NHS crumbling away...as predicted

[Seth]

Is it fair to deny fat patients and smokers surgery on the NHS? Joint replacements and IVF could be rationed to save money

More than a third of health trusts are considering rationing some surgery
Several admit they may impose 'eligibility' rules refusing some patients
Obese patients could be denied knee and hip replacements and breast ops
While smokers may be told they cannot have IVF procedures on the NHS

By Sophie Borland for the Daily Mail

Published: 10:01 EST, 22 April 2015 | Updated: 11:37 EST, 22 April 2015

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Patients who are too fat could be denied routine operations to save money, revealed a survey of health service bosses.

More than a third of NHS trusts are considering rationing some types of surgery and other treatments.

Several have admitted they may impose ‘eligibility’ rules which could affect smokers as well as the overweight.

The criteria for accepting patients for operations would be based on their Body Mass Index, a measurement of obesity.
More than a third of health trusts are considering rationing some types of surgery and other treatments to save money, according to a new study
+2

More than a third of health trusts are considering rationing some types of surgery and other treatments to save money, according to a new study

When senior managers at 67 Clinical Commissioning Groups – local health trusts – were asked, 39 per cent said they were planning to ‘limit access’ to routine treatment for financial reasons.

Procedures affected include varicose vein treatment, hip and knee replacement, and breast reduction surgery.

Others said smokers might be denied some treatments, most commonly IVF.

Senior doctors criticised the plans and accused health managers of denying patients vital treatment simply because they were considered to be ‘undeserving’.
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Dr David Paynton, of the Royal College of GPs, said: ‘Decisions about whether our patients are eligible for surgery or treatment need to be made on a case-by-case basis and by answering the question of whether surgery will benefit a patient’s long-term physical and mental health.

‘It should not be the role of CCGs to impose blanket bans on our patients’ access to surgery, nor to decide who is and who is not deserving of potentially life-saving treatments based on their lifestyle choices.

‘Of course, some surgical procedures cannot be performed on patients who are above a certain weight.
If we’re going to ration a service we should ration it for all people, not just those in particular groups and pretend it’s for clinical reasons. If it’s purely down to cost saving, it’s not ethical
Dr Richard Vautrey, chair of the BMA’s GP committee

‘In these cases, a clinical decision needs to be made about whether surgery would be beneficial if the patient lost weight and urgent steps would need to be taken to try and make this a possibility – but this is a separate issue.’

A Conservative Party spokesman said: ‘If health bodies stop patients from having treatments on the basis of cost alone, we will take action against them.’

Labour health spokesman Andy Burnham said increased rationing would lead to more patients having to pay privately.

‘Across the NHS, we are seeing a widening postcode lottery in access to treatment as financial pressures set in,’ he said.

‘The impact of this rationing plan is to expose the public to a greater range of charges for healthcare.’

There are 211 CCGs in England so the survey by the Health Service Journal covered just under a third.

Last year, Northern, Eastern and Western Devon CCG threatened to ban all non-urgent operations and treatments for anyone considered severely obese, with a BMI above 35.

This is equivalent to a 5ft 6in woman weighing 16st or a 6ft man being 18st 13b.

There was an outcry from patient groups and medical experts, including the Royal College of Surgeons, and the policy was subsequently dropped.
Obese patients could be denied varicose vein treatment, hip and knee replacement, pictured, and breast reduction surgery, while smokers could be banned from having IVF on the NHS
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Obese patients could be denied varicose vein treatment, hip and knee replacement, pictured, and breast reduction surgery, while smokers could be banned from having IVF on the NHS

A separate survey by GP magazine last month found that 80 per cent of CCGs ration at least one procedure to patients who are very obese.

Some claimed surgery was less effective for the obese, they took longer to recover or that the anaesthetic was high risk.

Dr Richard Vautrey, chairman of the British Medical Association’s GP committee said at the time: ‘It’s blatant rationing.

‘CCGs should be open. If we’re going to ration a service, we should ration it for all, not just those in particular groups and pretend it’s for clinical reasons.

‘If it’s purely down to cost saving, it’s not ethical. There are clearly cases where certain people’s body size may make it difficult to safely do a certain procedure, but they’re exceptional.’

