If you can afford to pay for an NHS Treatment you should

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Or at least consider it. My friend was forever moaning about her MIL (hip) op being canx and saying it wasnt fair and complaining about the NHS. I know the MIL has 4 children all comfortably off - not rich by any means. It did make me think why don't you all club together and go private. If you've got the means then why not?

Free to use is always going to make people use things more when they don't need it (think free bar at a works party). I have heard anecdotally that the biggest percentage rise in Prescribed items on the run up to Christmas was ......cotton wool. (Think decorations)

If there was a chArge of say£30 to see a GP, or £50 for an a&we visit then there is less likelihood of those services being abused, and it would be more likely that people would ask a pharmacist about a corn on their toe.

Due to work I be in A&e a lot (not as a patient) and I can almost guarantee there will be at least one chronic drunk in there, one person who would appear to have little wrong with them... handing a bill for treatment for times like this may ease use rather than actually making money for NHS.

Wow. Yabu in your conception of who is deserving and who isn't!

I was always a healthy weight and healthy. then I endured horrendous emotional abuse by my ex. Ended up suicidal. Put on very heavy anti depressants. Have put on a lot of weight. Trying very hard to get fit again but it just isn't that straightforward, the tablets make me zoned out and apathetic. I guess those kind of stories are behind a fair percentage of overweight /obese people actually.

In the USSR the big corporations used to have large sanatoria and all the employees used to have to spend two or three weeks there every year. It was a "health holiday". They were examined, tested, treated for any complaints. They were put on special diets, had steam treatments and massages. They enjoyed the sunshine and rest.

Most employees appreciated the break from work and the fact that their health was checked but they were not unaware of the more sinister side of things.

I am not for one minute advocating this - I just thought it was interesting and something I didn't know.

I really haven't had time to rtft I'm sorry, but the reason why the NHS hospitals in the north east get such high gradings is because the consultants aren't doing private work on the side I've been reliably told. They're 100% dedicated to the hospital they work in.

So going private creates Drs that want to also give private services, so creating/ cementing a two tier system.

How do you define affordability? that's different for different people. I'm going on a very nice holiday this year, which lots of people couldn't afford, but we haven;t been abroad in 10 years. My neighbours eat out every weekend but can't afford a new car. My sister pays for private education but can't afford private healthcare, my brother has private healthcare but can't afford private education. etc etc

Some people consider they can afford something if the cash is in the bank/they have available credit whilst others would think they couldn't afford it unless they have a cushion of savings.

I think that's a terrible idea as it creates a system of haves and have nots - the idea that you can buy your way to the front of the queue is not what the NHS is for. People can pay to go private if they choose but the NHS needs to remain a free service. Don't forget those who are better off are already paying more for the NHS through higher taxes and NI.

I heard on the news yesterday that some trusts are restricting hip and knee replacements for obese patients.
I don't even know what my own view is - and that is unusual for me grin

I think that policy makes sense. If somebody is obese then he likelihood of complications relating to surgery are massively increased (particularly for the anaesthetic) and the replaced joint is going to be under more strain than it would be in a normal healthy weight person which I imagine can also lead to more complications and expensive further surgeries.

Norma, it's common sense. If a person is abusing their body then they should not be entitled to major surgeries until they have sorted themselves out. A sports person isn't abusing their body. Why should an alcoholic be allowed to have a liver transplant and go back to being an alcoholic? Their alcoholism should be addressed first in an attempt to "cure" before they're entitled to surgery.

Userformally.... Who gets cotton wool Prescribed?

The drunks in A&E scenario is disenguious and just designed to demonise those society sees as weak and undeserving.

If you are an alcoholic you will require a higher level of medical treatment. You will have accidents, altercations, you may develop physical problems from drinking. You will be in A&E more than most. It doesn't mean when you fell over drunk and smashed your face in you shouldn't get treatment. You have a condition that necessitates a high level of care.

It is true that affordability is an impossible thing to define Figure17a - as indeed is deserving.

userformally what if somebody is genuinely unwell and doesn't have £30 to see a doctor? Do you think people too poor to pay the £30 should not be able to see a doctor?

Trainspotting1985 - some drunks yes. Some no. Plenty of people who do this are not alcoholics.

I know more than one person who has paid privately to get such an op done quickly, and the costs were rather less than I'd have expected. As a bonus, you have also saved the NHS and the taxpayer much needed money

Yes but what happens if the operation goes wrong and you cannot afford to pay for repairs etc?

The last time I was in hospital (for emergency kidney surgery just in case anyone thinks I am undeserving ) there was a young woman who had had bariatric surgery abroad, in Poland. She had found it cheaper, and thought she was taking a burden off the NHS.

