Not long ago, a gun was fired from a car at someone who was leaving the prison in which I work. Not long before that a man was shot dead in the pub opposite the prison. And not long before that a man was shot and seriously wounded in the same pub.

With increasing frequency, prisoners tell me that they expect to be shot when they leave the prison ó by rival criminals with whom they have fallen out. At least one such prisoner who told me this was shot dead within weeks of his release, just as he predicted.

Meanwhile, in the hospital in which I also work, surgeons grow experienced in the treatment of gunshot wounds, when a few years ago they had no experience at all. A month ago I was halted in the corridor of my own hospital as a man on a trolley, who had been seriously wounded in a gun battle, was hurried by, surrounded by about ten policemen in bullet-proof jackets, to protect him from further attack. And it is not unusual for our patients to need protection in the wards while they are recovering: one of the reasons our wards now have locked doors.

These are just everyday scenes from underclass life in Britain, a life to which our middle classes, intellectuals and politicians have remained impenetrably indifferent for many years. Never mind: before long, they will soon get a few lessons in underclass culture whether they like it or not. They wonít have to go to the slums: the slums will come to them.

The inexorable spread of firearms has continued quite undisturbed by the Dunblane gun law, just as critics of that law said it would.

Only a few years ago I could assume that if a young man whom I was examining had a scar on his scalp from a fractured skull, it was produced by a baseball bat; if he had a scar from a serious wound on his limbs, it was made by a machete; if it was in his abdomen, it was a knife wound. Nowadays, however, he is just as likely to have been shot: which he tells me with pride, as if he had thereby passed some test of manhood. You have not really lived until youíve been shot.

When my patients tell me that they would like to kill someone ó usually a former friend or lover ó I ask them how theyíd do it. They always reply that theyíd shoot him or her. When I ask them how theyíd get a gun, they marvel at my ignorance of common knowledge: surely everyone knows where to get a gun? You just go down to such-and-such a pub and ask for such-and-such a person. Guns are now cheap enough for someone on social security to buy them; and for some they are a fashion accessory, or a badge of seriousness as a person.

This, of course, is a disaster that was waiting to happen. An infantilised population, unable or unwilling to distinguish between fantasy and reality, intolerant of the slightest frustration or boredom, has been raised on a diet of glamorised gunfire. Someone once estimated that, by the age of 18, the average American had witnessed 15,000 deaths by shooting on the screen; and it is unlikely that the British, the worst-educated people in the Western world and therefore the most addicted to television, have seen fewer. Thus, shooting people is an everyday occurrence in their imaginal lives.

Guns have become easily available again ó as they were in the 19th century ó just as people have lost control over their emotions. Look at the expression on the faces of people who believe you have cut them up on the road: would you want them to have a gun at that moment?

The emotions of people in the underclass are permanently in such a state of inflammation, intense but shallow and changeable. Lacking structure in their personal lives ó stable families are but a distant memory ó they have never known restraint for the sake of others because they have never learnt it. The only means of social control is by violence: and, of course, guns are the ultimate in urban violence.

Most young men whom I meet who have been shot belong to what is known as the gun culture: and it is only an accident of history that they are victims rather than the perpetrators. This gun culture centres for the moment around drugs, gold chains and used BMWs (Bad Manís Wheels), but there is no reason why bad men with guns should always use them on each other rather than, say, on the readers of broadsheets. They might start to use them in a general redistribution of property.

Nor is there any reason, as guns become more commonplace, why only or even mainly drug dealers should avail themselves of their firepower. Every little dispute could be quickly and conveniently settled by a shoot-out. We shall reap what we have sown by our indifference, wilful ignorance, moral frivolity and neglect.