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Restricting IVF
Former Member
Posts: 1,876,323 The Mix Honorary Guru
A PCT is Hampshire is refusing to pay for IVF treatment for any patients, in spite of guidance from NICE.
Story
They claim that IVF isn't enough of a priority compared to "cancer services".
What do you think, are they right in their approach?
Story
They claim that IVF isn't enough of a priority compared to "cancer services".
What do you think, are they right in their approach?
0
Comments
On the terms that the NHS is provided, no.
10% chance of prolonging a life or 10% of making a brand new one that could become anything....and would have decades ahead of it at least for the same cash doesn't seem like a fair trade off to me.
Huh?
I'm not going to comment on the ethics of what you have said there, but the cost of IVF per case is lower than cancer treatment.
Do you have any idea of the lengths people will go to in order to have a child? Do you realise what IVF involves? If not I suggest that you read up on it and then ask yourself why people will go through that.
The NHS is an imposed burden. If you accept that it's valid then you accept that it's totally alterable with no recourse.
There are no ethics, the rationale was cash, not "morality", I thought it best to go through that door.
Nope. No clearer.
The limited cash is what makes the ethical discussion necessary. If the pot was limitless then all would be treated for anything.
Don't believe you.
Interesting.
How do you know it isn't?
Fair enough, but I don't know what you are trying to get at.
Because the man told me
That's what Hitler thought you know. Interesting point. Maybe you should read up on eugenics, basically it's selective breeding so only the strong can procreate.
I think both should be a priority, actually. At the end of the day though, I think living people should have 1st place, rather than 'potentially' living people. I know how difficult it is for people who have to have IVF etc. which makes it an even tougher decision.
Welcome to my world.
You have £200m. The service you want costs £300m. You decide who doesn't get treated.
In spite of klintock's criptive remarks, what you have here is a moral dilemma. It matter not what the cause is. So, question is, do you think that these PCTs have got it right, if so why?
This is why you are the most respected poster. >bow<
He did a lot more than that.
Well, given these wacky beliefs, the first thing you do is attack the time frame. Obviously as things stand the first thing you do is turn that £200mil into a constant stream of income to stand against the future. By spending it all you are dooming future health to the dustbin.
Everyone dies (so far) it's just a matter of when. the only real arguments are quality of life, and return on your investment - to a certain point of view.
If the question is that, yes they have a right local bodies making decisions on local priorities. PCTs are also scrutinised by local councillors so one can assume that if local people don't like it they have some sort of say over it.
Now, whether they've amde the right decision is another matter
In my opinion, no. Because the people with cancer who have the best chance of successful treatment will get treated anyway, except with this, the people who have the worst chance of cancer treatment being successful take precedent over the people who have the best chance of IVF. I think it should be bias towards cancer patients, but not 100% like this. When you have that last £50,000 or so for a chemotherapy treatment, or 10 IVF treatments, and the person with cancer is critically ill and they will never beat cancer, it can only be slowed. However, those 10 people who want IVF are the cream of the bunch of the 100s who have applied - those who really do have the best chance of success.
Everything in moderation and all that. I don't know if that's how the NHS actually works, but if I ran it I'd do it somewhere along those lines.
My personal opinion is... yes, they have reached the right decision. Well, that is to say, if the choice was between cutting cancer or other critical illnesses treatment, and cutting IVF treatment. I'm not saying IVF if the least important medical treatment to be considered, because I'm sure there must be other things that could be considered for the chop.
But yes, I would always choose critical illness funding over IVF. I would always put trying to save existing lives above granting a couple their wishes to have children. To be blunt, there are enough children in desperate need of a home out there. I'm sure it must be marvellous to have offspring if that is what a couple wants, but it is not the most important thing about.
Ideally though we should be able to accommodate everyone as well as possible. Which I'm sure is a very tricky balancing act anyway.
Seriously, I’m not suire exactly what you are getting at. I understand your line of thinking, in that the NHS is imposed on people. In so much as all taxpayers contribute towards it.
What I didn’t get was the change aspect.
The people who had to make this decision do not get an option on that. The funding must be spent during the financial year, and you cannot make a loss on the basis that you will make a saving next year. PCTs must balance their books every year.
It is possible though to invest in cancer services this year, remove the inefficiencies so that you don’t have to spend so much next year… but what you have to understand is where to make that investment.
How do you propose that this happens? How do I create an income stream when I cannot charge the user for something which they have already paid fr?
Not so. By spending it badly, you will only achieve that.
.. and there, ladies and gentlemen is your kicker. Quality of life. Try to make that judgement.
