Time to choose sides?

Since its inception in 1948, the Flagship of the welfare state, the NHS has remained true to its founding principles – free for all at the point of delivery irrespective of income or lifestyle.

Well, that was true up until now anyway. Under the captaincy of the coalition, the NHS is leaving its normal shipping lane and is entering uncharted waters.

Under government reforms unaccountable appointed Clinical Commissioning Groups have been set up. Rules laid down by the new (CCG), mean that those needing surgery will first have to satisfy their GP that they have lost weight and attended smoking-cessation courses before they will refer them on to be seen by a surgeon. Patients have been told that they cannot have routine operations until they lose weight and stop smoking.

This controversy is not new – there have been numerous reports in the past of surgeons refusing to operate on patients until they gave up smoking or lost weight. But what is different here is that these are guidelines being imposed from on high, not an individual surgeon assessing a patient and deeming the risk to be too high to warrant an operation.

Unlike in the past, the surgeon who would perform the operation and the anesthetist responsible for keeping the patient alive will not be part of the decision-making process.
Under these guidelines, they don’t even get to clap eyes on the patient, let alone assess them.

What is really worrying is that this is contrary to National Institute for Health and Clinical Excellence (Nice) guidelines on treating, for example, arthritis. It clearly states that obesity should not be a barrier to referral for joint replacement surgery, and yet the CCG is doing precisely that.

I have no doubt that this is more about money than patient welfare. We all know that the NHS is under pressure to make financial savings, and introducing artificial barriers for access to treatments is a fine way of doing it – especially if you can hide behind the cloak of patient welfare.

It is one of the worst kept secrets that the Tories would like to dismantle the welfare state and this is a very slippery slope the NHS is heading down. The NHS is not there to enforce lifestyle choices or to judge the choices people make about their lives. It’s also not there to pick and choose whom it treats. Which groups will the CCG penalise next as pressure mounts to make savings and reduce waiting lists. What about people who engage in dangerous activities – such as horse riding, rock climbing or motorcycle track days for example? Shall we restrict the treatments they can receive as well?

Some may accuse me of scaremongering, but don’t bet against my predictions.

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Originally Posted by monday21

Some may accuse me of scaremongering, but don’t bet against my predictions.

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I would ;)
G

Time will tell Gerry, not sure about the horse riding thing though because of ballot box reprisals.

Whether or not people going off in to the mountains should make provision for their own insurance to cover medical treatment in the unforunate event of an accident, is already under discussion.

We live in times when everyone is pointing the blame and different groups in society are attacking each other. Sadly, minority groups like bikers are soft targets.

The beginning of the end, IMHO >:( we are on the slippery slope to anti-collectivism :-/

All politicians are the same and just want to pull the wool over eyes.
They will keep raising taxes, making cuts that screw everybody but themselves over and enjoying lots of 'perks' courtesy of the tax payer.

I do question where the money goes, for example - the NHS is always making cuts and constantly delivering a poor service.....

But at my local hospital (RUH) theyve got a really pretty atrium. Why was it necessary? And how much did it cost? ::)

I failed to mention in my earlier post that denying patients who smoke routine operations will only encourage them to lie about their daily intake of nicotine - even the numbskulls who drafted up these reforms must have seen the implications before they rubber-stamped the bill.

I couldn’t help but notice that the obese and smokers, but not those with alcohol dependency problems are being discriminated against for NHS treatment.

Probably because the lawmakers must have been p*ssed-up in the commons bar courtesy of the taxpayer, when they drafted up this ridiculous bill.

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Originally Posted by monday21

I failed to mention in my earlier post that denying patients who smoke routine operations will only encourage them to lie about their daily intake of nicotine - even the numbskulls who drafted up these reforms must have seen the implications before they rubber-stamped the bill.

I couldn’t help but notice that the obese and smokers, but not those with alcohol dependency problems are being discriminated against for NHS treatment.

Probably because the lawmakers must have been p*ssed-up in the commons bar courtesy of the taxpayer, when they drafted up this ridiculous bill.

