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bazwillrun | 15:56 Sat 23rd Nov 2013 | News
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http://metro.co.uk/2013/11/23/britains-biggest-lottery-winners-pay-for-girl-4-to-have-pioneering-cerebral-palsy-surgery-4198514/

NHS refuse to fund op but seems able to pay for prisoner to have sex change ops (recent story)

and we can find money for immigrants to have flying lessons (recent story)etc etc etc thew list just goes on and on

and if you can be bothered to look at some of the "projects" the lottery has funded over the years without being sick to the pit of your stomach..and this poor kids parents have to go begging

what a disgrace this country is becoming...we are just sinking lower and lower

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boxy....if you had a daughter who had mobility problems associated with cerebral palsy, would you take the advice of a Consultant Neurosurgeon at the Frenchay or the opinion of a member of Nice or a representative of the RCT?
are you talking to me?
Yes...if your name is boxy...;-)
but it isn't so i'll leave boxy to answer
LOL...LOL...sorry bednobs......LOL
boxy, bednobs, RCT's, NICE...................glad i have retired.
SQAD, the English NHS has a finite amount of money to spend and they have various criteria to follow when allocating that money. How would you feel if several of your elderly relatives were denied life-improving surgery such as a hip-replacement because the money had been spent on a single person's more expensive operation? Someone has to make the decision and that decision often means someone does not receive treatment on the NHS.
CORBYLOON........Fine, I accept what you say, then why not come clean and say that the NHS cannot supply comprehensive health care and what it can provide is determined by independent factions.

Develop private medicine and give tax relief for people who decide to cover themselves with private insurance.
// Gromit.........you are being silly.

To the parents and the little girl, does it matter why she was refused treatment.? //

This 4 year old girl seems very young to have tried all the other treatments. Her mum reads about a miracle operation at a nearby hospital andwants it for her little girl. Because she hasn't tried the other treatments first, she is denied it.
I do not have all the answers but if there's a certain pot of money to be dished out, some method has to be used to determine who gets what and when, otherwise it could all be spent with half the year to come still. I am sure the family in this case would have been telt the reasons behind NICE's refusal.
i have no idea what criteria i would use to determine if my child should have an op. As an unlucky happenstance, i may well have to make a similar decision at some point in the future.
However, just because I want it, does it mean it should be provided? that is just like saying the sex changes SHOULD be provided because the recipients want them. As TCL says, some sort of criteria has to be applied, and i would rather the NHS used an evidence base as a criteria, than what the general public think *should* get priority
There have been plenty of examples of people in the US being denied medical treatment because they either have no medical insurance, or the insurance plan they do have does not cover the particular condition that they wish to have treated, or that the faceless bureaucrats and administrators that Sqad hates so much have found a way to weasel out of paying, thus saving their insurance company money.

To offer up such a system as some kind of better alternative to what the NHS currently offers us, despite some shortcomings, does not hold up under analysis.

Nor does the prospect of independent consultants offering any old procedure they feel like,to whomever they feel like, regardless of audits of the elective interventional procedure itself fill me with any confidence in such a proposed system.

And the recommendations made on interventional surgical procedures by NICE - who is it, do you think, who makes those judgements? Its consultant surgeons who specialise in such procedures - not "administrators and bureaucrats.

And contrary to received wisdom - NICE do not make their assessments as to the value of a proposed elective interventional surgical procedure based upon the costs of that procedure. Their guidance is based entirely upon the clinical merit of the procedure in question. The cost calculation and decision to proceed is made by the commissioning NHS Trust, who must weigh up that cost to the Trust along with the evidence from NICE and clinical opinion from their own local experts and the girls treatment team.

http://www.nice.org.uk/nicemedia/live/11220/52084/52084.pdf

Baz is using this story to make the larger point that money can seemingly be found from the public purse, for frippery or for unnecessary help to what some might consider to be unworthy recipients of such largesse, and it is a view held by many. And in the broadest terms, I can understand such frustration, even sympathise - Tighter restrictions on what money can be spent on should be employed across the whole public spending sector. But I do not think this specific case illustrates the point very well.
LazyGun

\\\\\There have been plenty of examples of people in the US being denied medical treatment because they either have no medical insurance, or \\\

The post and my comments have nothing to do with the system of health care in the US an has only been introduced by you as a "smoke screen."

