MegaSack DRAW - This year's winner is user - rgwb
We will be in touch
A message to NHS staff: Jeremy Hunt, Secretary of State for HealthWhen I was first made Health Secretary I said it was the biggest privilege of my life, and so it has proved. What I didn’t realise then was that it would also become my biggest passion –working in health is not just a job but a vocation.
The election period reinforced more acutely than ever the incredible work of the NHS, particularly the way staff dealt first with the global cyber-attack and then with horrendous terror attacks in Manchester and London. After the Manchester bombing I met nurses caring for bereaved families with incredible compassion, whilst in London I heard stories of doctors who cycled the length of the city at 2am just because they wanted to help. These stories speak to a wider truth – NHS staff do an amazing job, often in the most difficult of circumstances. And it is this which brings us all together: our great belief in the NHS, what it stands for and what we believe it can be.
Your compassion, energy, dynamism and total dedication, day in, day out, are truly humbling. When I look at what the NHS has achieved in recent years, I think you can feel very proud. Despite the financial crash and ensuing period of constrained budgets, today’s NHS has some of its highest ever satisfaction ratings, carries out 5,000 more operations a day, has lower MRSA rates than France, Germany or Spain, and sees its highest ever survival rates for cancer, heart attacks and stroke. One of the biggest expansions of mental health provision in Europe is underway right here, and there’s been a transformation in attitudes towards patient safety in the wake of Mid-Staffs. These achievements simply wouldn’t have been possible without you, our world-class doctors, nurses, paramedics and everyone else who works every day, across the country, to make the NHS the best it can be.
I am proud that this country was the first to say that no one – rich or poor, young or old –should have to worry about affording good healthcare; indeed we have made this pledge central to how people right across the world define a civilised nation. Going forwards, we must continue to focus not just on equity but also on excellence. We need to continue our work on patient safety, continue the transformation of mental health, continue developing new models of care and continue to put as much energy into prevention as into cure. That’s my mission – to support the NHS to become the safest, highest quality health system in the world.
This is not to ignore the fact that difficult issues lie ahead: money is always going to be a pressure, for instance. But I am confident that, working together, we can unite the whole NHS to deliver the safest, highest quality care anywhere in the world. I would like to take the opportunity to thank you all for your hard work to make this vision a reality.
We are so lucky to have such a wonderful man in charge 🙄
Yeah, you all great, the NHS is great, but I'm still not going to give you a pay rise, or fund it properly.
His biggest passion is himself.
****
Positioning himself for a tilt at the leadership IMO.
Positioning himself for a tilt at the leadership IMO.
I dont think its even that, I think its part of the new caring Conservative Party
uselesshippy - Member
****
Hunt?
or fund it properly.
How much money would be 'properly funded'?
Free boob jobs and sex changes for all!
Hunt is a this generations portillo
i doubt his rebranding exercise will be as successful but lets hope it also takes place away from power after a humiliation by the electorate
James Blunt said it best......
[img][url= https://c1.staticflickr.com/5/4214/34498003374_c09fcff8ca.jp g" target="_blank">https://c1.staticflickr.com/5/4214/34498003374_c09fcff8ca.jp g"/> [/img][/url][url= https://flic.kr/p/UythvC ]Capture[/url] by [url= https://www.flickr.com/photos/49281217@N02/ ]Scud75[/url], on Flickr[/img]
My wife working in the NHS, i can honestly say that i have never anyone she works with from cleaner to consultant that had a good word to say about him!
Free boob jobs
Don't see why not. If there's a medical need for it.
and sex changes for all!
Likewise, it's supposed to be "From each according to his ability, to each according to his need" (Marx), just because you don't need a sex change or a boob job doesn't mean the NHS shouldn't fund it.
Likewise if you broke your leg in a car crash, I'd expect the NHS to pay for it, not moan because my leg wasn't broken so why should yours be fixed?
Hunt and countryside?
How much money would be 'properly funded'?
I would say, just about the amount needed to pay your employees enough to not require the use of community food-banks.
That should do it.
