Crosswords7 mins ago
Should the NHS look at potential savings v costs by the case....
The NHS tends to have a "rules are the rules" type attitude to costs. Do you think they should have a system for judging each case on some sort of NHS equivalent of ROI calculation? Eg take this case:
http://news.sky.com/s...Weight-Loss_Operation
The gastric bypass would pay for itself in 3 years and probably save a future fortune, but no, the rules say BMI must be 45 to consider the surgery, hence this costs a lot more in the long run. This is not an obesity discussion, ok!
http://news.sky.com/s...Weight-Loss_Operation
The gastric bypass would pay for itself in 3 years and probably save a future fortune, but no, the rules say BMI must be 45 to consider the surgery, hence this costs a lot more in the long run. This is not an obesity discussion, ok!
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How do you put a price on extending a persons life. I have a friend who has terminal cancer and if he had a £20k operation it would extend his life by 2 maybe 3 months. He has refused the surgery but many would still want to have it. As Steve said how do you put a price on something that can not be bought at any price . Where do you draw the line ?
There is also the moral issue . Some would say obesity is self inflicted as in the case of George Best who had destroyed his liver through alchoholism . He had a liver transplant which he then destroyed within a year I think. Was that a waste of money and a liver that could have saved another life ? There is an argument about the long term effects of a gastric bypass some say only 10% are successful in the long run . Whatever the figures the NHS have an impossible task.
There is also the moral issue . Some would say obesity is self inflicted as in the case of George Best who had destroyed his liver through alchoholism . He had a liver transplant which he then destroyed within a year I think. Was that a waste of money and a liver that could have saved another life ? There is an argument about the long term effects of a gastric bypass some say only 10% are successful in the long run . Whatever the figures the NHS have an impossible task.
They should, and usually do. Picking a specific BMI seems a little peculiar, since a BMI of 40 or more is considered morbidly obese - and usually secondary complications, like diabetes, would mean candidates would be seriously looked at with a BMI of 35 or more.
However, surgical procedures should never be undertaken lightly, especially for this type of disease. Given an underlying condition of diabetes, one might expect to see the candidate wholeheartedly embrace dietary recommendations of their physician - Based purely on the text of the article, this seems not to be the case here - in fact the guy is deliberately stuffing his face in an effort to increase his BMI. All points to him looking for a "quick fix" - Assuming that the gastric band surgery will somehow resolve his weight problems and underlying diabetes as well.. Well, it doesn't work like that.
However, surgical procedures should never be undertaken lightly, especially for this type of disease. Given an underlying condition of diabetes, one might expect to see the candidate wholeheartedly embrace dietary recommendations of their physician - Based purely on the text of the article, this seems not to be the case here - in fact the guy is deliberately stuffing his face in an effort to increase his BMI. All points to him looking for a "quick fix" - Assuming that the gastric band surgery will somehow resolve his weight problems and underlying diabetes as well.. Well, it doesn't work like that.
This story disgusted me. Can he not just eat less and exercise more instead of holding the NHS to ransom to fix all his self inflicted problems? To deliberately gain weight rather than make the effort to lose it so that he can get the easy option quick fix at others' expense is a disgrace! There are many many people out there, desperate for treatment for illnesses that are no fault of their own, but the NHS cannot afford to treat them. Maybe if he spent less on food he could afford to have it done privately!
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I do understand where you are coming from but also can see the other side. In the last 5 years I have had an accident which means I am now classed as disabled and as such cannot exercise. I have put on 3 stone in weight, suffer from depression and am now awaiting another operation. I have also asked my GP about having a band fitted and this has been agreed but there is an 18 month waiting list. I have worked for 34 years until my accident and paid into the system so I resent the fact that people could view me as the person above when an asylum seeker could come into this country and get treated on the NHS system without paying in a penny. Every case has to be looked at individually as to why the person has the weight gain and if they would benefit but unfortunately all it is down to is budget and it should not be, but that's the system.
It sickens me (not cases like yours Jan) My Grandad is in hospital at the moment. He has worked hard all his life, and saved hard all his life. At the moment he pays for my Nans care (dementia) at £450 a week. He's been told that he will need extra care when he goes home...he currently has carers come to his home twice a day for 1/2 hour at £500 per month. They have told him that his renewed care will now be £1,000 a week. Can he get help....YES...he can claim attendance allowance as it's not means tested...for £70 a week...big wows.
Then you have this person making himself fatter...it sickens me.
Then you have this person making himself fatter...it sickens me.
Yep...£1,000....and that's for him to stay in his own home. And the chances are that when it's reviewed it'll be more than that...
So he can claim his £70 a week....and he also has a war pension of £434 a month. The rest comes from his own pocket...but not forgetting that the reason he is the way he is, is because of the war..!!!
So he can claim his £70 a week....and he also has a war pension of £434 a month. The rest comes from his own pocket...but not forgetting that the reason he is the way he is, is because of the war..!!!
mmm - are you sure about that cost? We are letting my mother live at her house, because that where she wants to be (she has dementia) and has carers in morning and evening to give her medication. The cost is nothing like that although she is paying for having to much money in her bank account through her and my dad saving for there old age.
