The Cellar - View Single Post - Brit doctors: don't treat people who make bad choices or get old

DanaC · 01-28-2008, 04:48 AM

There have always been some procedures and areas of medical care which have required payment from the patient: dentistry, even on NHS incurs a charge; unnecessary treatments are not provided on the NHS. That said, I would point out that even cosmetic treatment is provided on the NHS if it can be shown to be of enough benefit to the patient and if the lack of it can be reasonably surmised to be damaging to their physical or mental well-being. For example, I had real problems with my teeth, they were crooked and the enamel was porous so I could never make them look clean no matter how conscientious I was about dental care. I was given veneers for upper and lower front teeth (all bar the molars) partly because it was medically advantageous and partly because it was affecting my self confidence. If I'd had that done at my own cost it would have been several thousand pounds. Because I was unemployed and therefore able to claim free dental care it cost me nothing. If I had been working it would have cost me about £400 on NHS. Still significantly less than private.

There are some procedures and treatments that it is not sensible to allow to certain patients. It's about resources, but it's also about good medicine. Like monster says, giving a new liver to someone who refuses to stop drinking isn't just wasteful, it's medically unsound as it's highly unlikely to work. In terms of age, there comes a point where you are trying to hold back the tide...at that point it can be reasonably argued in many cases, that the medically sound tactic is to make that patient as comfortable as possible, rather than attempting to 'cure' them.

Making them comfortable, by the way, includes things like the provision of oxygen canisters and a variety of inhalers, all of which the patient is provided free of charge after the age of 65, and prior to that at the standard prescription rate of £6.75.

The NHS has been wonderful to me. It's been wonderful to my Dad. It's been wonderful to numerous friends and family members. It ain't perfect, but the cost equation in treatment rarely comes up, and that's the way it should be at the patient's end of things.

01-28-2008, 04:48 AM	#17
DanaC We have to go back, Kate! Join Date: Apr 2004 Location: Yorkshire Posts: 25,964	There have always been some procedures and areas of medical care which have required payment from the patient: dentistry, even on NHS incurs a charge; unnecessary treatments are not provided on the NHS. That said, I would point out that even cosmetic treatment is provided on the NHS if it can be shown to be of enough benefit to the patient and if the lack of it can be reasonably surmised to be damaging to their physical or mental well-being. For example, I had real problems with my teeth, they were crooked and the enamel was porous so I could never make them look clean no matter how conscientious I was about dental care. I was given veneers for upper and lower front teeth (all bar the molars) partly because it was medically advantageous and partly because it was affecting my self confidence. If I'd had that done at my own cost it would have been several thousand pounds. Because I was unemployed and therefore able to claim free dental care it cost me nothing. If I had been working it would have cost me about £400 on NHS. Still significantly less than private. There are some procedures and treatments that it is not sensible to allow to certain patients. It's about resources, but it's also about good medicine. Like monster says, giving a new liver to someone who refuses to stop drinking isn't just wasteful, it's medically unsound as it's highly unlikely to work. In terms of age, there comes a point where you are trying to hold back the tide...at that point it can be reasonably argued in many cases, that the medically sound tactic is to make that patient as comfortable as possible, rather than attempting to 'cure' them. Making them comfortable, by the way, includes things like the provision of oxygen canisters and a variety of inhalers, all of which the patient is provided free of charge after the age of 65, and prior to that at the standard prescription rate of £6.75. The NHS has been wonderful to me. It's been wonderful to my Dad. It's been wonderful to numerous friends and family members. It ain't perfect, but the cost equation in treatment rarely comes up, and that's the way it should be at the patient's end of things.