What should the NHS not fund?

[Username721]

Saw a thread on IVF for lesbians and some people felt that IVF should not be for anyone on the NHS. So it got me thinking.

Is there anything you feel should be exclusively private treatment? The ones often debated are things like weight loss surgery, cosmetic procedures, treatment for avoidable illness such as smoking-induced ones, liver failure through alcohol abuse, drug rehabilitation…

Thoughts?

Why are women attacking the support the NHS gives to other women?

IVF might seem a nice to have but for many it's one round, maybe a FET if they have some that made it to freeze. People saying the odds are low, the odds of getting pregnant in the first month TTC is only about 25% but 40% of couples will fall pregnant within the first 2 months.

I wouldn't want that chance removed from people, many need IVF because of other reasons endometriosis, ectopic pregnancies causing the loss of tubes, PCOS, cancer, those are true medical conditions.

Even for young men and women getting a cancer diagnosis, being able to soften the blow with 'we know you'll be infertile but we'll freeze your eggs / sperm so we can do IVF later' why would you want to remove that hope from someone?

And no we shouldn't have a limit on care for number of pregnancies either. What are you going to say next we'll only educate your first born?

I think cosmetic should be on a case by case. While a breast enlargement isn't normally something that should be done on the NHS, I can see it would be different for someone who'd had a mastectomy.

If I was unlucky enough to have battery acid chucked in my face, I'd hope the NHS would give me cosmetic surgery on the burns.....and I'm not someone who's vain at all.

Puberty blockers aren't just used to help people transitioning, my child is on puberty blockers, of course they would still need to be funded.

I actually think the NHS must do very little pure cosmetic surgery. Most of what the plastic surgeons do is probably reconstruction.

My LO caught a finger in a door, it was the plastic surgeons who put it back together. And rightly so they were lower down the waiting list than the burns cases they also had that day.

no, not if you eat them excessively - processed food at margarine lead to diabetes from just eating them regularly - may people eat margarine every day! ANd do not consider that excessive.

Tax on processed food and margarine, two of the biggest causes of obesity and/or diabetes in the country

The tax should be massive on these items. The tax on tobacco is high, why not on these equally damaging products? They cost the NHS just as much, probably more

IVF, puberty blockers, cross sex hormones and sex reassignment surgery

Just to clarify, I mean puberty blockers for the purpose of being, or thinking, a child is trans

It’s all surgery time. Each department doesn’t have its own theatre.

Fellow citizens should not have to pay for endless self-indulgence & failure to use contraception.

Yawn you're paying for much worse things you know.

Yeah just make women have unwanted babies. The costs of dealing with that are often astronomical - adoptions, children being brought up in totally unsuitable situations, etc. But don't let the reality get in the way of your prejudices.

I had cosmetic surgery as a child. It is from a major injury that would have seriously disfigured me. I suspect this is what we mean by NHS plastic surgery.

'Fair enough, though it's not the same procedure so I'm not convinced doctors who perform top surgery are equally qualified to perform cancer surgery - but let's assume they are. Breast surgery is a very small part of all cancer treatments though, so is that truly the cause for the long cancer treatment waiting lists ? As a large number of cancer patients :

• have a different type of cancer, not breast cancer
• a lot of cancer treatments are not surgical (various types of chemo, etc)

I think suggesting that the cancer waiting lists are due either totally or significantly to top surgery being available on the NHS does not reflect the reality.'

The OP you quoted didn't say that the cancer waiting list was because of top surgery. But it is true that there is a limited amount of theatre time and space and a limited amount of theatre and recovery staff by which I mean anaesthetists, nurses and HCAs. It's not just about which doctor does the surgery, it's a much bigger picture than that.

Unfortunately there is a mass of evidence that those seeking gender reassignment surgery do not get proper evaluation first. Plus it's not effective. We should only be funding health care that is effective and value for money.

And I have family experience of anything I would not fund, it's why I wouldnt fund it!

And then we'll go back to backstreet abortion

www.nhs.uk/conditions/ivf/risks/

www.hfea.gov.uk/about-us/publications/research-and-data/fertility-treatment-2019-trends-and-figures/

In 2019, birth rates for patients under 35 were 32% per embryo transferred, compared to below 5% for patients aged 43+ when using their own eggs.

If people did not pay for private operations the NHS would still be funding the aftercare for their op when they eventually had it, unless they died waiting. If the aftercare is greater because the operation was botched maybe you'd be willing to say that in court when the patient sues their provider? Somehow I doubt you would do that to your colleagues.

There is little I wouldnt fund until the government funds the NHS at a level comparable to other developed economies - because they dont currently do that.

@FixTheBone I actually agree that any complications caused by private treatment should be picked up privately. Insurance could be created to cover this. People going private should pay the real cost and that includes complications.

@anyolddinosaur Proving liability in court is incredibly difficult and often takes many years.
And complications happen naturally anyway that nobody could avoid. But the NHS sorting complications means that people going private are not paying the true cost of private medicine.

Ancillary care is a hard one, Some systems like Spain do this. But I think in Britain a lot of people would just be left without ancillary care and ordering take aways to the ward. We would end up with charities stepping in to do it for many people.
I know I would have had limited ancillary care when I was in hospital. My DH is disabled and really struggled to manage looking after himself when I was in hospital. My parents were very elderly. I know people who might have dropped in one meal, but nobody who I could rely on for a week. I could not walk down to the hospital shop or canteen. So I would have had to order food deliveries. And we didn't have much money so takeaways every evening meal would have been unaffordable. I would have asked someone to bring me in cheap cereal bars and fruit and just managed on those for a week.
I am one of Thatcher's generation whose home town was destroyed by her policies so I moved a long way from work. I now have only Christmas card contact with more distant family like my second cousin, and I have no close adult relatives left except my DH. In countries where ancillary care is provided by families, extended families still live close to each other and do not tend to move away.

Exactly Plastic surgery is much more than cosmetic. Reconstructing fingers comes under Plastic surgeons but it's not exactly cosmetic.

Plastic surgery was pioneered by Dr's and young war wounded men after the Second World war.

@FixTheBone I think we've met before on a similar thread, but I'll just add that as the taxpayer paying your NHS wages, I'm sick of having to pay privately for surgery that should be NHS funded. I'm waiting for number 4 now. Also, due to previous NHS incompetence and neglect, my next and final surgery will be in Germany next month as I'm too far gone for any of the UK specialists in my disease, and if I need aftercare or help after that then I absolutely expect the NHS to treat me as I have just effectively saved them thousands in the long term by stopping myself becoming ill and disabled. Whether you're sick of it or not will actually be irrelevant to me. I'm scared stiff and really don't want to go but it's my only chance of a normal life, and reading that you would begrudge me help if I need it when I return frankly disgusts me!

In that case though, the people who would suffer would be the children of poorer women, who would miss out on healthcare from before they're even born.

The other issue with having ancillary care by family is not everyone is close to the hospitals, especially the more complicated surgeries and things.

It's bad enough that people have to travel miles for treatments with out the added hassle of bring your own dinner.

@Forfrigz For the rime being, I think the idea of the government stopping fertility treatment is hilarious given there's virtually no one being born in the UK.

Where do you get that idea from?

A 20-a-day smoker is paying about £5000 a year in tobacco duty. Taking into account that they will not be requiring, e.g. surgery every single year and a proportion of smokers will never require any medical intervention related to smoking, I think smokers are more than funding their own costs.