[Closed] What treatments shouldn't be available on the NHS?

physio ?

It's kind of going that way.

IVF

all treatments for fattys and smokers.............. 😉

Any complications resulting from private healthcare - removing that burden from the nhs would save a fair bit of cash.

Surely treating fatties and smokers will bring the costs down in the long run?

*dons flameproof suit*

IVF

Heart transplants

Heceptin and similar

Gastric Bypass

Treatments all should be.

Cosmetic enhancements not unless they can prove there's some sort of psychological issue caused by them. Then even pay some sort of part cost.

Anything related to "Lifestyle"

Otherwise...FFS.

Oh, and injuries caused by falling off a horse.

Finger tip injuries caused by fixed gear chainring fettling, you've only yourselves to blame I'm afraid.

what was the reasoning behind heart transplants tj ?

Maybe treatments don't need to be cut. But start fining people if injurys are self inflicted whilst drunk or under the influence of other drugs. Obviously some cases won't be clear cut, but if someone crashes their car drunk or on CCTV clearly starts a fight then why not fine them a hefty sum to pay for their treatment.

Also, I've always wondered does the NHS sell equipment, skills or services to private companies? Surely having one of the largest medical organisations in the world there must be a business opportunity somewhere?

how about injuries caused by falling off a bicycle?

poor troll DD

[img] [/img]

It's all very well pointing the finger at [insert spurious choice of treatment here], but the real challenge is going to be provision of a decent standard of elderly care, coupled with the fact that what [i]really[/i] costs is things like ITU bed occupancy.

It'd work out cheaper if we could prevent things happening 'downstream' - but that would mean using our common sense...

I don't think there are going to be any easy answers, beyond making everybody do national service on the wards. 😀

anything for drug addicts. and fat people, oh and anyone with that tired all the time thing.

i can just see you in A and E now crikey " no you can fek of with that you moron " 😆

Car crash victims should be kept in some kind of stasis until the police have confirmed who's at fault. Any patient found to be at fault...down the chute to the incinerator.

Anyone injured by falling from a tandem. Even if it's not his or her fault.

😆 at ton

*Depending on whether people are prepared to be heartless in the name of cost savings, any treatment for the terminally ill that will prolong their life and not cure them could be axed.

The slogan "Man up & die for your country!" could be the next "Keep calm and carry on". But it probly wouldn't stimulate sales of spin-off paraphernalia about cup cakes etc.

Is that the kind of thing you wanted to hear?
Are bullets cheaper than pain meds?

the real challenge is going to be provision of a decent standard of elderly care

You not familiar with Logan's Run or Soylent Green?

*Not necessarily Rob's actual views.

Anyone injured by falling from a tandem. Even if it's not his or her fault.

There would have to be some sort of clause about helmets...

Cosmetic enhancements not unless they can prove there's some sort of psychological issue caused by them.

it's all too easy to convince a doc that you need something if you cry enough!

I think they should stop wasting money in other ways than cutting treatments. there are a number of overpaid middle and upper managers that could be got rid of.

Weekend drunken A&E ....

As an aside - does the NHS carry out any drug development research? That could save them or indeed earn them a fortune could it not?

Any complications resulting from private healthcare

(wouldn't really amount to much though, would it?)

It would, if they (private provider) had to pay full-whack for critical care capacity and workforce training. 😈

well workforce training's a bit different (I guess BA should pay the military for their pilots too ?)

critical care, a bit yeah but I doubt it's very common. They don't do many properly major ops in PP anyway (err, do they ?), so it's only when a simple one goes tits up

TandemJeremy - Member

*dons flameproof suit*

IVF

Heart transplants

Heceptin and similar

Gastric Bypass

I can sort of see where you're coming from with the IVF and gastric bypass (although I don't necessarily agree with the views) and I don't know what heceptin is but I'm wondering why you've included heart transplants in that list?

well workforce training's a bit different

I suppose it's a related issue - transparency of costs.

I've always wondered about drug research too. They're a few issues with it though, such as the huge investment to bring a drug to market and drug companies aren't known for being the most ethical organizations. Perhaps producing out of patent drugs could save money?

non essential cesarean sections.

apparently it costs £700 more than a natural birth so if people want to pay the extra fair enough but it shouldn't be a free option.

poor troll DD

Ah fleck it. Thought I'd disguised it really well.

Right, while we're at it; injuries from fighting in town centres at the weekend; sprained ankles from wearing high heels; brain surgery for anyone with a double digit iQ; heart transplants for those not in love; hip replacements for bad dancers.

Well, apart from the Wellcome Trust, you mean? 😉

The old saw is that the second pill costs £1, the first pill costs £100M. Drug research, especially getting through the layers of testing and approval before it can be prescribed, costs a huge amount of money.

We already use a lot of out-of-patent drugs, but it's pretty much a tautology that new drugs are usually better than the old drugs, so they cost more.

transplants due to lifestyle damage. ie liver for alcoholics. lungs for smokers.

