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

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

[url= http://farm4.staticflickr.com/3176/2920571243_84d6e4fa1b_b.jp g" target="_blank">http://farm4.staticflickr.com/3176/2920571243_84d6e4fa1b_b.jp g"/> [/img][/url]
[url= http://www.flickr.com/photos/25846484@N04/2920571243/ ]Trolls[/url] by [url= http://www.flickr.com/people/25846484@N04/ ]TandemJeremy[/url], on Flickr

Tons hair [i]has[/i] 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 [b]really[/b] 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 [b]them[/b], 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 [b]are[/b] 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, [b]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.[/b]

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

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....

[i]What [s]treatments[/s] education should[s]n't[/s] be available on the NHS?[/i]

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.****/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.

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!

Very subjective who to save and who not to save arguments that can go round and round for ever .
One way I think the NHS could save vast amounts of money would be to charge people for the food they eat while in hospital . They would have to pay for food if they weren't in hospital so why not charge them ? Even a nominal sum , say £5 per day would make a huge difference .

Only if the food is actually food and not moulded shizzle...

One of my work colleagues, 24yr old female, is hoping for gender reassignment surgery on the NHS. So far about 3 years since applying (if that's the right word). Branding them is a bit barbaric Z11. By all means discuss.

OK TJ, if I see my son again in another life I'll tell him
that by donating his heart it was a costly waste of time and I'll take the receipt for the cost and wave it in front of the recipients face and let him/her know what you think. That is of course if the recipient is there.

While its tempting to reduce costs by banning access to big ticket items on moral grounds the major problems are:

1. UK voters appear to want Scandinavian healthcare and American taxation
2. the service is free at the point of delivery and having no cost to the consumer it has a low value.

The best way of increasing the perceived value of healthcare and at the same time reducing unnecessary consumption would be to introduce a small charge for anyone (and I mean anyone) accessing services. Let's say either a small multiple of the cost of a packet of cigarettes or alternatively the cost a months Sky subscription. This would make everyone thing twice about whether they really need to seek medical advice. I would make only one exception: anyone requiring attention in the resus area of an accident and emergency unit.

You can get back to the jokes now 😳

Is there still the thing where HA's are charged a fortune for titanium screws and rods and other such tat just because they are for the NHS, but exactly the same as non-NHS/health bound items?

How in the world have we got this far without anyone mentioning homeopathy?

Wait, I still want it to be available just for the placebo value, but I want them to be using tap water and not paying for the "proper" stuff. Maybe they already are, that would be good.

That and a flat fee (£100 or so) for alcohol / drug fuelled idiocy.

Interesting to see the comments about IVF on here. Infertility is a medical issue, and needing a child is probably one of our most basic human needs. Infertility can lead to mental anguish, stress, depression, break up of relationships. I'm sure anyone who's suffered from it will most likely say it's the hardest thing they've ever had to deal with. Yet it is a very costly treatment with a relatively low rate of success.

Tattoos should be banned, people should be forced to pay for them. I think it's disgusting that the NHS will pay for these things!!!

Nah...slap a stupid tax on them. pays for any removals.

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

I imagine you'd be perfectly happy to say that to someone who was conceived as a result of NHS funded IVF, TJ. 🙄

Stupid troll thread, all cos SBZ was pwned yesterday. Pathetic. Move on SBZ; move on. Have at least [i]some[/i] dignity.

"No treatment for self inflicted damage" is one of those things that seems like a great idea when you're dealing with lung disease in a smoker, gets a bit cagier when you get a mountain biker with a broken collarbone. Motorcyclist in an RTA? Even if it's not his fault he probably wouldn't be so messed up if he was in a car. Where does it start/end? I don't want to be making that choice, not sure who I'd trust to do it for me either.

But then none of these are easy issues. Cosmetic surgery? I'm told can work out cheaper than treating depression. Gastric band cheaper than treating the long term conditions that they can prevent (though that goes back to the top of the post)

The one we're going to have to address and which I don't see much talk about, is life extension. We can keep people alive for much longer- but should we? The quality of life issues are important- especially for the elderly or very seriously handicapped/injured... But there's also the cost issues- at what point do you stop paying to keep someone alive for another month?

Elfinsafety - Member

I imagine you'd be perfectly happy to say that to someone who was conceived as a result of NHS funded IVF, TJ

Pff, everyone knows the unborn souls are queued up in the bardo waiting for a suitable body, they'd just have to wait slightly longer.

Interesting to see the comments about IVF on here. Infertility is a medical issue, and needing a child is probably one of our most basic human needs. Infertility can lead to mental anguish, stress, depression, break up of relationships.

And there is thoousands of kids born every year to parnts who cant lok after them or want look after them, perhaps adoption would be easier and cheaper than medical stuff.

Here's a serious question for you

isn't it a moral dichotomy that we're questioning the funding of IVF for one group of patients, but not questioning the NHS funding of abortions for another group?

The thing is some women who i know have had children to trap their husnband /boyfreind in a relationship, when before it was going off the boil.

While other couples have babies because theyre either catholic, and some old bloke in a dress says birth control is wrong,or because they failed to take the relevant precautions, in that case those babies so born should be handed over to the infertile couples.

isn't it a moral dichotomy that we're questioning the funding of IVF for one group of patients, but not questioning the NHS funding of abortions for another group?

No.

Next question pliz thx.

project - Member

in that case those babies so born should be handed over to the infertile couples.

Pff, who wants a used baby? Never know whether the previous owners serviced it properly.

And there is thoousands of kids born every year to parnts who cant lok after them or want look after them, perhaps adoption would be easier and cheaper than medical stuff.

