Obese patients "denied operations "
Discussion
Thoughts?
My own feeling is that both the individual and the NHS share responsibility for their health and if the individual makes themselves unhealthy then that should be taken into account when deciding treatment priorities.
BBC
Obese patients denied operations
Obese people are to be denied surgery in a bid to cut NHS costs
Obese people are to be denied some surgical procedures in a bid to cut costs in the NHS.
Three Suffolk primary care trusts have ruled patients with a body mass index (BMI) over 30 will not get operations like hip and knee replacements.
A person of average weight would have an BMI of between 18.5 and 24.9.
Dr Brian Keeble, a director of Ipswich PCT said: "We cannot pretend that this work wasn't stimulated by pressing financial problems."
Under new guidelines surgery will not be performed unless "the patient has a body mass index below 30 and conservative means have failed to alleviate the patient's pain and disability".
This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30
Dr David Haslam, National Obesity Forum
"Pain and disability should be sufficiently significant to interfere with the patient's daily life and/or ability to sleep."
Hospital consultants and GPs in East Suffolk came up with a list of 10 conditions for which there must be a threshold in order for surgery to be performed.
Included in the procedures for which there are conditions are such things as varicose veins and grommets for glue ear in children.
Dr Keeble said: "Our work on clinical thresholds has been a key part of this process.
"We started from the idea that operating on some conditions, either at an early stage or before other treatments have been tried, could actually be detrimental to the patient because of the risk of side effects from the procedure."
To deny someone surgery because they are obese, unless there is a clinical reason, is unfair
Patients Association
But he admitted financial pressures were a factor in the decision.
"I believe that these thresholds will produce some clear benefits in that both patients and their GPs will know when these procedures will be performed," he added.
The clinical director of the National Obesity Forum, GP Dr David Haslam, said that he was alarmed by the level being set at a body mass index (BMI) of 30.
"This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30.
"The argument that the life of joints is reduced because people are overweight is more relevant to those with a BMI of above 40.
"But I think that the trusts would be better off treating obesity or getting people to lose weight rather than introducing a blanket ban," Dr Haslam said.
A spokeswoman for the Patients Association said: "People are obese for all sorts of reasons.
"Unless there is a clinical reason for not carrying out surgery they should be entitled to have an operation as anyone else would be.
"People who are obese need education and help about healthy living. To deny someone surgery because they are obese, unless there is a clinical reason, is unfair."
My own feeling is that both the individual and the NHS share responsibility for their health and if the individual makes themselves unhealthy then that should be taken into account when deciding treatment priorities.
BBC
Obese patients denied operations
Obese people are to be denied surgery in a bid to cut NHS costs
Obese people are to be denied some surgical procedures in a bid to cut costs in the NHS.
Three Suffolk primary care trusts have ruled patients with a body mass index (BMI) over 30 will not get operations like hip and knee replacements.
A person of average weight would have an BMI of between 18.5 and 24.9.
Dr Brian Keeble, a director of Ipswich PCT said: "We cannot pretend that this work wasn't stimulated by pressing financial problems."
Under new guidelines surgery will not be performed unless "the patient has a body mass index below 30 and conservative means have failed to alleviate the patient's pain and disability".
This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30
Dr David Haslam, National Obesity Forum
"Pain and disability should be sufficiently significant to interfere with the patient's daily life and/or ability to sleep."
Hospital consultants and GPs in East Suffolk came up with a list of 10 conditions for which there must be a threshold in order for surgery to be performed.
Included in the procedures for which there are conditions are such things as varicose veins and grommets for glue ear in children.
Dr Keeble said: "Our work on clinical thresholds has been a key part of this process.
"We started from the idea that operating on some conditions, either at an early stage or before other treatments have been tried, could actually be detrimental to the patient because of the risk of side effects from the procedure."
To deny someone surgery because they are obese, unless there is a clinical reason, is unfair
Patients Association
But he admitted financial pressures were a factor in the decision.
"I believe that these thresholds will produce some clear benefits in that both patients and their GPs will know when these procedures will be performed," he added.
