation of mutant McKeiths, mean-spirited bullies, judging and reckoning, as if it was any of our business how next door chooses to lead his life, they have got us just where they want us.
The Liberal Democrats want to charge drunks for treatment in accident and emergency. So, there you go, we are now at Phase 2. Phase 1 was targeting fat people and smokers. And when nobody raised a peep in their defence, the new puritans could isolate the other runts from the herd.
After all, who is going to stand up for drunks when they can hardly stand up themselves? Then, it will be open season on the remainder.
Phase 3: the privatisation of the National Health Service by stealth. Everybody pays. You get stitched up just to get stitched up, because there is no way this scheme reaches its endgame by playing fair. In a few years, you won’t be greeted by a triage nurse in A&E anymore but a loss adjuster, whose very livelihood and Christmas bonus will depend on establishing that you were in some way responsible for your misfortune (as, indeed, we all are) and bill you for it accordingly.
Naturally, this will not be portrayed as a callous, hard-nosed financial measure, playing on our most petty and small-minded prejudices (the definition of a big drinker being a man who drinks more than you), it will be heralded as a new dawn for personal responsibility. And, pretty soon, all illnesses – well, let’s face it, you must have done something to give you cancer, sunshine – and all accidents bar acts of God will be offset by a middle manager in a cheap suit. Welcome to your brave new world. Hope you can afford it.
A few years back a chap down my road, a nice man, who did a lot to help the old lady next door, was up a ladder using a chainsaw to cut back an overgrown fruit tree that had become a nuisance. A large severed branch fell in his direction, causing him to jerk away, chainsaw in hand and, as I appreciate some of you may be having breakfast, let us just say that the phrase “I’ll make you smile on the other side of your face” took on a whole new meaning. Not wishing to alarm his elderly neighbour, he quietly went around to the front of the house and drove to the nearest A&E, where many hours later the two halves of his fizzog were reunited. I thought he was a stoic hero actually. Give it a few years and he will be more like the accused.
“Chainsaw, eh, sir. I see. What are you then, some kind of lumberjack? No? A television repair man? Really. And do you use chainsaws a lot in that type of work? No, I wouldn’t think so, either. So what exactly – oh, a favour was it? For a friend, yes I understand. Didn’t you think it was a bit dangerous? I mean, a man in your position, no previous chainsaw experience, on a ladder, up a tree, drunk – oh, I’m sorry, sir, I didn’t mean to insinuate, but it was after Sunday lunch you say. And did you have . . . well, exactly, I know what you mean, what difference is the odd glass or two going to make? I agree. I’m a white wine man myself.
“But the problem is, well, your problem is, that we really do have these strict guidelines on self-inflicted accidents and others on alcohol and I’m afraid we can’t just treat any old piss artist who comes in here wielding a chainsaw. Not without cash anyway . . .”
I know what you’re thinking. Slow down, mate, it’s only some kook from the Lib Dems that has proposed this (Norman Lamb, the right honorable kook for Norfolk North, actually); it is not as if it is government policy. Except a few years ago it was only the Lib Dems that were in a snit about 4x4s and green issues, and now they can barely get a word in edgeways for all the main political parties elbowing each other off stage in the frenzy to propose a new environmental tax.
Dear old Ming as good as had to flush his credibility down the toilet at a photo opportunity this week just to get a mention. Repackaged Lib Dem policies – airport taxes, recycling drives, getting the hell out of Iraq and pretending we’ve won – are all the rage right now; particularly those that fit so snugly with centrist ideas of citizenship.
The clue to accident and emergency is the name. It was an accident. It is an emergency. We all do stupid things because that is how we are made. A species that would never put a fork in the toaster to stop the bread burning would also be unable to come up with something as randomly wonderful as the motor car and would therefore never plough one into a tree at 70mph. A species that didn’t look at a mountain and wonder what was at the top of it would never need rescuing while climbing in flip-flops, but would also not have explored the sea beyond its own hunk of land.
It is our appetite for life, not for food or cigarettes or alcohol or chainsaws, that causes us to endanger it – and to start hiving off sections of society as needing help, and others an invoice, is to misunderstand our existence. The reason we don’t leave spur-of-the-moment mountaineers stranded in the Lake District or abandon overambitious sailors in the middle of the Atlantic is the same reason we do not charge people for staggering, blood-soaked, into A&E: because all of us are a little bit ill, a little bit fat, a little bit drunk, a little bit human.

Martin Samuel has been a sports writer and columnist for The Times since 2002. His football column appears every Wednesday and on Tuesdays he writes for the op-ed pages
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What a pity Martin Samuel spoils an otherwise good column by taking a swipe at "green" concerns. He's clearly right about medical treatment (who is so self-confident as to be certain someone's health problem is entirely self-inflicted?) but I'd have thought preserving the planet in a reasonable state for the sake of our grandchildren and their children was something that merited concensus among politicians of all parties.
