NHS may refuse to treat drinkers and smokers

[MistleToo]

news

first it's no new hips for the obese now this?

In the wake of George Best's death and a general feeling that he 'wasted' his new liver - what do you think?

so hold on. Scenario - you smoke then you develop asthma......not very nice. So, you continue to smoke - why would anyone do anything so utterly stupid as that????????

I don't think anyone woudl be denied palliative treatment - inhalers etc. But smokers should be denied access to expensive treatments. The best example I can think of is angioplasty to open coronary arteries. The stent/basket costs a fortune, yet if the patient continues to smoke it virtually guarantees a further blockage - making a mockery of the treatment in the first place.

What about all those people with NHS produced damage (ie from waiting too long, from dirty hospitals, from drug reactions, vaccine damage?) should they go to the top of the queue.

As as user of the NHS I don't see it as being some fantastic great, free thing. People I know who have relied on it have died from relying on it.

interesting debate but I'm afraid I must go and nap. Only 4 hours sleep last night.

I don't think a FREE national health service should be refused to certain people no matter what the circumstances.
Either a full free and fair service or a complete rethink and revamp, and make it like the Americans do it.

Highlander-its addiction. If you are going to insist that people don't smoke and they are so addicted that they behave stupidly then you need to give them something to work with their addiction (which could be seen a psychological condition).

Exactly Jingle!

Does that mean if I'm an alcoholic I can stop paying National Insurance??? Afterall... I wouldn't be entitled to any free healthcare anyway!

rethink and revamp agree- but I think there are better systems than the US one.

shudder at the thought of being judged morally okay before getting treatment.

shudder at the thought of being judged morally okay before getting treatment.

Can you imagine if the person morally judging us was a MUMSNETTER??? God help us all!

What would you do with an alcoholic smoking doctor? Or is it only poor smoking drinking fat people who are to be refused?

what about if you get pregnant although it is a medical risk for yourself

or you attempt suicide

or you go walking in the mountains

PMSL SA I'd stand no chance!

Zippi - snap with the mountain climbing!

Fantastic points!!!!

or you drive into a tree

There needs to be a complete separation between people's attitudes / judgements about smoking etc etc, and the concentration on prioritising expensive treatment where it will actually be effective and improve quality of life. This shouldn't become a 'punitive' issue, nor should any aspect of the NHS be linked directly to any income which may or may not be raised in taxes. The extension of that argument would mean, say, that a person obese on Mars bars would be way back in the queue behind a smoker, irrespective of treatment needed or degree of illness, because Mars Bars raise less tax!

Doctors already make decisions based on whether the treatment will in fact make someone well or improve qulaity of life - so it is logical that if continuing to smoke would undermine or negate treatment, that it is not worth doing the treatment. That should be the only consideration. Surely patients can come to understand this without it becoming a punitive thing?

The weight / hisp thing is hard - hard to excercise and keep fit if your hips don't function.

Anyone who can afford it will go get the treatment they need, while the most vulnerable, poor, less educated in society will suffer.

My silly aunt who smokes despite having suffered with TB as a teenager....

If that's the case then overweight people and smokers should stop paying taxes if they aren't going to be treated.

and what about diabetics for example who don't follow their care regimes properly

"The report comes after it emerged last month that obese people will not be entitled to hip and knee replacement surgery on the NHS in East Suffolk."

To be honest I don't expect a knee replacement to be succesful if you are particularly obese, I would say that is not about obese people being refused treatment but about insuring people do something (like loosing weight) before the operation to ensure this is successful.

Regarding people with suicidal tendencies... I'm I don't know if here in UK is the same, but I believe that you would not qualify for a transplant in other countries if you have suicidal tendencies, for the simple fact that they want to give priority to those that are convinced they want to live (after all, somebody who could have used that organ may die if a second organ is not find in time)

Agree jigleshells- the other problem is that excessive smoking, obesity etc is correlated (at a population level) with poverty, so social judgments are being made. Of course if someone's health is likely to suffer because they are not fit enough for an op then they shouldn't receive that op, but that's not the same as saying a blanket ban on operating if your BMI is over - whatever arbitary figure is picked.,......

This is a slippery slope. Of course we all need to take responsibility for our actions, but if someone is going to say you, you and you are worth treating because you towed the line but you, you and you were naughty so we are going to let you die, then that is damn scary.

Perhaps this is the final disintegration of the NHS. Would it really be so bad to think about moving over to an insurance system? Scrap NI. Those who currently pay NI contributions instead take out insurance, whereas those whose NI contributions are paid/subsidised by the state have their contribution paid to their nominated insurer? Course system would have to be safeguarded to make sure companies could not refuse to insure / insure at ridiculous price the high riskers! But a properly regulated and well thought out system, including lower premiums for people who have made healthy life choices would surely be a good thing.

That way, you get value for money and can swop insurers to get the best deal. it makes hospitals pull their socks up because you are paying customers, but it also ensures that the vulnerable ie those on low income/benefits are not left in the situation that happens in a lot of countries where you have to have medical insurance - no insurance = no or only most crappy treatment.

I think an insurance system would make individuals think alot more about their own responsibility to take care of themselves too.

I think the linked article is oversimplifying. Other reports I've read of the NICE recommendations are more detailed. As far as I can make out, NICE are recommending that denying treatment is only going to be an issue with people who have a known lifestyle factor that makes it more likely they will have a poor outcome for a given procedure.

Eg an obese person is likely to have a worse outcome for a knee replacement because (a) surgery is far more risky and (b) the joint is likely to wear out sooner. The implications of the NICE recommendations is that an obese person would not be referred for treatment unless/until they lost some weight, thus improving the chances of a successful outcome to the surgery.

Comparable examples would be eg. heavy drinkers and liver transplants, or heart-lung transplants in smokers. That doesn't seem so unreasonable to me.

No-one's saying that an obese alcoholic chain-smoker isn't going to get their broken leg or their brain tumour treated, just that they might not be a suitable candidate for a liver transplant.