Friday night in a big city casualty department is not a nice place to be. A reported 70% of patients are not really ill, just blind drunk. What on earth are they doing there?
The answer is that every social nuisance nowadays seems to lead either to a police station or A&E. In recent years, 12 British cities have been “experimenting” with so-called alcohol recovery units – sobering-up police rooms, lorries or “booze buses”. These are regarded as successful, and the government now proposes to extend the scheme to towns and cities nationwide.
The only mystery is why it has taken so long. To offer expensive A&E, free on demand, as an after-sales service to the urban alcohol industry is ridiculous. It is inefficient, unhygienic and unfair to other patients and to staff.
It is equally absurd that this cost should fall on the NHS, rather than on the culprits and on those who make money serving manifestly drunk customers. A £50 charge – certainly less than they spent getting drunk – would at least seem reasonable. As for the handful of serious cases who do need medical attention, and might pass unnoticed, that should be their risk, not the state’s.
Such lateral thinking – and alternative remedy – is needed right across the welfare state. Many police stations now complain that as much as two-thirds of incidents brought to their attention relate not to real crime but to mental health, drink, drugs and homelessness. Victims end up in police cars, police stations and cells, for want of anywhere else for them to go. Many GPs likewise admit that many of their “patients” are not suffering from illness or injury, but loneliness. They want an appointment with a sympathetic ear.
There is a clear need for alternative thinking about how to respond to such social dislocation. The steady closure of police stations, clinics, libraries, “cottage hospitals” and day centres for the elderly has stripped communities of so many lifelines for the inadequate and lonely. It has left them with only a 999 call to summon a human face.
Communities, not the state, must find a way to take on these responsibilities. Traditional centres of neighbourhood activity – churches and chapels, primary schools, train stations and town halls – all tend to have unused space. They are a wasted social asset. Most villages, towns and cities also have a wealth of potential helpers, if only a mechanism can be found to recruit them. From drunk tanks to care clubs should not be a giant step.
• Simon Jenkins is a Guardian columnist