I work with a brexit voting, right wing, telegraph reading, relentless Tory fanboi, who is also a Junior Doctor
he stall hates Jeremy Hunt
it's supposed to be "From each according to his ability, to each according to his need" (Marx), just because you don't need a sex change or a boob job doesn't mean the NHS shouldn't fund it.
I'd like a larger penis and a smaller waistline
Do you think that I should get them free on the NHS as well?
Anything else I don't really [u]need[/u] but would rather quite like that the NHS could pay for? Hair transplant, Spa weekend?
Would that signify a 'properly funded' NHS for you ?
I think it would be impossible to turn you into an even bigger cock 😉
I'd like a larger penis and a smaller waistlineDo you think that I should get them free on the NHS as well.
Sorry we thought you had a massive prick already.
I'd like a larger penis and a smaller waistlineDo you think that I should get them free on the NHS as well.
well gastric band surgery greatly reduces obesity related diseases like diabetes and cancer, that cost the NHS billions
your tiny penis is, however, your own burden 😉
ninfan - MemberHow much money would be 'properly funded'?
Free boob jobs and sex changes for all!
Pretty unthinking remark there.
(There was more here, but probably best left unsaid, all things considered.).
+1 kimbers and oldnpastit you kept it classy
I work with a [b]brexit voting[/b], right wing, telegraph reading, relentless Tory fanboi, who is also a Junior Doctor he stall hates Jeremy Hunt
Hunt's a remainer.
Yes, she really fits into my description of "for all" then doesn't she oldnpastit?
Come on, what constitutes a 'properly funded' NHS?
Where do you draw the line between need and would like?
You can argue the line should be drawn differently to where it is at the moment, that would be a perfectly valid discussion - but sooner or later there has to be a line, where does it need to sit in order to be a 'properly funded NHS'?
well gastric band surgery greatly reduces obesity related diseases like diabetes and cancer, that cost the NHS billions
Said it before - We'll have rationing back in shortly after Brexit, so thats the Obesity crisis solved in one fell swoop.
your tiny penis is, however, your own burden
But if I wanted it turned inside out instead, you would be happy to give it to me free?
(obvs, as we know, I don't need the NHS to give a **** when I am one already, etc.)
A knew he was really a compassionate soul.
Is Jeremy a country member? (With thanks to I'm sorry I haven't a clue).
They can take it out your waistline and inject into your penis. You might be able to get it on the NHS if you can show the lack of size is harming your mental health wellbeing but I don't know. For someone whos daughter had mental health issues your lack of compassion for others who may also be suffering is telling.I'd like a larger penis and a smaller waistline
or fund it properly.
Cant be cheap to provide health tourism for the rest of the planet.
Cant be cheap to provide health tourism for the rest of the planet.
cite- or youre just a troll
Where do you draw the line between need and would like?
It depends on the exact case surely? Medical reasons, psychological reasons, societal considerations etc. Not for you or I to judge, but for professionals who understand the impact of these decisions. They are the ones who should be drawing your line.
The problem is many people take a blasé attitude to stuff that doesn't fall into their own stereotypical "medical" viewpoint. It's why mental health has taken a backseat for so many years...
But if I wanted it turned inside out instead, you would be happy to give it to me free?
I never get drawn into these political arguments but it's obvious what you're insinuating and it's a reprehensible, damaging and downright sadistic way of thinking. I hope you've got time to edit both your post and more importantly, your opinions.
shame on you.
You can argue the line should be drawn differently to where it is at the moment, that would be a perfectly valid discussion - but sooner or later there has to be a line, where does it need to sit in order to be a 'properly funded NHS'?
Every day NICE and no doubt many hundreds if not thousands of very bright and very professional people have to make these choices of who gets treated, how and when. This line you speak of might help guide that process, but I'm confident you realise it's a lot more nuanced than "Boob jobs: yes or no?".
Can you all stop going off topic please, talking about the funding of the NHS
This thread is all about the caring 'one of us' friend we have leading the NHS.
I feel like I need to email him back just say how much I love him too
For someone whos daughter had mental health issues your lack of compassion for others who may also be suffering is telling.
