Below I extract a report from the BBC : http://www.bbc.co.uk/news/health-42506706
Drunk tanks may have to become the norm in towns and cities to keep "selfish" revellers out of A&E, the head of the NHS in England says.
Simon Stevens said he would be closely monitoring how the mobile units cope on New Year's Eve before deciding whether they should become a regular feature.
Drunk tanks provide a safe place for those who have over-indulged to be checked over and sleep it off.
They are often used over the festive period to stop people ending up at A&E.
There are around 16 mobile units - also known as booze buses - across the UK, according to a recent survey, and a number of cities operate them all year round, including Newcastle, Cardiff, Manchester and Bristol.
Mr Stevens said he may start recommending others follow suit, given an estimated 15% of attendances at A&E are due to alcohol consumption.
This rises to about 70% on Friday and Saturday nights.
Image caption
A number of cities have already introduced drunk tanks
He said he was thinking about the move after spending time with ambulance crews in London and the West Midlands in recent weeks.
"I've seen first-hand how paramedics and A&Es are being called on to deal with drunk and aggressive behaviour."
But Dr Katherine Henderson, a consultant in emergency medicine from Guy's and St Thomas' Hospitals, said it might be better to have a conversation about people drinking less on a night out.
She told the BBC: "By making this facility, it's like saying 'you can depend on the NHS to provide you with a safe place to sober up'".
"You're saying 'there's a safety net for you', rather than saying 'how are you going to get yourself and your friends home safely'?"
'Extremely drunk'
Dr Henderson also said she was concerned that NHS frontline staff were working in the mobile units, when "they could be helping others".
But she conceded that the last thing busy hospitals needed was more patients coming in to A&E.
"We are seeing people who are so intoxicated that they need to be on a trolley - which takes up a whole cubicle space; people who need cleaning up - which takes up a lot of nursing time; and people with serious injuries, who may be difficult to spot among the many that are extremely drunk.
"It's something we just don't need."
In Newcastle on a Friday and Saturday night, a Safe Haven van already operates to help vulnerable people - not just people who are drunk.
Dame Vera Baird, the Northumbria Police and Crime Commissioner, whose office part funds the van, said: "It's a safe location to help anybody who needs any support. It saves an enormous amount of money and time."
'Sleep it off'
Prof Simon Moore, from Cardiff University, is carrying out a study into the impact of different types of drunk tanks based in six cities in relieving pressure on the emergency services.
He said: "The very, very drunk with head injuries and similar will still need to go to A&E, but the health service is very risk-averse so they have a tendency to refer to A&E if they suspect something is wrong.
"So all you need is a good trained person - a paramedic or nurse - in the city centre to say 'we can hold off for a bit, this person is going to be fine in an hour or so', and then they can go home and sleep it off."
Prof Moore said it should be "a joined-up service" that refers people for treatment for their underlying drink problems.
In Northern Ireland, Belfast operates an NHS-run unit and an SOS bus, which helps anyone who is vulnerable.
In Scotland, there are no drunk tanks in operation and the government said they had no plans to introduce them.
How do drunk tanks work?
Bristol launched the UK's first drunk tank three years ago in a partnership between the police, ambulance and local hospital.
Known officially as an alcohol recovery centre, it is a state-of-the-art medical facility contained in a 60ft-long converted articulated lorry.
The vehicle has beds and seats as well as two showers. It comes with medical drips, oxygen, blood testing equipment and a pump system for the worst-affected revellers.
It is staffed by paramedics who provide basic treatment, although those who need it can still be sent to A&E.
Since it was launched, other cities including Manchester, Cardiff and Newcastle, have tried their own versions. The National Institute for Health Research is now looking at how effective they are at dealing with drunks.
As the nation prepares to see in the new year, Simon Stevens reminded revellers to be responsible.
"When the health service is pulling out all the stops to care for sick and vulnerable patients who rightly and genuinely need our support, it's frankly selfish when ambulance paramedics and A&E nurses have to be diverted to looking after revellers who have overindulged.
"NHS doesn't stand for 'National Hangover Service'," he added.
My summary :
Excessive drinking is a scourge on our streets - particularly late night in city centres. Violence and anti social behaviour is often an outcome.
The police and the NHS are being left to deal with the consequences. (A thankless task.)
The cost of doing so is massive.
Health care and policing budgets are under pressure and valuable resources are being taken away from other important areas in order to cope.
