Posted on 12/08/2005 5:44:11 PM PST by blam
NHS may not treat smokers, drinkers or obese
By Celia Hall, Medical Editor
(Filed: 09/12/2005)
People who are grossly overweight, who smoke heavily or drink excessively could be denied surgery or drugs following a decision by a Government agency yesterday.
The National Institute for Health and Clinical Excellence (Nice) which advises on the clinical and cost effectiveness of treatments for the NHS, said that in some cases the "self-inflicted" nature of an illness should be taken into account.
But the report bars any discrimination against patients on grounds of age alone.
Nice stressed that people should not be discriminated against by doctors simply because they smoked or were overweight. Its ruling should apply only if the treatment was likely to be less effective, or not work because of an unhealthy habit.
The agency also insisted that its decision was not an edict for the whole NHS but guidance for its own appraisal committees when reaching judgments on new drugs or procedures.
But the effect is likely to be the same.
Nice is a powerful body and the cause of much controversy. It is seen by some as a new way of rationing NHS treatment.
Across the country primary care trusts regularly wait for many months for a Nice decision before agreeing to fund a new treatment.
One group of primary care trusts is ahead of Nice. Last month three PCTs in east Suffolk decided that obese people would not be entitled to have hip or knee replacements unless they lost weight.
The group said the risks of operating on them were greater, the surgery may be less successful and the joints would wear out sooner.
It was acknowledged that the decision would also save money.
Yesterday's report, Social Value Judgment - Principles for the development of Nice guidance, said no priority should be given to patients based on income, social class or social roles at different ages when considering the cost effectiveness of a treatment.
Patients should not be discriminated against on the grounds of age either, unless age has a direct relevance to the condition.
Nice has already ruled that IVF should be available on the NHS to women aged 23 to 39 as the treatment has less chance of success in older women. It also recommends that flu drugs should be available to over-65s, as older people are more vulnerable.
But the report said that if self-inflicted factors meant that drugs or treatment would be less clinically and cost-effective, this may need to be considered when producing advice for the NHS.
The report said: "If the self-inflicted cause of the condition will influence the likely outcome of a particular treatment, then it may be appropriate to take this into account in some circumstances."
It acknowledged that it can be difficult to decide whether an illness such as a heart attack was self-inflicted in a smoker.
"A patient's individual circumstances may only be taken into account when there will be an impact on the clinical and cost effectiveness of the treatment."
Prof Sir Michael Rawlins, the chairman of Nice, said: "On age we are very clear - our advisory groups should not make recommendations that depend on people's ages when they are considering the use of a particular treatment, unless there is clear evidence of a difference in its effectiveness for particular age groups.
"Even then, age should only be mentioned when it provides the only practical 'marker' of risk or benefit. Nice values people, equally, at all ages."
But Steve Webb, the Liberal Democrat health spokesman, said there was a danger of primary care trusts following the same course of action.
"There is no excuse for cash-strapped hospitals denying treatment to people whose lifestyle they disapprove of," he said. "Treatment decisions involving people's lifestyle should be based on clinical reasons, not grounds of cost. The NHS is there to keep people healthy, not to sit in judgment on individual lifestyles."
A spokesman for Nice said: "We want to reassure people that in producing our guidance we are not going to take into consideration whether or not a particular condition was or is self-inflicted.
"The only circumstances where that may be taken into account is where that treatment may be less effective because of lifestyle choices."
Jonathan Ellis, the policy manager at Help the Aged, said it was pleased Nice had finally shown an understanding of the importance of tackling age discrimination.
"While this is a major feat, there is still some way to go to banish the evident inherent age discrimination that exists within health care services," he said.
"The NHS now has much to learn from this step change. It will ensure a fairer deal all round for older people using the NHS."
Only healthy people need apply. All you sick sots bugger off!
makes since, If you intend to continue the actions that got you into this mess in the first place, then why fix the problem that will probably self inflicted again.
Some Canadian friends of ours said the Canadian health system was great........... as long as you didn't get sick and need a doctor. I guess the UK is the same.
Just what I want to hear from my doctor when I am sick.
At some level, ~all~ health problems probably have a lifestyle component. Maybe not all, but lots.
I wonder if they considered AIDS to be in the same category.
but IN RETURN, I am going to deduct from my taxes the portion that would have been used for me.
Someone try that, and see how well it flies...
Think I will go have a JW, rocks, while I still can:
So much for the promise of universal health care.
If the NHS is not going to treat smokers or drinkers, then I wonder if there will be any great number of Brits that they would be willing to treat. :-)
...Which proves once again, that after taking their guns away, and even their toy BB guns, you can do ANYTHING you want to the People. You can tease them like a cat teases a mouse, with the same ending!
You can pull their little tails off and nibble on their tiny feet, and there is NOTHING they can do about it.
Ohh, the sick, sadistic FUN micro-endowed little wanking bureaucrats can have, after being beaten up and "Well-reared" years ago in the Public Schools! Who is laughing NOW???
I had better stop, as it is beginning to sound like our HMO administrators, who can only DREAM of graduating to such a sadistic paradise someday, after the Glorious Socialist Revolution.
But he had a great quote: "I spent a lot of my money on booze, birds and fast cars - the rest I just squandered."
The Brits were raising hell a year or so ago; lecturing us about providing adequate health care to the detainees in gitmo. Smoking, drinking, and eating are worse than being a terrorist, I guess.
Bwahahahahaha....your kidding right.
Those with AIDS born from the MUST NOT BE NAMED homosexual lifestyle being held accountable for their infection. Ain't happening
This might not pass a court challenge.
It is changing the rules way into the game.
Young persons being told this today would be a target for the future, but when you are already there, seems like you are just a great big target for those who want to run your life.
GASP! Such heresy! :-)
"Hi! I smoke and I'm sick."
"Die, Commoner."
Hi! I like to eat a lot, and I'm sick".
"Die, Commoner."
"Hi! I like to stop at the Pub quite a bit, and I am sick'"
"Die, Commoner."
"Hi! I like to do dirty things with boy's bums, and shoot up with recycled needles and I don't feel too good."
"My Kind of Commoner! Would you like to go on Holiday with me?"
Aids and all other STDs. Maybe they'll refuse to do abortions too because impregnation is a lifestyle choice. And I'm sure all those denied treatment will receive a full refund of lifetime taxes paid for NHS - not!
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