Author Topic: State Funded? (Read 5521 times)

Bodger · « **on:** May 10, 2013, 10:30:29 am »

An emotive question. Should this mans treatment be state funded? I can see reasons why it should and why it shouldn't. I'm undecided, what about you, what do you think?

http://www.bbc.co.uk/news/uk-england-suffolk-22457765

colliewobbles · « **Reply #1 on:** May 10, 2013, 10:48:20 am »

It is a tricky one but I feel it is a dangerous road to go down - does it mean we don't treat those with liver problems because they drink excessively, or those with diabetes because they are overweight or those with sport injuries because they took part in an extreme sport?

Whilst I am sure that we all feel aggrieved when some problems are perceived to be self-inflicted we do have a national health service in this country that is there for all (there's a whole other discussion there!!) and whilst we maintain that precedence in our health service then I feel we cannot deny this man treatment.

That's my two-pennorth worth anyway - I will now climb down of my soapbox.

Donna

Bionic · « **Reply #2 on:** May 10, 2013, 10:59:26 am »

Did the NHS fund the gastric band? If thats the case then I think they should take responsibility and finish the job. There was no way he was ever going to loose that excess skin himself.

Fleecewife · « **Reply #3 on:** May 10, 2013, 11:25:36 am »

Carting all that skin about is going to be bad for his heart as well as many other systems. To say 'you're not getting treatment free because you once ate too much' is simplistic and a bit vindictive. I think this chap has shown the great lengths he is prepared to go in order to get a normal figure - all praise to him.

However, the point is made that he needs to be at a stable weight, as further weight loss will only add to the loose skin problem. He says his ideal weight is 15st and he can reach that if he has the skin removal. He still looks as if he has surplus fat, as opposed to surplus skin, so he does have further weight to lose before he should get the surgery.

I can't help feeling though that he will have little incentive to keep losing weight if he feels that the NHS will refuse him the necessary surgery. So to set a possible date for him to lose the weight by, plus a bit to stabilise, then a tentative date for surgery, could be the best way to go. He needs support and encouragement for his achievements, not antagonism and blame. To give him the surgery may cost the NHS in one department, but not to will mean enormous expense with his on-going care in other departments.

But, it does raise the question of just how much surplus skin someone would want removed but expect to qualify for NHS treatment. When does vanity turn into a health issue?

lachlanandmarcus · « **Reply #4 on:** May 10, 2013, 12:19:05 pm »

Quote from: Bionic on May 10, 2013, 10:59:26 am

Did the NHS fund the gastric band? If thats the case then I think they should take responsibility and finish the job. There was no way he was ever going to loose that excess skin himself.

This. With cases that extreme then from a mental health pov I would think it right and a good investment to do the skin removal op.

plumseverywhere · « **Reply #5 on:** May 10, 2013, 12:27:13 pm »

I can see why people feel undecided. Some may feel he got himself into that mess, why should the tax payer foot the bill while others are also waiting for treatment for health issues that are not self imposed. However, my gut feeling is that there is a mental health issue here. In order to have become so obese he may have an illness that meant he lost control of his calorific intake and who knows what's happened in his life to lead him to that $:-\$ |He's obviously determined to change his life - good on him! I assume being that obese meant he's not been able to work etc too.
On the other hand, I remember George Best having a liver transplant then dying of liver disease after (from recollection) he drank that one away too? I believe that once given a second chance (such as this, if he gets the skin removed) we have to respect it 100% and not fall into old ways.
Looks like he needs to lose a bit more or he'll just have more loose skin to have removed. Currently he is also quite likely an anaesthetic risk still and if its going to be done, it needs to be done sensibly so that the NHS don't end up having to fork out etc for more treatment or ops to sort out complications

tizaala · « **Reply #6 on:** May 10, 2013, 12:35:58 pm »

Yes, he needs help , no question about it.

Clarebelle · « **Reply #7 on:** May 10, 2013, 12:54:07 pm »

I have to agree, I totally think he should be able to get that skin removed on the NHS. I have gone from 17stone in 2011 to 10 1/2 stone now. While I am obviously chuffed to bits to no longer be morbidly obese, I have been left with a large amount of excess skin, especially on my stomach (not helped by having had three children). When I am in the bath my stomach literally floats, it has no musculature, it is just skin and probably weighs about 1/2 stone. I would love to be able to have this skin removed on the NHS but I know my case is not extreme enough to warrant it. However, I totally feel for this guy, sometimes I get fleeting thoughts about whether I actually looked better off with the skin being 'bulked' out with the fat. Then of course I remember I am so much better off now

john and helen · « **Reply #8 on:** May 10, 2013, 07:03:24 pm »

if we can spend £64,000.00 on one missile in afghanistan, killing maybe one bad person..then we should be able to spend £60,000.00 on a BRITISH man who has done his best to get himself back on track....