Just about everyone involved including doctors, nurses, paramedics the police and the vast majority of law abiding public are frustrated and fed up with this type of selfish and anti social behaviour. As a nation we are embarrassed by it. Who would want drunks clogging up our hospitals and causing carnage on our streets.
The Police have powers of arrest and while they do when provoked (despite the time consuming bureaucracy they encounter) too often the Court sanction is a "caution" or a nominal fine.
In theory it is an offence for pubs and nightclubs to sell to drunks - but in reality this is a subjective judgement, hard to monitor and hard to enforce.
The NHS and the Police have assumed by default the responsibility and even the liability for the well being of drunks.
If someone is heavily drunk and falls over it is typically the Police and then paramedics, nurses and doctors who are required to assume the sole responsibility for care. If they miss a concussion - or if someone chokes on their vomit we know there will be a lawyer ready to pounce seeking compensation and accusations of negligence from belligerent families towards our emergency services. As a consequence the Police and NHS have had to become massively risk averse - and X rays and scans are often performed as a belt and braces precaution on people so drunk they can't stand or talk properly. It stinks.
What is being done about this problem ? In reality very little in as much as wider society continues to ignore the problem and our Police and NHS are too weary and too busy to make their case for change. Drunk Tanks might alleviate some of the pressures but will do nothing to bring about a change overall in this selfish, ignorant and anti social behaviour.
What do I think should happen? There has to be a step change in societies attitude to drunken behaviour and its consequences. It has to be less passive. We need more vociferous and meaningful public support for the lot of the Police and NHS and far less "understanding" of the cause of the drunk. The first thing that comes to mind is "Draconian measures" the second is "personal responsibility".
I would advocate :
Zero tolerance of (filmed) drunken and disruptive behaviour. Arrests followed up with statutory heavy fines and community service orders. (no court).
Attendance at A&E needs to made very much the exception rather than the norm. I would not let "drunks" into A&E. It is NOT societies problem.
I would legislate to say all the Police have to do is get them off the streets and into a cell. What happens after that is NOT the Police's responsibility neither is it the NHS's.
I have no sympathy. Drunks do not warrant our consideration. Personal responsibility has to be the cornerstone. If you chose to get paralytic - it is your choice and you suffer the consequences - not Society - even if that means you put your well being in jeopardy. (certainly I would not allow any liability claims against the Police and NHS). This is the only way attitudes will change. We need to toughen up in this area (and in so many others).
I am just back from Exeter having spent a special few days with my daughter and husband and my two darling little grand daughters who are Annabelle now 6 and Ayla 3.
Christmas preparations were very much evident and one of the lovely things I was able to do was to attend (with mum and dad) Annabelle's school Christmas Nativity play.
The nativity story is of course being played out in thousands of schools this time of year, as they have been for countless past years. I guess there was nothing particularly special about Annabelle's nativity play except my granddaughter was in it and that made it exceptional from our point of view. It was a lovely little half hour production. The basic nativity story was unchanging of course - played out by the dear little children in their hand made low budget costumes. All the songs they sang were gentle and tuneful and original (to me). Many of the children in varying states of nervousness and clarity spoke a few lines on their own (well done Annabelle!). It was especially moving when all the children sang together and fascinating to watch the little persons remember the words and play out the actions in unison or sometimes not - ha! Many a parent and grandparent had a tear in their eye. Amazing something so simple could feel and be so special.
My overwhelming thought was how vulnerable and innocent and genuine little children are. This is not new knowledge of course but sat there for that half hour or so really brought it to the fore in my mind. It is a beautiful thing. However it was thought provoking too - unsettling - because the wider world is not innocent - people are not always genuine and vulnerabilities are of course often exploited. All children - all of us - have many challenges to face - but somehow you feel you want to cocoon your offspring - all little children - from those negativities but that is not reality or probably even desirable.
I find myself asking what can we do to help them? Thinking out loud - what should we do?
Well several things came to my mind. The first is based on something an old uncle said to me light years ago. He said of kids - "if you love them son and they know you love them - they will turn out alright". Something Victoria said made me smile - she said I tell the girls - "there are many children loved as much as you but none who are loved more". It is shocking there are children out there who are unloved. It is too horrible to think about - but thankfully there are people out there that do offer wonderful foster care. Those that do it for the right reasons and do it well - are saints.
