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It starts.....obese people to be denied operations

Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
So is this the beginning of the end for free healthcare.......?

Story.

Personally I'm not that surprised, it was always going to be a matter of when not if.......question is where does it end......?
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Comments

  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Do fat people get a reduction in tax then?

    Do they fuck.

    I hope those cunting doctors get run over.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Do you think they did it because they hate fat people or something?

    They have limited resources and have to use them in the most appropriate way.

    I don't necessarily agree with this though........
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    apollo_69 wrote:
    So is this the beginning of the end for free healthcare.......?

    Story.

    Personally I'm not that surprised, it was always going to be a matter of when not if.......question is where does it end......?

    This one has me in two minds.

    If you're obese, you know you're obese and should be aware of the health implications that come with it. It does however seem inhumane to deny someone an operation that would increase their quality of life because they have a penchant for pies. The article seems to infer that it's relatively minor complaints that the surgery to fix could be denied though. IMO if the patients particular complaint could be recified by laying of the cream cakes i do think they should be told to do exactly that.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Toadborg wrote:
    Do you think they did it because they hate fat people or something?

    Yup.
    They have limited resources and have to use them in the most appropriate way.

    Yep, by giving the services to those who pay for them.

    If fat [people don't get NHS treatment, then any taxation on unhealthy food is completely unjustifiable.

    And whilst we're on the subject, I propose that we don't mend the broken legs of skiiers, cyclists, motorcycle riders or footballers. They caused it themselves, so lets save a fortune and not treat them.

    I'd also propose no maternity care. Women got themselves pregnant, why should we pay for them?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit wrote:
    And whilst we're on the subject, I propose that we don't mend the broken legs of skiiers, cyclists, motorcycle riders or footballers. They caused it themselves, so lets save a fortune and not treat them.

    I'd also propose no maternity care. Women got themselves pregnant, why should we pay for them?

    I don't think the examples above are directly compariable. You'd could argue a footballer or cyclist was trying to improve his health as one of the reasons s/he participates in the sport. I don't think cramming KFC down a persons throat could be seen as anything other being detrimental to a persons health.

    I don't agree that obese people should be denied operations but if they are going to be taking up an operating table when staying away from the chocolate drawer would have the same effect then it does muddy the waters a little for me.

    Edit: Also if an obese person comes back in for a repeat operation related to their weight after being told shifting the weight will remove the necessity for it, then i'd find it hard to have sympathy for them.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Hmmm tricky one.

    Can fatty go lose some pounds?

    Sure. How difficult is it to not do something?

    I think the point with these people is that until they lose the weight theres no point in fixing their legs or whatever, because it won't last.

    Problem lies with the point Kermit made - the people who are most likely to use the NHS are the ones who have put the most money into it. Your average smoker has pumped much more money into the NHS than a non smoker, a fatty will have done the same with his cream cake consumption.

    Of course theres always insurance to pay for these things. Or at least there would be if it wasn't ok to steal from people "for a good cause".
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    This one has me in two minds.

    If you're obese, you know you're obese and should be aware of the health implications that come with it. It does however seem inhumane to deny someone an operation that would increase their quality of life because they have a penchant for pies

    Exactly, I think the health dangers of obesity are well known, but at what point do you refuse to treat fat people? Choosing to deny anyone with a BMI over 30 seems pretty arbitrary......Kermit's point is valid in that fat people do pay taxes and if they don't get treated freely, then where exactly are their taxes going?......
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Weight gain can be down to factors other than being 'lazy' or 'greedy'... For example, anti depressents can make you put on weight, as can glandular problems...

    According to the doctor I'm "obese" (size 14-16), so does that mean I'll be denied treatment?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    apollo_69 wrote:
    So is this the beginning of the end for free healthcare.......?

    Erm.. two points.

    1. There is no such thing as free healthcare, just free at the point of delivery. The NHS does come with a price.

    2. I don't see how this story is linked to that comment at all. Can you expand?
    Soon enough there will be lots of cuts on NHS

    There is no difference between this and the refusal to treat unless patients reach other "thresholds", whether that is pain, disability or even cause of the condition.

