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WTF?! NHS in oddball decision again?!

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Mister James
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PostPosted: 00:53 - 01 Feb 2008    Post subject: WTF?! NHS in oddball decision again?! Reply with quote

Please read this: https://news.bbc.co.uk/1/hi/health/7219373.stm and tell me if I have got the wrong end of the stick.

I interpret it as this woman's NHS trust saying "if you can afford to scrape together some cash to try and save your life, we're going to withdraw all your free treatment so you have to waste it on that instead" - is that correct?

Quote:

A Department of Health spokesman said: "If those who can afford it start "topping up" their care it will create a two tier NHS. What about those who can't afford Avastin?"


The genuinely rich who ARE thumbing their nose at the rest of us will have gone private as a matter of course. Why should someone be penalised for taking the drastic step of selling their house to fund extra treatment that might cure them and relieve stress on the NHS?!

It's total madness, and seems to vindicate the Tory policies that I've only vaguely been aware of up to now.
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Mister James
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PostPosted: 00:57 - 01 Feb 2008    Post subject: Reply with quote

FFS thought I was posting in Current Affairs - could some friendly Mod please move it over?

Even an un-friendly Mod will do.
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Itchy
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PostPosted: 08:41 - 01 Feb 2008    Post subject: Reply with quote

well you could have deleted it yerself if you hadn't replied to it,

what do you mean Tory policies? ,
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Mister James
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PostPosted: 10:54 - 01 Feb 2008    Post subject: Reply with quote

They're talking about allowing this so-called 'topping up' to take place.

It was late, and I'd had a long and frustrating day Razz
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Annabella
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PostPosted: 11:12 - 01 Feb 2008    Post subject: Reply with quote

I have to stand up and defend the DoH and NHS on this one.

The drug has not yet been approved by NICE which means that it hasn't been proven to be effective, nor have the side effects been investigated thoroughly - hence the comment from the DoH.

If the patient decides to be treated using an unproven branded drug that consultants and NHS staff have very little knowledge or training to use then why should they be held responsible for any nasty side-effects - or even if the treatment doesn't work at all?

And why should the DoH encourage someone to sell their house to fund a drug that they don't approve and aren't even sure works??


What does disgust me is the oncologist recommending a drug that he knew full well wasn't available. Unfortunately, drug companies have lots of money and are able to provide consultants with wonderful complimentary holidays... oops sorry, research trips free of charge.

As for the pricing of the drug - do you really think it costs that much to produce it? The drug companies register a drug and then have a number of years where they are the only company registered to produce and sell that particular drug, meaning they can charge whatever they like for it. Once this period is over other companies can release the same drug and sell them as generic drugs for a fraction of the original price. Unfortunately, a lot of doctors and patients refuse to move over to these new generic drugs and continue paying sometimes more than 10 times the cost for a branded drug.

Ok, time for a cup of tea and a chance to breath.
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Mister James
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PostPosted: 11:25 - 01 Feb 2008    Post subject: Reply with quote

Annabella wrote:
I have to stand up and defend the DoH and NHS on this one.


I rather thought you might!

Quote:

If the patient decides to be treated using an unproven branded drug that consultants and NHS staff have very little knowledge or training to use then why should they be held responsible for any nasty side-effects - or even if the treatment doesn't work at all?


That could surely be handled in other ways than effectively withdrawing all 'free' care - I say 'free', because of course the NHS is already paid for by our taxes.

Quote:

And why should the DoH encourage someone to sell their house to fund a drug that they don't approve and aren't even sure works??


They certainly shouldn't be encouraging it - that isn't the same as effectively banning it.

Quote:

What does disgust me is the oncologist recommending a drug that he knew full well wasn't available.


Perhaps he genuinely believes it has the best chance of success?

Quote:

As for the pricing of the drug - do you really think it costs that much to produce it?


Of course not, although again - ultimately it is the government's responsibility to regulate the industry, and protect the public from such sharp practice.
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Annabella
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PostPosted: 11:44 - 01 Feb 2008    Post subject: Reply with quote

Mister James wrote:

Of course not, although again - ultimately it is the government's responsibility to regulate the industry, and protect the public from such sharp practice.


Yes.. I agree. However the largest industry in the UK is the drug industry. Our government are over a barrel on this one somewhat - prevent overpricing and have the industry withdrawn from the country? It's never going to happen.

As for withdrawing free treatment - how can clinicians differentiate between side-effects or illnesses caused by the unproven drugs and those that aren't?

