Bravissimo- it’s not worth it. His view will not change on this, remember? Not worth engaging with him any longer.

A quick Google reveals that IVF costs between £4000 and £8000 per cycle. People receive 2-3 cycles on the NHS. So, £16000-£24000 per patient.

Now, how much will the average person pay into the NHS over their lifetime?

How much will each child they have pay inot the NHS over their lifetime (assuming there will stiull be an NHS in years to come…)?

Not really rocket science this, is it?

You smash yourself up doing something like mountain biking, which is a ‘lifestyle choice’. You sustain serious injuries and need ambulance/helicopter, ITU, operations, after care, physiotherapy etc.

How much does that cost?

Should you be just left on the mountain, as it’s your own stupid fault cos you chose to do something dangerous?

Oh well, that’s that one sorted. Pint, anyone?

Craigxxl – must have changed massively in the last few months then:

http://www.bbc.co.uk/news/health-13670615

😉

Have they been forced, or have they been given guidance which approx 70% of trusts are ignoring?

So, where do you stop with the lifestyle argument?

At the bit where we decide that infertility is not a lifestyle choice. Or I dunno, we could think up ridiculous examples to support an argument (which may be more of a big hitter thing rather than one of principle). Not that you’d ever do that labby.

heres a thought there is a limited pot, so what hould be paid for on the NHS? IVF? cosmetic reconstruction? hips?

crikey, change it from within maaaan Join the debate

I tried, but kind of can’t be arsed; it’s predictable to the nth degree.

Ultimately, it’s not up to the NHS to decide who or what to treat; we are that much maligned thing; a public service, and so we should provide what the people want us to, within reason. Healthcare is an emotional subject, so we really need some kind of objective committee approach, hopefully free of political knobbers.

We really, really need to start throwing money at primary care; stop the people getting ill, improve lifestyles, improve health from cradle to grave instaed of being a safety net that catches people after they become ill.

Just like stopping people committing crimes is 100 times better than sending them to prisons…

its going to be a nightmare , but im sure some multi million pound PLC, is already doing the sums ready to take over when cameroooon say jump.

Alas, I am not even remotely joking, and it’s already far beyond doing sums, but I’d be in all sorts of bother with my employer if I elaborated.

DD – seriously, it was a fair question,

At the bit where we decide that infertility is not a lifestyle choice

And where is that?

Fertility naturally drops off in the late 30’s , even lower in the 40’2s- so where do you propose that “lifestyle” limit actually lies? 30? 40? 50?

At what point do you draw the line?

heres a thought there is a limited pot, so what hould be paid for on the NHS? IVF? cosmetic reconstruction? hips?

I’d happily pay for all of those. Would you mrmo? (given that the cosmetic reconstruction isn’t for an breast increase from 32B to say, I dunno…40DD).

@ crikey, +1 to everything you said in your last post.

so we really need some kind of objective committee approach, hopefully free of political knobbers.

Like NICE – which is being dismantled by the Condems

At the time of the survey 5 out of 130ish trusts offered no IVF at all but the remaining 125ish do offer IVF just not to NICE guidelines. It’s still there just not as much as what it should be getting there.

In a foreword to the report, Health Minister Anne Milton said many PCTs had made good progress towards implementing the NICE recommendations.

“I am aware, however, that a small number of PCTs with historical funding problems have temporarily suspended provision of IVF services.

“I have already expressed my concerns about this approach and would encourage all PCTs to have regard to the current NICE guidance.”

Doesn’t really support your assertion that:

NHS trusts are been forced to comply with NICE guidelines on fertility treatment

then, does it?

The NHS will not be privatised as a whole, but parts of it will and that is wholly appropriate on economic, political and moral perspectives. As in other aspects of life we will move to a more mixed-market approach to the provision of healthcare.

Spending on health is likely to continue to increase for various reasons. Economists will point to the fact that it is a superior good ( and hence % of spending goes up as income goes up), demographers will point to the increases in life expectancy and practitioners will point to the fact that the cost of medical equipment tends to rise faster than inflation.

