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To think that if you need very expensive medical treatment due to a self inflicticted cause, the NHS should still pay?

(95 Posts)
BoobleBeep Sat 15-Oct-11 09:46:32

I have been wondering about this.

If someone smokes 40 a day, drinks extremely heavily or is morbidley obese and has been given all the treatment available on the NHS to try and help them with their condition but still continues to smoke/drink/eat and as a rsult needs expensive surgery should the NHS pay?

scaevola Sat 15-Oct-11 09:51:12


AKMD Sat 15-Oct-11 09:53:02

Just lost my post...

My gut feeling is that YABU (if you think the NHS should pay regardless) and that the people you describe in your scenario should have to pay at least a good proportion of the costs. In practice though, once you start assessing how 'worthy' someone's illness is, it becomes a very grey area.

Vinomcstephens Sat 15-Oct-11 09:53:53

Yup. That's what the NHS is all about imo. Some people will go their whole lives never needing NHS treatment, others will need constant medical attention. Whether it's "self inflicted" or not, the whole point of having the NHS is that we get treated, regardless!

CogitoErgoSometimes Sat 15-Oct-11 09:54:28

Not necessarily. Treatment is designed to improve quality of life. If all the possible treatment has been given and the prognosis is that further treatment will not improve quality of life, then a clinician has to make a judgement whether it's worth continuing. And that has nothing to do with money.

featherbag Sat 15-Oct-11 09:54:40


Most ilnesses/injuries, if tracked back far enough by someone pedantic enough, could be classified as 'self-inflicted'. E.g., injuries sustained in a car accident - should've walked. Gastric cancer - should've avoided whichever foods/drinks are thought to cause it this week. Cervical cancer - shouldn't have had sex. Only providing free treatment to those deemed deserving is a very slipper slope that we as a society just can't afford to start sliding down.

PrettyCandles Sat 15-Oct-11 09:56:03

Yes. The NHS is there to support our health, not judge our worth. Though I have no objection to the treatment being conditional on the patient doing something to address the issue that caused it, and that the "something" should also be supported by the NHS.

Birdsgottafly Sat 15-Oct-11 09:56:54

You cannot give a senario because the doctor decides based on clinical need and decide on whether the risk is worth the outcome. For example my 80 (now 81) year old mother needed vascular surgery to be pain free, the doctor gave us the facts about recovery, possible cons etc and together we made the decision not to go ahead. The same thing happens across all departments.

Any doctor will also tell you that you cannot say 100% that one factor has caused the condition that they need the operation for, so it would be unfair to make the decision based on lifestyle.

My answer would be that it is written that 'the public' has a joint responsibility alongside the welfare state to do their best to improve their situation, so the doctor or ethical committe needs to be weighing this up.

People don't get 'all the treatment' to help, either there are bigs gaps in services, especially MH, which includes councelling, therapies etc.

ggirl Sat 15-Oct-11 09:57:57

you'd end up with masses of very ill people being unable to afford treatment
sort of third world like
a step back for society I think

huge % of diseases are somewhat self inflicted

Birdsgottafly Sat 15-Oct-11 09:59:27

Just to ask, should we charge parents if later in life the correlation has been made to their adult childs bowel cancer and early weaning, or to their back pain (which has happened) and the over use of a walker etc.

We would have to be constanly making someone 'responsible' to make it fair.

BimboNo5 Sat 15-Oct-11 09:59:30

Yes, this is the whole point of the NHS health for ALL. Im not sure really what else there is to say...

TeamDamon Sat 15-Oct-11 10:02:04

I think each case should be judged on its own merits.

However, I am strongly of the opinion that part of the country's general malaise at the moment is as a result of some people being very well-informed about their rights and conveniently choosing to ignore that we also have a responsibility to ourselves and each other. I agree with PrettyCandles that treatment of those who smoke, drink to excess, or are obese should be conditional on their making positive changes to their lifestyle to try to help themselves.

SayGhoulNowSayWitch Sat 15-Oct-11 10:02:07

I don't think anyone can make a judgement decision on whether or not someone is worthy of NHS treatment. However, there are some cases in which someone's suitability will be taken into account for a certain treatment, e.g. a transplant. Someone who smokes 40 a day will be lower down the lung transplant list than, say, a 6 year old with respiratory problems. But that's why they have ethics committees at hospitals.

The Hippocratic oath that medical professionals take forbids them to make those kind of snap judgement calls. A doctor can NOT ethically treat a paedophile / serial killer any differently from a child, much as he or she may want to.

ScottOfTheArseAntics Sat 15-Oct-11 10:04:05

People who smoke and drink heavily are paying a fair whack in duties. I see that as their premium. My parents didn't invest in genetic screening before giving birth to me so it is their fault that I have genetically inherited health issues which require NHS treatment - should they/I be paying for that treatment.

lechildrenofthecornsilk Sat 15-Oct-11 10:06:10

yes - addiction is an illness

ragged Sat 15-Oct-11 10:06:30

Ethical minefield.
I suppose taxes could be added to ciggies & the least healthy foods and ring-fenced to pay for relevant procedures.

CaptainNancy Sat 15-Oct-11 10:08:48

What corny said- same with someone that attempts suicide, or should we charge them too for being mentally ill?

lechildrenofthecornsilk Sat 15-Oct-11 10:09:39

adding taxes to cigs and alcohol yes
adding taxes to unhealthy food...only if they are going to reduce the price of healthy food

scaevola Sat 15-Oct-11 10:13:04

If you believe in an NHS that is free at the point of use, then it would be wrong to introduce payments for some.

The thin end of the wedge may already be with us (not outcome based rationing as that is not done on a paying basis, but potential billing via insurance companies after RTAs). It would be a major step towards all sorts of fees and charges.

LostInTheWoods Sat 15-Oct-11 10:19:29

Of course.

The point of the NHS is that it is free at the point of need. I do not want it tinkered with.

yellowraincoat Sat 15-Oct-11 10:21:16

You should be able to access the NHS for whatever reason. If you started charging people for self-inflicted, very expensive treatment, we'd just end up with an American-style system where very poor people were left with no way of getting treatment.

caramelwaffle Sat 15-Oct-11 10:30:20

Not necessarily.

Liver transplants. Current low donations.
Mr Allan says "feck orf' I'm still having whiskey everyday"
Mr Brookes says "I'll stick to camomile tea"

Mr Brookes should get the liver.

Even if donations improve, Mr Allan should still be kept lower on the list.

TheVampireEmpusa Sat 15-Oct-11 10:32:08

What CaptainNancy said.

Allaboutcalm Sat 15-Oct-11 10:33:52

I'm not sure how I feel about this......

My mother is a chronic alcohol, she get's more in benefits than most working people. She has carers come in 4 times a day to check on her and see if she needs anything. She can be abusive to them, rude, belligerent and more often than not dead lock her door so they can't get in. In the last month alone they have had to call an ambulance for her over 10 times, usually because she is drunk, has fallen and has passed out on the floor. IF she does go to the hospital to be checked this usually results in her sobering up (slightly) and signing herself out. She has been offered every kind of help available but refuses it all as she "isn't an alcoholic and doesn't have a problem"! How would you feel if you had a seriously sick child or relative and you urgently needed an ambulance but there wasn't one available as they were busy tending someone like my mother. Should she be made to pay?.......... your opinions please

Salmotrutta Sat 15-Oct-11 10:34:46

Adding taxes to cigarettes and alcohol eh?
Wonder why they haven't already thought of that?
Oh wait! They have.

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