We do tend to make some of our own people who have worked hard and saved hard to pay for their care..ie alzhiemers , and other dementia sufferers.... yes i know there is a safe net for those who could not afford the care..and rightly so

so ..the man should get the treatment

MAK · « **Reply #9 on:** May 10, 2013, 07:35:28 pm »

I agree with Coliiewobble .
It is a dangerous road when we ask health care providers to play G_d. Opinion and beliefs then determine decession making about what and who to treat. That said funds and thus resources are limited and it may vex patients and specialists who do not or can not treat a disease or disorder because they perceive money is "wasted" in other parts of the NHS.

Lesley Silvester · « **Reply #10 on:** May 10, 2013, 10:08:04 pm »

Yes, he should have the operation if it's safe to do so. The NHS funds people to overcome drink compulsion, give up smoking, etc if they are prepared to do their bit. This man has proved he wants to improve his health.

Looking on the practical side, he must have problems getting clothes to fit when he has all that skin. The right sized waist for him probably wouldn't fit lower down.

tizaala · « **Reply #11 on:** May 11, 2013, 07:12:22 am »

Where will they draw the line between help/ no help ?

You will get NO help :
Because you are OLD and have paid your dues,
because you chose to live with a smoker and got cancer through passive smoking !
had a mental disorder that caused an eating disorder, and are going to cost the NHS a few thousand that were destined to be spent on admin and the consultant's holiday fund.

You will get Help :
because you are a waste of space who has never contributed a penny to the system,
and abused your body with piercings /tattoos, drugs, contracted aids through your debauched lifestyle, and you need your 5th abortion because you think it's a form of birth control...

plumseverywhere · « **Reply #12 on:** May 11, 2013, 09:04:12 am »

Quote from: tizaala on May 11, 2013, 07:12:22 am

Where will they draw the line between help/ no help ?

You will get Help :
because you are a waste of space who has never contributed a penny to the system,
and abused your body with piercings /tattoos, drugs, contracted aids through your debauched lifestyle, and you need your 5th abortion because you think it's a form of birth control...

I remember working with a consultant in opd once and a patient almost knocking him out because he refused her 4th termination of pregnancy. I think she was about 20 and the NHS 'only' funds 3 (only?!)
on the other side of the coin...my mum who lives with us saved up all her life, worked hard (several jobs cleaning, dinner lady etc) and now because of her borderline savings threshold has to pay for her own care and respite. Respite = £999 per week. She therefore can only afford one week per year...that's not really respite is it?!
sorry, I realise I've gone slightly off of topic here!! was agreeing with Tiz's sentiments about where the line gets drawn.

suziequeue · « **Reply #13 on:** May 11, 2013, 02:10:22 pm »

It's complicated..... You would think that if the NHS funded the original surgery then they should have said yes to subsequent plastic surgery at the time of the original application.

However, assuming the NHS funded his bariatric surgery (which he would have undoubtedly have met the criteria for!) - not all bariatric surgery policies will include subsequent plastic surgery. If his didn't then the excess skin would need to be considered under the aesthetic surgery policy and not the bariatric surgery policy.

In the article the comment "the NHS says Mr Mason has to have a stable weight for two years before the skin removal operations can be considered" sounds like there has already been some liaison about this intervention with his local commissioner - or maybe that's just a general thing. To me that doesn't sound unreasonable.

HOWEVER..... I think he would have grounds for exceptionality. He has lost an exceptional amount of weight.....

If he had the band put in privately then it's up to the private sector to follow through. The NHS does stick pretty closely to it's policy of not picking up the pieces of private interventions. Remember the hoo ha around the PIP breast implants??

Sorry - this is a particular hobby horse of mine.

I would be voting to fund this on an IFR panel - there's a clear case of "a stitch in time" but only once he has kept his weight stable for two years.

I think in general, dealing with the aftermath of bariatric surgery is going to become increasingly prevalent and there needs to be some policy development in the NHS in this area. My experience is that the NHS is in no mood for policy or service development at the moment