This will require a more sensible debate on whether a state monopoly on the provision of healthcare is the best way of allocating scare resources. I hope that this will move beyond the sterile (pun intended), polarised debate between the zealots of the command and free-market economies to recognise that a better system will result from taking the positive aspects of both systems and learning from the provision of healthcare in other parts of the world.

The NHS will not be fully privatised for the very simple reason that the the concept of provision based on need rather than ability to pay is correctly entrenched in our society. However, a system that relies solely on funding via taxation will dissappear for two simple reasons – one, evidence shows that this typically leads to relatively low levels of spending in aggregate and as a % of national income and, two, it unfairly results in the suppression of wages of medical staff (unless they supplement their income by working in the private sector as well). But as some commentators have noted, we cannot keep rationing ourselves to death as we do now.

The New NHS will be allowed to focus on treating serious, long term illnesses and be given a mandate to improve customer experience/treatment. Beyond that taxation will be supplemented by cumpulsory social insurance (as in Europe) that will be borne by individuals not corporations and that will include protection for low paid/unemployed and possibly a progressive nature to ensure a greater burden being shared by those who are able to afford it. This will do two things – one it will increase the overall money going into the system and, two, money would be “spent by those needing treatment” ie, revenues will accrue at the point of service and demand rather than (supposedly) trickling down from a centralised pot. Just like in most normal busineses. Finally (although not exclusively) the politicians will be removed from the management of the process to be replaced by those who know what they are doing. And the system will be broken into more manageable units.

So we will get a system that is better funded (ie more money), more economically and politically neutral, better able to match supply and demand while respecting the principle of ensuring provision for all.

The again this could all be a dream!! It can’t be that simple!

At what point do you draw the line?

I dunno. Individual cases would require adjudication. I have no problems with fair questions, but don’t expect not to be pulled up when you load the question with a ridiculous example which is hardly even that likely to happen. I also am aware that those with SBZ’s viewpoint (and yours if you agree with him, but I haven’t quite worked that out) always drag out “lifestyle” as if it somehow strengthens their standpoint. Once we start using “lifestyle” related conditions to deny treatment, well, then we could save ourselves a fortune.

DD, while i am happy to pay there comes a point when you can’t afford. Where that point is, is open to discussion though, as medical care gets more and more expensive you could spend all the money available and at some point you will still have to make a choice.

I suppose the question is what is the best way of spending the money available, something tells me paying profits isn’t it.

TJ, that NICE really are a pain! No wonder the present government are dimantling them.

-how are the government’s friends and relatives errr, big pharma and private hospitals offering simple and low risk elective elective surgery supposed to cope when you have an organisation telling us how to get better value overall for taxpayers? 🙄 and indeed 😉

So would “NHS trusts are changing to comply with NICE guidelines on fertility treatment” be better?

Bravissimo; I’ve already sorted it:

You smash yourself up doing something like mountain biking, which is a ‘lifestyle choice’. You sustain serious injuries and need ambulance/helicopter, ITU, operations, after care, physiotherapy etc.

How much does that cost?

Should you be just left on the mountain, as it’s your own stupid fault cos you chose to do something dangerous?

Oh well, that’s that one sorted. Pint, anyone?

🙂

It all depends….

Are we going to judge or apportion treatments by outcome? Or are we just going to offer them regardless?

I don’t know the success rates of IVF, but I do know that we aren’t offering it to 18 year olds from less privileged backgrounds, because the human body is designed to be fertile from that age, not at 35-40-45 when we have careers…

The success rates of emergency Aortic aneurysm surgery are somewhat dismal, but we seem to have no problem in trying to fix them.

The success rates from Out of Hospital Arrests are laughable, but we still put these people in ITU for 24-48-36-72 hours at a cost of £2-4-6-8000 just in case.

It’s complex and emotional, and I suspect we aren’t going to solve it here.

It’s complex and emotional, and I suspect we aren’t going to solve it here.

Nope, you’re right. But we can have a good old barney. 🙂

DD – the example was of course a ridiculous one, but it demonstrates that you can never make a hard and fast rule saying that you must never consider lifestyle as a relevant factor.

As Mrmo says, Where that point is, is open to discussion – and to be honest, the thing that riles me about Fred’s approach on this thread was that straight out the bat he started calling SBZ arrogant and offensive for even daring to have an opinion that was one side of a very long series of shades of grey.

