To wonder if perhaps the answer is just to stop paying?

[Resurgam2016]

Listening to the radio the other day and there was a South African lady who was having kidney dialysis in the UK because she couldn't afford it in her home country. Apparently in SA they don't fund this treatment for the over 65's. There just isn't the money. She was a medical tourist but that is another issue entirely.

So what if we contemplated something similar to help 'save' the NHS? No treatment for life limiting conditions over, say 70 years. No treatment for conditions that are not life saving (so fertility treatment or breast rebuilding for example). Making people (or their relatives) pay for all but the medical care they receive (so food etc.). It's a horrible thought but maybe the answer?

FYI I have a chronic illness so might well be 'caught' under these new rules. I'm just wondering if it is 'acceptable' in SA why we don't debate it here.

What a horrible concept. It's essentially killing off old people once they have nothing to contribute. Where's the humanity in that? What about old people with no family?

The UK has actually cut - not just failed to keep up with inflation but cut - spending on health and social care since 2008. Under the banner of austerity.

I said at the time that the cuts of funding to councils, which provided the social care, were a backdoor cut to the NHS and would end up bringing it down.

And here we are a few years later. Completely predictable.

(Almost as if someone planned it. Funny how it dovetails just so perfectly with the "NHS isn't fit for purpose, we can't afford the NHS, oh whoops we'll have to privatise it" narrative.)

There is a genuine problem with increasing social care and health costs, because the number of people over 80 is rapidly increasing. That's a major challenge in itself and one we need to be realistic about.

But any discussion which does not acknowledge we have actively CUT spending on social care is not a realistic one.

Why should a wonderful, much-loved person with a life-limiting condition be refused treatment because of age, and some domestic abuser or child rapist be given treatment because they are fortunate to be young enough to qualify?

We can't make these judgements so glibly.

Having spent 5 days in hospital with dd2, paying £10 a day for parking, plus the petrol to and from the hospital for my dh (it was a special children's hospital over an hour away from home) paying for food for me in the form of m&s ready meals and toiletries for me. Yes let's charge more at point of entry and price people out of life saving treatment.
We couldn't plan for dd2's hospital admission because it was an emergency, I didn't know we were going to get sent from the GP, to the local a&e then be ambulanced over an hour away with nothing but what we had with us. That's what emergency treatment is.
To charge for dd2's meals (when she wasn't eating anything, saying she wasn't hungry and the drs telling us she couldn't go home till she has eaten) wouldn't have been right. Some parents wouldn't be able to afford £2.50 a meal 3x day (that's based loosely on school meal prices!)
And as for not giving treatment to thoes over 70

I'm all for a debate but OP you've really fucked me off with your suggestion that premature babies shouldn't get help unless they're over 28 weeks gestation.

Do you know that babies are resuscitated from 23/4 weeks (if they show signs of life) because medically THEY CAN SURVIVE. And more and more can survive with fewer life long problems. My 24-weeker (and many of his friends) who weighed just 1lb8 is absolutely thriving now and I find your inference that he should've been left to die is ignorant at best and downright offensive at worst.

If you're taking this view, you might as well enforce abortion for anyone not completely perfect/with any form of medical needs, so they're not using up NHS resources.

None of us know how our health is going to pan out, somethings can be influenced by life style, somethings not. But to penalise they relatively old or very young to save resources is barbaric.

I hope you're a journalist because otherwise you have a very warped view on who is important/"deserves" to live.

Means testing is a slippery slope. It often gets introduced at a very high level where no one can disagree really but then they sneak the level right down and it's easier for people not to notice and then, poof, it's gone. So, for example, they'll say, anyone earning over £100K has to pay for treatment then, before we know it, it'll be £40K, which isn't massive where I live and property prices and therefore mortgages are sky high.

I would happily pay more tax and council tax if I felt assured that my money was not being wasted

(Almost as if someone planned it. Funny how it dovetails just so perfectly with the "NHS isn't fit for purpose, we can't afford the NHS, oh whoops we'll have to privatise it" narrative)

I've noticed that incredible co-incidence, too Flatly. But of course, that wouldn't have happened would it? I mean, the fact that so many MPs are advisory to private health. care and medical companies is purely co-incidental, obviously.

