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Obese Patients And Smokers Banned From Routine Surgery In 'most Severe Ever' Rationing In The Nhs

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http://www.telegraph.co.uk/news/2016/09/02/obese-patients-and-smokers-banned-from-all-routine-operations-by/

Hospital leaders in North Yorkshire said that patients with a body mass index (BMI) of 30 or above – as well as smokers – will be barred from most surgery for up to a year amid increasingly desperate measures to plug a funding black hole. The restrictions will apply to standard hip and knee operations.

The decision, described by the Royal College of Surgeons as the “most severe the modern NHS has ever seen”, led to warnings that other trusts will soon be forced to follow suit and rationing will become the norm if the current funding crisis continues.

“It’s the only way providers are going to be able to balance their books, and in a way you have to applaud their honesty. You can see why they’re doing this – the service is bursting at the seams.”

The symptom of an infrastructure / population size mismatch.

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A lot of different arguments to be had but perhaps if we had the balls to sort "2008" out properly we would not be in this mess/as big a mess.

Not to mention the reorganisation of the NHS that the Camoron wasn't going to happen... We have ended up with even more pen pushers. Some stupid number of CCG's which just adds to costs and confusion.

I really do worry as a young man (and an NHS worker) who will pay for me when I'm old and grey. Oh yeah, I'm going to work till 80 having paid in to a meaningless pension and die.

The thing that worrys me most though is a lot of people don't realise how great the NHS is (not perfect, has problems) but on the whole it's pretty damn good. Such a comprehensive service for not that much money.

We are being softened up for health insurance.

I know we don't have a bottomless pit of money (wait we do?!) but with out health, your lifes going to be pretty crap. It affects everything. Can't we spend that bit extra like our European colleagues do? Is it not worth it?

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I know we don't have a bottomless pit of money (wait we do?!) but with out health, your lifes going to be pretty crap. It affects everything. Can't we spend that bit extra like our European colleagues do? Is it not worth it?

I agree.

And think how much we could spend on health if having basic shelter wasn't so expensive!

A properly run health service is never going to be cheap, and I'd rather we spent a lot more on it, and a lot lot less on bloody housing which let's face it - doesn't actually add any value to the economy. Health DOES add great value to the economy. I don't just mean a service that treats the symptoms, but a health revolution in the UK that helps prevent the causes. And I also don't mean a crappy government ad campaign to get people cycling. I mean a grassroots revolution that permeates every aspect of our working day. Make walking and cycling a lot easier. With cheaper housing, people can work within 5 or 6 miles of work at most (possible). We should divert so much money to such a health drive - get people happy and healthy and in turn they are more likely to contribute positively to society.

It all sounds idealistic, but it only sounds idealistic because of the mess we have now that bases everything on high house prices and mass uncontrolled immigration (which in turn puts extra stress on the NHS).

Edited by canbuywontbuy

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I can only agree with the above 3 posts.

And while I'm all for a bit of personal responsibility, can our law makers really say hand on heart really say they are doing everything possible to reduce the temptation to take up smoking/eating crap food and becoming a couch potato?

Our transport infrastructure is still heavily biased towards the car. It was in the Netherlands too until the 1970s before they decided to turn it around.

As far as food design, marketing and availability is concerned - it is the wild west out there. Some of us are simply wired to seek out high calorie options and temptations exist everywhere now which screw up your biochemistry enough you essentially become addicted to them.

Education is 90% sitting at a desk, which sets up a work life for many which is exactly the same. Ditto home life. It's perfectly possible to have some work meetings which walking.

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Presumably we'll also be seeing a new lower income tax rate for those with a BMI over 30 as we've excluded them from elements of the services their taxes are funding.

This also removes the moral high ground narrative for the eye watering levels of taxation on smoking,

It's this sort of ******** that will lead to the destruction of the NHS.

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Hospitals need a matron. A middle aged battleaxe of a woman that all the staff are scared of, including the doctors. She gets to call BS if there are too many managers and has the power to get rid of them.

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Hip and knee operations mentioned on the wireless this morning.

Insofar as obesity may be connected with lack of exercise, this begs the question: how is a patient who can't use a hip or knee going to get normal exercise?

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Presumably we'll also be seeing a new lower income tax rate for those with a BMI over 30 as we've excluded them from elements of the services their taxes are funding.

This also removes the moral high ground narrative for the eye watering levels of taxation on smoking,

It's this sort of ******** that will lead to the destruction of the NHS.