The point is, if this drug was proven to be effective it would be available on the NHS. It hasn't been proven as such and so isn't available. I agree, if someone wants to waste their own money they should be allowed to, but not when there is little or no knowledge of a drug and it's side-effects and NHS clinicians are expected to deal with these.
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Walloper
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PostPosted: 12:04 - 01 Feb 2008    Post subject: Reply with quote

So the lesson is:

For a healthy life.
Eat better.
Do not smoke.
Do not drink.
Avoid Stress.
Childbirth.
Sex.
And do not ride a motorcycle. Razz

Is this an 'unfortunate one off' headline making case?
There are also loads of folk out there who have treatable health issues which NHS is not able/willing to address.

The NHS (No Hope of Salvation) is dying of inoperable cancer, we should all know that.
Who gives a fuck?
"Not me I have BUPA....." Thumbs Up Crying or Very sad

But we should not only rely on our National Health Service as our safety net. We all should get smarter and take MORE responsibility for our own well being. (And encourage friends and family to do so.)

Just a suggestion.... Embarassed
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Mister James
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PostPosted: 12:33 - 01 Feb 2008    Post subject: Reply with quote

Annabella wrote:

Yes.. I agree. However the largest industry in the UK is the drug industry. Our government are over a barrel on this one somewhat - prevent overpricing and have the industry withdrawn from the country? It's never going to happen.


All the more reason for the government to find other ways to compensate us - the taxpaying durg-buying public - for their inability to protect us from price-gouging!

Quote:

As for withdrawing free treatment - how can clinicians differentiate between side-effects or illnesses caused by the unproven drugs and those that aren't?


As I understand it, the drug has been licensed (meaning that it is believed to be relatively safe, as far as can be tested?) and any dispute over whether it should be made available is due to cost, not effectiveness?

Even if that isn't the case with this particular drug, with 'post-code lotteries' and much publicised cases like this one - how can the public have confidence that the NHS genuinely has clinical concerns, or just wants to save a bit of dosh?

Quote:

The point is, if this drug was proven to be effective it would be available on the NHS. It hasn't been proven as such and so isn't available. I agree, if someone wants to waste their own money they should be allowed to, but not when there is little or no knowledge of a drug and it's side-effects and NHS clinicians are expected to deal with these.


If this lady arrange private treatment, was discharged but then suffered a reaction or side-effect and was taken seriously ill, would not the NHS have to treat her?

I appreciate your point, I just don't know if I'm comfortable with the NHS stomping its collective foot down on this one particular vector, while we all cry "nanny state" when government bodies posit ideas such as withdrawing care for those who abuse alcohol and food.
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Itchy
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PostPosted: 12:38 - 01 Feb 2008    Post subject: Reply with quote

I care cus I can't afford private,

but that said the NHS budget it 80bn right? , if 8bn =2% income tax , changing to private ought to mean zero rate of income tax up to 40K, since i'd only save oh 2-3K and I don't think this will buy bupa treatment
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repiV
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PostPosted: 12:47 - 01 Feb 2008    Post subject: Reply with quote

Avastin is not approved by NICE because it isn't considered cost-effective. It has nothing to do with the usefulness of the drug.
They're trading lives for pennies, it's that simple. In any case, when you have a disease for which exists no effective treatment, why the hell shouldn't people try other options besides certain death?

I used to work for the Department of Health, they're more interested in covering themselves than anything else.
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Itchy
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PostPosted: 12:57 - 01 Feb 2008    Post subject: Reply with quote

But then NICE is odd anyway, like Invitro yes we shall fund this, not having children won't kill you (infact it seems that it is the inverse) , and this costs ££££££££££££££.

Where is the life saving aspect of this? ,

EDIT

the problem with the NHS is that is also is a gigantic pyramid scheme much like pensions, the base of the pyramid is reaching jupiter sized proportions.
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Ichy
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PostPosted: 13:40 - 01 Feb 2008    Post subject: Reply with quote

Itchy wrote:
changing to private ought to mean zero rate of income tax up to 40K


Totally agree. I already have a private pension, dentist, optician and doctor. Why do I need to keep paying National Insurance?
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Mister James
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PostPosted: 15:01 - 01 Feb 2008    Post subject: Reply with quote

Itchy wrote:
I care cus I can't afford private,

but that said the NHS budget it 80bn right? , if 8bn =2% income tax , changing to private ought to mean zero rate of income tax up to 40K, since i'd only save oh 2-3K and I don't think this will buy bupa treatment


There was an article somewhere in the press a few months ago that proved that most middle-income types would be far better off not paying national insurance/tax contributions to the NHS/whatever, and putting the money into private pension pots and health insurance.

Obviously, the (or probably any) government doesn't want you to be able to do that, because the money you over-pay goes to pay for those who are a net drain on the system.

I'm relatively socialist in that I believe we should all contribute to a system that supports the needy; I suspect most fair-minded people would subscribe to that ideal to some extent. The problem these days is that there is a growing belief that the hard-working majority are being rinsed by an ever-expanding group of spongers and money-wasters (both civilians and officials).
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Annabella
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PostPosted: 15:48 - 01 Feb 2008    Post subject: Reply with quote

I'm sure the cost effectiveness is more important than just the cost.