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There are tests that are used to tell if you're still smoking or not and can also be quite accurate on the amount you smoke. These are used in the sponsored councelling and support programmes which are jointly funded PCT (NHS if you like) and the County Councils. As there's a high cost to this 1-1 counselling service on quiting smoking all the candidates take one of these tests at each appointment otherwise they lose the financial support they're getting to help them quit. Seems fair to me.

Oh I see Graeme. The Clinical Commissioning Groups will insist that all local GPs test smokers waiting for an op before a referral is made to a surgeon.Hmmm :-/

Beginning to understand now why so many GPs are against the reforms

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Originally Posted by monday21

Oh I see Graeme. The Clinical Commissioning Groups will insist that all local GPs test smokers waiting for an op before a referral is made to a surgeon.Hmmm :-/

Beginning to understand now why so many GPs are against the reforms

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No, that's not what I meant Ken. All I was mentioning was that the technology is available for testing smokers to prove if they have quit and if not how much they're still smoking. It was just in referenc eto your comment about them lying about whether they have quit or not. Also, in the service I mentioned, the GP's are not in the loop.

Sorry Graeme, I wasn’t questioning the technology. Up until now surgeons who were going to carry out the procedures on smokers took the decision as to whether or not there was a clinical risk due to smoking.

Can you just imagine the damage to the GP-patient relationship this new change will cause? "I need to test you to see if you have given-up."

I have read pages on the new reforms from both sides and I just get the feeling that it has been rushed through to save money without enough thought put into it.

I can't say I'm that clued up on the proposals but I could believe that there would be a cost saving to all of us taxpayers if the vetting process was done at a local GP level rather than further upstream by the more expensive area of that particular community.

As an ex smoker myself (we're the worst) I can't see anything wrong with asking the questions about their health if an operation would be pointless or life threatening if it were to go ahead with incorrect information. Its not just about cost, there are many different types of operation where the survival rate is too low should the patient not be healthy enough (in whatever form) to have it.

Graeme, let me clarify. Irrespective of the risk - if you smoke or are obese no operation. that's what is happening now. that is why it is being taken out of the surgeon's remit.

If you read my first post, hopefully you will understand better what I'm getting at.

Next there will be a cut off point when you reach a certain age.
Hands up everyone that thinks your tax goes to the NHS

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Originally Posted by Swanny

Next there will be a cut off point when you reach a certain age.
Hands up everyone that thinks your tax goes to the NHS

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I'm sure part of my tax goes to pay for the NHS - whatever anyone thinks of the service or the politics, it doesn't come from anywhere else in sufficient quantities to pay for it.

Despite the fact that I’m now a non-smoker, I find it ironic that smokers subsidise the NHS through the tax on tobacco products (£12 billion take for the treasury this financial year) yet they are being denied routine treatment.

I repeat, who will be next? Those who participate in high-risk activities like, rock climbing, motorcycle track days and so on?

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Originally Posted by monday21

Despite the fact that I’m now a non-smoker, I find it ironic that smokers subsidise the NHS through the tax on tobacco products (£12 billion take for the treasury this financial year) yet they are being denied routine treatment.

I repeat, who will be next? Those who participate in high-risk activities like, rock climbing, motorcycle track days and so on?

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What about procreation ??

that makes babies and costs too.....you wait...sex will be taxed next lmao........I'd like to see them try that one and enforce it hahahaha ;D ;D ;D ;D ;D



Ahhh, says the doctor, you've been having sex, you're pregnant.... But we can't help you with childbirth because you shouldn't have been doing it anyway lol ;D ;D ;D

Have a listen to this to better understand our country

http://video.google.com.au/videoplay...1930&hl=en

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Originally Posted by Swanny

Have a listen to this to better understand our country

http://video.google.com.au/videoplay...1930&hl=en

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Thanks - just wasted 15 seconds of my life ;D

In this country everybody has the right to be treated, regardless.
The NHS have to prioritise operations Heart surgery, Transplants, Cancer more life threatening than someone being obese & or smokers. It's not about subsidising the NHS we all pay tax towards the NHS.

If that means if you require Bariatric surgery & you have to weight then tough, Eat less move more....!

Trust me you should here what "some" surgeons have to say about performing Bariatric surgery....!

