The NHS and "self-inflicted" illnesses
Monday, June 29, 2009 Oxford University is currently hosting an online debate on the motion "The NHS should not treat self-inflicted illness". I have received an email from the University inviting members of the public to take part in the debate and I would urge you to do so.
According to moderator Dr Paula Boddington:
The debate raises the wider question of what the NHS stands for, and what role it should have in society, what it is fair to expect from the NHS, and what individuals should do in return. It raises questions about living in a liberal society, about the rights and responsibilities that each of us has in such a society and how free we should be to live the lives we choose.
There are many voices urging us to take responsibility for our own health – from food labelling, advice about alcohol consumption, exercise and obesity, to legislation restricting smoking. Calls for greater responsibility can easily seem, on the one hand, calls to treat people like sensible adults in charge of their own lives, yet on the other hand as unfairly apportioning blame.
The university has now posted two contributions apiece from the debate proposer and opposer and members of the public are invited to leave comments HERE.
Reader Comments (16)
Been there, done that.
No comment showing. Is it the Mods day off or have I upset their delicate sensibilities?
I merely told the truth. Some don't like that.
I put a comment there too but these things are to stimulate discussion and do not necessarily reflect the views of those who debate them.
However,it has been mentioned numerous times before and there is a danger that it will be come accepted practice. I would prefer if the government scrapped the NHS altogether and gave us our national insurance money back to pay for private care. They could also reduce the taxes on beer and tobacco as they would no longer need it to fund the NHS.
Us smokers could then take our money and seek proper health care and better pension entitlements as we are expected to live less. The main sufferers under such a scheme would be the octagenarian nad nonagerian non smokers on their fifth hip replacement gobbling down 30 pills a day. Who would pay for them?
I'm with you, Michael. If it leads to the scrapping of the NHS, great.
As it surely will. If they were to exclude smokers, drinkers and the obese, for example, from NHS treatment, it destroys a central plank of the ethos of the NHS. Without the oft-repeated mantras of "Free at the point of delivery" and "healthcare for all citizens when it is needed", the whole system is exposed as merely piecemeal and no longer comprehensive. If that is the case, how can government defend a compulsory comprehensive charge for the service?
Nutty nurses like Jane DeVille-Almond calling for smokers to be denied treatment (see the sound file here) are blithely oblivious to the fact that they are advocating the start of a process which could result in them being out of a job in the long term, or if not, a hell of a lot of their fellow professionals instead.
Reckon I might get into the debate later. ;-)
Well, choose your words carefully. You only have a budget of 600 characters to work with.
Cool.
Comments are now up.
The sun has been shining strong and hot in the South East for the last few days. The papers are full of semi naked office workers enjoying prolonged lunch breaks. A couple of weeks ago a radio phone-in highlighted the increasing incidence of skin cancer. Will these misguided souls have to pay for their own treatment? I doubt it but, if you accept the stupid premise, perhaps they should.
The NHS should treat everyone irrespective of lifestyle or wealth, that's why it was set up wasn't it? ...and no we shouldn't ditch the NHS, i was reminded of this last year while on business in Houston chatting to a 78yr old waitress, she had to work to pay her medical insurance and her rent.
Talk of scrapping the NHS is ludicrous nonsense. The NHS was built on a marvelous philosophy.The problem is the raving, self-rightious idiots who want to destroy that, while still calling it the NHS.The same people who are behind the anti-smoking hysteria.They are truly destructive, dispicable bastards.
A 60 year old marvellous philosophy, Zitori, which doesn't work anymore.
And Fragpig, who said the 78 year old waitress would have to pay for her own health service? I didn't.
A system which provides adequate vouchers for full basic health service for every citizen is fair and equitable. If you want more, you pay more, if you don't, you don't.
Kills the red herring of alternative lifestyles costing the NHS stone dead. Competition is introduced which means less waste on nurses being paid for spouting nonsense about letting people die, and you get to choose exactly where you get your healthcare. If your doctor is an arse, you tell him so and move elsewhere.
Master being re-installed as master rather than servant. And for much less than the cost of the average wage-earner's NI contribution (which is now just a tax and not ring-fenced).
The NHS has taken the mickey for too long and needs its nails clipped.
Comment added to debate. Well a sort of a summary really. Anyways while agreeing with much of what Dick Puddlecote says, the fly in the ointment seems to be compensation. The compensation bill for the NHS has gone up as more people are 'compensated' for medical error. This would apply even more so in a mainly private system as in the US.
This 'compensation' culture pushes up charges and results in tests and procedures being performed that are not needed 'just in case' and to avoid negligence claims. Of course more procedures equals more risk, more costs, more time and less meaningful intervention. In addition, medical insurance costs escallate fueling the problem. How is this avoided?
