Cutting benefits for drunks and the obese isn’t cruel – it’s kind

USUALLY, I just drink cider, but I treat myself to a bottle of Scotch on payday,’ said the patient sitting in front of me. I looked up from my notes. ‘What do you mean “payday”?’ I asked. ‘I thought you were unemployed?’

‘I am,’ he said, grinning. What he meant was the day he received his benefits.

‘Payday’ was an expression I quickly became used to in the years I worked in a drugs and alcohol clinic. But I hated it — and still do.

Being ‘paid’ suggests some sort of transaction has taken place: you are paid in return for work, and I don’t think sitting at home all day drinking yourself into oblivion — as, sadly, many of my patients did — counts.

I’m not just talking as a grumpy taxpayer here. This sense of entitlement to a state subsidy for self- destructive behaviour is a gigantic roadblock stopping people like my cider-guzzler from facing their problems.

Yet when David Cameron launched a fullscale review this week into whether drinkers, drug-takers and the obese should have their welfare cut if they refuse treatment, he was denounced as heartless.

The internet lit up with indignation, and charities and campaigners were united in their condemnation. Professor Sir Simon Wessely, the president of the Royal College of Psychiatrists, branded the plans ‘unethical’ and ‘probably illegal’.

Now, I have a great deal of respect for Professor Wessely, and we see eye to eye on many subjects. However, on this, I couldn’t disagree more.

It is right and just that those who cannot work because of sickness or ill health are supported by the State. The rest of us take collective responsibility to ensure their welfare, and I would hate to live in a society where this was not the case.

But when there’s a significant psychological component to health problems, such as alcohol and drug addiction or overeating, those affected have a responsibility of their own. If they want help from others, they must also help themselves — and change their behaviour.

My patient who referred to his ‘payday’ had come in complaining of feeling depressed. He drank two to three litres of cider a day and had been doing so for eight years.

I tried to explain that alcohol is a depressant, so it was no surprise that his mood was low when he was drinking so much. There was nothing I could do for him until he made a concerted effort to give up.

But he had already been in and out of alcoholism centres, receiving costly inpatient detoxes, as well as outpatient care. Countless professionals had tried to help lift him from his self-created quagmire.

He’d stay dry for a few weeks at best, attend a few appointments, but soon fall back into his old ways.

Everyone knew it would all be futile until he decided he wanted to stop drinking. That might be next week, next year — or never. Is it right that the State should support him, no strings attached, and, in fact, pay for the alcohol causing all his problems until he finally makes up his mind?

More than 170,000 people claim benefits because they are alcoholics. This has more than tripled from 48,700 in 1997. A further 280,000 are on benefits for addiction to opiates, mostly heroin.

RESEARCH shows that, in England alone, one in 15 benefit claimants are dependent on drugs. And more than 7,000 are on benefits simply because they are obese.

Am I alone in finding all of this both astonishing and galling?

As I’ll never tire of saying, there is an element of choice in alcoholism, addiction and obesity that is not afforded to those with, say, multiple sclerosis or cancer. Yes, you have the right to live your life how you please. But you can’t expect others to provide indefinite financial support so that you can make selfdestructive choices.

Look at it this way: if someone was unable to work because they had, for instance, a fractured hip, then it would only be right that the State supported them until they got better.

However, if they were offered an operation to fix their hip and refused it, preferring to limp along and not work, we’d shake our heads and say they were abusing the system.

Yet this is precisely what is happening with those who refuse treatment for their addictions.

The welfare state was designed as a safety net to catch people down on their luck. It was not intended to help the morbidly obese fund their chocolate biscuit habit or to pay for alcoholics to buy Scotch.