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Obese patients and smokers banned from routine surgery with the NHS

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In the long run, this may cost the NHS more. Deny people their routine surgeries, and they'll be in the emergency room more often, which is a hell of a lot more expensive.
Original post by nulli tertius
What virtually all the posters have ignored is that this scheme was dropped as soon as it became public because the lawyers quietly explained to the Health Authority that it was illegal.

It is possible to restrict access to certain treatments on medical grounds ie the outcomes for particular operations are worse for smokers or obese people than non-smokers or non-obese people but that wasn't what was being done here. There was no evidence base considered by this Health Authority and why does any outcome problem miraculously go away with a 12 month delay irrespective of whether the patient has made a lifestyle change?

Smoking and BMI were being used simply as a rationing technique and choosing those who smoke or those with a high BMI is no more rational and lawful than choosing Manchester City supporters or Audi drivers.

Why would it be unlawful to ration NHS care preferentially to Manchester City supporters?
Original post by Underscore__
I hate this argument, it's such a minute percentage of obese people


Posted from TSR Mobile


Glandular issues, PCOS, athletes/bodybuilders/weightlifters... There is more than one reason for having a high BMI. On top of that you have differing metabolisms - some people can exercise the same amount, weigh the same, but one can eat 2500 calories a day and the other 1500 or less.

Even if you are obese because you just simply eat too much, which is an eating disorder, do you support restricting NHS care to people with other eating disorders that cause them to have a poor BMI, such as anorexia, bulimia, etc?

The truth is we tend to view anorexics as victims of poor mental health and the media, and obese people as simple gluttons, who could lose the weight if they just dieted. People tend not to say 'well she wouldn't be anorexic if she just ate more ' ... People are aware with anorexia that there is more than simply wanting to starve yourself. For many people with the condition, they simply don't feel hungry, dont have an appetite, or feel ill when they want to eat - it's not just girls starving themselves, in the same way that some obese people can just always feel hungry. Yet it is so much easier to say 'stop eating' than 'start eating'.

This is why the policy is so discriminatory; if you want to take away access to healthcare for people with high BMI (on the assumption that they are not looking after their bodies adequately) then why not people with a BMI that is too low, also? Because that can also lead to other problems - organ failure, stomach ulcers, mental health issues, etc.

Should we limit access to steroid abusers, drug users, injured athletes, etc. If you fall out of a tree and break your arm, shouldn't we just leave you to suffer? Why did you climb the tree in the first place? Taking it to the hyperbolic, of course, but where would this policy stop?
Original post by 1010marina
The truth is we tend to view anorexics as victims of poor mental health and the media, and obese people as simple gluttons, who could lose the weight if they just dieted.


Section the obese! :fuhrer:
Original post by JamesN88
Tbh it's particularly harsh on smokers, they pay their fair share in taxes on tobacco for the demand they create.


How is it particularly harsh? If anything, a person can have a BMI over 30 due to a number of factors such as a thyroid issue, a disability, a genetic condition and so on. But for smokers? It's a habit they choose to have (yes, many overweight people choose it too, but its a hell of a lot harder to lose weight than dropping smoking). I mean, should a smoker be allowed any sugery to do with throats or lungs if they activily ask for that problem? As it stands, both vices are bad, but smoking is just that little bit worse tbh.
Original post by MPH125
How is it particularly harsh? If anything, a person can have a BMI over 30 due to a number of factors such as a thyroid issue, a disability, a genetic condition and so on. But for smokers? It's a habit they choose to have (yes, many overweight people choose it too, but its a hell of a lot harder to lose weight than dropping smoking). I mean, should a smoker be allowed any sugery to do with throats or lungs if they activily ask for that problem? As it stands, both vices are bad, but smoking is just that little bit worse tbh.


I'm not in favour of this at all(I made the first reply to the thread saying I though it was draconian) but when planning measures like this due to a lack of funding it doesn't register with me to target people who over contribute towards the system(which smokers do via taxes on tobacco). The fact that anyone is refused treatment isn't acceptable IMO.

In terms of kicking either habit(which doesn't include people with medical reasons) that depends entirely on the person.
(edited 7 years ago)


Nar mate, didn't do it on purpose, was doing a spot of naked hoovering and tripped.
Original post by JamesN88
Tbh it's particularly harsh on smokers, they pay their fair share in taxes on tobacco for the demand they create.


its only you your killing, don't bring the rest of us down with you!
Original post by DANIELREED
its only you your killing


How?
Original post by JamesN88
How?