Its easy to be a critic and whinge about "properly funding the NHS" - less easy to recognise that its a really big issue that you can never satisfy all needs, wants and requirements, and that often the difference between the two is a matter of judgement and viable alternatives.
so, where would you draw the line?
but I'm confident you realise it's a lot more nuanced than "Boob jobs: yes or no?".
Did I suggest no boob Jobs? No, of course I didn't - that would be just as much of a ridiculous extreme as boob jobs for anyone who wanted them.
But where does the line lie between those two extremes in order to produce this mystical "properly funded NHS" that people are speaking of?
Same goes for expensive cancer therapy that might buy an 80 year old a few extra months, versus the same in someone younger - where does the line lie that allows us to signify the NHS being properly funded?
I feel like I need to email him back just say how much I love him too
Apologies FunkyD, give him a kiss and a hug from me!
Why don't you start a thread about it ninfan? You clearly want answers.
You clearly want answers.
Well, the government that (just about) got voted in gave someone the job to look at this and draw those lines
Seems that some people think he's got it wrong, so all I'm asking is where [u]they[/u] would draw them instead.
I think the issue is, this is the MP for Health and not one person i've met working in the NHS has time or respect for him?
How do you think the A&E nurse on duty at 1am on Saturday morning dealing with the next drunk feels about the fact that Jeremy Hunt and friends all got pay rises in April, yet they haven't had one for four years?
My wife is a lead radiotherapist, used to be a 8-4 or 9-5 job Monday to Friday for her with final salary pension, she can now work any hours 8am -8pm 7 days a week at her hospital, for no-more money at all than she was on 4 years ago?
MP's had a 10% pay rise in 2015 and a further pay rise in April 2016 and April 2017.
Let's have all the NHS staff and public sector workers tell us the huge pay rises they've had................
Every day NICE and no doubt many hundreds if not thousands of very bright and very professional people have to make these choices of who gets treated, how and when. This line you speak of might help guide that process
*Might* help?
I'd say it's pretty much essential.
Cross party agreement on what 'good enough' means is the starting point for any sane plan for the future.
its far easier to be a troll and just shout, Humphreys style, how much, would you pay for x would you pay for y etcIts easy to be a critic and whinge about "properly funding the NHS"
How about
" do you think the NHS needs more money ninfan?
If i said to you i want to ride my bike more would you grill me on the terrain and the dates and the distance and what tyres etc or just accept you knew what the statement meant
DO you ever feel the need to engage on the topic rather than scribble and deraill
If you asked for help for your daughter should they just grill you on exactly what you mean to the n th degree or just help you ?
You need a better hobby and we need to stop feeding your scribbles
Scud - not sure I agree with you there Agenda for Change staff have had pay rises in the last 4 years, they have just been pretty low.
Also again agenda for change means that working unsocial hours is paid at higher rates.
I think 99% of people that work in the NHS accept it can no longer be a Mon-Fri 9-5 job, or that it should ever have been
The A&E nurse would probably wish there were more staff available before thinking they are not getting paid enough
You need a better hobby and we need to stop feeding your scribbles
Seems to me you just have a tough time actually engaging and debating on issues where shouting someone down and calling them an evil tory **** doesn't have the desired effect.
" do you think the NHS needs more money ninfan?"
No, we've tried that, and it hasn't worked - I think they (and the surrounding support services that feed into the system) need to begin spending money in a radically different manner and reassess completley what the role of the NHS is, particularly regards preventative medicine and lifestyle based illness.
But closing hospitals and moving doctors and nurses into the community instead would just be more evidence of 'cuts' wouldn't it - see the political football that A&E closures always becomes.
Seems to me that JH is just trying to do his job as his boss has told him to do it.
Get more results with less resources - not much different to 1000's of other middle managers hated by their employees in other companies/sectors up and down the country.
ninfan makes a very good point about 'adequate funding', and imo the way the world is these days, there's so many people that would be unhappy no matter how much money you throw at the NHS.
Great Auntie Doris has X terminal illness, we can [u]extend[/u] her life by 6 months for: £1k? £10k? £100k? £1mil? £10mil? Where do you draw the line? To her loved ones you cant put a price on it, but someone somewhere has to assess whether £XX would be better spent on Auntie Doris or something else.
