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Obesity and the NHS

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Kathyan | 09:45 Wed 30th Aug 2006 | News
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A few years ago it was smokers who were targeted as not being allowed teatment on the NHS, now it's the overweight! Which group will it be next? All these people, whether they are smokers or overweight, have paid their NI contributions and Income tax and under the terms of the NHS should receive treatment 'free at the point of need'. Are they trying to dismantle the NHS by stealth?
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I'm a nurse in the NHS Kathyan, and fully agree with you - a while ago it was a clampdown on smokers, but people tended to stop championing the cause once they realised how much tax smokers pay which inadvertantly goes towards the NHS. The same with overweight people and their contributions through taxes, N.I. etc. Of course, I have seen more than a fair share of people who seem to relish the fuss of being in hospital - in some cases refusing to leave even when medically fit - who haven't worked a day in their lives, and thus contributed nothing.

Around 60% of hospital beds are occupied by people aged 60 and over and - even though they paid their 'stamp' (although some did not, in cases of war and those who worked unpaid as housewives / mothers) - the contribution they made in their heyday comes nowhere near to funding the cost of the treatments they have today, as they tend to be more complex, chronic health problems, and more prone to social problems afterwards. For the NHS to sustain itself, we need lots of people paying into it, but very few ever using it. I can't see it being financially viable for much longer.
Smokers actually provide more income to the NHS than they draw from it due to the fact that they tend to die earlier and although they cost more from lung cancer they would otherwise live longer and cost more in terms of geriatric ailments.

It's a complex calculation though and there's a specialist researcher at Durham University (I think) who specialises in it - I think I dragged out a paper or two last time this came up.

The economics are beside the point though. I think the main justification for refusing artificial fertility treatment is on the grounds that it would place additional strain on the health of both the mother and baby.

Incidently they reccomend the same refusal to the severly underweight too for the same reasons - but obviously that doesn't make such good rant fodder for the media
While many people have paid their NI contributions and rightly feel entitled to use its services, the increased and varied demands placed upon the NHS today are making it more difficult to justify many types of treatment.

It was designed as a resource to treat the sick, but has developed over the years into a service that helps with medical conditions that are neither life threatening nor some kind of human right, like fertility treatment.

http://news.bbc.co.uk/1/hi/health/5296200.stm

Even the originators were stunned and concerned about the amount of use the system experienced at its onset. One of the earlist concerns was the number of women seeking medical assistance to deal with conditions caused by years of child bearing with insufficient medical assistance. The number of surgeries to repair female prolapse shocked many politicians.

It would be lovely if the system could continue to satisfy all sections of the public, but sadly there will come a time when a government of one persuasion or another will have to bite the bullet and draw the line at what can and cannot be offered in a free at the point of service system.

I wouldn't suggest this is reform by stealth, but more a realistic attempt to cater for medical need rather than medical want.
I don't think it does any harm to overweight people or smokers to have the withdrawal of NHS services as an incentive to live a more healthy life style. It is their own self indulgence that has led them to be as they are and they are drawing on resources that could be used to provide better care for children and people that have always made an effort to be healthy.
Whichever way the sword falls it will mean the same thing: if you have the money you will get the treatment. Some things never change. Look at how the dental service has gone. From being free or part-funded it went to 'if you haven't been for 15 months we will take you off the NHS list and put you on to the private one' to 'sorry, no more NHS patients'. It will become a two-tier system. We are told to keep fit; don't smoke; eat healthily, so we don't overburden an ailing NHS - fine - I do all those things. But do you know what frightens me? I will end up with a healthy heart & body, suffering from Alzheimers, drooling, doubly incontinent and left to starve in some old people's home. My idea of hell on earth. Rant over (I think). =0)
With your attitude I wouldn't brag too much about being a nurse in the NHS Dizzieblonde. You are obviously a degrace to that honourable profession. What do you suggest Dizzieblonde, a lethal injection in the arm for anyone over 60. Incidently there was no NHS to pay into during the war. But without those non financial contributions that were made during this war, you most likely would not be around today to pontificate.
Not at all anotheoldgit - I chose to work in that area because it's rewarding to look after them, although the general politics and working of the NHS itself is worse than most people realise. All I'm stating is that when it costs an estimated �100.00 each day purely for the cost of an NHS bed in an acute hospital - that's without a patient in it, and without any staff doing anything - whatever contribution people aged over 60 made before inflation comes to very little.

Maybe when you or a member of your family is waiting on an unpadded trolley for 6 or 7 hours waiting to be seen by a doctor, purely because someone is using a bed who open admits he feigns cardiac pain because he "likes the company and likes the free meals" - a genuine case not so long ago - then you'll think differently about it. Equally, when you have these very same people spitting, punching, swearing and throwing faeces at you, then you�ll see why very few people want to do the job at all - although I assume from your knowledge you must be from the medical profession yourself?
As I said over on "News", it is a disease, not a case of too many pies. Different people have different addictions- some alcohol, some nicotine, some food. All these are addictive for different reasons- some physical, some emotional. Some people are just born with "addictive" personalities. Others can take or leave anything.

I think if they are going to target a group to not be allowed fertility treatment on the NHS, it should be the wealthy. People who earn over a certain bracket should be expected to finance it themselves. People who have not a hope in hell of raising the money could maybe get help towards it, like with all the other benefits.
I pay �223 per month for National Insurance. I know that it is a contribution towards my state pension and also the NHS. I have not used the NHS personally for nearly 30 years. If, when I need it, I am told to go away because I am a smoker/obese/left-handed or they just don't like the look of me then I will be pretty pi$$ed off.

I am sure that for �223 per month I could cover myself for adequate health care and the equivalent of the state pension but I do not have that option.

I don't mind paying in but I do detest the waste especially on over management. How, as mentioned in one answer, can it cost over �100 per day to look after an empty bed.

I also think that most of the money should be spent on saving lives and not providing extras such as IVF etc.

It's a very complicated issue and there is not an easy answer.
all of these people that say they dont use the nhs are talking a load of bollox. You pay to have an a and e service on standby in case you are in an accidet do you? have your own prIvate ambulance service on standby 24 hours a day do you? in case you need it. Have your own private gp service do you?
Shouldn't worry too much about 'targeted groups' as the NHS is imploding quite nicely by itself. Most trusts are laying people off (predicted 1 in 10 redundancies at the hospital I work for). In my own profession, physiotherapy, some �2.7 million was spent training just over 2,000 graduates this year. 93% of them have failed to obtain employment. Similar story on the nursing front, where students I meet on the wards despair of getting employment once qualified. So next time you're waiting for treatment whether you're overweight (we currently have a female patient on our ward who is 35 stone), a smoker, an alcoholic , whatever, think of the silence that dear old Patricia Hewitt is maintaining.
bednobs, I apologise if English is not your native language. Otherwise, please read my answer carefully.
Contrary to some of the replies above, NI contributions don't fund the NHS, per se, though it might have been a convenient means for politicians to sell the original idea. Just think of it as yet another tax, which goes into a large bag of money called the Treasury, to be doled out to all Departments as Cabinet sees fit. Any thought that the Health Secretary can say ' I'm entitled to a bit more money because the NI contributions are up this year' is a non-starter.

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