[PsychoSerenity]

Yes, it was predicted that if the Tories had their way with the NHS they would fuck it up, and they did. They removed the government's responsibility to provide an integrated health service, splitting it into separate commissioning groups made to run as businesses, cutting their funding, and forcing them to compete with private companies who are just out to make a quick profit from the sick. As demonstrated in the article, it's quite clear that this leads to unethical decisions being made about how our health service is run, which underlines the fact that private profits and market systems have no place in healthcare.

[Seth]

Yes, it was predicted that if the Tories had their way with the NHS they would fuck it up, and they did. They removed the government's responsibility to provide an integrated health service, splitting it into separate commissioning groups made to run as businesses, cutting their funding, and forcing them to compete with private companies who are just out to make a quick profit from the sick. As demonstrated in the article, it's quite clear that this leads to unethical decisions being made about how our health service is run, which underlines the fact that private profits and market systems have no place in healthcare.

Well, free market economics only work when it's actually a free market, and no government-run organization can ever be a free market operation because the incentive to provide good service at a low price is entirely missing when the government mandates that the NHS provide free medical care of every kind to everyone at taxpayer expense.

It's entirely unsurprising that the NHS is a failure and that rationing of health care takes place, I've know that to be true since socialized medicine began. There is no other choice in fact. People point to the free market system and say "but there's rationing there too" and they are quite correct, there is. The difference is that the free market never promised to provide anything to anyone who wasn't willing and able to pay for it. Government-run health care promises exactly that, and then cannot deliver. In other words, governments that promise universal health care simply lie through their teeth to the credulous proletarian masses strictly for political reasons having nothing whatever to do with providing health care to anyone.

Free market economics is at least honest and truthful: "If you want a product or service, you have to be willing to pay what someone demands for that product or service, or do without."

Everybody knows exactly where they stand and exactly what they will get in return for their investment. Everyone's exactly equal in that respect.

Don't have money for health care? Then take care of yourself and don't get hurt or sick, and save up money from your job for future unexpected medical needs rather than spending it buying the latest OLED 4K 70 inch television set.

And if you make the decision to buy the TV instead of saving for medical needs, then don't bitch about it when you get sick and don't have any money to pay for care. You made your choice, now live with it and don't demand that other people give you their money, the money they prudently decided to save against a rainy day, to compensate for your stupidity.

[pErvinalia]

Yes, it was predicted that if the Tories had their way with the NHS they would fuck it up, and they did. They removed the government's responsibility to provide an integrated health service, splitting it into separate commissioning groups made to run as businesses, cutting their funding, and forcing them to compete with private companies who are just out to make a quick profit from the sick. As demonstrated in the article, it's quite clear that this leads to unethical decisions being made about how our health service is run, which underlines the fact that private profits and market systems have no place in healthcare.

[Tero]

Adapt or die! Lose the fat.

[Seth]

Yes, it was predicted that if the Tories had their way with the NHS they would fuck it up, and they did. They removed the government's responsibility to provide an integrated health service, splitting it into separate commissioning groups made to run as businesses, cutting their funding, and forcing them to compete with private companies who are just out to make a quick profit from the sick. As demonstrated in the article, it's quite clear that this leads to unethical decisions being made about how our health service is run, which underlines the fact that private profits and market systems have no place in healthcare.

Private profits and market systems are the only way anyone can get top-notch health care (or pretty much any health care for that matter). Socialized medicine doesn't work, has never worked, and cannot mathematically or fiscally work. It's just a simple economic fact that no nation can provide all the health care that every person will need in their life for "free." As we see in the UK, trying to do so ends up bankrupting the national treasury because it must, as a matter of economic natural law, which states "There ain't no such thing as a free lunch."

The simple global economic fact is that everyone cannot have all the medical care they might need or want. There's always going to be a shortage of medical care because medical care resources are finite, specifically including doctors and nurses, who don't have to work for free. Make being a doctor too much of a pain in the ass and not profitable enough to attract students to medical school and you can have all the best medical technology in the world and still not get any care. It's a market-based economy for health-care professionals and always has been, since the cave-tribe shaman discovered that willow bark tea alleviates pain. Scarcity equals value, and doctors are quite scarce, particularly in socialist states where the government underpays and overworks government-employee health care professionals who soon stop giving a fuck about helping people because they aren't being paid enough to give a fuck, so they just phone it in and let patients die of thirst on hospital wards.