With new and more expensive drugs/treatments being developed all the time, costs are only going to increase and much as we would like there to be, there isn't an unlimited amount of money.
One of your better goads its a crock and a straw man but its still a great goadSeems to me you just have a tough time actually engaging and debating on issues where shouting someone down and calling them an evil tory **** doesn't have the desired effect.
Yet, we're still (apparently) spending less on the NHS than in comparison to other western developed countries.
I would agree that there needs to be an overhaul particularly with regard to increases in prevention, but singling out the fat, transgender, anxious, depressed etc. seems a heartless way of doing it.
I would also think that longer term planning would come in to it - prevention strategies may not bear fruit for years, maybe even decades. This needs to be accounted for in the short/medium term in the same way that technology needs to be. None of this seems compatible with a Govt. that changes more frequently than these time frames.
Then there's all the rubbish about free parking etc. why spend money on clinical care when you can use it providing subsidies for the folk who can afford to drive?!
Lots of problems, not helped by denigrating those you don't understand or aren't willing to accept have medical issues that don't fit with your views.
It is not about asking where people would be drawing the line in made up use case, it is about having the funds to just do the basic job - enough staff, enough hospitals to treat those that need treating to maintain what we have had.
More elderly people = more ill people = more money required to maintain the same standard. Or do you want the standards to go down and keep the funding the same?
[quote=ninfan ]Free boob jobs and sex changes for all!
Sadly the empathy transplant you [b]need[/b] isn't yet available on the NHS
Then there's all the rubbish about free parking etc. why spend money on clinical care when you can use it providing subsidies for the folk who can afford to drive?!
Because its basically a tax on either being sick or having sick family members. And unless you live in a city, a car may be the only practical way to get there. Bit harsh to ask parents for £3 a time to visit a sick child twice a day.
But I agree, I'd rather spend the money on actual care than free car parking.
I don't think anyone actually [i]wants[/i] standards to go down, but we've been living off artificially high standards based on debt (both personal and national) for a long time. Standards and quality of life are quite likely to stagnate or deteriorate for a while until things re-balance. And I don't think thats unique to the UK, and its being shown throughout the developed world (hence Trump).Or do you want the standards to go down and keep the funding the same?
it is about having the funds to just do the basic job
Indeed, and to do that you need to define the 'basic job' in objective terms.
do you think the NHS needs more money
Yes, as do lots of other government provided services, trouble is we can't afford them without either:
a). Discovering massive natural resource wealth (preferably that doesn't trash the environment when it's extracted)
b). Change to an export led economy and benefit from a huge balance of payments surplus and at the same time extract more revenue from those exporters (whilst maintaining/improving wages and magically still being cost competitive with the rest of the world).
c). Tax the citizens a vast amount more/try communism
d). Possibly other equally unrealistic options
I'm not saying Jeremy Hunt is doing a good job, far from it, but I doubt anyone could do a good job (according to the majority) given the circumstances.
evil tory ****
If the cap fits.
Because its basically a tax on either being sick or having sick family members. And unless you live in a city, a car may be the only practical way to get there. Bit harsh to ask parents for £3 a time to visit a sick child twice a day.
But I agree, I'd rather spend the money on actual care than free car parking.
Impressive doublethink! But that's probably for another thread, and I do empathise - society constantly tells you to have a car, then penalises you at every opportunity...
Tax the citizens a vast amount more/try communism
We live in a low tax - low spend economy in the UK. We could easily raise more tax to pay for the NHS. It's just politically unpalatable.
Alternatively, scrap Trident, or try communism (the latter hasn't been tried properly IMHO yet!).
We live in a low tax - low spend economy in the UK.
We look to be well towards the top end however you calculate it:
https://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_to_GDP_ratio
Alternatively, scrap Trident
Wouldn't really scratch the surface.
Did a bit of googling on that the other day.
We are currently spending ~7.5%GDP on NHS.
The estimated lifetime cost of Trident renewal varies depending on which source you look at, but looks to be an annual cost of ~0.2%GDP.