You'd think so, wouldn't you. Also for some people the basic need to have their own biological child is sufficient that they are driven to round after round of IVF (definitely not an easy option!)

Pff, who wants a used baby? Never know whether the previous owners serviced it properly. And it won't have that new baby smell either.

Worth a LOL that.

You'd think so, wouldn't you. Also for some people the basic need to have their own biological child is sufficient that they are driven to round after round of IVF (definitely not an easy option!)

take out a loan to pay for the treatment then, or get a previously owned one for free.

Toothache treatment.

Give it a day or two and the patient will surely out of sheer desperation just do it themselves.

[img] [/img]

i could save the NHS zillions and make it millions evry year at no cost to existing patient care with no restrictions etc etc..

in every drs / hospital /clinic recepetion add 1 little middle aged lady.. her job would be simple.. you turn up she says.. proof of eligibility for treatment or cradit card number please..

job done piece of cake simples.. cant believe no one has thought of it..

Would like to see some stats around unused perscription meds. Reckon most people who are meant to be on regular medication have unused cupboards full. Don't think anyone should get free prescriptions, though a sliding scale may work best.

in every drs / hospital /clinic recepetion add 1 little middle aged lady.. her job would be simple.. you turn up she says.. proof of eligibility for treatment or cradit card number please..

Bring thatcher out of hibernation then, or perhps she already has that planned and to implemented by camerooooon plc.

Don't think Cosmetic surgery should be funded nor reversal
loss of virginity should be funded fully by the NHS
Also any private surgery gone wrong the NHS should be able to claim monies back.

This may already been said But not going through 4 pages.

Rather than working out who deserves treatment and whose ailments are self inflicted, we could accept that everyone has health risks of one kind or another and all chip into a central fund to pay for treatment. We could call it National Insurance.

sweepy - Member

Rather than working out who deserves treatment and whose ailments are self inflicted, we could accept that everyone has health risks of one kind or another and all chip into a central fund to pay for treatment. We could call it National Insurance.

Great idea sweepy.Why not take it a stage further?
To help alleviate poverty for old people why not set up a scheme where each employee and their employer sign up to a contract of agreed benefits and payments then they both put away money all through their working lives.The government could lead the way in this innovative scheme. We could call it a public sector pension!

grantway - Member

loss of virginity should be funded fully by the NHS

I [i]think[/i] I know what you mean. But still, LOLZ.

nor reversal
loss of virginity should be funded fully by the NHS

Good 😉

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.

Interesting to see the comments about IVF on here. Infertility is a medical issue, and needing a child is probably one of our most basic human needs. Infertility can lead to mental anguish, stress, depression, break up of relationships. I'm sure anyone who's suffered from it will most likely say it's the hardest thing they've ever had to deal with. Yet it is a very costly treatment with a relatively low rate of success.

take out a loan to pay for the treatment then, or get a previously owned one for free.

A mate once suggested all mountaineering related injuries should be automatically be referrerd for psyciatriatric treatment. ... (Id include myself in the group mountaineer).... 🙂

Do you know how difficult it actually is to adopt? Clearly not.

Or the grilling you get off Social services when you try to adopt and you haven't been through IVF...

I feel rather embarassed to have belittled comments by mastiles et al. IVF is in certain circumstances more in keeping with funded treatment than many i am involved in.

docrobster - Member

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?.

This is the key point. Herceptin is (depending on sources) £20 000 - £100 000 pa per patient and gives a couple of months extra time to die in on average compared to the much cheaper treatments

On the heart transplants - I deliberately picked an emotive one. 131 people transplanted last year - survival rates are better than they were which to some extent demolished my argument but for the cost of those 131 heart transplants we could have had a couple of thousand of hip replacements. I am a registered donor tho for everything

IVF - another emotive one and people can live perfectly healthy lives without it.

the issue is cash is limited - and always will be as demand is more or less infinite. It needs hard decision taken in a non emotive manner to decide on what is done and what is not.

Personally I would strip the NHS of these expensive treatments of little utility and instead make sure the basics are done to the very highest standards. I think that would do "more good" So the little old lady gets home care with time for a chat, those in hospital get decent food. Gps run 15 min appointments not 7 and so on.

I'd like the NHS to ban anything I currently think that I or a member of my family won't need in the future.

And reduce waiting times for anything I've needed or think I might need in the future.

Friend of mine is going into hospital in 9 months for an operation to alter her jaw-line using titanium inserts. On the NHS, surprisingly.

Or the grilling you get off Social services when you try to adopt and you haven't been through IVF...

Or the grilling you get off Social services when you try to adopt and you have been through IVF!

tazzymtb - you're posting comedy but this place is part of the NHS: http://www.rlhh.eu/

Nuke it from space and sell the site to Bovis LendLease (or someone), and that's a few million quid right there.

Even a nominal sum , say £5 per day would make a huge difference .

Usual scumbaggery from Z11 displaying usual ignorance is unsurprising.

c-section I can live with, but home births are just stupid and a huge waste of money, add to that water births and any other shite that the modern mother wants.
The NHS should just state if youre pregnant you will have the birth how we(NHS) deem safest and it will be done in a hospital.
If the mother wants an alternative, fine go pay for it.

Every time theres a home birth, you need a whole duplicate team also on stand by in the hospital waiting for the possible complication which means the mother has to be brought in to hospital, and saved.
And when a birth goes wrong and anything ruptures the mum will lose pints of blood in minutes and no amount of hot towels and birthing baths will save her.

Home births aren't stupid or a waste of money. They are cheaper than hospital births and if carefully selected a whole lot safer too.
(2nd child born at home in water. Easy peasy. First born in hospital ventouse delivery. Difficult and expensive.)