That may or may not be quite true, as i would bet my pension that on NICE, they do not have a Neurosurgeon who specialises in this kind of surgery and probably more to the point happens to be in Private Practice.
Yes, NICE does have a place in State controlled medicine, but here i feel that we need a little common sense rather than an academic accolade.

The question is quite simple.....a Consultant Neurosurgeon has examined a child with limited mobility following on from cerebral palsy and in his opinion found that that child may well benefit from an operative procedure, which will cost the NHS £40,000.,an operation that will probably only be performed once or twice a year.

An elected (one hopes) committee has decided that the NHS would not feel able to foot the bill, the reasons being, I presume, that the benefits do not give value to the money paid......FINE.

My point is that there seems to be a humanitarian aspect to this case outside of Politics,or indeed comparing it to the US, which has been ignored by an inflexible committee.

\\\faceless bureaucrats and administrators that Sqad hates so much\\\\

Exactly.
@ Sqad You regularly complain about the shortcomings of the NHS when compared to the US insurance based system, sqad. You know you do. You introduced that issue yourself, in this thread, very early on, when you posted this;
"No wonder many of my colleagues in the US are worried about an NHS type health system"
But healthcare rationing already happens in the USA, and is much more common and much more obvious, and is very definitely with the involvement of bureaucrats and administrators at the insurance companies themselves. Trying to pretend otherwise would be facile.
You then comment that you would bet your pension that no consultant neurosurgeon at NICE ... but the expert opinion that informs NICE guidance is not made up by surgeons directly employed by NICE!! They are drawn up by working groups made up from consultant surgeons actually working in the NHS, in the private sector, within the UK, eminently qualified to make an assessment on whether or not an elective surgical procedure has clinical merit or not.
And by the way, did you actually bother to read the NICE guidance on this specific procedure before making the comment that NICE need more "common sense and less academic accolade"?

Of course they have expertise in this specific area to draw upon. They can draw upon the experience and opinion of eminent consultant neurosurgeons throughout the UK, including from Frenchay Hospital, which have pioneered a rather refined variant of this specific procedure.

I repeat - When it comes to elective surgical interventions, NICE guidance does not reflect the cost of the procedure, just the clinical merit. The cost consideration is done by the commissioning NHS Trust. I know that does not quite fit with your view of socialised medicine, Sqad, but your opinion does not change the actual facts.
LazyGun.....once again our ideas of the provision of healthcare differ.
From the Frenchay Hospital link which I posted earlier.

// Patient case study – Beau Britton (7) from Kelly Bray, Cornwall

If they had not received the operation on the NHS Tracy says the family would have had to fundraise for the £40,000 to take Beau to America for the operation.
Tracy said: “We would have had no option other than to fundraise and we feel incredibly fortunate that Beau has been able to have this procedure on the NHS in Bristol. The care he received from Kristian and all the staff at Frenchay was just wonderful. I cannot thank them and Cornwall and the Isles of Scilly PCT enough. //

http://www.nbt.nhs.uk/news-media/latest-news/uk’s-first-pioneering-operation-at-frenchay-offers-hope-children-cerebral-pal

Patients are referred to this neurosurgery unit in Bristol and are operated on as NHS patients. They must have been assessed by NICE process and the operation approved. So the assertion that there is no one qualified to approve this procedure on NICE is clearly wrong. They do approve this operation based on a clinical assessment.

We do not know why this little girl was denied it. But it wasn't because the assessment process is under qualified.
From a story about a different child.

// Their own doctors were not enthusiastic. The surgery cuts open the spinal cord, so that a surgeon can test which nerves are sending messages to the legs to be stiff. These are then cut. Approximately two vertebrae will be removed for good to enable access to the nerves.
In the UK, it is usually performed between the ages of seven and eight, as younger children are considered too immature, not just for the surgery, but to take on the months of demanding physiotherapy that follow. Moreover, most NHS trusts will not fund it. The family of a two-year-old boy in Manchester last week announced they have just raised the £24,000 to get SDR surgery performed in Leeds. A spokesman for NHS England said: “Funding is only granted in exceptional cases.” //

http://www.telegraph.co.uk/health/children_shealth/10178774/How-selective-dorsal-rhizotomy-SDR-allowed-a-cerebral-palsy-sufferer-the-chance-to-walk.html

So the reason that the NHS do not routinely fund this procedure on 4 year olds is not because of lack of money or ignorance. It is because they physical demands afterwards are considered too hard for a youngster.

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