As Dr Alf may remember, A&E is in constant crisis every year, and nothing is ever done about the root causes:

–Malingerers, usually pensioners with nothing wrong with them, who first clutter up doctors surgeries, and then insist on presenting themselves at A&E, normally at weekends, and outside GP surgery hours, with nonexistent ailments and afflictions

–Nightclubbers, drunkards from sleazy bars and pubs who fight in the street, injure themselves and then get taken to, or present themselves, to A&E to overwhelmed doctors and nurses at weekends when A &E is under most stress

–People who call ambulances for fun or because they need a prescription for aspirin or something that they could have dealt with themselves

–Hypochondriacs who are attention seekers who insist on not going to the doctor and then make a great show of going to A and E

–People who have overdosed on illegal drugs

–Rough sleepers(often ex forces people who local authorities refuse to rehouse or house) who become too cold or too ill to sleep outside

–Drug addicts looking to get into hospitals to steal drugs which they can then sell to finance a heroin or ‘skunk’ habit.(My own hospital, the Lister at Stevenage, employs G4S security guards and cameras to stop addicts breaking in and stealing drugs but many of these addicts go to A&E try to get seen by a doctor, go to the toilet and then try to hide in the hospital prior to attempting to break into drugs stores in other parts of the hospital complex

The first two categories of people need to be made to pay for abusing the NHS, which is supposed to be free at the point of NEED, not free when there is nothing wrong with you and free to irresponsible people who fight, injure themselves and others in drink/drug fueled evenings of excess and debauchery.

Payment plus heavy fines and jail at night would wake people up and concentrate minds.

Drug addicts should be made to go into cold turkey programs, as happens in Japan where the zero tolerance regime scares the people straight so that they can be reintegrated back into society.

The ex Forces rough sleeping problem is the fault of local authorities who should give these people housing priority in all cases.

Those that don’t comply or who “push back” should be put into “special measures” and their service directorates should be fired en mass and be replaced by Government hit squads.

Persistent malingerers and truculent night-clubbers would be named and shamed in newspapers and NHS websites so the message would go out and the pressure on A&E would dramatically reduce to manageable levels.

John Gelmini