David Rew Consultant General Surgeon

The Times - Bare-knuckle cheek

9th May 2026, David A Rew, Consultant Surgeon

Sir, Your report on the delicate sensitivities of a visiting US bareknuckle fighter punchily exposes the fundamental flaw with the concept of the NHS and the constraints upon it. Engage in illegal fights, drink yourself senseless, eat without restraint, drive like a maniac, or take any risks you like with your own or others’ wellbeing: the British taxpayer will always pick up the costs of your incentive-free self-indulgence.

The time has come for sensible folk to get into the ring, take the gloves off and slug out the alternatives.

David Rew
Consultant general surgeon, Southampton Hospitals

Background
On Friday 9th May 2026, The Times ran the following story:
NHS ‘animals’ attacked by bare-knuckle boxer from US
________________________________________
Poppy Koronka - Health Correspondent
________________________________________
“An American boxer has called NHS hospital staff “inept animals” over the care he received after a fight in Britain.
Paulie Malignaggi, a 45-year-old bare-knuckle boxer, received treatment at Leeds General Infirmary after beating Tyler Goodjohn in a bout at a boxing event in the city last October.
The fighter was left with two severe cuts above his eyes and multiple fractured ribs. He claims that the treatment he received has caused one of his cuts to become “constantly infected” and said that staff “wouldn’t even be allowed to work on farm animals” in America.
Malignaggi insisted his care would have been better in America, claiming he heard staff “gossiping” in another room while he was waiting to be seen.

“The cuts would have been a regular stitch job in a regular hospital in the United States,” Malignaggi said on The Ariel Helwani Show, a sports podcast.
“But they have people in the UK who work in the NHS who in America probably wouldn’t even be allowed to work on farm animals ... I was there all night.”
He added: “Absolute inept animals, keeping me in the waiting room, not cleaning the blood dripping down my face. I’m hearing them gossiping in the other room - the hospital is almost completely empty. They don’t even have a guy there to stitch anybody.

“My wounds were not cleaned. Basically, what I’m getting at is [that] one of the cuts has been constantly infected and pussing out up until a few weeks ago. It is closed at the moment - I expect it to open up in a fight.”
The Times understands that the emergency department was treating about 100 patients on the evening of the fight - a typically busy Saturday.
Leeds Teaching Hospitals NHS Trust said: “We prioritise patients based on clinical need to ensure that the most critically ill are treated first ... We would be happy to discuss his complaint.”

Bare-knuckle boxing is a full-contact sport where participants fight without gloves. The sport was banned in the United States for more than 130 years until it was legalised in 2018”.

My Observations
It has long been obvious to me that a root cause of the funding problems for the NHS “free at the point of use” model is that it also dis-incentivises every citizen from taking responsibility for the costs of his or her own health and risk-taking.

The mental picture of a purportedly rock hard, animalistic bare knuckle cage fighter getting himself in a big tizzy about drips of blood on his face and “pussing up” in a heaving Leeds Infirmary A and E Dept with drunks and the seriously unwell everywhere, and with beleaguered staff run off their feet on a typical Saturday night, was just a little amusing.

It offered an open goal for wordplay to make the more general point about citizen responsibilities for their own well being and about the urgent need for alternative ways of funding the NHS, whether through direct pay-for use or through proven forms of state backed health insurance systems to dis-incentivise dangerous self-indulgence.