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Originally Posted by GixxerStu

In this country everybody has the right to be treated, regardless.
The NHS have to prioritise operations Heart surgery, Transplants, Cancer more life threatening than someone being obese & or smokers. It's not about subsidising the NHS we all pay tax towards the NHS.

If that means if you require Bariatric surgery & you have to weight then tough, Eat less move more....!

Trust me you should here what "some" surgeons have to say about performing Bariatric surgery....!

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Stu, I agree with your opening statement and that was the point of my original post – smokers and overweight patients are being blatantly discriminated against by the NHS.

Data shows that more than a quarter of Primary Care Trusts in England have brought in new restrictions based on patients’ lifestyle criteria in the last year.

In the case of one trust, NHS Hertfordshire, a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery.
This is a blanket policy and the patients are not medically examined by a doctor to determine whether their lifestyles could pose an additional health risk during surgical procedures.

I made the factual statement that smokers subsidize the NHS (indirectly) because I believe it is relevant to my argument.

Politicians and medical bodies have been telling us for years that smokers place a financial burden on the NHS. We are told that it now costs £6.5 billion to treat patients with smoking related illnesses. Joe public is more likely to accept this discriminatory policy if he is force-fed with half-truths.

The treasury’s take in duty and tax from all tobacco products sold in this financial year will probably exceed £12 billion. And or course, smokers and the obese are not exempt from paying NI contributions.

There are a number of reports out from different organisations, which claim that non-smokers who live a healthy lifestyle cost the state more in the long –term because on average they live much longer – quoting pensions and care for long lasting-illnesses such as Alzheimer’s disease as factors.

I take it the surgeons you are referring to are not those who have made a small fortune out of performing bariatric surgery? :-?

Hey Stu I see what you did there-----very subtle word changes 8-)

Can I have some chips for noticing ;D

We all make decisions & proiritise our own needs & wants.

Hospitals do the same. It's not about goverment subsidies or who pays what tax. It's about managing their budget to the needs of the patients. I think you need to come with me & see behind closed doors. You might change your point of view.

Internal politics & to many line managers within all NHS trusts have wasted money in miss management. If they had more Doctors, Nurses & paid them a decent salary instead of the middle management then perhaps the NHS would be in such a hard times. There are too many people with in the NHS more worried about covering their own arses if something goes wrong.

I'm sorry Ken. In my opinion your wrong on this, your socialist views need to see behind closed doors, then perhaps you'd understand the NHS & it's fight to provide care.

Ok true story told to me by a Surgeon. Teenager, been waiting for years for New Heart & Lung. Middle aged man in his 50's Smoker & not too over weight also needs Heart & Lung, 1 donor who gets it....? Both have weeks to live.
Now Prioritse....!

Also, Routine operation to fit a gastric band, Surgeon about to perform the operation is called away to examine a patient with acute pains in their chest.

Does the Surgeon go attend the patient with pains in their chest or carry on & perform the operation.
Proritise....!!

If your over weight then wait

Blue Stu :P, you are right – if I was to join you on a tour of a busy hospital, it probably would alter my political position. I suspect I would walk in the front doors a socialist and come out of the back doors a communist.

I’m not quite sure as to what part of my standpoint you don’t agree with as we appear to be singing from the same hymn-sheet. I’m in total agreement with your eloquently written statement, “In this country everybody has the right to be treated, regardless.” That was the point of my post.

Your comments relating to the smoker in his 50s versus the teenager is a bit of a red herring in the context of this debate. I’m not taking issue over difficult day-to-day decisions surgeons/consultants have to make.

I’m challenging government reforms which allow NHS managers to discriminate against smokers and overweight patients, denying them routine operations. What about all those who consume over the daily recommended amount of alcohol?

What about bikers who are 25 times more likely to be involved in an accident – should they be forced to take out additional insurance cover to pay for NHS bills in the unfortunate event of an accident? This is a dangerous precedent and paves the way for the NHS managers to sit judgement on those patients who they deem to lead unfit lifestyles.

I smoke, I drink, I weigh too much, have high blood pressure, diabetic and ride a motorbike too fast. Looks like I'll be written off.

