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

[BoobleBeep]

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?

Hypothetical scenario:

Suppose I went to my GP to ask for a referral to have my (slightly long but not ginormous) nose corrected.Or my saggy but okay-in-a-decent-bra boobs lifted.
He considers and says "no" quite rightly, there's nothing wrong with your nose/boobs.

I'm not happy so I pay to go private. Unfortunately, the operation goes wrong. I don't want to go back,and I can't afford to find another surgeon.

Should the NHS pay to fix my self-inflicted health issues?

The Vampire - no. Suicide attempts usually come from a mental illness (not always, granted) so it would be an ongoing illness and not really self-inflicted. While some mental illnesses may be brought on by drug use, the propensity has to be there for the drugs to bring it on - genes aren't "self-inflicted", so even the drug-induced mental illnesses wouldn't really qualify.

LordoftheFlies - the NHS cleans up after private health gone wrong all the time. Although you chose to have the operation-that-went-wrong, doctors were the ones who caused the problem, so you should be treated. IDEALLY you should be treated for free by the incompetent who cocked it up in the first place, because that's what happens in other industries, isn't it? You don't get the service you paid for, so you get a replacement/repair FOC.

My late uncle, who spent the last few years of his life carrying oxygen around, and died from emphysema, was told that he really was at the end of the waiting list at the Chest department, due to his advancing years, and the fact that he had smoked all his life, and had not stopped smoking when he became ill, and that he was taking a piss coming to hospital with his oxygen in his backpack, complaining about his cough and breathing difficulties, as long as he was still smoking. Others with non-self inflicted chest issues had to be given first priority.

Rightly so.

According to DH I should have been looking where I was going when I fell and broke both ankles - so should I have had to pay for my treatment?

Seriously there's often a root cause behind an addiction (because that's what we're talking about be it smoking, drinking or obesity) be it mental health or poor education or another cause and the NHS should be there to help those in need.

Age is usually the main driver behind the "to treat or not to treat" philosophy. When I worked in the blood labs, there was a guideline that anyone over the age of 55, iirc, who presented with CLL or CML (chronic leukaemia) wasn't ever considered for bone marrow transplant. The disease would definitely shorten their lifespan but it was considered that they were too old to derive sufficient benefit from a transplant, so it wasn't done.

QuintessentialShadyHallows

Waiting lists are not worked out like that - he would have been at the end of the list because he still smoked (treatments less likely to succeed) and his advancing years. Treatments are rationed out to those most likely to benefit. I've never heard of any clinician doleing out treatment according to some psuedo-moralistic sliding scale.

I am just repeating what my aunt said. But maybe the doctor just wanted to jolt him, I dont know. This was in Norway btw.

However, I would think policies would be quite similar regards to this, this day and age.

Most medical problems are tecnically self-inflicted. The majority of cancers alone are caused by lifestyle choices.

Fair enough. That's not how things technically work here, however the effect would be the same in that treatment is more likely to be allocated to a younger non/ex-smoker than to your uncle. That would not be because of any moral concerns but so much as the best use of resources.

Oh and I'm very sorry that your uncle and family suffered this - terrible disease.

piprabbit said: "I'm also interested in how the NHS could charge the parents of children with genetic diseases. If a couple has genetic counselling and know that they have a 50% chance of having a child with a disease, but they choose to go ahead and have a baby anyway - would that also be self-inflicted? Would the parents bear the medical costs until the child reached adulthood, at which point the NHS would take over as the disease isn't the (now adult) child's fault?"

If they ever made me king of the world those parents would be given the choice to either terminate or lodge a substantial bond (say 150,000 GBP) against future healthcare costs for the resulting child.

There was a British documentary shown on our Aussie ABC TV last night about resuscitation of premature babies born at 23 weeks. The upshot was that in most cases it costs 100,000 GBP to keep these poor little buggers alive for an extra six weeks. The majority who survive go on to need ongoing healthcare for various problems associated with their premature birth. Of course it would be a tragedy to the parents and loved ones, but someone at arms length has to be able to do the maths and make the hard decisions in these cases.

The problem I think is that when the NHS was launched nobody had any idea of the technological developments that would take place in the 1/2 a century afterwards. Initially it was there to ease symptoms and provide solutions for things like leg ulcers and a variety of diseases for which there were fewer cures or resoloutions than there are today and diagnostic facilities ended and stopped with the opinion of the doctor and an xray or blood test. The sophistication and the cost have spiralled beyond that which anyone could have imagined when my parents were children.

Over the years it has become a bureaucratic nightmare where care all too often seems to have flown and sophisticated diagnosis sits side by side with being unable to get through to a dr's receptionist to make an appointment for a three minute consultation to see a specialist because of the spectre of litigation and the reluctance of many GPs to provide practical advice in the first instance.

I don't think the present service can be retained as it is and there will have to be a time when there is an entry level, palliative NHS and a second tier insured service for more sophisticated treatments. The problem with treating the effects of drug and alcohol abuse is that the government raises vast amounts of tax on cigarettes and alcohol and cannot therefore refuse to treat the consequences as present. Reducing opening hours would be a step towards positive measures though.

My dad is currently dying of kidney cancer which is the 8th commonest cancer. This is from the cancer research website:

There are some kidney cancer risk factors we know about. These are

Smoking - if you smoke your risk could be double that of a non smoker - my dad has never smoked
Faulty genes - some people inherit a tendency to develop kidney cancer (hereditary or familial kidney cancer) don't know about this one
Certain inherited conditions nope - no inherited conditions
Having a relative with kidney cancer nope
Being obese nope - always been fit, active and a healthy weight
Having kidney disease that needs dialysis nope
Hepatitis C infection nope
Having a relative with kidney cancer nope
Previous treatment for testicular cancer or cancer of the neck of the womb (cervix) nope
Other risk factors that have been investigated and may increase risk include high blood pressure and heavy use of mild painkillers (non steroidal anti inflammatory drugs - NSAIDs) such as aspirin, paracetamol, and ibuprofen. nope, my dad has never had any need for heavy use of painkillers and we as a family have never really taken painkillers unless absolutely necessary

There are lifestyle factors indicated here, but they cannot be sole factors - given that my dad doesn't tick any of the boxes....

What about expensive infertility treatment for women who have difficulties as a result of untreated STDs they contracted in their younger and less careful days?

It would end up being a very slippery slope with moral judgements made by people about other people. Doesn't sit very comfortably with me!

yoou coudl say pregnancy was self inflicetd though

Hmmmm I think yabu.

I have had pre eclampsia with all of my pregnancies, all requiring long hospital stays, free medication, inducing of labour and then 1 to 1 care while in labour.

Should I be charged as pregnancy if self inflicted ? Too many grey areas, too many people who pay tax towards the nhs being excluded,

Worst idea ever.

what the people who set up the NHS didn't fully realise, is that (compared with the 1930's) even modest medical and nursing care would result in more ill people. There was a perception that by treating people, they would get better and be able to lead full and useful lives. Which in many cases they did.

Prior to that, a lot of people had died quite quickly once they got ill (imagine having TB, Pneumonia, polio, miner's lung, food poisoning, flu, old age) and stopped being a costly nuisance; but with treatment, they might not get fully better, but would carry on living and neding continued care.

It will probably come as costs rise and money dwindles.

Some countries have an insurance based health system, and your premiums are influenced by lifestyle choices.

One of the most common afflictions of modern society is high blood pressure which is often caused by eating too much salt. So should anyone who has shaken the salt cellar at their chips be as liable as some posters would make someone with a drinks habit? The problem is just as likely to be self inflicted, but much harder to prove than drink or smoke- salt doesn't smell and I could just deny it.