Even the fairly modest LD pledge for 1% Income tax rise for NHS would raise more than scrapping Trident.
Hunt's a remainer.
I doubt it, particularly. He votes with the party line. When the party line was Remain, that's what he went go for. When the party position shifted, he fell into line. I've had a few bland pro-forma letters from him (South West Surrey - he's my MP. Country-ish. Certainly not inner city) about The Will Of The People in response to my concerns about Brexit.
fifeandy and ninfan have a point, we do need to have a sit down and a think about what we fund and how we fund it. But defunding the existing system to point of collapse is only polarising the parties involved and making that debate impossible. (compare your response to ninfan's arguments vs fifeandy's - you need to take people with you)
The thing that I find most repugnant is how the current course is set to line his pockets and those of his family and friends. Makes it very, very hard to argue that the current direction is motivated by very much else than self interest.
http://hat4uk.wordpress.com/2012/10/10/revealed-at-last-the-hunt-bottomley-link/
Edit: That story is blatently written from a certain point of view. Tone down the turn of phrase as much as you feel like, but the facts remain.
I don't think anyone actually wants standards to go down,
A government that sees the standard drop and doesn't do enough to stop that happening while giving money away to the rich doesn't give the impression they don't want them to go down does it?
We look to be well towards the top end however you calculate it:https://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_to_GDP_ratio
br />
34.4%, the lowest* out of western Europe?
*just scanning the list, I may have missed something.
Free boob jobs and sex changes for all!
You really are a classy piece of work, aren't you.
You do realise - you [i]surely[/i] must realise, even over on Planet Ninfan where you appear to be doggedly in favour of us going back to the halcyon days of 1940 - that there is a fundamental difference between "want" and "need."
People don't get these operations on the NHS simply because they "want" them. Someone who is transgender doesn't wake up one day, think "yeah, life's great but think I quite fancy a penis" and sign themselves up for a free slapadicktomy. Similarly, I doubt Katie Price's bresticles were an NHS job. Conversely a friend of mine had breast reduction surgery a little while ago because walking round with Right Said Fred up her jumper for twenty years was causing severe back issues.
I can only conclude that you're either massively ignorant of the world around you outside of your own little bubble, or you have an underactive empathy gland and really don't give a tuppeny shite about anyone but yourself. You might want to give that some thought, though I suspect you simply won't care.
34.4%, the lowest* out of western Europe? *just scanning the list, I may have missed something.
Indeed, you've missed the countries that aren't in Western Europe.
The difficulty being those who have empathy (which seems a bit of nature and nurture) should be showing empathy to those that don't (the tory) but we struggle with that for some reason....
that there is a fundamental difference between "want" and "need."
Agreed
You seem to have kicked off with a knee jerk reaction to what you [u]think[/u] I said, rather than what I [u]actually[/u] said - in fact it seems to be a bit of a repeated pattern with you Cougar
As I said on the previous page:
[i]Did I suggest no boob Jobs? No, of course I didn't - that would be just as much of a ridiculous extreme as boob jobs for anyone who wanted them.
But where does the line lie between those two extremes in order to produce this mystical "properly funded NHS" that people are speaking of?
Same goes for expensive cancer therapy that might buy an 80 year old a few extra months, versus the same in someone younger - where does the line lie that allows us to signify the NHS being properly funded?[/i]
What you appear to have done is failed to differentiate the very principle of [u]want[/u] and [u]need[/u] that you slapped around yourself. Where would you draw the line between the two? At what point, precisely, does want become need?
Now, theres lots of massively emotive issues within the NHS where the same principles apply, see IVF/Fertility treatment as an example.
are kids a want or a need?
Where do you draw the line?
as someone who works in the nhs its always interesting to read views from other people.
There is a lot of interesting chat amongst people I work with about where the line is and that the NHS works with a lot of companies who are in it for the money/profit and so if the nhs had more money would that mean they wanted more money to?
There is certainly a lot of interesting chat about the procedures that some don't deem worthy of nhs money.
Even given my own not insignificant experience of the nhs I would stuggle to say how much is enough funding.