The example of mountain biking is a good one, since its just another of those “lifestyle” options somewhere between smoking crack and being a Jehova’s witness (both of which can have pretty drastic effects on your health outcomes) where you cannot draw hard and fast lines.

..and the problem still remains that even with private medical care, the NHS still has to pick up all the pieces when it doesn’t go well.

Go into private hospital for elective surgery, pay, go home.

Go into private hospital for elective surgery that then goes wrong, the NHS will give you ITU care, HDU care, rehab and all with no cost to the private side.

If private Healthcare had to pick up the tab for everything resulting from private medicine we would start to see the real costs emerging.

This will require a more sensible debate on whether a state monopoly on the provision of healthcare is the best way of allocating scare resources.

Debate is over. state monopoly is best. It provides more treatment for less money. well proven and known.;

The again this could all be a dream!! It can’t be that simple!

Correct – it isn’t that simple – adding different revenue streams in requires complex financial management which costs a lot on money.

If private Healthcare had to pick up the tab for everything resulting from private medicine we would start to see the real costs emerging.

Now that’s an interesting quote, but probably not in the manner intended. I agree with the point, but find the hidden aspect also intriguing ie, the concept of “real costs emerging”. Free-markets have their failings, but a real benefit is better transparency in pricing. This is lost in a command system. In this example, the fact that the NHS provides an opaque backup is all part of the problem, surely?

It provides more treatment for less money

Doesn’t necessarily provide better treatment, or better health outcomes though.

I agree wholeheartedly, teamhurtsmore, the problem with the NHS and it’s policy of treating everything and everyone is that we end up treating everything and everyone…..whether that’s the right thing to do or not. This means that lots of people end up in critical care facilities being ‘treated’ for what is essentially death.

A less emotional and more outcome focused approach to all healthcare would improve everyones experience and save money.

Z-11, but your example of a 60 year old woman being infertile is hardly down to her lifestyle is it? Anyway, that’s done and dusted. Infertility for many people isn’t a matter of “lifestyle”. Saying it over and over again does not make it so. As has the argument about IVF here may times. As for Effin’s attitude towards glupton/Smee/TZF/SBZ, well I’m afraid he asks for it.

OK TJ – we will remain with a system that is poorer than in large parts of the rest of the developed world in most senses of the word. Great. Of course, the folly of your suggestion is that those that can afford it, will continue to be able to bypass and (to take crikey’s comment) abuse the system, leaving the rest to face the consequences. Very smart?!!?

I will add to the list of absurd quotes (” we are an undertaxed economy”) this one:

Debate is over. state monopoly is best. It provides more treatment for less money. well proven and known.;

Ok – Time for a fun Saturday – goes away shaking head!!

Infertility for many people isn’t a matter of “lifestyle”

With huge respect to anyone involved, concentrating on a career and subsequently waiting till you’re 40 years old before trying to conceive, given that it is known that fertility drops so significantly at that age, is very much a lifestyle choice.

TJ:

Although survival rates for different cancers are improving in the UK, most other OECD countries achieve higher rates. The UK does well in avoiding hospital admissions for people with uncontrolled diabetes, but could improve the treatment of people with asthma and chronic obstructive pulmonary disease.
Details:

? The 5-year relative survival rate for breast cancer during 2004-2009 was 81%, up from 75% during
1997-2002, but still lower than the OECD average of 84%. For cervical cancer, it was 59%, also lower than the OECD average of 66%. And for colorectal cancer, the 5-year relative survival rate in the UK during 2004-2009 was 54% for females and 53% for males, compared with an OECD average of 62% for females and 60% for males.

? Avoidable hospital admissions for asthma complications and chronic obstructive pulmonary disease are higher in the UK than the OECD average. For asthma admissions, the rate was 74 per 100 000 adults in 2009, compared to an OECD average of 52. For COPD it was 213 (OECD average 198). On the other hand, admissions for uncontrolled diabetes in the United Kingdom are less than half the OECD average (24 vs. 50 admissions per 100 000 population).

http://www.oecd.org/dataoecd/12/59/49084307.pdf

Teamhurtmore – I suggest you go and do some research on this. The nhs is as good as most systems and is cheaper. Some things it does very well indeed – some not so well. However it is significantly cheaper than most. So in terms of treatment per £ it is among the best in the world.

