Should we pay for emergency care?

Should we pay for emergency care?

Should we pay for emergency care?

First published in Columns

JUST how much responsibility should we take for our own actions?

And is it right to expect others to pick up the pieces when things go horribly wrong?

I ask after reading that people who end up at hospital accident and emergency departments as a result of drinking or taking drugs should have to pay for their treatment.

Edwin Poots, Northern Ireland’s health minister, has suggested the possibility of people paying for emergency care if alcohol or drugs contributed to their need for hospital treatment.

According to the BBC, Mr Poots said: “The principle of it has merit. The implementation of it is more challenging.

“We need to ensure that people who need medical care are not put off receiving that medical care.”

At face value, this seems to fly in the face of everything we know and love about the NHS – that it’s a universal service free at the point of delivery.

But of course, it’s not free and never has been. Everyone who works makes National Insurance contributions which go towards its funding. And anyone who has needed dental treatment can testify just how expensive that can be, even if you are treated as an NHS patient.

And anecdotally, I’ve heard that people who are involved in road traffic accidents get a bill for ambulance travel.

I happen to think that as adults, we are responsible for everything we say and do. Every action has consequences and as that great philosopher Kelly Osbourne said: “You play, you pay.”

I can well imagine Mr Poots’ plan to charge drunks and druggies for their accident and emergency treatment after a big night out on the town will have the tweed and twin-set and pearls brigade nodding sagely into their single-estate Bordeaux.

However superficially tempting the plan may be, surely it is massively flawed. Underpinning the idea is a moral judgement. The logic is that those turning up at A&E under the influence of chemical substances have been the authors of their own downfall and have therefore abdicated responsibility for their own actions.

As a result, they are thought to have stepped outside what the rest of society considers to be acceptable and we, the rest of society, shouldn’t have to pick up the bill for their treatment.

But if you apply that reasoning to the rest of the population, just who else wouldn’t be treated?

We are constantly told we are facing an obesity crisis. But who is responsible for that? Yes, I know food manufacturers are often accused of “hiding” fat and sugar in processed food, and yes I know the pace of modern life means many families don’t have the time to cook healthy meals from scratch.

But surely we are all responsible for what we eat. Is obesity as morally unacceptable as drinking to excess or taking illegal drugs?

The same could apply to smoking. I don’t smoke now but I did for many years. I actually started as a young teenager and at the time, I did not understand the health implications. I was a really heavy smoker for more than 30 years and fully expect to suffer some health issues as a result as I get older.

Over the years, smoking has become increasingly socially unacceptable. If I suffer heart or breathing problems as a result of smokingmy actions, should the NHS deny me treatment or charge me, despite the fact I’ve paid my National Insurance contributions for decades?

The government has had the money from me on the understanding I will be treated for my illnesses or injuries, irrespective of how I acquired the condition.

I am happy to live in a country that considers the NHS as one of our jewels in the crown. I would hate to live in a the sort of country where you had to pay for treatment, like America, where only the rich get good treatment and others has to make do.

But I do wonder just what the outcome will be should Mr Poots’ plan go ahead.

Will the NHS set up morality panels at GP surgeries and hospital A&E departments, sitting in judgement on who can be treated for free and who will have to pay?

It will be a dark day for us all if that ever comes to pass.

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