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UK To Ban Surgery For Smokers and The Obese To Reduce Health Care Costs
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Rosemary7391 wrote: »VintageFeline wrote: »Yeah it's not a total ban and appears to only be in one area. There are just minimum requirements related to weight and smoking cessation. In the case of hip and knee replacements the outcomes are better for those with a lower weight so it makes sense to try and improve that by reducing body weight. They have 9 months to do so. Smoking has to be stopped for 8 weeks.
So it's a pretty narrow range and not necessarily a bad thing.
Yes, it looks more like trying to get the optimum outcome for the patient rather than pure cost cutting. If it was for any surgery then that'd be different, but I guess hip and knee surgery is particularly badly affected by weight. Not sure how smoking fits into it, but as switching to vaping is an option then that doesn't seem a huge hurdle - the waiting list is likely to be longer than the time you'd have to switch for so probably very little delay!
Smoking reduces oxygen carrying capacity = delayed healing.3 -
VintageFeline wrote: »VintageFeline wrote: »To further my point, I actually walked myself to my local A&E at the time because of dreadful chest infection that as an asthmatic could kill me. They have both a walk-in centre and A&E. I actually went to the walk in first who promptly told me to bugger off to A&E because I should be seen more urgently (turns out they thought it was pneumonia, thankfully wasn't quite that bad!).
I think that model would be a great way to triage people whichever place they walk into first, send them where they should actually be.
That's if you have a local walk in centre though. I live in London so 9/10 I would always chose walk in over A&E (including the time I had to hop there when I had glass embedded in my foot) but many people in other areas are not so fortunate.
That's my point. I was saying the presence of both on the same site is a great idea, not that they should be sent off across a city/town to a walk in. I am also in London, the hospital I went to was St. George's.
Tooting is able to offer that because it's such a large hospital. But many other local hospitals don't facilitate the option, and as such A&E feels the strain. Ideally, GP surgeries should offer this service (whether that be with a dedicated team on a non appointment schedule) to relieve the stress on other healthcare providers. I'm unsure if this is an option, but due to the unique funding of the UK healthcare and an ever increasing unhealthy population, the days of an efficient and quality NHS were always numbered.
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VintageFeline wrote: »VintageFeline wrote: »To further my point, I actually walked myself to my local A&E at the time because of dreadful chest infection that as an asthmatic could kill me. They have both a walk-in centre and A&E. I actually went to the walk in first who promptly told me to bugger off to A&E because I should be seen more urgently (turns out they thought it was pneumonia, thankfully wasn't quite that bad!).
I think that model would be a great way to triage people whichever place they walk into first, send them where they should actually be.
That's if you have a local walk in centre though. I live in London so 9/10 I would always chose walk in over A&E (including the time I had to hop there when I had glass embedded in my foot) but many people in other areas are not so fortunate.
That's my point. I was saying the presence of both on the same site is a great idea, not that they should be sent off across a city/town to a walk in. I am also in London, the hospital I went to was St. George's.
Ah I see what you mean. Yes that is a good idea and I didn't know that about St George's. Tooting is very accessible to me so I'll remember that if I have an urgent medical issue.0 -
Isn't that discrimination! What about alcoholics? What about drug addiction? That will improve overall health, shouldn't they be restricted too? Oh wait a minute, I forgot, providing help to these individuals will cost the system more money, so we can't do that!
I think it isn't quite the same. Let's say alcohol has trashed your liver. I guess it makes little difference to the outcome whether you stop drinking then get a liver transplant or get a liver transplant then stop drinking, since alcohol leaves the body pretty quickly. (Although I don't know what'd happen if you turned up for surgery drunk!) But if you lose weight, then get a hip replacement, you're gonna do much better in the long run than someone who gets a hip replacement then loses weight, since all the time you're losing the weight you're also putting extra wear on the new hip. Aren't second replacements less effective as well?
Nutmegoreo - yep, that makes sense. Although that presumably isn't specific to the type of surgery as well, like weight loss is to hip/knee replacement, so why wouldn't they ask for any surgery? It makes sense to ask people to take measures to make treatment more successful though - it's normal to be asked not to eat before some things isn't it? And I'm sure there are plenty of drugs you're not supposed to mix with alcohol/etc.1 -
The wise judgment of the death panel in socialized medicine.
Coming to a local hospital near you...soon.13 -
Rosemary7391 wrote: »Isn't that discrimination! What about alcoholics? What about drug addiction? That will improve overall health, shouldn't they be restricted too? Oh wait a minute, I forgot, providing help to these individuals will cost the system more money, so we can't do that!
I think it isn't quite the same. Let's say alcohol has trashed your liver. I guess it makes little difference to the outcome whether you stop drinking then get a liver transplant or get a liver transplant then stop drinking, since alcohol leaves the body pretty quickly. (Although I don't know what'd happen if you turned up for surgery drunk!) But if you lose weight, then get a hip replacement, you're gonna do much better in the long run than someone who gets a hip replacement then loses weight, since all the time you're losing the weight you're also putting extra wear on the new hip. Aren't second replacements less effective as well?
Nutmegoreo - yep, that makes sense. Although that presumably isn't specific to the type of surgery as well, like weight loss is to hip/knee replacement, so why wouldn't they ask for any surgery? It makes sense to ask people to take measures to make treatment more successful though - it's normal to be asked not to eat before some things isn't it? And I'm sure there are plenty of drugs you're not supposed to mix with alcohol/etc.