I don't think my grandfather - 78yo - should be having all the rounds of cancer surgery he is getting.

Palliative care should be offered.

I love him to bits but he's 78. He's had a cracking life, will be missed dearly but the surgery he is having right now has left him in bed and unwell for months. He should be spending the last year of his life living not existing in a hospital bed after yet another surgery to prolong a life he really does have much left of.

I don't see why someone who chooses to overeat

Not everyone who is overweight chooses to overeat. As a PP says, there is a link between poverty and obesity. There are also medical conditions that can cause weight gain/make weight loss incredibly difficult. People may have mobility issues that contribute to weight gain. Certain medications can cause weight gain. Then there are psychological disorders such as emotional eating, disordered eating, binge eating and so on.

It's not as simple as "no health care for you because you did this to yourself, you disgusting fatty."

There should be a portion of the NHS budget directed at preventative measures such as early interventions for weight management, smoking cessation support, mental health support services and so on.

Well I wouldn't have got my cornea transplant then - it's not lifesaving. So I'd just have to be legally blind and not able to work and therefore a drain on society.

By the way, you do pay tax on your pension. If pensioners are still funding the NHS they should be entitled to use it.

Not all pensioners are wealthy, there seems to be a unwritten law that the baby boomers and over 70s are all living it up, paid off their mortgage, own lots of properties etc etc. Its not the case for everyone and wont be in a few years time either, with the retirement age going up and people not able to buy a home. They are not all rich, not at all. My dad didnt buy his own home for a whole load of different reasons.
I bet all this comes in though - they have already told someone i know that her dad wont get his op as he is too overweight - fair enough, she knows he needs to lose 3 stone, but he wont do it. He will be discriminated against - then a few months time it will be some other reason not to do it, even if he did lose the weight and on and on it goes. i can see all sides, but saying to the over 80s, your finished isnt fair either.

I am not a journalist and I don't agree the situations I have given.

I am just saying we need to have a debate that goes beyond the individual circumstance and looks at what is 'acceptable' in today's NHS. If some countries have boundaries (age (young or old), infirmity, non essential nature of treatment etc.) should we?

What is essential and what is not?

Personally I think lifestyle should be considered especially if the messages about it in have been in the public arena. Also I am not sure that fertility treatment is essential. But I don't know.

I think the number of children you have should be limited if you can't afford it. So you can only claim for 2 or something.

But Broken - does he want to have the surgery?

I have had 2 relatives diagnosed with cancer in their 70s. One opted for low dose chemo to extend her life to get her affairs in order and stopped when she became unresponsive, but did not choose invasive treatment.

The other said straight out that he didn't want to end up like the poor people he saw when he arrived for his diagnosis. 'Shells' is what I think he called them. He opted for no treatment at all.

Everyone has a choice. Your grandfather has not been forced at gunpoint to have treatment. He could have said no. Why would you want to take away his choice?

Personally we had no choice with my Granddad - his cancer went undetected until the day he died from it.

65/70 is too certainly too young but surely there has to be some sort of cut-off?

organ transplants, artificial joints, heart surgery for 90 year olds?

Arbitrary decisions made on whether they are independent or in a care home?

(I wouldn't fund IVF and many cosmetic procedures either btw)

I can see a time not that far off when the NHS will only be free to treat acute life-threatening conditions.

Yes we need to do something about the hundreds of millions spent unnecessarily on prescriptions for otc drugs. But what about the people who get free prescriptions on income grounds? Paracetamol may be cheap but can they afford to be buying antihistamines, anti-fungals etc?

Free prescriptions also need to be looked at. No reason why OAPs should be exempt if they can afford to pay. And in terms of free prescriptions for medical conditions (which I also personally benefit from), it might be better to give free medication for the treatment of that condition but pay for everything else (maybe have a box for the doctor to tick when prescribing).

It shocks me that people still get gluten free products on prescription when its perfectly possible to live a normal and healthy life without specialist gluten free foods. I know because that's just what I do!