Although I am distant (in miles only) my sister and brother are visiting on a regular basis - almost daily
Although I am distant (in miles only) my sister and brother are visiting on a regular basis - almost daily
Morning R1 et al, good thread this.
To return to the question: Should the NHS look at all cases on individual merits? Yes, to degrees, and I think they probably do.
Darin McCloud seems to be a bit of a plonker to me, ransoming the NHS with your health is not going to win over anyone. If he just lost the weight, then he might be fine - or at least as fine as he would through surgery.
///Mr McCloud, who has diabetes, believes the operation will mean he can come off the insulin treatment for the condition///
It's great that he believes that, but does his doctor? If his doctor doesn't, then he has to deal with it himself, like an responsible human being - rather than a petulant child sqweeming and sqweeming until he gets his way.
All the best,
Spare Ed
To return to the question: Should the NHS look at all cases on individual merits? Yes, to degrees, and I think they probably do.
Darin McCloud seems to be a bit of a plonker to me, ransoming the NHS with your health is not going to win over anyone. If he just lost the weight, then he might be fine - or at least as fine as he would through surgery.
///Mr McCloud, who has diabetes, believes the operation will mean he can come off the insulin treatment for the condition///
It's great that he believes that, but does his doctor? If his doctor doesn't, then he has to deal with it himself, like an responsible human being - rather than a petulant child sqweeming and sqweeming until he gets his way.
All the best,
Spare Ed
For all of you having a rant that the NHS shouldn't being paying for his self-abuse then how do you answer the case that the same should apply to anybody injured sthrough sport. Should boxers, etc. recieve free at point of use NHS care when they choose to engage in a dangerous sport. What bout skiers skydivers, etc. You could potentially etend this to pedestrians injured because they chose to jaywalk.
As for the hospital not considering the forward savings, I am sure that this will be budget related. IOW, any saving will not be for the surgical budget for that particular hospital.
As for the hospital not considering the forward savings, I am sure that this will be budget related. IOW, any saving will not be for the surgical budget for that particular hospital.
Yes Berkshire I agree It's stupid to go down the route of not treating self inflicted issues, where to you draw the line? Just about anything is self inflicted ultimately.
Anyway what I'm talking about here is just doing a bit of arithmetic and yes I know that some cases are more complex but let's look at the simple ones. In this case if they do the op the NHS is in front within 3 years regardless, even if he dies on the table.
Anyway what I'm talking about here is just doing a bit of arithmetic and yes I know that some cases are more complex but let's look at the simple ones. In this case if they do the op the NHS is in front within 3 years regardless, even if he dies on the table.
I don't think he will get the op anyway Ed, or that he has been given the correct information for getting a gastric band. You have to meet the criteria, which includes the fact that you can actually lose weight yourself, or at least have tried. The first steps are to see a dietician at the hospital to try yourself and then have an assessment with a Counsellor who will assess your mental health. You still then have to meet with the surgeon who will also assess you to see if they think you will keep to the required diet once you have had the band fitted. A friend of mine has just had the band fitted and it took her 18 months in total to go through the process so it's not just the quick fix that some people think it is.
Don´t let´s compare medical conditions, let us stick to the case above.
He states that he has had "weight problems"...been fat...all his life, through school, laughed at called names, lousy at sport and been called "fatty" and possibly bullied. He then probably found it difficult to get a job, difficult to get a girlfriend and all in all, he had nothing going for him. He sought medical advice, told to lose weight, but just couldnt, the misconception held by the majority is that if you release more calories than you take in....then you will lose weight...........this is not always the case.
He then develops diabetes, we dont know whether it is Type 1 or Type 2 and the introduction of Insulin beckons the onset of complications.
Gastric Band surgery is a method of attaining weight reduction.......celebrities have used this....but our man is no celebrity, he is just Joe Ordinary and the local health trust needs him to have a BMI of 40.
Bloody stupid rule.....not the fault of Joe,but that IS the rule and for our Joe, by attaining a BMI of 40, he will get his operation.
Good for him and yes the NHS should pay.
He states that he has had "weight problems"...been fat...all his life, through school, laughed at called names, lousy at sport and been called "fatty" and possibly bullied. He then probably found it difficult to get a job, difficult to get a girlfriend and all in all, he had nothing going for him. He sought medical advice, told to lose weight, but just couldnt, the misconception held by the majority is that if you release more calories than you take in....then you will lose weight...........this is not always the case.
He then develops diabetes, we dont know whether it is Type 1 or Type 2 and the introduction of Insulin beckons the onset of complications.
Gastric Band surgery is a method of attaining weight reduction.......celebrities have used this....but our man is no celebrity, he is just Joe Ordinary and the local health trust needs him to have a BMI of 40.
Bloody stupid rule.....not the fault of Joe,but that IS the rule and for our Joe, by attaining a BMI of 40, he will get his operation.
Good for him and yes the NHS should pay.
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