You've got to wonder with this list of side effects whether the extended life it promises to offer would actually be worth living?

The "Lives for pennies" arguments always pop up but someone has to make a decision about where money should be spent. So chose:

An immensely expensive, unproven drug that has a list of side effects resulting in fatality as long as your arm for one woman to spend the remaining months of her life with skin sores, vomiting and with no appetite
OR
At least 8 masectomies and subsequent chemotherapy to allow eight women to be completely free of breast cancer for the rest of their lives


It breaks my heart to read articles like this and I could never be in the position to make that sort of decision, but I can see the logic that has to be used...
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repiV
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PostPosted: 16:14 - 01 Feb 2008    Post subject: Reply with quote

Annabella wrote:
I'm sure the cost effectiveness is more important than just the cost.

You've got to wonder with this list of side effects whether the extended life it promises to offer would actually be worth living?

The "Lives for pennies" arguments always pop up but someone has to make a decision about where money should be spent. So chose:

An immensely expensive, unproven drug that has a list of side effects resulting in fatality as long as your arm for one woman to spend the remaining months of her life with skin sores, vomiting and with no appetite
OR
At least 8 masectomies and subsequent chemotherapy to allow eight women to be completely free of breast cancer for the rest of their lives


It breaks my heart to read articles like this and I could never be in the position to make that sort of decision, but I can see the logic that has to be used...


It's hardly relevant to draw such a comparison since that kind of either/or decision would never happen in the real world.
It is in fact outrageous that cancer patients get such a raw deal in this country when you can get breast reduction surgery and IVF on the NHS, and when so much public money is just frittered away.
Even worse is the subject of the article - that is, punishing patients for choosing to fund their own treatment when necessary. Sounds rather like playacting communists to me.
Ultimately it all comes down to one thing - that the health service and the country is managed by people who know fuck all about management, and have no real business experience. If substantial corporate experience was a prerequisite for entering politics, our leadership might actually possess some kind of sanity.
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Walloper
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PostPosted: 16:41 - 01 Feb 2008    Post subject: Reply with quote

repiV wrote:
Ultimately it all comes down to one thing - that the health service and the country is managed by people who know fuck all about management, and have no real business experience. If substantial corporate experience was a prerequisite for entering politics, our leadership might actually possess some kind of sanity.


Spin time...

Corporate management such as:

Northern Rock
Société Générale

Shocked
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Shay HTFC
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PostPosted: 16:45 - 01 Feb 2008    Post subject: Reply with quote

Ichy wrote:
Itchy wrote:
changing to private ought to mean zero rate of income tax up to 40K


Totally agree. I already have a private pension, dentist, optician and doctor. Why do I need to keep paying National Insurance?


Thats like the argument that people who send their kids to private school shouldn't have to pay tax for free education.
Thats detrimental to society as a whole... and its society educating (and in the case of the NHS, looking after) the population that keeps the economy going.

If everyone who is private stops paying tax for the NHS, then more people will go private and then we really will see a two-tiered health scheme. Effectively, go private or suffer a massively underfunded public health service. i.e. the USA.

I think most people with an ounce of common decency will agree that that is not an ideal situation and a free health service for all is better!

Do you agree with people who send their kids to school not paying tax for free school places?
What if someone gets private security, then should they not pay towards the Police?
You can apply that logic to any public service.
Its your choice to go private, but don't complain when you don't get to stop contributing towards the benefit of the nation as a whole.
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repiV
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PostPosted: 16:54 - 01 Feb 2008    Post subject: Reply with quote

Walloper wrote:

Spin time...

Corporate management such as:

Northern Rock
Société Générale

Shocked


Put it this way, I'd rather have Richard Branson or Alan Sugar running the country than any slimey bastard of a politician.
Nothing qualifies a politician to run anything except the votes they receive - sounds fair and just in theory, but the reality it creates is self-evident: politicians are by far the least competent of all professions, to everyone's detriment.
Most modern politicians have lived their entire working lives in the vacuum of politics, they have little conception of the realities of life for anyone outside of politics.

In the corporate world, people choose a line of work and, throughout their time, become more and more important in that line of work. When they get to Directorship level, still they will have special responsibility over the areas they are experienced in.
In government, smiley fucking Tony just decides that the fat little scrote from Hull should be responsible for the country's finances.
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Annabella
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PostPosted: 17:07 - 01 Feb 2008    Post subject: Reply with quote

repiV wrote:

It's hardly relevant to draw such a comparison since that kind of either/or decision would never happen in the real world.


