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LeftishBrit

(41,205 posts)
Sun Sep 4, 2016, 09:59 AM Sep 2016

Plans to deny surgery to obese people and smokers put on hold


A health authority that suggested it would deny non-life-threatening surgery to the obese and smokers has said it will put its proposals on hold.

The plans by Vale of York clinical commissioning group (CCG) could have meant that patients who exceed a body mass index (BMI) of 30 would face delays in receiving some NHS surgery for up to a year.

Leading medics have warned it could become part of a growing trend in hospitals that could result in overweight patients being denied elective medical procedures in a bid to cut costs. ...


But the North Yorkshire authority said it had been asked to review the plans by NHS England. It said in a statement: “NHS England has today asked us to review the draft approach, which we will now do, and will hold off implementing anything until we have an agreed way forward. ..



https://www.theguardian.com/society/2016/sep/03/vale-of-york-nhs-obesity-smokers-deny-elective-surgery
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Plans to deny surgery to obese people and smokers put on hold (Original Post) LeftishBrit Sep 2016 OP
Thanks a LOT UK get the red out Sep 2016 #1
I think just because we have the single payer system this can be defeated LeftishBrit Sep 2016 #2
Here's a copy of a relevant post that I made on 27.3.12 LeftishBrit Sep 2016 #3
BMI is a lousy standard for this BlueStreak Sep 2016 #4

get the red out

(13,466 posts)
1. Thanks a LOT UK
Sun Sep 4, 2016, 10:10 AM
Sep 2016

Giving the anti-health care people in this country another talking point to fear monger against single payer. I hope they decide against this.

LeftishBrit

(41,205 posts)
2. I think just because we have the single payer system this can be defeated
Sun Sep 4, 2016, 10:14 AM
Sep 2016

It's one local authority that's considering it, and NHS England seem not to be accepting it.

Such things were never even considered during the first 62 years of the NHS; but in the last government, an element crept in of treating health and social welfare issues as a matter of moral judgement. Iain Duncan Smith was perhaps the worst in this respect; but helped along by elements of the media.

LeftishBrit

(41,205 posts)
3. Here's a copy of a relevant post that I made on 27.3.12
Sun Sep 4, 2016, 10:16 AM
Sep 2016

An example of the sheer vileness of the right wing these days

This is an article by Cristina Odone in the Torygraph. She starts out with the valid issue that elderly people often don't get the best from the NHS - which I think is partly due to ageist prejudices, but to a large extent simply to the fact that medical administration and the training of doctors and nurses all stem from a time when far fewer people lived to be very old, and haven't caught up with modern realities.

But then she goes on to say that one should instead reduce services to the 'undeserving'.

http://blogs.telegraph.co.uk/news/cristinaodone/100146838/why-should-fat-people-take-precedence-over-the-elderly-in-the-nhs/

'There are plenty of conditions, though, that are the direct result of bad habits, poor diet, and the wrong choices. These conditions range from obesity and diabetes to smoking-related diseases like emphesema. If a 20-stone, 30-something woman comes into hospital with a bad diabetic attack, does she deserve to be at the front of the queue or the back? She has chosen to stuff her face with Mars bars and Coke, and is now suffering the consequences of her choice. She cannot claim ignorance of the dangers of her diet: the Government has carpet-bombed us with health advice, from schools to GP practices. Class no longer regulates access to healthy living: everyone who can watch the telly, let alone read the magazines, knows that a high-fat diet will make you look bad and feel worse.

Does the obese 30-something lay claim to NHS services and a hospital bed when this means thousands of others will have to do without?

The septuagenarian who develops breast cancer has done nothing wrong – except grow old. The NHS has to consider that there are deserving cases and undeserving ones. Age should not be a barrier to optimum care; but bad habits should be.'

I just find this sort of stuff incredibly vicious. There is a recent tendency to be incredibly nasty to and about the chronically sick and disabled - which mostly still at least pays lipservice to the idea that deservingness is based on medical needs, not moral virtue as judged by someone else, and that it is malingerers, rather than the genuinely ill, who are their targets (pull the other one, but at least it's what they claim). But this is naked blaming-the-victim; judging people by their moral 'deservingness', not the genuineness of their needs. Is this what we should expect in the future from a semi-privatized health service?

And of course ultimately it's The Lower Classes who most need to be assessed for their deservingness! I doubt that Cristina Odone would demand that Eric Pickles, to give just one obvious example, should lose weight before he has the right to medical care. The reader 'steffanjohn' summed up a lot of her attitude:

'It's not 'hidden decision making by health managers and medics'.

The current principle is based on primarily on medical need, with cost-to-life-extension a secondary consideration on the very expensive treatments.

What Odone is advocating is that instead of basing it on medical need, we should also judge it according to a moral judgement too.

Obese people pay their taxes, and from a statistical basis it's clear that healthier people are more of a 'burden' on health services overall.

Underneath all this really is a disgust at obese people - and underneath that is a disgust at working class people.

Why else did Odone refer to 'magazines' (not newspapers), 'mars bars and Coke' (as opposed to cheese and wine) and 'telly' instead of television?

Why else is the article adorned with a picture of two women of the 'lower orders' rather than professionals, or just something non-descript class-wise?

It's because it's proles she doesn't like'

 

BlueStreak

(8,377 posts)
4. BMI is a lousy standard for this
Sun Sep 4, 2016, 11:35 AM
Sep 2016

I understand a desire to prioritize resources where they will be most effective. And this has always happened on an informal basis. We don't do heart transplants for 80-year-olds. We generally don't do knee replacements on people that weigh 300# etc etc.

The problem with BMI is that it is simply a calculation of weight and height without regard to the general health of the patient.

For example, my BMI is right on the edge of 30. But I do rugged backwoods hikes of 5-10 miles a week, play at least 3 hours of vigorous sports a week, and have a lot of other exercise. My BP is consistently 110/70 which is good for my age. In other words, while I am not going to be featured in Body Builder Magazine any time soon, I am in decent shape and can easily survive an operation and the subsequent therapy.

To get out of the "overweight" category according to BMI, I'd have to lose 50#. IMHO, my ideal weight would be 20# lighter than I am. I once lost 30# and that last 10 made me completely miserable.

My point is that if there can be a sensible, objective scale related to the actual health of the patient, then maybe such restrictions make sense. But using BMI is completely arbitrary.

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