    Some surgeons will already refuse to treat smokers because of the anaesthetic risk for example.
    It does however seem inhumane to deny someone an operation that would increase their quality of life because they have a penchant for pies. The article seems to infer that it's relatively minor complaints that the surgery to fix could be denied though. IMO if the patients particular complaint could be recified by laying of the cream cakes i do think they should be told to do exactly that.

    I think that the interesting point with the story here is that we are talking about hip & knee operations.

    I wonder how people are expected to lose wait when they cannot exercise because they have a... erm... hip or knee injury.
    I don't think the examples above are directly compariable. You'd could argue a footballer or cyclist was trying to improve his health as one of the reasons s/he participates in the sport. I don't think cramming KFC down a persons throat could be seen as anything other being detrimental to a persons health.

    Except the moderation rule applies.

    What Kermit is pointing out is that cycling, skiing etc carry risk of injury. No-one is forced to do either activity and therefore does it knowing the risk. Why should the NHS pick up the tab for their treatment.

    Rationing of NHS treatment has a place and should be debated, but all aspects should be considered - such as the contribution to the tax burden made by smoker/acoholics etc.
    I don't agree that obese people should be denied operations but if they are going to be taking up an operating table when staying away from the chocolate drawer would have the same effect then it does muddy the waters a little for me.

    Again this takes me back to smokers. Should we refuse to treat respiratory conditions in smokers?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    i thought it would have been because they were at a higher risk of complications during surgery?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Or because they might need two beds and double prescription of whatever's in the drip.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru





    Again this takes me back to smokers. Should we refuse to treat respiratory conditions in smokers?
    smokers keep the nhs running with the 10 billion quid a year they pay inand then ...die before they need pensions and healthcare etc.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I think that the interesting point with the story here is that we are talking about hip & knee operations.

    I wonder how people are expected to lose wait when they cannot exercise because they have a... erm... hip or knee injury.

    It wasn't exclusively knee or hip operations, IIRC varicose veins were mentioned.
    What Kermit is pointing out is that cycling, skiing etc carry risk of injury. No-one is forced to do either activity and therefore does it knowing the risk. Why should the NHS pick up the tab for their treatment.

    Rationing of NHS treatment has a place and should be debated, but all aspects should be considered - such as the contribution to the tax burden made by smoker/acoholics etc.

    I understand the point Kermit was making. I just don't think the comparisons were exact. Using a black and white arguement like that you could argue that people leaving the house to work in the morning are putting themselves at a higher risk of injury than sitting at home on the sofa and hence shouldn't be treated either. I think a degree of rational and common sense has to be applied.

    As i stated earlier i'm in two minds about the issue. I think that asides from the tax reasons people should have a social conscience. If you know that you have a medical condition you are prolonging or aggrevating by continuing to abuse your body then you have to be aware of the fact you're taking valuable operating table time away from someone who, as far as i'm concerned, is more deserving of the treatment.
    Again this takes me back to smokers. Should we refuse to treat respiratory conditions in smokers?

    As a 20 a day smoker I fully accept the increased risks of various diseases i am running. If i was put in a situation where i needed an operation and had the option of putting someone i felt was more deserving ahead of me in the queue then i would defintely do so. Also if i had the operation and the doctor told me i had to stay of the ciggies or i'd be right back in the same situation, i'd do so. My social conscience alone would be strong enough to make that decision for me.

    Maybe it's a case of treating it the first time but giving lower priorty to "re-offenders", as it were.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    smokers keep the nhs running with the 10 billion quid a year they pay inand then ...die before they need pensions and healthcare etc.

    :D Of course there is that argument as well!
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I think that the interesting point with the story here is that we are talking about hip & knee operations.

    I wonder how people are expected to lose wait when they cannot exercise because they have a... erm... hip or knee injury.

    Good point.

    It's along the same lines as liver transplant patients being alcoholic. Liver transplant patients have to be dry (at least in the PCT where I live).