And yes – we are undertaxed which is why our public services are underfunded.

Have a look at a comparison with Germany and the Netherlands and remember that in Germany you pay for your healthcare on top of tax. The german system is a social insurance funded model – admin costs are twice as high

They pay more tax than us and then have to pay for healthcare on top out of the income left.

It may not sit well with your ideology but it is the truth.

La sécu c’est bien, en abuser ça craint.

How about means testing the winter fuel payment (or whatever it is called today)? One of the most disgusting things I’ve ever heard was Ken Clarke’s response when asked whether he needed the however many hundreds of punds the government gave him through this payment. “I think of it as a tax rebate” was his answer. It’s not meant as a tax rebate though is it Ken? And do you not claim for gas and electricity via expenses?

With an attitude like that no wonder the country is screwed.

The translation for us doesn’t work too well, Edukator, but I think I get the idea.

A supreme irony being that even as the public sector gets slagged off, the likes of Circle are leeching off entirely dependent upon NHS capacity and workforce training.

At its best, acute care in the NHS works because of co-operation – I’m willing to bet that the political fetish for “competition” is actually going to push both costs & bureaucracy up.

Would love to stay and chat, but I’m on me break. 😕

Teamhurtmore – I suggest you go and do some research on this.

Of course, silly me. Never thought of that.

The nhs is as good as most systems

If only

Some things it does very well indeed – some not so well.

True

However it is significantly cheaper than most.

Partly because we underpay (patronise?) those who work in the industry.

in Germany you pay for your healthcare on top of tax. The german system is a social insurance funded model

Sounds pretty good so far…

– admin costs are twice as high

So needs better admin, next? As I say learn from others – copy their successes, avoid their mistakes.

With huge respect to anyone involved, concentrating on a career and subsequently waiting till you’re 40 years old before trying to conceive, given that it is known that fertility drops so significantly at that age, is very much a lifestyle choice.

Jeez, there you go again, choosing examples on the edges of the curve to suit your argument. No matter how many times it’s pointed out to you, you’ll continue to do it. Ah well, TeeJ has arrived for you now, and I have an engagement party to attend. The two of you can spend Saturday evening posting links at one another. 🙂

By the way, that party – it’s for two lesbians. I hope they get help from the NHS to conceive some time in the future.

Have a read of this

http://www.guardian.co.uk/commentisfree/2011/nov/24/reform-bad-for-nhs-oecd

One of the Key things from that oecd report is that the NHS outcomes improved rapidly over the last decade as the money we spend on it increased. Far more quickly than others

When labour came to power we spent around 3/4 of what most comparable countries spent on healthcare and thus it was not great we now spend around 9/10 as much and outcomes have improved rapidly – matching or close to matching the the best in most areas despite still spending significantly less

The other issue with the selective quoting from Zulu is that we have higher rate of some of these illnesses in the population.

However some people are so idealogically wedded to the idea that private is best that they will never be convinced of the truth which is that the NHS provides more and better care on average per £ than any othe rsyutem.

The only one I know of that is significantly cheaper is the japanese – and I don’t know enough about it to know why.

to be honest, the thing that riles me about Fred’s approach on this thread

I’m glad it riles you. 😀

As for Effin’s attitude towards glupton/Smee/TZF/SBZ, well I’m afraid he asks for it.

This, quite frankly.

If someone’s gonna post up deliberately provocative crap, then they shoon’t be surprised if they provoke a response. And SBZ’s said his onion isn’t going to change, which means he isn’t actually open to debate or discussion, from which he might actually learn something, which strikes me as pretty narrow-minded and blinkered tbh. But then, that’s his ‘lifestyle choice’…

DD – all they need is a volunteer and a turkey baster 🙂 if you were a gentleman ….

I ain’t gonna argue with the right wing idealoges any futher.

DD – all they need is a volunteer and a turkey baster if you were a gentleman ….

😆

Now TeeJ, do you not think that joke has been done over and over (sensitively of course, as befits a liberal hand-wringer like myself). Thing is, they’re both very pretty. 🙂