The clinical director of the National Obesity Forum, GP Dr David Haslam, said that he was alarmed by the level being set at a body mass index (BMI) of 30.
"This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30.
"The argument that the life of joints is reduced because people are overweight is more relevant to those with a BMI of above 40.
"But I think that the trusts would be better off treating obesity or getting people to lose weight rather than introducing a blanket ban," Dr Haslam said.
A spokeswoman for the Patients Association said: "People are obese for all sorts of reasons.
"Unless there is a clinical reason for not carrying out surgery they should be entitled to have an operation as anyone else would be.
"People who are obese need education and help about healthy living. To deny someone surgery because they are obese, unless there is a clinical reason, is unfair."
Isn't using the BMI index a bit of a flawed approach? I know people including myself for whom the BMI result is complete rollox.
Oh also given the budget of the NHS has doubled since 97 I'd also like to know where all of the extra money has gone? If not into extra treatment capacity?
IMO the conversation must have run something along the lines of
"right we've spent our budget on wage increases for ourlseves so we're running a bit short of cash for operations".
"Okay we'll just have to do fewer operations"
>> Edited by timmy30 on Wednesday 23 November 10:22
Oh also given the budget of the NHS has doubled since 97 I'd also like to know where all of the extra money has gone? If not into extra treatment capacity?
IMO the conversation must have run something along the lines of
"right we've spent our budget on wage increases for ourlseves so we're running a bit short of cash for operations".
"Okay we'll just have to do fewer operations"
>> Edited by timmy30 on Wednesday 23 November 10:22
therei s a medical factor here, if you are obese their is a higher risk of dying under the anaesthetic....
So it is very good clinical advice to lose some weight before an operation (unless obviuosly an emergency) to give you a better chance of surving.
My father went through a kidney transplant this year,, and this was one (of many, for him risk factors) they would have done it, if a suitable kidney had come up, BUT was told months before hand lose the weight, it will give you a much better chance of survival.
B
So it is very good clinical advice to lose some weight before an operation (unless obviuosly an emergency) to give you a better chance of surving.
My father went through a kidney transplant this year,, and this was one (of many, for him risk factors) they would have done it, if a suitable kidney had come up, BUT was told months before hand lose the weight, it will give you a much better chance of survival.
B
I wouldn't say you were being that controversial Mr Rascal. As a smoker, if I was told that I wouldn't receive some sort of necessary treatment unless I gave up, then I would do. In the same vein, if I was a heavy drinker etc..
Lards shouldn't be any different, and I agree that they will have to base it on something else in conjunction with BMI - possibly cholesterol??
Lards shouldn't be any different, and I agree that they will have to base it on something else in conjunction with BMI - possibly cholesterol??
Wouldn't it be better to give the NHS a kick up the arse and ask why if the budget has doubled in 7 years it appears to be able to offer only the same number, or even less treatments than before? Why is it even necessary to discuss rationing? GBrown told me and all other tax payers that the huge injection of public money into the NHS was to fund more nurses, more doctors, more surgeons.......where are they?
timmy30 said:
Wouldn't it be better to give the NHS a kick up the arse and ask why if the budget has doubled in 7 years it appears to be able to offer only the same number, or even less treatments than before? Why is it even necessary to discuss rationing? GBrown told me and all other tax payers that the huge injection of public money into the NHS was to fund more nurses, more doctors, more surgeons.......where are they?
It's Mr BLIAR's new system - all new doctors and nurses are replaced by managers and administrators
timmy30 said:
Wouldn't it be better to give the NHS a kick up the arse and ask why if the budget has doubled in 7 years it appears to be able to offer only the same number, or even less treatments than before? Why is it even necessary to discuss rationing? GBrown told me and all other tax payers that the huge injection of public money into the NHS was to fund more nurses, more doctors, more surgeons.......where are they?
yes but look at all the lovely artwork theyve managed to buy for the hospitals with the money...
anonymous said:
[redacted]
That sounds like a good plan!