    How are obese patients meant to lose weight in a safe way (through exercise) if they can't even stand up due to dickie knees/hip? What's the point of putting people through traumatic surgery if in the long run quality of life is not going to be improved?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    smokers keep the nhs running with the 10 billion quid a year they pay inand then ...die before they need pensions and healthcare etc.

    Very true. And I'm willing to wager that it costs a tiny fraction of that to treat all the smokers who go into hospital with respiratory problems. They should start taxing fast food and then fat people could pay for their own treatment in the same roundabout way the smokers do.

    *prepares to be flamed for making fattist comments*
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    The NHS is funded by smokers and people who drink. Smokers put in about three itmes what they take out; this country would be up shit creek without a paddle if everyone gave up smoking, drinking and eating out tonight.

    It really isn't as simple as saying "lose some weight, fatty". The whole argument about fast fatty food misses some crucial points too, such as that people are actually eating much less- in terms of calorie content- than they did 50 years ago. Trouble is, we all have desk jobs, so we aren't burning the calories off like we used to.

    If you partake in dangerous exercise such as skiing or climbing, should the NHS stump up the bill? If so, why so? There are plenty of much safer low-impact exercises, such as swimming, that are just as effective at keeping people healthy.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Erm.. two points.

    1. There is no such thing as free healthcare, just free at the point of delivery. The NHS does come with a price.

    you know what i mean, of course it comes with a price but now fat people will have to go private to get the operations in question, so it's no longer "free" in the sense that their taxes and NI don't cover them....
    Can you expand?

    i'd rather not, i'm still eligible for free hip and knee ops thank you. :lol:
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It wasn't exclusively knee or hip operations, IIRC varicose veins were mentioned.

    VVS is already restricted in many places because it's seen more as a cosmetic issue these days anyway.
    Using a black and white arguement like that you could argue that people leaving the house to work in the morning are putting themselves at a higher risk of injury than sitting at home on the sofa and hence shouldn't be treated either. I think a degree of rational and common sense has to be applied.

    Precisely, everything we do carries a risk. Therefore if you start to restrict treatment on the basis of "self infliction" you are going to get onto thin ice.

    Yes common sense applies however that is a subjective viewpoint. We don't all agree on what comes under the heading "Bleedin' Obvious".

    Smoking and Obesity are areas where people believe that self infliction should be taken into consideration because we all "know" the risks involved. However, as Kermit and I have pointed out there are obvious risks to many thaing which we all do without thinking and yet we never seem to involve those actions in a debate like this.

    NHS Professionals have an expression - A&E Anything and Everything. It is very hard for us to start having this debate unless you can point to clear clinical reasons why treatment should be refused.

    In the case of alcoholics and liver transplants there is clear medical evidence that continuing to drink will put the transplanted oragn at risk (see George Best) and so there is a resonable restriction here - ditto smokers will not get lung/heart transplants easily.

    Restricting hip/knee operations because of weight is, IMHO, difficult to justify. In this example cost is being given as a reason - although as an insider I know that capacity is also going to be a factor. Personally I find it difficult to use finance as a reason to refuse operations. NB BMI is also a poor indicator of obesity. If you use the 30+ BMI example here then you would rule out many rugby player and most US Football players from this kind of treatment...
    As a 20 a day smoker I fully accept the increased risks of various diseases i am running. If i was put in a situation where i needed an operation and had the option of putting someone i felt was more deserving ahead of me in the queue then i would defintely do so.

    I think many people would, it's interesting to not the issue around Herceptin and the number of people who support the treatment even though the national cost (£60m plus) will mean that other treatment cannot happen. Funnily enough people think that these women are more worthy than they are...

    However, how do we define "more deserving"?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    And I'm willing to wager that it costs a tiny fraction of that to treat all the smokers who go into hospital with respiratory problems.

    It is estimated that smoker contribute over £10bn to the Treasury in taxation but only £1bn is spent on treating smoking related disease.

    That is a big gap to fill and I don't think that those promoting a ban on smoking have thought through how that gap would be breached.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Sudden lack of money? :p
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    This is just a forerunner to...