I guess it would be the point where I know treatments are based on clinical need alone.
coming back to one of the points earlier about the A&E nurse at 1am, dealing with the drunk... from my experience of having those chats, the normal conversation is it would maybe better to be working at aldi or lidl overnight where the money is prob not that different but you don't get people endangering your life and showing you no respect.
I think the biggest threat to the nhs is the talent that is leaving, I know of many outstanding doctors and nurses who are walking due to the lack of being valued - and that is a mixture of financial and holistically.
We look to be well towards the top end however you calculate it
True, it's a shame how little humanity values society.
Wouldn't really scratch the surface.
Shame, would've killed two birds with one stone.
The difficulty being those who have empathy (which seems a bit of nature and nurture) should be showing empathy to those that don't (the tory) but we struggle with that for some reason....
You know what, you're right! I don't really understand why either. I think it may have something to do with them having the same or greater intelligence, education and opportunities than me, but still not recognising that. Frustration is the natural enemy of empathy I reckon.
The problem ninfan is you've made a whole load of assumptions to get to the point where the line needs redrawing in order to properly fund the NHS.
Many of which I would refute.
Then the other opposite point is that if you accept this drift into private healthcare, where is the line drawn then? It will be based on what you think you might need in the future - i.e. people will gamble, or people will simply be mistaken and it will undoubtedly cost more than they were paying in tax for the vast majority of people.
Sammysquid, great post, very interesting
There is certainly a lot of interesting chat about the procedures that some don't deem worthy of nhs money.
I hope you will take my point that its not necessarily an issue of 'deem worthy' its more a case of, as I keep saying, where do you draw that very difficult line, as the 'controversial' procedures are just a more visible/easier example of the underlying issue - e.g. the same applies to cancer treatment in kids, old people, all sorts of situations.
Even given my own not insignificant experience of the nhs I would stuggle to say how much is enough funding.
I guess it would be the point where I know treatments are based on clinical need alone.
That seems like a very good measure, but as mentioned, where does that sit with things like infertility (especially where tied in to obesity etc)
You've made a whole load of assumptions to get to the point where the line needs redrawing in order to properly fund the NHS.
What assumptions have I made? its other people that are saying that the the NHS needs to be 'properly funded' - I'm just trying to ask what the hell they mean by that, what is their measure of 'properly funded' because 'need' is almost endless - the NHS looks after and treats far more conditions now, in a far more extensive and impressive fashion than it did in the 1950's and 60's - but where does it stop growing? particularly with the endless medicalisation of issues, as many argue things like Female sexual dysfunction are.
I met mr hunt once, he was nice, he shook my hand and told me that I was doing "vital, essential, important work". That's why I quit the CQC, if Hunt thinks you're doing a good job, you've clearly become something quite monstrous, and that monster goes against the values and ideals that I thought were my core. I do miss getting paid loads and doing nothing though.
You seem to have kicked off with a knee jerk reaction to what you think I said, rather than what I actually said
I know what you said, really my objection was to you lumping in gender reassignment in with your list of people who want cosmetic surgery. They're not even remotely the same thing and that fact that you appear to think they are is offensive.
Did I suggest no boob Jobs? No, of course I didn't - that would be just as much of a ridiculous extreme as boob jobs for anyone who wanted them.
So... given that neither of these things are the current state of affairs, what exactly is your point?
People wanting / needing this sort of surgery will go through countless processes to ascertain their suitability and decide whether an operation is the appropriate next course of action. I've never been through either operation as I'm quite happy with both my breasts and my penis, but every assessment I've ever seen for anything in the NHS is a series of criteria with a score. At the end of the list a total is calculated and that result recommends a course of action. So in answer to your question of how / where we draw the line, that's exactly what we already do.
I do agree with you on your other point though, I expect that like many public organisations the NHS does need to spend money more effectively. Blindly throwing money at the problem isn't necessarily the answer (though throwing less certainly isn't). But it's easy to say "do more with less" and rather more tricksy to put into practice (or we'd all be doing it). Is the government providing any resources to teach them how to do that or is it just another empty soundbite? Perhaps in the short term we need to give them consultants who can look at their processes and try and streamline everything.
