bloke on that new doctors thing had a bog brush stuck up his ring………….how did that happen?

I have a whole family of trolls. They are my friends. I don’t see why they should be taxed

Trolls by TandemJeremy, on Flickr

Tons hair has grown..

pink?

every time you go the the GP you get a check up and if you’re healthy you get a full allowance, then if you’re say; a bit overweight or you’ve been drinking too much, the the allowance is cut slightly, so if you get ill and need hospital treatment, the bit that’s ‘free at the point of use’ is reduced slightly, so at the end of any treatment, there’s a bill.

incentivices people to keep themselves healthy, overwise it’ll have an impact on their wallets/purses.

Sara (mrs emsz)

Speaking of Trolls:

Treatment of head-injuries on non-helmet wearers… 😉

Anyone injured at work.
This would be paid for by the employer’s liability insurance.
Incentivise companies to reduce any risk of injury to their staff.

wonder how many treatments axing these ‘workers’ would pay for…
http://en.wikipedia.org/wiki/Jane_Pilgrim

Treatment of head-injuries on non-helmet wearers…

Sure, but only if you apply it to car occupants as well. Fair’s fair.

and pedestrians

Gender Reassignment Surgery… Well, at least they should give them a tattoo or something, so you can tell, because your mates really take the piss out of you when it turns out you’ve pulled one and you only find out afterwards like 😐

Zulu – usual unpleasant predjudical nonsense from you. How about editing it

teethgrinder, that’s not what the OP asked.
Maybe if it was “Who should be sacked?”, but that’s a different thread.

Full time reps save money. Unions are entitled to time off for union activities – in big workplaces full time reps are often useds it means a rep is available at short notice ( good for management as well) and cover does not have to be found.

Waht – being an unpleasant prejudiced numpty – strangely enough no.

I have no problem with your silly right wing rants. I have a big issue with that sort of post. Very demeaning.

It might be more cost effective if the nurses at East surrey did some work rather than treating the ward reception desk as their own private social club. They could also make sure my dads bag wasn’t backing up, that his inflatable mattress was inflated and that the man next to him could actually reach his dinner.
Nurses used to be called angels I just think of them as lazy gits.
I’m sure that not all of them are that bad but the ones where my dad died were unbelievable.

Z11, have a word fella, not a nice to say.

Z11 – you been on the wife beater this afternoon?

+1 or 2 or whatever to “the complications arising from private treatment”.

An example: I work near a private treatment centre for non-trauma orthapedic surgery, which takes ‘patient choice’ referrals from the NHS. Their ‘crash team’ is the ambulance station half a mile away and the NHS Emergency Department (rebranded A&E) a mile away. If they screw up, the patients goes back to our frankly excellent local NHS orthapedic services for them to pick up or rather ‘stick back together’ the pieces. Meanwhile the NHS orthapedic department (and particularly the 140 inpatient beds) gets more full of risky, chsallenging (and of course expensive!) trauma and emergency work per bed/oputpatient/surgery slot. The availability of Orthopedic surgeons across the hospital out of hours for emergencies incliding any that arise from the new orthapedic treatment centre is diminished, because overall funding is cut beacuse some of the treatment and therefore money is being farmed out to the ‘treatment centre’ down the road.

While I’m at it, exactly the same goes for the Nuffield hospital right across the road.

Obviously in practice this would be very difficult to quantify, both in terms of what defines a ‘complication’ that wouldn’t have happened if the poor pateint had been in public hospital, or how you add up the bill.

Nope SBZ – but if TJ’s allowed to take the piss out of and refuse treatment for fatties and cancer victims – I can’t see why I can’t object to my money being used to help perfectly physically fit healthy human beings mutilating themselves out of some perceived unhappiness with their equipment, rather than being helped to be happy with what they’ve got 😕

Z11, there are ways to express that that don’t require you to be offensive. An apology regarding the above would help I think.

I can’t see why I can’t object to my money being used to help perfectly physically fit healthy human beings mutilating themselves out of some perceived unhappiness with their equipment, rather than being helped to be happy with what they’ve got

If that was all you’d said the first time then that would not have looked out of place given the other suggesttions on this thread.

Aside from you girls bitching at each other, the NHS looks at the cost effectiveness of treatments in terms of Quality adjusted life years, the last time I was aware £26000 per year being seen as cost effective.

The below is taken from a presentation I use

The Quality Adjusted Life Year (QALY) has been created to combine the quantity and quality of life. The basic idea of a QALY is straightforward. It takes one year of perfect health-life expectancy to be worth 1, but regards one year of less than perfect life expectancy as less than 1. Thus an intervention which results in a patient living for an additional four years rather than dying within one year, but where quality of life fell from 1 to 0.6 on the continuum will generate:-
Intervention gives 4 years extra life @ 0.6 quality of life = 2.4
Without intervention = 1 year @ reduced quality (1 – 0.6) = 0.4
Therefore QALYs generated by the intervention = 2.4 – 0.4 = 2.0

In terms of cost effectiveness to the NHS the top three interventions are as follows (primary and secondary care)

1. Childhood vaccinations
2. Hip replacements
3. CPAP for obstructive sleep apnea (my industry).

A large number of the things mentioned in this thread so far e.g IVF, many form of transplantation (given long term anti rejection therapy), gender surgery are not cost effective but have been establised in the NHS repetoire prior to NICE so are difficult to subsequently reverse.