Agreed.

The NHS needs to make savings but this is not the way.

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Presumably we'll also be seeing a new lower income tax rate for those with a BMI over 30 as we've excluded them from elements of the services their taxes are funding.

This also removes the moral high ground narrative for the eye watering levels of taxation on smoking,

It's this sort of ******** that will lead to the destruction of the NHS.

Quite.

I understand the argument for 'sin' taxes though often the logic is a bit wonky (i.e. if smokers die younger presumably they consume less in the way of pensions, free bus passes etc than non smokers so probably are not the drain on society some claim). Simply to deny treatment to people who have effectively paid for it via their taxes on the basis of something as medically dubious as BMI is immoral. Strange that the NHS when I was a kid had more beds than now even with a smaller population and a poorer country. One wonders if that decline is matched by a rise in the number of management consultants and contractors ripping the shit out of it. There are quite a few parallels here with the way rail transport is handled.

My view is that the ideal envisaged by politicians, civil servants and certain other members of the management class in the UK is to simply farm all taxes, provide no services and simply pocket the money themselves. Certainly that seems to be model GTR are working towards in Southern region. No trains, no rail workers, no passengers; just farm the taxpayer subsidy and pocket the money. It will soon be the same in the NHS, i.e. no hospitals, no doctors, no nurses, no health workers just an army of 'outsourcing' specialists taking a huge cut of the nation's health care spend for adding f*ck all in the way of real value.

Personally my view is if the people who advise, plan and the Department of Health and the NHS did not prepare for this situation then clearly they are not up to much as managers and simply need to be fired on on mass.

Edited by stormymonday_2011

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Maybe it would be easier to treat patients if the BMA hadn't spent the last few decades limiting the number of training places for new doctors to such an extent.

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Hip and knee operations mentioned on the wireless this morning.

Insofar as obesity may be connected with lack of exercise, this begs the question: how is a patient who can't use a hip or knee going to get normal exercise?

This is true.....but what if people knew that a bmi over a certain figure might jeopardise access to certain treatments at a later date.....do you think it would help change their lifestyle habits?....;)

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The plan for the NHS is to make it so useless that anybody that can afford to pay private will. This has actually happened close to home very recently.

I suspect they think this is easier than reform.

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I cannot help myself when shopping and see really fat unhealthy people to look in their trolly, it is just so obvious why so many are that way. Yet another great service is going to be pushed to the brink because people no longer take responsibility for their own well being as much as is possible

Okay, but there are reasons why people eat unhealthily. Stick people in a stressful and unpleasant built environment, take away meaningful employment and make them dependent on handouts, then rig the electoral system so it ignores them and guess what? They stuff themselves with unhealthy comfort food, fags, booze and drugs to dull the pain. You could do the same experiment with any mammal in a cage and get the same result.

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The plan for the NHS is to make it so useless that anybody that can afford to pay private will. This has actually happened close to home very recently.

I suspect they think this is easier than reform.

From just a gut feeling I can see us going down the line of a two tiered health service....the basics as free on delivery....extras or fast track extras will require private insurance.....hope it doesn't go down the pet insurance route where mass insurance sales has caused pet treatments to be extortionate in cost, far greater than when people paid as they used the service....now they have uped the price of treatments knowing that the policy will pay and the people will pay the policy.....what if a pet in a family that can't pay the premium?;)

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I once met somebody in an NHS management job, after about 15 minutes chatting to her about her job I was still none the wiser about what she actually did. Admitedly, the same could be said for when talking about my own job (quite a complex role) but as I'm in the private sector I do at least have to justify my position in pounds and pence of added value.

It is a catch 22 for me on NHS funding. It does provide great value and needs to be adequately funded but when I hear of the latest £X billion going into it, one immediately wonders how much of that is not going to find its way to frontline services but line the pockets of pen pushers, contractors and guru consultants. You do hear some ridiculous accounts of waste which you could only truly associate with a layered public sector management structure. Prime example recently being of a hospital director (or whatever her fancy title was) being sacked for not investigating dozens of mortalities appropiately, only then to get appointed in a consultancy role on the exact same salary (something like £160k) for another Trust. Must be a cosy world for these guys. That is like me being sacked by my employer and not being able to return to head office but then re-employing me into another job on another company site a few miles down the road.