And I'd hate to get bogged down in the semantics of smoking/NHS treatment/funding with BR, but without the extortionate tax on cancer sticks, the NHS would be....well I was gonna use financially crippled but I think f
d sums it up better 
ADDYBOY1982 said:
I wouldn't say you were being that controversial Mr Rascal. As a smoker, if I was told that I wouldn't receive some sort of necessary treatment unless I gave up, then I would do. In the same vein, if I was a heavy drinker etc..
Lards shouldn't be any different, and I agree that they will have to base it on something else in conjunction with BMI - possibly cholesterol??
but due to tax smokers and drinkers contribute more into the nhs slush fund anyway?
anyone know how the scales balance on all that, regards to fixing drunks on the weekend and long term support of older smokers?
just curious if it all balanaces out in the long run.
Jaglover said:
Thoughts?
"This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30.
He sounds like a bit of a sensationalist!
I'd hardly say not being able to get an operation to reduce their weight "condems them to misery"! A bit dramatic isn't it? What about those who are happy being overweight? Or losing it another way? Surgery should surely be a last resort..
Anyway I can't talk, my BMI is 9.6% measured on the digital home scales!!
Russell
Code Monkey said:
I wouldn't say you were being that controversial Mr Rascal. As a smoker, if I was told that I wouldn't receive some sort of necessary treatment unless I gave up, then I would do. In the same vein, if I was a heavy drinker etc..
Lards shouldn't be any different, and I agree that they will have to base it on something else in conjunction with BMI - possibly cholesterol??
but due to tax smokers and drinkers contribute more into the nhs slush fund anyway?
anyone know how the scales balance on all that, regards to fixing drunks on the weekend and long term support of older smokers?
just curious if it all balanaces out in the long run.
I don't think anybody really knows, but I had heard that the funds left after subtracting the cost of treating diseases and illnesses directly caused by smoking, made up 35% of NHS cash.
Although you know what they say about statistics
Being overweight significantly increases your risks of serious complications in the case of relatively routine operations. Even things like having a "general" is a risk for a healthy person, factor in weight and it starts to become a real danger....
Seems reasonably fair to start to restrict operations to those who have the best chances of full recovery - forcing those who are overweight to loose it to help them and the NHS....
Though, admit that BMI is probably a flawed approach to working this out...
Seems reasonably fair to start to restrict operations to those who have the best chances of full recovery - forcing those who are overweight to loose it to help them and the NHS....
Though, admit that BMI is probably a flawed approach to working this out...
The simple solution is to impose a "FAT TAX" - basically your income tax would be proportional to body fat % - assessed in early Jan each year 
( discussed this the other weekend with my mountaineering mtn biking friends - we thought it would be a good idea
( ..... and we are all skinny BTW ))
The implications would be that really fat people pay shit loads of tax - helping to fund the cost of health care - If you were REALLY obese you would not be able to feed yourself .... so would be "self correcting "
Women would unfortunately pay more income tax than men (oops )
Middle aged people with generally more income / assets would pay more than young people
There would be a long term improvement in the "Gene Pool" as real genetically pre-disposed fat arsed porkers would not be able to afford to have kids .
could map out as :
Body Fat % Income Tax %
< 15........ 15%
< 20 ....... 20 %
< 25 ....... 25%
< 30 ....... 35%
< 35 ........ 40 %
over 40......... 50%
( discussed this the other weekend with my mountaineering mtn biking friends - we thought it would be a good idea
( ..... and we are all skinny BTW )) The implications would be that really fat people pay shit loads of tax - helping to fund the cost of health care - If you were REALLY obese you would not be able to feed yourself .... so would be "self correcting "
Women would unfortunately pay more income tax than men (oops
) Middle aged people with generally more income / assets would pay more than young people
There would be a long term improvement in the "Gene Pool" as real genetically pre-disposed fat arsed porkers would not be able to afford to have kids .
could map out as :
Body Fat % Income Tax %
< 15........ 15%
< 20 ....... 20 %
< 25 ....... 25%
< 30 ....... 35%
< 35 ........ 40 %
over 40......... 50%
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