    PRIVATISATION.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Spliffie wrote:
    This is just a forerunner to...

    PRIVATISATION.

    How so?

    I think that there are other indicators which are more applicable, and which I don't think the public fully appreciate, but I'd be interested to see how you make that link...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    How so?

    I think that there are other indicators which are more applicable, and which I don't think the public fully appreciate, but I'd be interested to see how you make that link...

    Because you're forcing people from NHS cover and thus forming what is effectively a clique. What next? Drug users? Smokers?

    It's downsizing the NHS for the private takeover of the sector.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Restricting hip/knee operations because of weight is, IMHO, difficult to justify. In this example cost is being given as a reason - although as an insider I know that capacity is also going to be a factor. Personally I find it difficult to use finance as a reason to refuse operations. NB BMI is also a poor indicator of obesity. If you use the 30+ BMI example here then you would rule out many rugby player and most US Football players from this kind of treatment...
    Nonsense. BMI is a perfectly reasonable measure for obesity. Of course there are exceptions to its validity, but that is all part of the clinical judgment by the orthopod. There is clear evidence that surgery of this sort has better results in those who are not obese - the decision to operate is therefore evidence-based. And, pertinently, now that the public is demanding to see success figures for individual surgeons, what kind of idiotic surgeon would it be that took on unnecessary risks on his operating list?
    I think many people would, it's interesting to not the issue around Herceptin and the number of people who support the treatment even though the national cost (£60m plus) will mean that other treatment cannot happen. Funnily enough people think that these women are more worthy than they are...
    Herceptin is a case in point. A treatment without sufficient evidence but which has been highjacked by the gutter press because breat cancer is a glamorous disease and a treatment which is impossible to argue against. I remember the woman in question on being asked how she could justify cutting anothjer service as a result of her case saying, "I'll leave that to my legal team". No! How can we trust the lawyers to dictate medical treatments?
    However, how do we define "more deserving"?
    He who shouts loudest, normally...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Spliffie wrote:
    It's downsizing the NHS for the private takeover of the sector.
    This is a good point. Now that the waiting lists are falling markedly in all specialties, the surgeons have to find another way to keep demand for private operations high. [/cynic]
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    Of course there are exceptions to its validity, but that is all part of the clinical judgment by the orthopod.

    My understanding of this "treatment threshold" is that it is absolute.

    I take the point but BMI will only give you one indication and this policy doesn't seem to take into effect those other factors...
    There is clear evidence that surgery of this sort has better results in those who are not obese - the decision to operate is therefore evidence-based.

    If that was the reason given then I would agree with you. If they had used the NZ Hip Scoring tool, for example, then I wouldn't have a problem because that is clinically driven.

    This is a "cynical" attempt to save money, which is what the PCT spokesman admitted.
    And, pertinently, now that the public is demanding to see success figures for individual surgeons, what kind of idiotic surgeon would it be that took on unnecessary risks on his operating list?

    Totally agree, lord save us from irrelavnty comparative league tables.
    No! How can we trust the lawyers to dictate medical treatments?

    It's bad enough leaving the decision to doctors, managers and (in the Herceptin case recently) ministers...
    He who shouts loudest, normally...

    Indeed.

    And those who are friends with politicians...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Do you think this could be an attempt to jump the gun by the NHS? They know that if the smoking-in-public bill passes which I think sadly will, then are they just pre-empting the fall in money by trying to save now rather than when they really have to?

    Just a thought.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    They're basically denying services to people who have paid for them already. There is no way of getting around that point.

    They start with a group that is universally vilified, and suddenly its the old man who's worked all his life down the mines. He brought in on himself, guv.

    Start of a very slippery slope.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit wrote:
    They're basically denying services to people who have paid for them already. There is no way of getting around that point.

    They start with a group that is universally vilified, and suddenly its the old man who's worked all his life down the mines. He brought in on himself, guv.

    Start of a very slippery slope.
    What about cosmetic operations? We pay for a health service, we demand an operation!!11!1one!
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