Of the parenting role I think a crucial objective is to try to do everything possible to help our offspring develop a bullet proof self esteem because without strong self esteem I cannot see how it is possible to be truly happy (and all we really want is for our little children to grow up healthy and safe and fundamentally - happy.) In today's world young people are under so much pressure - particularly from social media and it can start at an early age. Somehow children must learn to be themselves and not be worried about what everyone else thinks. Very hard to do. I am not giving advice here but I mentioned a parents understandable inclination to want to cocoon young children so they are safe and happy. However and somehow children have to learn to cope - to be tested - to tackle adversity - even fail on occasions - because out of that comes real self confidence and an ability to survive in a Darwin world. Am I talking about tough love? Maybe I am.
Another thought - religion. Those dear little children in the nativity were so innocent. They absorbed the nativity story. It was gently done and did not feel particularly Christian. I rail against "faith" schools. I do not think it is right that children should be indoctrinated with their parents/schools view while they are so vulnerable. I will concede religion should be taught in schools but in a multi faith academic way. When children know their own mind they can make their own minds up. It is immoral how young children are exploited by religious zealots.
I know I am a pontificator - ha! Just one more thought and it was very much prompted by the nativity play. It is easy to say "we should leave the planet in a better state than we found it - (or at least no worse)". We know that - but it is not how our generation is living in the world as a collective. Those little 6 year olds have to follow us on our planet. What state are we actually going to leave it in for them? I feel guilty about that. We are too materialistic. We are too selfish. What can we do? What should we do? What can we change? What should we change that will make a difference? As an individual probably not very much - but that is a cop out. Being so clearly propmpted by the collective sight of those innocent little children has brought these thoughts to mind - pollution - global warming - over population - intensive farming. But I am likely to be a hypocrite like most others. Head will go back in the sand and hope for the best! That is crap. I have to make some more changes - somehow. It is the right thing to do.
On October 25th we left Gunwarf Marina, Portsmouth to deliver a 72' Challenger yacht owned by The Tall Ships Trust to Gran Canaria. In total we had a crew of 16 - a professional skipper and first mate - the rest of us a sundry group of amateurs who had never met before we formed the crew. Our boat was Challenger 1. Challenger 2 - an identical yacht was setting off at the same time. The primary purpose was to deliver the boats to Las Palmas Marina, Gran Canaria because they were entered to sail in the forthcoming ARC race across the Atlantic and which starts from Las Palmas. Although the primary purpose was to deliver the boat we were in a nominal race with Challenger 2. The plan was to sail down to Cascais in Portugal for a stop over and then onto the Canaries. Wind and weather were of course the big variables particularly as we had to cross the Bay of Biscay.
This was my first long distance off shore cruise and quite different from the mainly coastal sailing I have done. It was also early winter as we set off - but we were heading south for the sun! The voyage I was undertaking was an end in itself - a challenging sail of over 1500 miles - and I was looking forward to everything it might offer. However there was an added purpose - because as I have mentioned in earlier blogs I am forming part of the crew on Dare to Lead - one of the yachts in the Clipper Round the World race. (Challenger yachts are similar to the Clipper yachts) I am doing leg 6 of the race - The Mighty Pacific leg - China to Seattle in the USA. We leave in March 2018. I had enrolled for this run down to the Canaries to give me some more experience before the Pacific and I am glad I did it.
As in all passages the weather shapes and dominates everything and when you are sailing of course - wind direction. Weather forecasting over a period of 48 hours and up to 5 days is pretty good at sea - less so of course if it is a longer forecast. As we set out we expected a mixed bag - little or no wind initially (and we had to motor - something that you can't do in the Clipper race of course) - but eventually fair wind and building which sounded a bit ominous. All the crew had the notorious Bay of Biscay in mind - ha!
My intention was to keep a daily log but I have to admit time and days blurred. I guess it is because you do not have a normal structure because on a voyage like this the boat functions with a watch system ie the crew are divided into two "watches" and they operate as 7pm to 11pm, 11pm to 3am, 3am to 7am and then 6 hours to 1pm and 7pm. This is a disorientating system initially but it works well and you eventually fall into the routine. The routine is eat, sleep whenever you get the opportunity and do your stint on deck. Sleeping was an issue for some of my crew mates even though they were desperately tired - but fortunately I found I could sleep well and easily. However wake up calls came around early and they were often a jolt - very unlike my normal routine. The hardest thing about waking up was you then had just 20 minutes to get up on deck. This really is a challenge particularly if the boat was pounding and at 45 degrees which for several days it was. The space is cramped - everyone needs to get to the heads and then get properly dressed for the deck which includes foulies and sea boots as well as your life jacket. It is a half a sleep scrum and needs a lot of self control and will power. It was usually a wonderful relief to get up on deck once you had adjusted.