I think the smoking one is for a broader range as the article indicated the joint surgeries as "such as".1 -
I would be interested to know what the protocol would be if the patient fails to meet pre-surgery requirements. I am absolutely against not performing needed procedures at all.3
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I'd agree with the last paragraph, these things only become necessary when there isn't enough money (and appropriate management of that money, I'm not denying there are issue with the NHS) to fund everything as required. I've been directly impacted by it myself and it's no fun.1
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I was told in 2016 I would need a hip replacement and told to lose weight. It was very difficult to exercise due to the pain. I am down about 24 lbs now and have been allowed to see a Consultant. I will know in a few weeks if I have lost enough weight for the op... I quite understand the medical reasons for delaying the op but the pain is so bad now it is affecting my full time job, driving etc... fingers crossed!2
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Smokers actually contribute more to the NHS than they cost the NHS. So without smokers the NHS would be worse off7
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suzannesimmons3 wrote: »VintageFeline wrote: »To further my point, I actually walked myself to my local A&E at the time because of dreadful chest infection that as an asthmatic could kill me. They have both a walk-in centre and A&E. I actually went to the walk in first who promptly told me to bugger off to A&E because I should be seen more urgently (turns out they thought it was pneumonia, thankfully wasn't quite that bad!).
I think that model would be a great way to triage people whichever place they walk into first, send them where they should actually be.
That's if you have a local walk in centre though. I live in London so 9/10 I would always chose walk in over A&E (including the time I had to hop there when I had glass embedded in my foot) but many people in other areas are not so fortunate.
I live in cumbria....doctors 3 weeks wait if it's not an emergency and 48 hours if it is....absolutely no walk in centres anywhere in the area so a and e is sometimes the only option....we need better ooh doctors
With respect, the NHS is amazing. I live in ireland can get a doctor monday to friday, 60euro a visit and I have to pay for the medicine, thats with health insurance.2 -
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suzannesimmons3 wrote: »suzannesimmons3 wrote: »VintageFeline wrote: »To further my point, I actually walked myself to my local A&E at the time because of dreadful chest infection that as an asthmatic could kill me. They have both a walk-in centre and A&E. I actually went to the walk in first who promptly told me to bugger off to A&E because I should be seen more urgently (turns out they thought it was pneumonia, thankfully wasn't quite that bad!).
I think that model would be a great way to triage people whichever place they walk into first, send them where they should actually be.
That's if you have a local walk in centre though. I live in London so 9/10 I would always chose walk in over A&E (including the time I had to hop there when I had glass embedded in my foot) but many people in other areas are not so fortunate.
I live in cumbria....doctors 3 weeks wait if it's not an emergency and 48 hours if it is....absolutely no walk in centres anywhere in the area so a and e is sometimes the only option....we need better ooh doctors
With respect, the NHS is amazing. I live in ireland can get a doctor monday to friday, 60euro a visit and I have to pay for the medicine, thats with health insurance.
It is amazing but they need better options available to all to ease peoples a and e visits because it's the only option left to you.
I am sure the the NHS liek the irish public health service has a major problem with being abused, if we could get that sorted I think a lot of issue woudl disappear. Getting so drunk that you need hospital care and start abusing staff, thats just not cricket. They should be fined3 -
suzannesimmons3 wrote: »VintageFeline wrote: »To further my point, I actually walked myself to my local A&E at the time because of dreadful chest infection that as an asthmatic could kill me. They have both a walk-in centre and A&E. I actually went to the walk in first who promptly told me to bugger off to A&E because I should be seen more urgently (turns out they thought it was pneumonia, thankfully wasn't quite that bad!).
I think that model would be a great way to triage people whichever place they walk into first, send them where they should actually be.
That's if you have a local walk in centre though. I live in London so 9/10 I would always chose walk in over A&E (including the time I had to hop there when I had glass embedded in my foot) but many people in other areas are not so fortunate.
I live in cumbria....doctors 3 weeks wait if it's not an emergency and 48 hours if it is....absolutely no walk in centres anywhere in the area so a and e is sometimes the only option....we need better ooh doctors
With respect, the NHS is amazing. I live in ireland can get a doctor monday to friday, 60euro a visit and I have to pay for the medicine, thats with health insurance.
It certainly is amazing and I don't think most want to see the NHS become private but there are issues with lack of GPs and underfunding alongside mismanagement. The NHS needs work but there is no indication of that happening at the moment. Bar making things worse.1 -
Rosemary7391 wrote: »Isn't that discrimination! What about alcoholics? What about drug addiction? That will improve overall health, shouldn't they be restricted too? Oh wait a minute, I forgot, providing help to these individuals will cost the system more money, so we can't do that!
I think it isn't quite the same. Let's say alcohol has trashed your liver. I guess it makes little difference to the outcome whether you stop drinking then get a liver transplant or get a liver transplant then stop drinking, since alcohol leaves the body pretty quickly. (Although I don't know what'd happen if you turned up for surgery drunk!) But if you lose weight, then get a hip replacement, you're gonna do much better in the long run than someone who gets a hip replacement then loses weight, since all the time you're losing the weight you're also putting extra wear on the new hip. Aren't second replacements less effective as well?
Nutmegoreo - yep, that makes sense. Although that presumably isn't specific to the type of surgery as well, like weight loss is to hip/knee replacement, so why wouldn't they ask for any surgery? It makes sense to ask people to take measures to make treatment more successful though - it's normal to be asked not to eat before some things isn't it? And I'm sure there are plenty of drugs you're not supposed to mix with alcohol/etc.
VintageFeline addressed the types of surgeries. With regards to the liver transplant and drinking: I'm not sure about the NHS. In Canada, to qualify for a liver transplant, the person must quit drinking for a period of time prior to being eligible to receive a new liver.1
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