So if you want medical care, you'd better save your pennies and take care of yourself so you can afford medical care if and when you need it, because nobody's going to give it to you for "free" for very long, and if you can't afford to pay what the market demands for service, nobody's under any obligation to slave on your behalf to give it to you without their consent.

It just goes to show you that sometimes you die.

[cronus]

I believe the only way of saving the NHS, as with much else here, is to remove all foreign interests starting with American ones. Same with everything else really - change is homegrown. Tag your chute with a bigger guy with a larger failed chute and you only hit the ground faster. Time to jettison America.

[piscator]

Yeah! But most of the top 10 pharmaceutical manufacturers are in Switzerland or Germany, and they'll shag you just as enthusiastically as their American entities. So what will you have gained, besides a distinction without a difference?

[Hermit]

Yeah! But most of the top 10 pharmaceutical manufacturers are in Switzerland or Germany, and they'll shag you just as enthusiastically as their American entities. So what will you have gained, besides a distinction without a difference?

Granted, pharmaceutical manufacturers operate to make a profit just like any other business, but health care systems are about a lot more than providing medication. Most health care in the UK, Australia and a few other countries is provided by government owned hospitals, government ruled insurance and many other facilities concerned with providing services to the sick, and they do not add a margin for profit to the cost, nor do they squeeze the level of care to maximise return on investment. Government run health services are also massively bulk buyers of pharmaceuticals, so they can and do negotiate significant discounts on the price of medications and ancillary supplies.

[mistermack]

The cost of drugs isn't entirely in the hands of the drug companies anyway.

If a drug is considered too expensive, we don't buy it. There may be an outcry by some, but the principle applies to everything in life.
And if you don't spend a hundred grand on a new drug with a silly price, you still have that hundred grand, and you can spend it somewhere where it will do more good. That's the judgement everyone has to make, whatever the system.

The NHS actually wields a lot of buying power, compared to a fragmented private system.

[Collector1337]

I for one actually agree with this policy.

If your BMI is >25... literally rethink your entire lifestyle.

[mistermack]

It's entirely unsurprising that the NHS is a failure and that rationing of health care takes place, I've know that to be true since socialized medicine began.

It's such a failure, the parties are falling over each other to claim that THEY are the ones most committed to it, in the current election campaign.

Unsurprisingly, there is NO demand to pay nearly three times as much per person, for a system that doesn't cover everyone. Like they do in the US.

And the US has far more rationing of health care.
The only difference is that it's insurance companies who do the rationing.

[laklak]

I for one actually agree with this policy.

If your BMI is >25... literally rethink your entire lifestyle.

I agree also, though BMI isn't the best measure, IMO. Body fat percentage is a better metric, though a bit more difficult to measure.

I was in Wally World the other day getting some groceries, and the fat-ass Walmartian in front of me had a trolly packed with shit food. Not a fresh veggie in sight and pre-packaged everything else. Her bill was over $120, whereas mine was around $100 for a trolly full of fresh veg, meats, fish and dairy. So the idea that poor people can't afford to eat a healthy diet is bullshit, they're just too fucking lazy to make the effort. Why should the rest of society have to pay for their completely avoidable health problems? Same goes for smokers. There's no fucking excuse to start smoking these days, so if you're stupid enough to start and come down with lung cancer it should be your problem, not everyone else. That said as a former two-pack a day smoker.

[Brian Peacock]

Yes, it was predicted that if the Tories had their way with the NHS they would fuck it up, and they did. They removed the government's responsibility to provide an integrated health service, splitting it into separate commissioning groups made to run as businesses, cutting their funding, and forcing them to compete with private companies who are just out to make a quick profit from the sick. As demonstrated in the article, it's quite clear that this leads to unethical decisions being made about how our health service is run, which underlines the fact that private profits and market systems have no place in healthcare.

Liar.

[Brian Peacock]