They are? PCTs are “performance managed” by the Health Authority, not councillors. At least I’ve never been held to account by anyone elected – unless you count the HealthSec.
Excellent point. You’ve highlighted what I would see as bad management. Not directing the funds to those who would benefit the most from treatment.
Thing is, I don’t believe that was the actual balancing act they were faced with. It’s just better to spin it that way so that it looks like a good decision.
I would be very worried if, after all the investment in cancer services over the past seven year, they were actually left with this choice.
I suspect that it has more to do with the cost of the new GP contract, the changes to out-of-hours services, the cost of the “Choose & Book” programme (coming to a GP surgery near you as we speak) and the fact that so many organisations have thrown money at achieving targets for short term gain without actually solving the root cause of the problem.
Cancer is a good word to use. As this discussion has shown, it carries a lot of emotion…
Ahh if you accept that it's got limited resources and someone else decides how they are used then you have to accept it will make stoopid decisions.
Interesting us of the word contribute.
I am betting it's not been thought of.
So, spend it on something that will appreciate in value.
What i meant was slap the lot into bonds or something and then after a few years your budget would be wholly me by the "private" sector and would be making the same healthcare.
Ever asked for volunteers? Donors? To trade what you know with other related fields for stuff? Ever bartered directly? Ever whipped round a collection plate? Ever set up a political party JUST for the NHS? Ever used kickbacks from the wealthy to fund the poor?
And so forth....
http://www.hda.nhs.uk/hdt/1202/scrutiny.html
Learn something new every day!
Just had a look on my local County Council website (as our Committee was mentioned in that article), and it does indeed exist.
Bit worrying really that I'd never come across it then. Says something about it's influence, non?
To be fair in some areas they do seem to work (or at least councils claim they do) whereas in others the picture is probably a little more variable. Like most of these things they need both the councillors making realistic recommendations and the various health bodies treating them seriously and at least considering implementing recommendations.
(and people say we have technical discussions in P&D :nervous: )
Diffcult not to really. The tax burden is only so high, and the treasury sets us limits on what we can spend - only giving us a certain amount each year (approx £1100 per head of population per year). We cannot spend what we do not have.
Don't disagree with that principle. There are some elements which are driven centrally, and some which are driven by me.
Guess which I thinks makes the stupid decisions!
Good isn't it? Accurate too.
Of course, it could be argued that it's not voluntary
Yeah it has. It would cost my Finance Director, CEO and Chairman their jobs though. Hence why it doesn't happen.
So not in nurses and prescription drugs then?
How do services appreciate in value?
And in the interim? How do we get around our statutory duty to provide health care?
Do both, but there are limits to what this can achieve. With volunteers we rely on goodwill and their abaility to be available when they are needed.
With donors, we have to consider ethical implications (such as donations from the Pharma industry) and how much of our soul we can sell.
Must admit that we are bad here. We really should charge the private sector when they learn from us, we do charge the Pharma industry for our input into their programmes.
By the same token though, we learn from them and I'd hate to get that bill!
Isn't that taxation by another route - this time voluntary.
But yes, we do that. It's usually referred to as League of Friends...
:thumb:
oops my gubmint paranoia taking over there I fancy.
There'll be a way round it. there always is.
What I meant was accept that you aren't going to provide all, all you can do and salt some of the money away to one side to grow, keep doing it and eventually you will have multiple streams of income. Long term it's a winner, short term it's a bit harsh.
You admit you already don't. (Fully) So what's the difference? One eye on tommorrow must be better, surely.
Aye, fair enough.
:thumb:
We have to demostrate that the funds are spent on healt hrelated issues, and we cannot carry across any upsent balance to the next financial year. Any surplus must be returned to the treasury.
"Open and accountable". It where the NHS wastes resources and it's done at the behest of those who want "control", to satisfy the media and to avoid legal claims.
It's not possible to fund every treatment which a member of the public would like to have.
Okay strike that.
The financial cost of doing that would be so far in excess of what the public could afford/would accept that it's not an option.
Who to, out of interest?
Ridiculous but there you go.
Hence the decisions you have to make, I understand. The question would become for me how do you convince the "public" to voluntarily send you all their cash.
National Audit Office
Certainly is. They use it to ffset against overspends but also to fund something the following year. It's why I treat with contempt any political announcement of "new" funding. I'd rather see it staying with the team who made the saving so that we could invest in something else... which we actually needed.
Baseball bats.
Oh, that's not voluntary. You can't get people to do it voluntarily, they have to want to, by definition.
Hmmm...