When you smoke you are damaging your body and us descent people have to pay for you. Your feeble mind just cannot realise that you are the problem.
Original post by DANIELREED
When you smoke you are damaging your body and us descent people have to pay for you. Your feeble mind just cannot realise that you are the problem.


There's one slight problem with your analysis.

Spoiler

Original post by JamesN88
There's one slight problem with your analysis.

Spoiler


I'm no sure if you misunderstood my post. I was not necessarily talking to you but to smokers. However to think that those who cannot quit are not weak then you must be as unintelligent and lacking mental capacity as a they are.
Original post by DANIELREED
I'm no sure if you misunderstood my post. I was not necessarily talking to you but to smokers. However to think that those who cannot quit are not weak then you must be as unintelligent and lacking mental capacity as a they are.


You replied to me directly and said "your only killing yourself"(or something along those lines). Anyone with a reasonable level of intelligence wouldn't have done that if they were talking to smokers generally rather than to me individually.

N.B. Before you question my mental capacity you should learn the difference between your and you're.
(edited 7 years ago)
Original post by WBZ144


This is difficult because the NHS was formed to treat everyone with no bias or discrimination...

My issue here is obesity (especially in severe cases) and smoking is totally self-inflicted in 99% of cases, but I do not think rationing their treatments is going to work. Instead we need to work harder to address the issue at the source and help these people lose weight or stop smoking in the first instance.
I also think it would be better to get these people to try to give up smoking or lose weight for a good amount of time before surgery or treatment for their problems caused by their obesity/smoking (unless life threatening) is offerred so people will not see it as their "way back to health".
Original post by Vividly clear
No it doesn't.

I actually prefer private healthcare, rather than the socialised crap we have here in the UK, sweden canada and cuba, where it would take me 8 months just to see a dentist just cause it's free


That's exactly the problem though, dental IS private.

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Original post by Observatory
Why would it be unlawful to ration NHS care preferentially to Manchester City supporters?


As the bureaucratic state developed; the common law developed doctrines that bureaucratic powers could only be used for the purposes for which they were conferred and that decisions which no reasonable bureaucrat could have made were invalid.

Although one can point to examples where these doctrines have been used to thwart decisions which should, in a democracy, belong to politicians, they are very much the exceptions. For the most part these doctrines keep bureaucrats under political control.

In the case of the NHS the courts will invariably uphold (a) medical decisions to prioritise and (b) a queue; but the courts will see that there is no support in the legislation underpinning the NHS for rationing decisions to be made on any other basis. Neither money nor geography nor support for Manchester City will be permitted to get you priority for NHS treatment.

On the other hand money will get you to the front of a Home Office queue to obtain a visa and indeed money will buy you a visa and a court will not say that a particular new charging arrangement is unlawful because legislation shows that Parliament tolerates such arrangements.

Likewise geography will prioritise one child over another in the case of admission to an oversubscribed school because the use of geography is assumed in the legislation.

Ultimately the decision whether to use the NHS to punish people for disapproves lifestyles and the sort of lifestyles disapproved of, should be a decision for politicians, not some unelected committee in one part of the country.

Politicians have to have the confidence that bestowing a discretion on a bureaucrat does not give him licence to do as he pleases.

Few people would disagree with this this. People may differ as to whether, for example, there should be charges for GP appointments, but people are very united that such decisions should be made by politicians not bureaucrats.
Original post by Natalierm2707
This is difficult because the NHS was formed to treat everyone with no bias or discrimination...



Of course we expect the NHS to treat people with bias and discrimination

"I am sorry Mrs Jones, I realise your husband is having a heart attack but Mr Smith and his ingrowing toenail were next in the queue."

The issue is what biases and what discrimination are acceptable.
Original post by nulli tertius
Neither money nor geography nor support for Manchester City will be permitted to get you priority for NHS treatment.


What about all the NHS postcode lotteries?
If this is the case, then should smokers and obese people be exempt from paying national insurance, and be able to pay less in other taxes?
Original post by dingleberry jam
What about all the NHS postcode lotteries?


That is a media term and in most cases simply identifies more plentiful or better treatment available in some parts of the country.

Occasionally it relates to some treatments not being routinely funded in particular areas though in all cases a patient can seek funding.

However no NHS unit can geographically restrict to whom services are provided, and except in medical trials, all treatments are available to all of the population.

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