Should An Nhs 'In Crisis' Stop Offering Non-Essential Treatment?

[naomi24]

IVF, non-essential plastic surgery, non-essential gender reassignment procedures, and gastric bands and 'tummy tucks', for example? Additionally, GPs hand out millions of prescriptions for remedies that can be bought over the counter often for far less than the cost of the prescription so would 'getting back to basics' reduce the strain on NHS resources and go some way towards a cure?

[Redhelen72]

I thought it had, I know NI will not do a lot of what you mention up there although we do get our prescriptions free the GP's will not write scripts for cheap over the counter meds.

[bednobs]

what non-essential plastic surgery do the NHS do?

[naomi24]

Procedures carried out to relieve claimed psychological disorders, bednobs.

[Peter Pedant]

My loo-lee has just had her melanoma excision cancelled
and doesnt feel that way

facial, wide excision needed stage 2.

[Redhelen72]

How many of those types of procedures are carried out per year Naomi?
I also think your description of 'claimed' is wrong - people don't just rock up 'claim' this condition and get surgery.

[naomi24]

No idea how many, RH.

[Redhelen72]

without knowing how many are carried out how can you claim that they are a drain on resources?

[naomi24]

Any non essential procedure is a drain on resources.

[andy-hughes]

I wonder if it's time we stopped regarding the NHS as a sacred cow, and start looking at means-tested payment for services.

The NHS has always been an admirable concept, but it was conceived in a very different time.

It was never envisioned that so many more people would live for so much longer, putting an intolerable strain on the resources avaialble.

That coupled with the endless tiers of highly-paid management, the wilful waste caused by the complete absence of anything approaching accountability, and the increasing reluctance of successive governments to divert sufficient funding into the reality of paying for the service they claim to offer, it's time to stop and have a serious look at what is happening.

Of course, it won't happen, because for any government to confront this notion of stopping free healthcare is political suicide, so we limp on and on, getting less and less for more and more.

There is no end , because the end is something no government will consider, even though it is clearly what is needed to get us out of this mess.

Ditching non-essential procedures would be a start, but radical and urgent re-thinking is needed, and will not be forthcoming.

[Untitled]

it might be harder to distinguish than first appears... a hernia operation is minor and not typically urgent but can become an emergency if left untreated... gender reassignment typically requires years of waiting and withdrawing it can cause devastating mental health problems that the NHS then has to deal with elsewhere...

tummy tucks and purely cosmetic surgeries are good candidates but there is a high chance they are being postponed for more urgent surgeries anyway... hence waiting lists

[Zacs-Master]

The link below provides a list of cosmetic surgeries which the NHS may pay for. I just thought it might be pertinent to a meaningful discussion on this thread:
https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-procedures-on-the-nhs/

Tummy tucks are not free:
https://www.nhs.uk/conditions/cosmetic-procedures/tummy-tuck/

[vulcan42]

Redhelen, I realise this is only one example but I have a friend in Northern Ireland who regularly gets indigestion tablets on prescription.

[Redhelen72]

Well Vulcan I was going to say shame on the dr and shame on your friend for accepting them
But then I thought perhaps your friend cannot afford to purchase the tablets or needs them in such quantities that the dr feels he is helping out.

[THECORBYLOON]

Would, "claimed psychological disorders" not need to be supported by a psychological assessment prior to any treatment?

[Zacs-Master]

Indeed it would, TCL.

Here's a little more information on weight loss surgery / gastric bands:
https://www.nhs.uk/conditions/weight-loss-surgery/

[rowanwitch]

Once we have got rid of the human rights legislation... The right to a family is included and has been used to access Fertility treatment.
Bariatric surgery is proven to be cost effective in feeling term as it can prevent serious morbidity in the obese which can be a lifetime drain on resources. Gastric banding and balloons are the least successful long term so maybe only the more radical measures should be used..

[Zacs-Master]

The procedures for Gender dysphoria (or more accurately Gender Incongruence) are as follows:
• Referral to a specialist Gender Dysphoria Clinic from primary,
secondary or tertiary care or by self-referral
• Assessment for gender dysphoria, and diagnosis
• Individuals who meet the criteria for gender dysphoria related to
gender incongruence are accepted on to the NHS care pathway and
an individualised treatment plan is agreed
• Therapeutic interventions delivered by the specialist Gender
Dysphoria Clinic; and / or referral for interventions led by other
providers, including for surgery
• Ongoing review and monitoring during and after interventions
• Conclusion of contact: discharge to primary care.

https://www.england.nhs.uk/wp-content/uploads/2019/07/NHS-England-Service-Specification-for-Specialised-Gender-Dysphoria-Services-Surgical-v4.pdf

[Redhelen72]

Plus the gastric band needs ongoing adjustments which are costly.
80% of bariatric patients will need the gallbladders removed in the future so why not remove at the same time as the surgery to save future costs.

[rowanwitch]

There is a fine line between some cosmetic and treatment surgery. A good example of this is breast reduction. In the worst cases without surgery the women concerned would suffer a lifetime of back pain, which would mean lost work time, plus treatment for the pain, it becomes cost effective very quickly.
At the same time there are expensive cancer drugs that are known to offer short term life extension of a few months, certainly less than a year. The cost can be tens of thousands. Hate to be the administrator doin g the cost/ benefit/ calculations on that.

[nicebloke1]

If the NHS cant get to grips with paying between £3/4 per box for paracetamol from a wholesaler, when Aldi, B&M and many other retailers sell them for pence. What chance is there of sorting any other problems out?