Crikey – are you an offended transexual?

if not, then climb off the outrage bus, I’ll apologise to anyone who I’ve actually offended with a comment about them, not anybody who’s upset on behalf of a theoretical someone who might or might not be offended but you feel sorry for just in case, since you clearly think they’ll be unable to speak for themselves.

If there are any post op TS’s on the thread who I’ve slept with, I’d like to apologise if I’ve offended you, I’d also like to take the opportunity to apologise for the brief and probably fairly unsatisfying sexual experience that I gave you, and the long term psychological damage that the experience of my grunting face hovering over you has undoubtedly caused.

zulu – the difference is I gave reasons or could do so why I suggested the things I did – I did not do so out of prejudice. I did not take the piss out of anyone.

I did not suggest branding a group of people and thus valuing them less.

I know it was intended to be lighthearted which is why I suggested you edit it and then I could have edited out my response. Instead yo make a stromash out of it.

is there any NHS treatment for people who aren’t easily offended ?

I sometimes feel I’m really missing out 🙁

I ain’t offended but I do feel its right to challenge prejudice.

so you think Z11 actually wants transexuals to be branded ?

or are you prejudiced against him because he’s a tory ?

See, on occasion you have said things which are worthy of comment, which I agree with. But if you think that kind of knuckle dragging moronity is acceptable, it marks you as someone unable to function in any debate.

Ooooh…Branding and body modification corrective surgery and tattoo removal…pay or cope. You paid to get it. Pay for removal.

Why not just broaden the range of activites where health insurance is compulsory paid for either by the user or the provider so that treatmnet resulting from things like private surgery are covered. AFAIK if you have a car crash then your insurance pick up the NHS bills so why not extend it to playing sport,motor racing,helicopter flying etc That would free up NHS funds for so much more
The NHS should also take a long hard look at the money it pays to the big drug companies for many of the drugs it prescribes- treating depression for example as they are often expensive and less effective than other treatments.

Zulu-Eleven – Member
Crikey – are you an offended transexual?

If there are any post op TS’s on the thread who I’ve slept with, I’d like to apologise if I’ve offended you, I’d also like to take the opportunity to apologise for the brief and probably fairly unsatisfying sexual experience that I gave you, and the long term psychological damage that the experience of my grunting face hovering over you has undoubtedly caused.

Surely you would know……..

See, on occasion you have said things which are worthy of comment, which I agree with. But if you think that kind of knuckle dragging moronity is acceptable, it marks you as someone unable to function in any debate

ah, thanks for the faint praise 😉

I have little doubt that Z11 and me will never be mates but if that sort of (as I see it) caricaturing engenders such strong response in you I can’t help but think you’d be too much effort to engage with in debate anyway

Anyone mention HIV treatment for intravenous drug users?

I like the idea of ‘health credits’ that someone elluded to earlier, which would mean people who look after themselves would get IVF for free, but overweight alcoholics wouldn’t, however the main flaw with ‘health credits’ is that some people’s genes mean that they are ill very regularly, but are still able to earn and make a significant contribuiton through their taxes.

The herceptin question is a tricky one.
If you tell people there is a drug that works better and keeps people alive for longer most people will say yes please.
However if it costs several times more than the alternative that is almost as good you have a conundrum.
Do you keep 100% of your patients alive for 6 months or 25% of your patients alive for 12 months?
You decide. Which is better?
Not an easy call to make. And you will find people who believe strongly in both options.
This is what healthcare commissioning is all about.
What is important in transparency.

(of course I made those figures up, no idea what the data is for herceptin.)

Good to see the debate, although it seems some people aren’t aware of the list of things that the NHS already doesn’t fund (tattoo removal etc)

Just a flying look in.

I’m not hanging around, as you know, its still the W/E and I’m busy.
But….

What treatments education shouldn’t be available on the NHS?

FTFY

Byeeeee.

😉

Ah I see Labby’s covering himself in glory again. Did you close your eyes and think of Dan Labby? Ya did dint ya!

Yep DD – You see, I can even tie it in with public sector pensions:

http://www.dailymail.co.uk/news/article-2066721/Sex-change-officer-Jan-Hamilton-quits-police-learning-shell-WPCs-pension.html

😉

The NHS should also take a long hard look at the money it pays to the big drug companies for many of the drugs it prescribes- treating depression for example as they are often expensive and less effective than other treatments.

Don’t worry, we already do. Certainly in primary care. The PCTs keep all sorts of data on generic prescribing rates etc and the list of drugs we are being encouraged not to prescribe is ever growing. I personally have no real problem with this but some doctors don’t like their clinical freedom being eroded and patients can get upset when you tell them they are being taken off one drug and put on a more cost effective alternative.

So on the one hand I have to give the patient in front of me the very best treatment that is available but on the other I (will) be involved in making decisions to ration these treatments.

You can see why some GPs aren’t that keen on the care reform bill.
And why the govt can’t wait to offload the responsibility for making these decisions onto the clinical commissioning groups.
Fun times ahead for the NHS!

Anyone in a union should not get treatment, either that or take it out of their pension fund!