Oh, and the problem isn't the cost of treatment, it's the lack of attention to making sure that treatment never becomes necessary. It's like reducing your bike repair bills by deciding to do without brakes, instead of giving the cables a little bit of oil occasionally.

Yeah, I know, bad metaphor 😉

Weekend drunken A&E ....

We have a winner!!!

Heceptin and similar

Seriously? What's your reasoning that breast cancer treatment shouldn't be available on the NHS?

Sunburn for baldies; get a hat!

Seriously? What's your reasoning that breast cancer treatment shouldn't be available on the NHS?

Maybe TJ is an ass man?

Or

An ass, man.

?

Any banana skin related falls; come on people, you know how they work...

There should no treatment at all for the over 50s.

Or ginger people.

nonk - Member

what was the reasoning behind heart transplants tj ?

cost / benefit. very expensive, absorbs a lot of money and skilled labour which is in short supply, outcomes not that great on the whole.

Heceptin and similar

Seriously? What's your reasoning that breast cancer treatment shouldn't be available on the NHS?

Not all breast cancer treatments but herceptin and a number of similar drugs are very expensive and produce little benefit this is why NICE refused them. The manufacturers did a lot of lobbying and of course people will want any treatment possible. However all it does is gives them a few months more to die in. Not useful life but prolonged death.

http://www.guardian.co.uk/society/2010/aug/20/price-cancer-drug-herceptin

Doctors at the Norfolk and Norwich University hospital NHS trust said it would cost £1.9m a year to pay for Herceptin for the 75 patients with the type of breast cancer for which it is recommended. That is four times the cost of the drugs used to treat a range of other cancers, including lung, colon and post-menopausal breast cancer. The doctors calculate that the trust could only pay for Herceptin if they did not give treatment to 355 patients with other cancers, 16 of whom would be cured.

http://www.bmj.com/content/333/7578/1118.full

Air ambulances for injured people who ride beyond their ability in remote areas? Surely you should get insurance cover for that.

Complications of cosmetic surgery performed overseas by cowboys? In fact any complications of bungled cosmetic surgery by non trained personnel in private clinics.

It is nearly impossible to get any cosmetic surgery done on the nhs. My wife is a plastic surgeon and she does virtually no cosmetic work, it is all cancer related and reconstruction after cancer surgery and trauma.

As for those saying no gastric bands, it seems that gastric bands and bypasses are cheaper than treating the complications of morbid obesity long term.

The problem is that everyone is selfish about their own healthcare. Cuts need to happen but you try telling someone who wants the nhs to pay for their sex change that we need to prioritise cancer ops etc. they will be straight down to their nearest lawyer complaining of breaches to their human rights.

Do the NHS pay for air ambulances? Thought they were independent charity funded.

No not in wales as far as i know. Its a charity i think. No it definately is a charity. Dunno about the rest of the country mind you.

Let's simplify it to trail centre riders need to be insured 😀

non essential cesarean sections.

Define "non essential". At least 50% of the kids my wife "teaches" are due to problems during birth. That kind of care costs serious money, is it more or less than the cost of generalised c-sections?

* "teaches" - most of them are seriously disabled, and there's a limit to what they're capable of learning.

Compared with most countries we have a pretty good mechanism for looking at cost effectiveness.

My PCT has a 20 page list of things that it will not fund. Lots of drugs do not make it to the NHS because the cost-effectiveness evidence is so poor. NICE etc etc

IVF is actually pretty cheap these days - and most of the people who can pay, do so.
Not doing Heart Transplants would render us a third world country. Virtually all other treatments for heart failure and cardiomyopathies prolong survival, but do not improve quality of life.
Gasttic bypass surgery is cost effective, gastric banding perhaps less so.

One trouble is that some really very useless things (PSA tests in men with no symptoms, Osteoporosis "screening" in people with no risk factors or fragility fractures) etc have big lobby groups behind them with celeb and Daily Mail and daytime TV endorsements... 👿

I heard on the radio the other day that all women will now have the option to have a cesarean, whether they need it or not.

That shouldn't be allowed.

[b]flow[/b] - whilst I have some sympathy with your view... I think I'd ask the opinion of a bunch of people who were likely to be able to have a caesarian, rather than you and I... 😉

flow - along with proper counselling on the risks of caesarian the hope is to actually reduce the numbers by providing proper information and stopping it being an adversarial situation.

Wonder what it would do to the NHS budget if we abolished patents on drugs?

That shouldn't be allowed.

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A friend had her breast cancer treated with herceptin. She's still alive 5 years on. Difficult to know what the outcome would have been without it of course, but her it's all good.

[i]all women will now have the option to have a cesarean[/i]

Um, I would hope that this is the case, just like everyone with appendicitis has the option of an appendectomy/appendicetomy (I'm never quite sure which of these terms is correct).