Yet, we're still (apparently) spending less on the NHS than in comparison to other western developed countries.
This is true, but the US invests more than anyone per capita in health care and they're 100% private insurance based system which nobody wants, so this is not a measure to look at in isolation or the answer would be a private insurance based system. Looking closer to home with systems like the French NHS and into Europe, they have significantly more private involvement than we do in our NHS. If you involve private companies and if you properly govern them and incentivise them they they will provide additional investment.
Its not just about more money, its about how its spent and all the other health systems in the world have a completely different approach than the NHS to patient care. The NHS is simply not fit for purpose. It rolls on from one crisis to the other - it has for all my life as far as I can remember - it has never been in a 'good' place.
Why is it that as a nation we seem to be completely incapable of having an open and honest discussion about the NHS and how we might better run it in a sustainable manner for the benefit for all. We don't have to re-invent the wheel here, we can just take a survey of how other nations who do it better than us do it. It's not rocket science. It would be an irresponsible government who would just keep plugging more and more money blindly into a system that doesn't work in a sustainable way.
You seem to have kicked off with a knee jerk reaction to what you think I said, rather than what I actually said - in fact it seems to be a bit of a repeated pattern with you Cougar
Might be a reaction to how you present your arguments/statements, ninfan.
If the style of your communication continually provokes misunderstanding, maybe change your approach?
But comments like "free boob jobs for all" suggest you're quite happy to provoke unnecessary friction, when you're very aware that a more nuanced approach would lead to productive exchange of ideas.
People wanting / needing this sort of surgery will go through countless processes to ascertain their suitability and decide whether an operation is the appropriate next course of action. I've never been through either operation as I'm quite happy with both my breasts and my penis, but every assessment I've ever seen for anything in the NHS is a series of criteria with a score. At the end of the list a total is calculated and that result recommends a course of action. So in answer to your question of how / where we draw the line, that's exactly what we already do.
You've just restated the problem though. Currently we draw a line. If you're one side of the line, you get the thing; if you're the other side, you don't. Is the line in the right place?
There is actually a grain of truth to a single aspect of the usual Ninfan rant.
We have seen again & again that previous generations really did cherish the NHS and would rather almost die at home rather than "trouble the nice Doctor" or god forbid ring an ambulance.
NHS is a pretty much taken for granted by generation snowflake innit..
Then the other opposite point is that if you accept this drift into private healthcare, where is the line drawn then? It will be based on what you think you might need in the future - i.e. people will gamble, or people will simply be mistaken.
Someone is already gambling on our behalf. Private healthcare allows people to make their own gamble.
Personally, so far, I've pretty happy with the gamble the NHS makes on my behalf but you can't escape from the large numbers of people in threads like these who are not remotely happy with it.
Is the line in the right place?
I've no idea. I'd assume (hopefully?) that the systems have been designed by people who know far more about healthcare than you or I do. Maybe it needs reviewing? But then we're back to having the funds and resources to to that review.
Maybe it needs reviewing?
That's what he said. Except he was an arse about it.
But then we're back to having the funds and resources to to that review.
Worth spending a little to work out whether you're spending it in the right place, though? Just budget control.
You've just restated the problem though. Currently we draw a line. If you're one side of the line, you get the thing; if you're the other side, you don't. Is the line in the right place?
Or you could use the current line - are we funding/handling in correct way to meet the current line?
As sammysquid said
"I guess it would be the point where I know treatments are based on clinical need alone."
again it continues to make you think and it makes you reflect on your own views.
ninfan - MemberI hope you will take my point that its not necessarily an issue of 'deem worthy' its more a case of, as I keep saying, where do you draw that very difficult line, as the 'controversial' procedures are just a more visible/easier example of the underlying issue - e.g. the same applies to cancer treatment in kids, old people, all sorts of situations.
Well for some this has already been decided - there is a lot of input that goes into the idea of a Qaly, and if a procedure is worth it and this is true of where there is a lot of money in the pot and where there it little. This is the grand scale and then people decide where on this list things fit, and sensibly there is room for some discretion.