Edited by SillyBilly

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You would think that a public service would work for the common good, but like anything that has power and influence they create special jobs for special people...don't think it would be any different in private ownership....just looks worse in a public one because we all own it.;)

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I'm as critical as anyone when it comes to obese folk and personal responsibility, but to deny them treatment is barbaric.

People overeat for all sorts of reasons, depression, stress ect... and if someone is fat and needs a knee operation, denying it to them just means they'll be disabled and get fatter.

Dare I say it, if we're needing to shut out people from access to the NHS to save money, perhaps we could start with immigrants.

We also need to look at why so many people are obese - they're an easy target (no pun intended) but walk into any supermarket today and most of the stuff there is designed to make you fat and sick. Our favorite pastimes as a nation are boozing and eating, again things that will make you fat and sick.

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How about a formula based on the estimated cost of a course of treatment vs the likelihood of it being successful?

This is sort of what is done with the Quality Adjusted Life Year (QALY) used to aid judgements on whether treatments are cost effective

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I think there should be an annual health check, a bit like an MOT, not sure how draconian the measures should be if you fail on obesity though!

That would take a lot of resources, the NHS relies on a sizeable proportion of the population not troubling the service almost ever to accommodate the serial users who live at their GPs.

Edited by crashmonitor

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Quite.

I understand the argument for 'sin' taxes though often the logic is a bit wonky (i.e. if smokers die younger presumably they consume less in the way of pensions, free bus passes etc than non smokers so probably are not the drain on society some claim). Simply to deny treatment to people who have effectively paid for it via their taxes on the basis of something as medically dubious as BMI is immoral. Strange that the NHS when I was a kid had more beds than now even with a smaller population and a poorer country. One wonders if that decline is matched by a rise in the number of management consultants and contractors ripping the shit out of it. There are quite a few parallels here with the way rail transport is handled.

My view is that the ideal envisaged by politicians, civil servants and certain other members of the management class in the UK is to simply farm all taxes, provide no services and simply pocket the money themselves. Certainly that seems to be model GTR are working towards in Southern region. No trains, no rail workers, no passengers; just farm the taxpayer subsidy and pocket the money. It will soon be the same in the NHS, i.e. no hospitals, no doctors, no nurses, no health workers just an army of 'outsourcing' specialists taking a huge cut of the nation's health care spend for adding f*ck all in the way of real value.

Personally my view is if the people who advise, plan and the Department of Health and the NHS did not prepare for this situation then clearly they are not up to much as managers and simply need to be fired on on mass.

This is best seen at councils.Close front line services,but no office/managers go.You end up with everyone sitting in a room and all taxpayers money funding wages and pensions.That really is whats happening.

The NHS is fantastic,but there are areas where people are vastly overpaid,and the agency bill is shocking.

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That would take a lot of resources, the NHS relies on a sizeable proportion of the population not troubling the service almost ever to accommodate the serial users who live at their GPs.

Would early detection of diseases and other conditions save money in the long run?

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Quite.

I understand the argument for 'sin' taxes though often the logic is a bit wonky (i.e. if smokers die younger presumably they consume less in the way of pensions, free bus passes etc than non smokers so probably are not the drain on society some claim). Simply to deny treatment to people who have effectively paid for it via their taxes on the basis of something as medically dubious as BMI is immoral. Strange that the NHS when I was a kid had more beds than now even with a smaller population and a poorer country. One wonders if that decline is matched by a rise in the number of management consultants and contractors ripping the shit out of it. There are quite a few parallels here with the way rail transport is handled.

My view is that the ideal envisaged by politicians, civil servants and certain other members of the management class in the UK is to simply farm all taxes, provide no services and simply pocket the money themselves. Certainly that seems to be model GTR are working towards in Southern region. No trains, no rail workers, no passengers; just farm the taxpayer subsidy and pocket the money. It will soon be the same in the NHS, i.e. no hospitals, no doctors, no nurses, no health workers just an army of 'outsourcing' specialists taking a huge cut of the nation's health care spend for adding f*ck all in the way of real value.

Personally my view is if the people who advise, plan and the Department of Health and the NHS did not prepare for this situation then clearly they are not up to much as managers and simply need to be fired on on mass.

Re. the availability of beds in the past. I think basically nursing ratios and patient facilities were not so strict.

My experience of being an in patient aged nine in 1973 after breaking my arm...

(1) Put on an adult ward, the only child.

(2) 40 beds lined up in a former workhouse with no cubicles.

(3) As few as two staff manning at night.

(4) One bathroom.

Edited by crashmonitor

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