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Woah. Is this the actual beginning of the end for the NHS as we know it?
Bang out for overweight people though
a large percentage of post pregnant women will have a BMI of +36. Will they be denied surgery on this basis?
why stop there - why not deny alcoholics surgery too?
but i do enjoy ragging on smokers, and this seems to suggest that obesity is the result of "poor life decisions" or some such, which is rubbish.
involved in a person's weight?
but obesity is a far more complex issue than just someone's eating habits, which these measures don't account for.
"All of these temporary measures relate to planned operations and treatments, not those which must be done as an emergency or to save lives.....We recognise that each patient is an individual and where their GP or consultant feels that there are exceptional circumstances we will convene a panel of clinicians to consider the case."
But I hope the CCG, and the local area team, have the capacity to deal with the amount of complaints they're going to receive.
I thought this was standard practice nationwide? Heard lots of people say "they won't do the surgery til I've lost weight/stopped smoking."
but that's way above a BMI of 36
that this is the direction some CCGs are going in. It's terrifying.
It's simply about being able to receive healthcare no matter who you are or what your choices have been.
Except now it's about the responsibility of patients to be up and working as long as possible, and so if you're making the wrong decisions you're not entitled to it. Our country's a till and I want out.
about something like this.. about neoliberalism and obesity and refusing treatment. can't remember what it was but I think it was relevant to this.
just like surgery and drugs are healthcare.
The founding principles of the NHS by Bevan say people should be entitled to 'good healthcare' - sadly there isn't a definition of what 'good healthcare' is. Bevan doesn't give us a free pass to go to our GP or consultant and demand exactly what treatment we want. We live in a medicalised world where if someone walks out of a consultation with leaflets and videos rather than a prescription or theatre appointment then they feel conned or that they're getting inferior or cost-cutting care.
Morbidly obsese people and smokers aren't being denied 'healthcare' - they're receiving a different package of care to other people because their mobidity, mortality and outcomes from different treatments will be different - it's how healthcare works. It's worked like this for ages, but we're projected to see 0% growth in the NHS budget over the next 5 years, but roughly 4% health inflation per year (population increase) - CCGs are shitting a brick and more and more 'obvious' rationing is having to occur.
If you need a routine (rather than emergency or lifesaving) treatment such as a hip replacement for osteoporosis, then if you're morbidly obese and/or a smoker then losing weight and/or quitting smoking will positively and significantly improve your mobidity and mortality in general, and it will also improve the outcomes associated with treatments like surgery (this is the case in pretty much every situation). All this CCG is saying is that they're going to encourage care providers in their area to ensure that patients are helped and supported to try and lose weight/quit smoking. In some cases it will avoid the need for certain operations. In many cases it will reduce length of stay, complications, future health expenditure and improve health. I appreciate that some people find the concept of the NHS advising lifestyle changes uncomfortable, but I don't think this debate is about personal choices or responsibility, it's about improving care for people when our budgets are continuing to be restricted.
The statement from the CCG linked to in the article also made their point more clearly than the way the BBC reported the news.
But the lack of funds and the enforcement of certain lifestyle changes are complicit with each other, those at the top don't want to fund public healthcare but if they're going to it'd better be justifiable economically. And so on until approval becomes low enough to scrap the whole thing.
The practitioners are just doing the best they can with what they've got, there's more recoveries by those not stuffing or smoking their face in, so they discourage it but semantics aside the NHS is based on empathy not rationality so to let it slide towards this is very sad is all i'm saying.
For a while (even before the current govt) there has been a strong push to ensure that health is improved with the aim of improving productivity. In recent years there's been a plan (finally and fortunately rejected) to include 'productivity' as one of the measures by which NICE would approve new drugs. You start getting into a real mess when you prioritise services or treatments which improve productivity over and beyond other treatments which may offer the same health benefits, because the system is in balance and you have to withdraw some service somewhere else to finance it, and inevitably those services are those which don't provide productivity benefits - mainly older people services, very serious illnesses etc.
Something else which is concerning is the current drive of using the NHS as a carrot to promote and boost our pharma and life sciences industries. There's been talk for a while about 'innovation' becoming much more important when it comes to approving new drugs and medicines. Companies will be allowed even earlier access (with less safety and effectiveness evidence) and also allowed a premium price. It's basically double-counting because companies are already rewarded for innovation via the price they can charge for their drugs.
the current "NHS Innovation" motto is "Health and Wealth" - Seems pretty weird to start taking a ring-fenced health budget and expecting the NHS to provide direct benefits for the wealth of our country. Why can't it just indirectly do that by focussing 100% on health?
these threads always work better if you go on the headline alone.
the tax on cigarettes/ tobacco products yielded HMRC via excise and VAT was £12.3 billion.
i feel like being a giiiiiiiiiiiiiiiiiiirl
rather than two: http://www.mirror.co.uk/news/uk-news/more-nhs-cuts-means-deaf-4743680
Of all the old people I know with hearing aids, none of them use them!
or none. It probably evens out actually.
The mrs' dad got one on the nhs but would have to hand over some benjamins for another
oh nobody's actually read the article or the statement? I've read them both in full and still think this is a bad policy for smokers and fat people.
I don't think it's bad policy to help someone quit smoking before a surgical procedure, if that procedure is going to be rendered useless by continued smoking.
However, I do think that 'blanket' procedures like this are unhelpful. What if an otherwise healthy smoker suffers a torn ligament playing rugby? Would he or she be denied a routine operation to fix the knee because of their smoking habit?
and being asked "Do you smoke?", "Yeah", "Oh sorry you can't have this op until you quit"
"OH did you mean smoke cigarettes? No not me, I smoke kippers mate, professional kipper smoker. Now where's that consent form?"
In all seriousness though. The CCG's measure are for where smoking and or weight will increase a patient's surgical risk, or reduce the outcomes associated with the operation. A healthy smoking rugby player I guess would be unlikely to fall into this bracket.
Also, maybe the NHS or govt to provide a regulated and controlled vaping service which enables people to more easily quit smoking.
"Wednesday's announcement applies to all routine procedures."
the memo from the CCG is here:
Basically talking about best outcomes after surgery is one thing but the fact remains that this decision was primarily based on cost. How much do the NHS actually think this is going to help with a deficit that's currently 14.5 million and what sort of decisions are going to be made in the future with the same intention.
so be it.
was overweight smokers being turned away at the hospital doors.