"boob jobs" are on the whole not allowed but specific cases can be made and are made and I think people cleverer than me try and come up with sensible approaches.
ninfan - MemberThat seems like a very good measure, but as mentioned, where does that sit with things like infertility (especially where tied in to obesity etc).
Again very interesting, certainly people all have differing views. I think there is benefit from tightening belts - there is a reluctance to operate/treat the overweight, now part of me would love to say that is because often the reduction in weight would mean the the treatment would be more effective and the complications less.
But there are certainly times when I think the goal posts are maybe moved for other reasons.
I'm sure the introduction of extra criteria which leads to a longer time before operation has been assessed and some people are aware it might affect the total spend on such operations.....
"I guess it would be the point where I know treatments are based on clinical need alone."
clinical need, “the input needed to reduce risk and achieve predicted outcomes, ”
Pretty subjective, which is why it needs to be reduced to a points scoring system.
but sammysquid is claiming there's a point at which he will "know" (KNOW!) that all treatments delivered in the UK conform to his (or whose?) idea of clinical need.
Edit: sorry sammy, only saw your comment out of context - I think we're on the same page.
I suppose some examples to encourage some more thoughts?
the nhs initially turned down the drugs to help breast cancer in terminally ill patients - this has been changed due to a deal between the nhs and the drug company - if they wouldn't have turned it down initially they would have paid more...
and yes comparing tens of thousands to give a patient an extra 3 months of life with tens of thousands to recruit another mental health team is really fascinating.
I think you can argue either way.
The one thing I think we have to be careful of is that I truly do think the nhs is not destined to be with us for much longer - especially in its current form. And then it will be private insurance companies who make these decisions....
nedrapier - MemberPretty subjective, which is why it needs to be reduced to a points scoring system.
but sammysquid is claiming there's a point at which he will "know" (KNOW!) that all treatments delivered in the UK conform to his (or whose?) idea of clinical need.
Edit: sorry sammy, only saw your comment out of context - I think we're on the same page.
so like I say I work within the health service. An example would be- there has been previous history of post codes lotteries, and I am saying I would want to be able to treat my patient based on their clinical need not on their post code. 🙂
sorry one last point...
"Pretty subjective, which is why it needs to be reduced to a points scoring system."
if you were really jolly unwell, would you prefer someone to be looking at you as a set of numbers? or would you prefer them to be looking at you as a person? would you get points for family? or kids? for pets? for the job you do? for the amount you earn? point systems guide yes, but imagine being told that you can't have a treatment as you don't have enough points - if only you were 1 year younger or that you had got married instead of just living together....
Free boob jobs and sex changes for all!
Free at the point of delivery!
It's as it should be, the longer you live the more you'll have paid in and just when you get to the age where you need breast reduction surgery - bingo! there it will be on the NHS. Vote ninfan. I certainly will.
Personally, so far, I've pretty happy with the gamble the NHS makes on my behalf but you can't escape from the large numbers of people in threads like these who are not remotely happy with it.
Quite. Those whose only concern is money.
sammy, agreed on all your points, it is fascinating, and an impossible task trying to decide who's worth spending money on, and what problems are worth treating.
now I see your point about clinical need. Wife and I moved house nearly 3 years ago and ended up on an IVF path, some if it funded by the NHS trust. If we'd bought the other house we were looking at, less than half a mile away, we'd have got nothing.
Ned, I think its great to talk about, I am not always right and I know that! its always good to talk about things. The system isn't perfect and I have certainly seen it abused.
Like I say I think this nhs is not going to be something we pass down to our children.
personally I think there is a lot of stuff the NHS funds that it shouldn't. IVF being one. Some hugely expensive and not very useful cancer drugs is another - but when you are dying and somone says this pill could help you its natural people fight for it and the right wing press will pick up on the fight to further its aims of kiulling the NHS. £50 000 for drugs to give you another couple of months to die in or a full time MH professional for a year. the other thing is futile treatment.
IVF being one
Not going to say you're wrong. Current NICE guidelines recommend that 3 cycles are funded, with a justified rationale. No problem with anyone disagreeing with it, it's on the list of things to discuss cost/benefit analysis, along with everything else.
Some trusts follow current recommendations, some don't.