Maybe not like that, but budgets have to be agreed somehow, and there's not a magical bottomless pot. Budgets are usually agreed using historical data, prevalence models and predicted numbers with a bit of wiggle room for any extra cases.

I'm not going to even start trying to argue with you about managers within the NHS, maybe I'm just incredibly fortunate that my local PCT has a really good balanced mix of managers with backgrounds in private industry (Sainsbury's, Severn Trent Water) and clincians (a surgeon, head nurse, mental health nurse, and a GP).
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Walloper
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PostPosted: 17:43 - 01 Feb 2008    Post subject: Reply with quote

repiV wrote:
Walloper wrote:

Spin time...

Corporate management such as:

Northern Rock
Société Générale

Shocked


Put it this way, I'd rather have Richard Branson or Alan Sugar running the country than any slimey bastard of a politician.
Nothing qualifies a politician to run anything except the votes they receive - sounds fair and just in theory, but the reality it creates is self-evident: politicians are by far the least competent of all professions, to everyone's detriment.
Most modern politicians have lived their entire working lives in the vacuum of politics, they have little conception of the realities of life for anyone outside of politics.

In the corporate world, people choose a line of work and, throughout their time, become more and more important in that line of work. When they get to Directorship level, still they will have special responsibility over the areas they are experienced in.
In government, smiley fucking Tony just decides that the fat little scrote from Hull should be responsible for the country's finances.


Oh you mean a Dictatorship....?
My way or the hi-way?
Your jacket is not nailed to the wall. If you do not like things the way I do it then leave? That kind of 'leader' ship.

Politicians rely on Experts to provide information to make their judgements based on sound political belief.

The experts are taken from a broad cross section of society and industry is involved.

I do not think the Hi-heid-yins of corporate world choose to live here, UK, just because they get their Sunday Times on print day.
Most of them like the place.

There are loads of things wrong with government/s the way it is but if you have away to please everyone then let us know.

Like Annabella said the NHS makes it's cruel business decisions everyday.
I do not think the decisions can always be made on compassionate/emotional grounds or we would be bankrupt by lunchtime tomorrow.
Some hard Cnut has to make a decision.
Someone else may have to tell a person no.

It is easy to kick the NHS, but no-one or not very many want to fight for it.
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Mister James
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PostPosted: 18:05 - 01 Feb 2008    Post subject: Reply with quote

Quote:

Like Annabella said the NHS makes it's cruel business decisions everyday.
I do not think the decisions can always be made on compassionate/emotional grounds or we would be bankrupt by lunchtime tomorrow.
Some hard Cnut has to make a decision.
Someone else may have to tell a person no.


Definitely - and I don't know enough to state whether this should be one of those cases - I just have an immense feeling of unease over the comments made by the PCT.

I would also cite repiV's comments about being able to get cosmetic surgery and IVF on the NHS, while people die of cancer.

There are always going to be grey areas, I'm just not sure we have it all correctly 'weighted' at the moment.
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Itchy
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PostPosted: 18:40 - 01 Feb 2008    Post subject: Reply with quote

Mister James wrote:
There was an article somewhere in the press a few months ago that proved that most middle-income types would be far better off not paying national insurance/tax contributions to the NHS/whatever, and putting the money into private pension pots and health insurance.


The problem is though is that me and you would probably be sensible and spend the tax savings on healthcare/pensions, but many many people would not, and see it as a bonza and and spend it without thinking through the consequences.

And thus people who do get into accidents would have no cover and would be left to suffer.

Though of course your health insurance would be more expensive due to a more dangerous occupation, and the fact you live in London.
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Annabella
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PostPosted: 15:56 - 02 Feb 2008    Post subject: Reply with quote

Mister James wrote:

I would also cite repiV's comments about being able to get cosmetic surgery and IVF on the NHS, while people die of cancer.



That's down to the decision of the individual PCT. In 2005 our Trust Board passed a paper that withdrew cosmetic surgery from treatment.

Previously to that each case was dealt with individually with a psychological assessment required (although, I am sure plenty of people managed to find enough tears to convince the psychiatrist that they're slightly wonky nose was the cause of all bad in their lives).
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Walloper
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PostPosted: 16:02 - 02 Feb 2008    Post subject: Reply with quote

Annabella wrote:
Mister James wrote:

I would also cite repiV's comments about being able to get cosmetic surgery and IVF on the NHS, while people die of cancer.



That's down to the decision of the individual PCT. In 2005 our Trust Board passed a paper that withdrew cosmetic surgery from treatment.

Previously to that each case was dealt with individually with a psychological assessment required (although, I am sure plenty of people managed to find enough tears to convince the psychiatrist that they're slightly wonky nose was the cause of all bad in their lives).


Yes I'm getting pen*s reduction, as I convinced the local Health Board it's been the cause of endless troubles in my life. Sad (Endless was not a pun)
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