Unfortunately for her it went wrong and when she got back to the UK had to be admitted as an emergency surgery case.

The gastro consultant shouted at her in front of the whole ward that his job wasn't repairing messes from the private sector, she got herself into this mess and she should sort it out, etc etc.

Patients can't bloody win. We're either feckless scroungers after our free calpol and bothering poor overworked A&E every time we have a virus, or we're all off consulting Dr Google and thinking we know better than The Professionals (how very dare we).

Seriously there is loads of patient-bashing in the media and on MN and it sucks. Lots of patients stood up for drs when they were on strike, including me. Patients deserve support too.

The things is unless we can easily afford and have all the resources to treat everyone all of the time immediately for everything then we need to discriminate, to prioritise, to choose.

We could do it on financial grounds, who can pay. Or on who is of most use to society, (so elderly and disabled go last. ). Or on a waiting time basis. Or on a "is it your own fault?" basis. Or on a "likely outcome" basis, so only treat those with a better than average chance of recovery. Or on a "how long have you lived in the area/country?" basis.

In reality we use to some extent all these factors at the moment without actually admitting it - but we are still struggling.

I supported the Drs strikes too johnny. I do think most doctors are in full support of their patients. But it isn't the individual doctors who restrict access to medications or decide on waiting times. I think most doctors would love to be able to provide whatever medication they think will be most helpful to their patients and they would love to offer timely surgeries to everyone in need. The problem is funding and decisions made at a higher level about what we can have.

It is political, there is enough money to fund the NHS. It is a choice not to do it. How much is planned to be spent on Trident and HS2, wouldn't that be better used for NHS? I think it is a big concern that Theresa May is costing up to Donald Trump looking for 'deals' - this could be the start of US interests buying into NHS.

Six yes I do not think its is drs here bashing patients! Rather it is that discussions like this always set one group against the other which is a false dichotomy as we all need the nhs.

As a pp said the cost of a hip operation is about £15,000, which doesn't include the room charges, consultation fee, anaesthetist fee, physiotherapist, radiology fee (scan or X ray) or pathology (blood tests). Very few families have a spare £20,000+ sitting around.

If anything goes wrong in the operation leading to complications you end up in an NHS hospital anyway as private hospitals don't have emergency facilities. This is why the vast majority of patients have little choice other than to wait.

We should stop prescribing cotton wool, paracetamol, gluten free bread on the NHS, when these items are freely and cheaply available elsewhere..

So many myths.
Independent does not provide a better service because

• They are not treating same patients
• Many are excluded because of co-morbidities
• Most do not have back up in case of emergency. They transfer to NHS via 999.
• Medical cover is one junior doctor for whole hospital working 24/7 on call.
• They fail to meet same standards as NHS for cancer care, often for endoscopic services, paediatrics and critical care where provided.

The risk of impact of obesity is minimal scaremongering and blaming. Risks associated with anaesthesia are very, very low - deaths are generally related to frailty or serious co-morbidity such as heart failure or respiratory failure. The absolute risk of death from anaesthetic is around 1:100, 000. For people with BMI over 50 it rises to 1:150 000 so, technically, a rise of 66% but given minimal nature of absolute risk and fact it is not a straightforward risk the strategy is unfair. Particularly as it is being imposed on people with much lower BMIs.

rainbow an alcoholic who is still drinking will not get a liver transplant.
Unless they live in a country where health care can be bought.

So if we go down the route the OP is suggesting it may well result in what you think happens already.

In which case they could simply buy a liver and that liver would have to come from the limited supply available leading to a hell of a lot of queue jumping and zero chance of poor people getting what they need.

Surely there are far more fat people in the UK than can be accounted for by medical conditions?
We recently visited Budapest and Madrid, and were struck by how few fat people we saw. It is hard to believe that Spaniards and Hungarians are happily much freer from such medical conditions. More likely to be a healthier diet.

I totally agree that not all drinkers are alcoholics bad knee but if someone is drunk trips over and splits their head open they still need medical treatment don't they? There isn't a way around that

I am not disagreeing, (my ex DP had a serious head injury caused by falling down when intoxicated. Thank goodness they treated him). And I do agree about demonisation of any group being an unhelpful thing. BUT we do have to discriminate in some way who gets treatment - we already do. The question is are we discriminating in the way that works best for us a a society?

By treating the drunk who falls over the old lady who banged but didn't split open her head goes one place back in the queue. By treating the old lady, (who is not contributing to the tax system), the worker who slipped on the factory floor goes one place back, and by treating him my/your child has to wait longer in pain. etc.