I could wax lyrical (if I was a poet!) about being up on deck when it was good. Huge seas, huge sky, the moon, often starlit, sun rises and sets, just the noise of the wind and sea and water rushing past the bow when we were sailing fast. We saw quite a lot of wild life - seas birds swooping and soaring (it would be great to know more about them - what they are doing - where they are going?) dolphins became common place in Biscay - but a privileged sight. We saw large tuna jumping, the odd flying fish and one whale (wow) - apparently a Minky - (There are photographs - not many as they are there and gone quickly - and I have yet to get hold of them because the photographer is doing the ARC.) Another thing about being on deck in a huge sea is the cold. It can be exhilarating I think - when you have the right gear on - and then later as we got further south - the sun on deck - a wonderful feeling of being subject to the elements. Finally I have to mention bioluminescence. It is an extraordinary phenomenon. I always understood it to be how light reflects on the surface but it is not - it is a chemical reaction within living organisms. We observed the electric blue colour on the surface and in the waves on several nights - and spread over a wide area. It really does stand out bright. (if you go to the heads and leave the light off and flush with sea water you can see the bright blue in the pan.) It is a complex mystery indeed.
The other feature that comes to mind is you have time to talk. Strange - your crew mates - you had never met before and likely will never meet again but conversations flowed - were often quite private - (wind noise and voices do not carry) and meaningful. It might be something to do with the bond of trust you build with your crew mates rapidly. It has something to do with your situation. You are literally "in the same boat" - ha! I can imagine how it might feel after 30 days or so crossing the Pacific.
On the sailing it was great to get the boat going well and we all seemed to enjoy the challenge of helming and I think I got some valuable experience for the Clipper race. There is a big difference in the boat speed the helm can achieve by handling the wheel well - especially at the same time maintaining the course to steer - ha! I am not saying I have cracked it but I improved a lot I think. It is tremendous when the wind is blowing downwind - the big rollers are coming up behind, lift the stern of our 50 ton yacht effortlessly and roll underneath - lifting the bow high so you lose the horizon and then runs out and you slide down the wave before the next one comes in. If feels great. It makes you smile. It makes you feel like punching the air at times - all that power under control - amazing. But it can be scary. The sense of responsibility. Lose control and the boat can pitch or gybe - don't go there!
It also comes as no surprise that food became a major focus on the boat (as trekking). It is obvious why. The range of food available has to be limited because it has to be stored for long days and there is little in the way or freezer capacity. Meals can be desperately hard to prepare on a gimbled stove with a boat at a precarious angle and the crew are always starving - the nature of being on a boat. (Everyone loses weight despite the masses of chocolate and biscuits consumed.) Everyone has to be "mother" from time to time and in a strange way the responsibility of cooking weighed as heavy on me as anything else on the boat because you understand how much the crew are looking forward to something tasty and hot and you do not want to disappoint.
We got away relatively lightly with our Biscay crossing. From Ushant for two thirds the wind was kind and the seas likewise despite dropping off the continental shelf and into unmeasurably deep ocean. However as we approached Finisterre the wind strengthened, we were beating into it and the sea rose. It was grey, wet and uncomfortable but the Challengers are well up for it with a reefed down mainsail. It never felt unsafe but it was hard to function and a very thought provoking insight into what we will have to face in the North Pacific.
Eventually we get down to the marina at Cascais, Portugal for a 2 night stopover and an opportunity for the sailors fantasies - shower, beer and a sit down dinner - ha! We took the opportunity to make the short train journey into Portugal's capital city - Lisbon ( I attach a few photos ).
Thereafter we had favourable conditions for the long sail down to the Canaries. It was great. It gradually got warmer, the wind strong but we could sail consistently on a broad reach which is champagne sailing. The swell was massive but reliable and we surfed up and down on our steady platform. Truly memorable - it just makes me smile.
My reflections on the sail were entirely positive and I got some useful experience. It has made me very reflective however on what is to come in the Pacific and how hard and challenging it will be. (and by comparison we were not racing as the Clipper race - there were few sail changes and we never used a spinnaker). I will admit to being anxious about it - but at least not naïve.
Thank you Tall Ships Trust for the opportunity and thank you to my crew mates for making it such an enjoyable time.
Helming is fun if it is going well
Challenger 1 72'
Challenger 2 in photo distance. Can look pretty small on the ocean. 2 reefs in the main.
