NHS may refuse to treat drinkers and smokers

[MistleToo]

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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?

Not sure people have read this properly - they are not going to refuse treatment on the grounds that someone is fat. But they can refuse it if they think treatment will be ineffective. sounds fair enough to me.what's the point of wasting money on inneffective treatments.

well, the rule could be abused if the doctor doesnt like your face.

There is an interesting article on the BBC today about how successful Sweden has been in persuading people to be healthier.

haven't read all this, but quickly taking up nightynights's point about a doctor refusing treatment because they don't like your face, I do share her unease. Is it really wise to give indivitual doctors more power to refuse to treat a patient? Who has the deciding vote about a possible treatment being 'ineffective'? Is life this black and white?

Bet this has been covered here already, sorry if repeating earlier messages.

the thing isn't actually saying that smokers and drinkers will be refused treatment, only that they may not get certain treatments if their habit will affect the success of the treatment.

I'm pretty sure that happens now: alcoholics have to give up the booze before they can have a liver transplant, for example.

As a form of health rationing, I don't really think it's unfair: if not everyone can have treatment then it should go to those most likely to benefit. (although I am deeply uncomfortable about any talk of rationing on the grounds that disease is "self inflicted")

HOWEVER should treatment be rationed at all? before we go down this road I think there should be a referendum about the NHS in general. Either we pay more taxes or things start being rationed or we start having to pay.

But in a system that is always strapped for cash, it is surely sensible to only offer appropriate treatments. For example, I heard a programme about Jehovah's Witnesses who have been diagnosed with a particular type of leukaemia - the treatment is chemotherapy to kill of the bad cells, (killing good ones along the way), along with blood transfusions to replace the good ones. The JW refuse the transfusions, but want the other half of the treatment, but it is rendered useless by a choice they have made - it generally will just kill them more quickly! I don't think it is unreasonable for doctors (who on the whole are highly professional) to make a judgement about whether a treatment is appropriate or will be effective. If it makes more money available so that effective treatments are more accessible (am thinking high profile drugs like interferon)then that is surely all to the good.

The obvious thing about rationing is that patients will simply start lying to their doctor's about their lifestyles.

How many smokers will put down on their GP form that they smoke if they think they'll be denied medical treatment? How many boozers will admit to drinking more than 10 units a week?

It's just so bloody obvious that people will start lying to their GP's. And that's really going to help the NHS, isn't it.

Treatment already is rationed. I've now lived in 2 areas who appeared to have a policy of giving 6 weeks blocks of speech therapy to children with minor problems (eg mispronouncing a few sounds), whilst giving none at all children with complex problems (like my son - who still can't talk aged 6). he does get SALT now, but he comes under the learning disabilities team which I think may have some education funding (???). Had no hands on SALT for 5 years.

I don't think there's a problem with rationing if a lifestyle choice is going to render treatment useless. But rather than write off addicted smokers/eaters shouldn't they be being offered CBT or something?

Also I think you end up on a slippery slope to rationing accorsing to success- so easy cases get treated, difficult complex ones (like my son) get nothing.

good point. another thing is that doctors currently have the right refuse a patient to be on their surgery list without giving a reason why. I know somebody who was refused. First, the surgery said that her visa did not entitle her to treatment, and when I pointed out that that was not true, they just refused with no reason.

I drew my own conclusions, based on the fact that their catchment area is around 45% non white, and of their staff of around 50 people, only one person (a doctor) is non white as far as I know.