----
Well, we could start by repealing the Solicitors Rules 1990 which allow them to advertise on TV, and the section of the Courts and Legal Services Act 1990 which allows conditional fees (no win, no fee).
After all, if you hide something, no-one will ever want it. Isn't that what Labour are saying in parliament at the moment? ;-)
If doctors did not make mistakes they would not be sued. Scrap the NHS and we could then pick and choose which doctors we would use. They could publish a league table of mistakes and the bad doctors would then find it difficult to get work and all doctors would be extra careful where they leave their needles.
At the moment we have no idea who we are being treated by and what their history is even though our taxes pay these people. Doctors seem to spend too much time spouting anti smoking lies on breakfast TV shows and not enough time looking after patients. Maybe if they were being paid directly by us and not through our taxes they might shut up and get on with their jobs. Doctors are one of smokers biggest enemies given their cosy deals and backhanders from the drug companies. They might change their tune if they had to actually pitch for their work and not just treat who they want when they want and still get rich off our taxes.
A 60 year old marvelous philosophy Dick? Yes, and the age means nothing, it still is. The problem is not with the premise, it's with the way it's run now. It needs to be changed drastically, and I know that is a big ask, but the alternative is not to my liking.
In the States the treatment of the poorest is pretty abomnible, and without insurance,with huge costs of operations and treatment as we would have here, it's a travesty, in the so-called richest country in the world. There is always plenty for war. I think we have the better of the two evils, but I agree that it's going in the completely wrong direction, but so would treating people by how rich they were. Dispicable.
You really still don't understand, Zitori. It has nothing to do with how rich you are. The state will still pay, it's just that the NHS would be broken up and you could choose who you 'bought' your healthcare from.
Your doctor would be very slow to criticise you if it meant you took your vouchers to another practice and he lost money, don't you think?
This is the problem with having this debate. No-one can ever see past the break up of the NHS as meaning leaving people to rot in the gutter. It quite simply isn't the case.
Yet everyone will have a story of irritation, inefficiency, woe or even shocking disaster due to the NHS, a 60 year old system which just doesn't work anymore.
I don't know anything that has lasted in the same form since 1948, yet somehow the public has been hypnotised into thinking the NHS is some miraculous case ... no matter how shit it actually is.
'You really don't understand Zitori'.
Oh sorry for being so stupid, and not seeing the brilliance of the voucher scheme!
Do us a favour please!
I think that the problem with the NHS is that they are engaging in health areas for which the NHS was not set up. The NHS was set up to give BASIC health care. In other words, to cure our illnesses, fix our broken bones, etc. If I were to get a cancer (which I did, by the way), I would expect to NHS to try to cure me (which they did - only a small, not very dangerous, but still malignant, skin cancer).
I do not think that it was ever intended that the NHS should cover EVERY possible health event. For example, I do not think that the NHS was intended to provide drugs and care, at enormous expense, in order to prolong the life of a person, who is dying, for a few months. As far as the NHS is concerned, such a situation is a 'there is nothing that we can do' situation. If people want to spend their own money in order to prolong their lives for a few months, then that is their decision. By the same token, 'in vitro' fertilisation should be a PRIVATE matter, and not a public one. Persons who cannot have children in the normal way should accept it, or pay for treatment themselves.
The arguement that smokers harm themselves and therefore should not be treated for free opens a huge can of worms, as has already been said (eg. footballers, rugby players, the obese, etc). I would be extremely surprised if such an idea ever actually takes off.
Here is a very interesting idea.
The NHS is FAR TO BIG AND IS TAKING ON FAR TOO MANY RESPONSIBILITIES. For example, we can consider the case of the disease, Alzheimers. We all know that this disease cannot be cured. Nevertheless, people with this disease need to be cared for. In my opinion, it makes sense for the NHS to DIAGNOSE the condition, but for ANOTHER BODY (separate from the NHS) to take over at that point in order to care of the affected person.
I feel sure that this is already the case, but the ACTUALITY is so obfuscated by the powers- that-be that only people who are important in the industry know what is going on. Ordinary people do not.
I believe that there are lots of activities of this nature which it is in the interests of NHS senior professionals to perpetuate, and that this goes right to the top. Politicians are far too busy writing their expenses claims and wining and dining to know the reality - and that goes for Health Secretaries (Patricia Heewitt) and their Assistants (the Caroline Flint). They let the Chief Medical Officer write the law (remember that he said that he would resign if he did not get his own way!), the Ministers accept his word for it and propose his laws and the ignorant MPs (they do not READ the laws that they pass) vote for the laws. What a joke!
Don't destroy our wonderful NHS (the envy of the world), reform and rationalise it!