I think the point should be that only the people who medically require a caesarean section should get one; it shouldn't be an 'option' in the sense that you get to choose.

Anyone got the rates of C-Sections in the UK compared to other countries handy?

Not doing Heart Transplants would render us a third world country

Why? Its a huge amount of money tried up in heart transplants to benefit a few people only. IMO your attitude is more about prestige than health

IVF - thousands of pounds a cycle - its a significant sum across the country for something that has no benefit to health.

NIce is OK on the whole but does fold under pressure. To be abolished by teh condems tho IIRC

another one - drugs for dementia such as aricept ( well its now of patent so should be cheaper) but thes have huge costs for small benefits

all women will now have the option to have a cesarean

Um, I would hope that this is the case, just like everyone with appendicitis has the option of an appendectomy/appendicetomy (I'm never quite sure which of these terms is correct).

I think the point should be that only the people who medically require a caesarean section should get one; it shouldn't be an 'option' in the sense that you get to choose.

So that would be why I wrote

all women will now have the option to have a cesarean, [b]whether they need it or not[/b].

mrblobby - Member

Wonder what it would do to the NHS budget if we abolished patents on drugs?

Thats a tricky one because then there is no incentive to produce new drugs.

However generic substitution would be a cost saver. at the moment if a gp prescribes "panadol" the chemist has to supply panadol even tho its far more expensive than the generic equivalent - this only applies for out of patent meds.

Its already done in hspital but I don't think it is in General Practice

Dog owners that get bitten.
IVF for drug addicts.
Wrist surgery for pron-addicts.
Dental work on people who never smile.

Anyone with a live rodent up their farter should be refused surgery.

Removing foreign objects from orifices where foreign objects should not be with a special dispensation for children under 10

EDIT Oh beaten to it

Patents last 20 years. 15 of those minimum are from discovery, thorough to clinical trials 1, 2, 3 and 4. The remaining 5 are where the pharma company has to recoup it's R&D investment and make a profit hopefully. They are not charities, you know.

If you abolish patents on drugs I think you'd find that no pharma company would bother to bring any drug product or substance to market or investigate and develop new ones.

I'd then probably lose my job and therefore home so I'd have no option other than hunting you down and killing you, or working in the public sector and lazing around all day counting my gold-plated pension...

edit: No issues from with use of generics, though. You'd have to be a **** to spend £3plus on Nurofen when you can get Tesco Value ibuprofen for 20p or something.

Ok, didn't see that bit, apologies fella.

...as for it 'not being allowed'...dunno.

There is a suggestion that one reason for the rise in rates of C-sections is that babies are getting bigger but ladies pelvises haven't caught up yet. This would seem to imply that God likes big buns, and he can not lie....

Who has a child under ten in an orifice it shouldn't be?

😀

We see the new medicine problem with antibiotics; what is the point in spending lots of money on developing a new antibiotic when it may only be used for 2 weeks by each patient, then end up having bacteria become resistant to it and become useless in a couple of years?

The cash is in drugs that people take every day for the next 20-30-40 years...

I personally think the welsh should pay for prescriptions, and there should be a charge for lifestyle treatments i.e. gastric bands should not be covered.

all treatment to people who do not reproduce should be stopped.
for not contributing to the worlds gene pool.
and cos they aint normal either.......... 😀

[i]Removing foreign objects from orifices where foreign objects should not be[/i]

Oh the (professional rather than recreational) stories I could tell....

[i]all treatment to people who do not reproduce should be stopped.
for not contributing to the worlds gene pool.
and cos they aint normal either.......... [/i]

If your address is:
Ton,
Under a bridge,
Near the field with the Billy goats in,
Green Grass Farm.

..I think you should have to pay a tax too.... 😉

what about treatment to those contributing to the gene puddle? Cousin-cousin marriage, sink estate mouth breathers etc...

Come on crikey. I could listen to "objects we've removed from people" stories all night. Since my brother in law left the NHS, I've been missing the tales. Dish us up a few.

Interestingly, although there probably are a few over paid managers, firing them all would be a drop in the ocean compared to the nhs drug budget (which,I believe, is the biggest spend). So all staff could stay,a long as we rationalise the prescription of certain drugs...

DrP

Well, remember the advert 'Acting on Impulse' for those perfume sprays in a handy size? Yup. About half full when we gave it back to him.

crikey, troll tax could raise a rake of moola, just from stw alone............ 😆

Nooooooooooooooooooooooooooooooooooooooooo to troll tax.

...and the poor unfortunate who was vacuuming in the nude, in the garage, and fell backwards onto the tow-bar cap?
Shiny thing make it all better, maybe.

[i]Nooooooooooooooooooooooooooooooooooooooooo to troll tax.[/i]

Hmmm, I detect a certain amount of self interest.. 😀

Removing foreign objects from orifices where foreign objects should not be

Oh the (professional rather than recreational) stories I could tell....

*Spits out German sausage*