Barry, Wallington, UK
Speaking as someone who works in A&E I am someone who has to take the abuse, the urination on the floor and try to treat these drunks.
What from the comfort of your office is "high jinks" is a nightmare for me and my colleagues.
I'm no "puritan". Legalise heroin, cannabis and even cocaine if you must. They cause far less disruption than ethanol.
And lastly, money isn't endless. If you pay for drunks others suffer. Again you can decry the situation, but that is the reality.
Rory, London,
A few years ago an aquaintance of mine broke her back falling off a horse. I visited her in hospital when she had just been visited by the consultant who had logged her injury as 'self inflicted'.
She made a full recovery - some of which was to do with luck and a lot of which was to do with her level of fitness and muscle strength due to riding horses every day of her life (and not smoking or being overweight!)
Would one circumstance cancel out the other?
Sue , Swansea, Wales
You missed the obvious. Make health insurance work like it should. Gather the cash, put it in a separate fund and let the hospital submit a claim per treatment. Its easy, its accountable, and it works. And it means that civil xervants and petty time-servers can't milk the pot for other things. Modern business does it every day, but our so-called government lives in the dark ages.
A real re-think of the NHS would begin by separating the provision of service from government service, completely and for ever.
KR, Stockport,
I agree with Martin Samuel, we are "a little bit human". So, just as a dog is allowed its first bite, the first admission to A&E by a drunk should be tolerated and the unfortunate person treated for free. However, repeated visits to A&E by that same person, who clearly needs to get himself sorted out, should warrant a charge. There are too many other patients who have a need for emergency treatment who have absolutely no choice but to attend.
Jane Barnett, London,
But we do leave children to drown in a pond because we haven't been trained to save them and someone might blame us or even sue us if something goes wrong. There are professionals to do that sort of thing you know - what do you mean they won't arrive until too late? More than my job's worth to wade in, mate.
alexandria, Sheffield, UK
The commonality between all these Lib Dem policies which have been so enthusiastically embraced by the other parties is that they serve to increase the size and funding of the government! By that criteria, I'm just surprised they've managed to keep this one to themselves this long!
Dominic Graham de Montrose, London,
I was thinking of staying in bed to avoid all possibility of injury but then realised I would probably get bed sores that would be deemed to be self inflicted ('So the decision to stay in bed for three months was entirely your own, was it? Did you consult your GP before embarking on this self-medication?) and I would have to pay for treatment.
Not sure what to do now...
Tony Jones, Grantham, Lincs
Those whose health problems are self inflicted should not expect those addressing healthy and safe living to pay for
their health injuries . Those who stuff up should foot the bill
not he NHS
Charles, Perth, Australia
Ah, there is another sane person out there. Soon we will have to meet in secret before we are allowed to even talk about such things.
Bill, Hants,
The best coup the Government has managed to land within this debate is surely to make sure that the people are now turning against each other: Why should I pay for the fatty down the road who's heart attack is self inflicted (just stop eating, it's simple really), the smoker next door who got cancer (pick any cancer, if you smoke it's now you're fault), the biker who got taken out by a car (we all know just how dangerous bikes are, don't we now), the footballer with the nasty knee injury or the horse back rider with the broken arm (well surely madam, if thou can afford this sport then thou can afford to pay for the treatment of one's injuries) etc. They've now successfully achieved to shift the focus (and blame) from their own mishandling of tax payers money to all those "irresponsible" , "selfharming" and risktaking people who are now being blamed for draining the NHS. Not only blamed by the government but by all the "good" people. Very clever! Seems to work though...
Carole, Norwich,
Assuming that whatever work is done by any doctor or nurse must be paid for, then if we're not assuming that "Everybody pays", then we are left with "Somebody pays" This country is going to have to wake up sometime and realize that the "Somebodies" that are paying are getting a rough deal. The future of the UK depends on these "Somebodies" and you can only tax them so much before they simply start moving on to greener pastures. Its time to get real and start thinking beyond the end of our noses. Its time to start rewarding the innovative, the productive and not continually tax them.
Paul Ferry, Bristol,
There you go man
Keep as cool as you can
It riles them to believe that you perceive
The web they weave
And keep on thinking free
(moody blues)
My father is in hospital with a stroke at the moment.
Most of what you say is already being put into practice now.
Do yourselves a favour, don't become ill in the UK
Mike, Bremen,
But surely getting you off paying your bill is what DNA profiling and ambulance chasing lawyers were invented for?
Ian Kemmish, Biggleswade, UK