I'd feel really bad getting food on prescription.

and diabetes medications. Insulin. Yes it should be free. It is lifesaving.
but there's a lot of type 2 diabetics who are on a lot of medications that could be reduced if the person lost weight and adopted a better lifestyle and it really winds me up they get free prescriptions whereas me - severely allergic to a couple of things, asthmatic and in need of steroids for psoriasis and an ENT issue- have to pay for all of my prescriptions. Necessary life saving prescriptions. If I could adopt a healthy lifestyle and never take medications again I would.

We do need a sensible debate though. Do we all agree to pay a directed tax to the NHS (polling indicates yes but in elections we don't seem to vote this way) or do we get harsh in deciding who has treatment?

E.g on hospital (BBC2) last night there was a 98 year old who had heart surgery, which caused a stroke and obviously cost £££. BUT, he appeared to recover well and may well have a good few years of decent health left. Also interestingly the surgeon said this surgery may prevent multiple future admissions costing £££ so in effect saving money.

Do we prioritise him over, say, a 50 year old obese man who smokes? I don't know.

As the programme said, the NHS is a victim of it's own success. Generally we are healthy, live longer and costs more.

It's a tough one.

Prompto-you missed out the last part of my sentence.

Like I said -I am bias. And I never said anyone was a disgusting fatty.

What I'm trying to say is that imo-people who choose to eat unhealthy food in excess and then suffer health problems from it should-imo not get treatment quicker than a dc (my dc atm) whose education and daily life is being affected while waiting for an operation.
Many issues caused by overeating can be reversed with a change in diet and exercise.

I know people will disagree with me and that's fine.

Maybe people might like to see the return of the poor house? my dad can remember them being spoken of - his parents did everything they could to keep out of them, but for some, there was no choice.
Yes, lets have them back - lets put the old folk away somewhere and forget about their contribution to society in the past shall we? the government would love it -unless your a very very rich pensioner of course, they are all okay, they can have all the treatment and the doctors at their beck and call.

What would happen (already happens) is that those who can afford to pay, get good healthcare and those who can't don't.
So if you aren't born into a family with money then you're more likely to be ill and less likely to have good treatment. You're then less likely to be able to work so you'll even less likely to be able to afford care so you and your family wil be more likely to be ill. Daily mail splashes stories about you not deserving healthcare because you don't contribute on its front page. Add into that people who are already disadvantaged in some way because we know there are massive inequalities in the current system.
That's why we can't start withholding care from some people. Your health affects every other aspect of your life.

Op-refusing treatment for the elderly and now refusing fertility treatment??

You are definitely after an argument.....

does he want to have the surgery? now he wished he had never had it. He's not as mobile as he once was. is in a lot more pain than he was. He has said if he had been given the choice again he'd have said no.

It is a contentious issue. But there does come a point where the fight to prolong/extend life really isn't worth it. We need to be better at saying that. The holy grail seems to be to live as long as possible regardless of the pain or quality of life.

For my granddad his prognosis is the same now as it was before he had the surgeries. The only difference is he has 1 lung, a colostomy bag and now can't get out as much as he could and is in a lot of pain. He's depressed and miserable. He's said himself he'd rather have went out quicker and happy than where he is now. I agree with him.

@Rhoda

"If pensioners are still funding the NHS they should be entitled to use it"

But that is NOT how the current system works. The system is RESIDENCE based so whether you pay or have paid is irrelevant. And it is that which is unsustainable.

Why should pensioners and those whose income is derived from investments (unearned) income not pay into the NI system if they can afford it? There are many wealthy pensioners/investors out there.

And the principle that if you pay tax in UK you get health care does not exist. We are higher rate UK tax payers who have spent all our working lives paying into the UK system. Because we are now non resident we are not entitled to NHS care and have to take out private insurance in our EU country of residence. This is means tested.

The return of the poor house.
It seems to be the only way ( sarcastic of course, but i can see it happening) or older fitter folk going to work for the gentry, so many ways the government can screw us over again, all for the good of the rich/ people would vote for it still as well.