I could tell the doctor the above but he is foreign and doesn't understand English too well.
Looks like I'm totally buggered.

Live for today :)

While in a meeting today with some NHS Estates Manager & Capital Planners. We touched on why the NHS is in such a mess.

They touched on why patients are being turned away, oh I thought I wished my Redneck manc friend was with me to hear this.
The were speaking about Peterbrough & the population boom they've had & how people are living longer & advances in medical science. It was mentioned that as an NHS Foundation Trust the goverment pay the trust to conduct operations. An example was given. For example have to state how many for eample, hip operations they are likely to do in 1 finnacial year. The Trust give a figure of 1000 for which they recieve £100. But if they go overthat amount 1001 then the figure drops by a 3rd. As it is NHS policy that everybody is entitled to treatment then the trust is obilged to give it. But now they are turning patients away & only giving treatment to non elective patients, when they are close to reaching the agreed figure.

So what does the Trust do. If they increase the figure they have to reduce it elsewhere as the trust won't get an increase in budget.

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Originally Posted by GixxerStu

While in a meeting today with some NHS Estates Manager & Capital Planners. We touched on why the NHS is in such a mess.

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and nobody said it's because our fabulous wannabe-anti-collectivist PM & his monkeys are doing their best to privatise it :-[

Perhaps you can see why I despise the wealthy Tory (red, blue and yellow-bellies variants of the same) Toffs who run our country. OK to deny access to treatment to those who can’t afford to go private like them.

Bottomless pit to engage in wars or bail-out banks, but there’s never enough cash to treat our own citizens.

Get the the bloody greedy profiteers out of our hospitals now!!!! >:( >:( >:( >:( >:( >:( >:( >:( >:( >:( >:( >:( >:( >:( >:(

Hate to say it....but it's only going to get worse :'( Goodbye Great Britain and hello Unites States of Britain ::)

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Originally Posted by Goldie

Hate to say it....but it's only going to get worse :'( Goodbye Great Britain and hello Unites States of Britain ::)

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Barack Obama’s recent victory on healthcare reform in the US will mean medical coverage will be extended to 96 per cent of the country. The President publicly implored supporters to "answer the call of history" and implement what has become his top domestic priority.

Goldie, we are going in the opposite direction to the US and you are right about it getting worse. The privateers are not falling over themselves to hack of a slice of the cake because they care about the nation’s health. Profits will always take precedence over health care.

If you go private. The Private sector claim to be MRSA free.

They aren't.....! If you contract MRSA or anything else while in your nice private hospital. The first thing they do is call an Ambulance & send you off to the nearest NHS Hospital. Why...? Private Hospital aren't equipped or set up to handle infectious deseases.

Another reason as to why the NHS is stretched & can't privde treatment to those who can't afford private

Extracts from “Our-Beeb” report

In the two years building up to the government’s NHS reform bill, the BBC appears to have categorically failed to uphold its remit of impartiality, parroting government spin as uncontested fact, whilst reporting only a narrow, shallow view of opposition to the bill. In addition, key news appears to have been censored. The following in-depth investigation provides a shocking testimony of the extent to which the BBC abandoned the NHS.

Much has been written about the failure of the BBC to properly inform the public of the nature of the coalition government’s NHS bill, now the Health and Social Care Act, passed by the Lords on 19 March 2012. Many felt the BBC had abandoned the NHS under Conservative pressure and it appears significant numbers lodged complaints. And quite rightly. Having spent a number of days researching BBC coverage of the NHS, the picture which emerges should be of deep concern for both the BBC and the public. For whatever reason – and there are a number – it appears the BBC made a concerted effort to follow the government line, censor critical facts, bury fundamental elements of the reforms and present opposition to the bill in an intentionally limited and shallow manner. Their requirement to report impartially appears to have been fundamentally breached.

I make no apologies for posting the above as it may be of great concern to those who share my belief that we have a duty to protect the NHS for our children and grandchildren.

Moreover, as a stakeholder in the BBC, I think it raises serious questions about the impartiality of the publicly owned TV channel - save that one for another day. :-X

Crazy thought.
Maybe they could divert money from fighting wars and killing people into healing people instead ???