Tories discuss stripping benefits claimants who refuse treatment

[Nystagmite]

Caro - that's my concern too. The prescribed treatment may not be suitable due to other disabilities the other person has. And then there's those of us with Autism who lumped with people who have mental health issues and are sometimes offered the same treatment, which isn't appropriate for us and doesn't actually work.

[fletch70]

Lapsed

You are of course entitled to your opinion but I fear that you are misunderstanding my viewpoint. I want well run efficient public owned services . In no way am I in favour of privatisation. I am not quite sure where you got your costings from but this suggests differently http://www.kingsfund.org.uk/projects/general-election-2010/faqs. http://www.leicestercity.nhs.uk/Library/Spendingpriorities.ppt

Sadly though if you think that you will get all the cancer treatment you need regardless of cost on the NHS you are not living in the same world as I am. I refer you to treatments not recognised by NICE . Rationing in the health service is a fact and one that i do not particularly like

[citizenB]

And what do you do if you are sent for treatment at a hospital that is in special measures.. for giving poor treatment ?

[antone]

Lapsed

You are of course entitled to your opinion but I fear that you are misunderstanding my viewpoint. I want well run efficient public owned services . In no way am I in favour of privatisation. I am not quite sure where you got your costings from but this suggests differently http://www.kingsfund.org.uk/projects/general-election-2010/faqs. http://www.leicestercity.nhs.uk/Library/Spendingpriorities.ppt

Sadly though if you think that you will get all the cancer treatment you need regardless of cost on the NHS you are not living in the same world as I am. I refer you to treatments not recognised by NICE . Rationing in the health service is a fact and one that i do not particularly like

 

There is no healthcare system in the world that does not ration treatment by one means or another.

[fletch70]

Antone

I am sure you are right . I can not see anyway round it if we are to keep the health service free but it doesn't mean I have to like it. It means we are putting a value not just on a life but also on the time that life exists .

 

This thread has now gone way way off but it is interesting how different people think and what they believe .

[antone]

Antone

I am sure you are right . I can not see anyway round it if we are to keep the health service free but it doesn't mean I have to like it. It means we are putting a value not just on a life but also on the time that life exists .

 

This thread has now gone way way off but it is interesting how different people think and what they believe .

 

Yes. For example, in the US, healthcare is broadly rationed by means of ability to pay. Here, it's more on the basis of what's cost-effective. Having lived in both countries, I'll take the NHS.

 

You're correct, of course, that to some extent this system attempts to place value on the length and quality of human life. That's utterly unavoidable no matter what system is used to deliver and pay for healthcare. This is not to say, of course, that the NHS is the best possible way to do that - I suspect the systems used in France, Germany and Canada are superior in terms of outcomes. But they're nowhere near as cheap.

[worried33]

I am starting to form an opinion of the NHS that unless its blindingly obvious they are by default diagnosing people with minor conditions as a cost effective way of dealing with patients, and perhaps only looking into it more when the patient comes back again repeatedly. This also creates a nice kickback to the tablet companies as these probably get prescribed medication.

 

I read a story only yesterday, a 38 year old guy called an ambulance with chest pains and was told not to worry its a panic attack, what happened next was probably very lucky, as if it happened say 5 minutes later after the paramedic left he would likely be dead. He responded by having a cardiac arrest caused by a heart attack.

 

I cant help thinking if he was 68 would have he been told its a panic attack? diagnosis by age based on whats common?

 

I am tempted to tell doctors to "think out of the box".

[ims21]

I have removed some posts from this thread.

 

Please feel free to continue the discussion but in a civil manner.

[Lapsed Workaholic]

I can’t understand the logic by which you can form the opinion that for cost effectiveness the NHS is diagnosing people and pronouncing their condition as minor and that you should tell doctors to ‘think out of the box’ because you read somewhere what happened after a paramedic had already turned up and completed an initial check.

It seems the patient was indeed lucky and all credit to the paramedic for identifying the condition when it actually developed. I’m not sure if paramedics are qualified to the standards of a nurse, far less a doctor.

All credit to all them anyway. You won't see many BUPA types scraping bodies off motorways after accidents, or attending riots, bombings and fires.

[antone]

Mistakes are made, of course, but doctors, nurses and paramedics don't make decisions based on how much those decisions will cost the NHS. The NICE makes decisions on what treatments will be available on the NHS, but the only people who decide whether a particular person needs a particular treatment are the medical professionals involved.

[fletch70]

Antone, I would generally agree that nurses and paramedics and possibly GP's do not make decisions based on cost but I do believe that decisions are made every day by consultants and the like based on resources. Of course NICE decide if a drug can be used on the NHS but there is still variations based on the areas you live in.

 

On that subject, GP practices around here get graded on how many referrals they make, red amber and green. Green =good red=bad. Green is on lower referrals and red is higher referrals. This is to incentivise the GPs NOT to refer their patients

[worried33]

GPs are under pressure to reduce refferals, and likewise hospitals are under pressure to free up beds, there is constant budget pressures in the NHS.

[estellyn]

and likewise hospitals are under pressure to free up beds

 

Yes and no. Sadly the NHS still seems very much wedded to 'old' ways of doing things. They could free up many more beds if community based nursing was instituted for able, self caring patients, who just needed IV's and intermittent monitoring. A couple of nurses could monitor maybe 20 patients in the community, freeing up the beds and saving a lot of money. But change takes time. Half of my admissions are simply IV drugs for exacerbation or severe infection which could be managed by a community nursing service.

 

Likewise, this referral business with GP's has become stupid. It seems like some GP's barely even examine a patient. I was astonished when my husband attended a referral at the hospital for some symptoms he was having, and was just given a basic physical check and some blood tests, which could easily have been done by the GP - how much money is wasted by these type of referrals? Not to mention the referrals for off label prescribing, rather than the GP themselves looking up the med and deciding if it is appropriate - I had two appointments with a specialist for a drug that could easily have been prescribed by the GP.

 

There is a lot of waste in the NHS and I feel a lot of it is about fear of litigation and covering their backs for fear something will go wrong.

 

I also feel that part of the problem is that there seems to be no formal ongoing training program for GP's. Yes there are good GP's who try to stay up to date, and measures have been brought in recently to try to encourage it, but we're rather at the mercy of the training, experience and motivation of the individual GP. Better training leads to better care, better targeted resources and less waste.

[worried33]

Interesting experiences estellyn, seems to conflict with the information about GP's having to cap referrals to keep under budget. Is it another postcode lottery situation with different areas having different pressures?

 

A blogger (I will find the link if I can) mentioned last year she was told by her GP to go back a month later (was march) as he couldn't refer her until the next budget interval starts as they had hit the budget.

 

Likewise I have also talked to other people in waiting room's with me about their experiences, and generally people seem as frustrated as me having a hard time getting issues investigated (aka referred).

 

Then we have the above poster who seems to have discovered some kind of performance data for GP surgeries in his area with green. amber, red, to me does seem all a bit fishy.

 

Your husband's experience wasn't far of mine tho, remember I was admitted 2 weeks ago, and my GP was telling me it was having various tests done including scans, and I ended up only having a blood test, blood pressure test and ECG. It is possible your GP was expecting your husband to get more then that.

 

In my eyes better to be cautious, refer if 'any' doubt and if its waste so be it, better than people sitting at home in pain, crippled without help they need. Its one or the other as a perfect balance is a unrealistic expectation. ITs either not enough referrals or too many and I think the latter is preferable.

[worried33]

Sorry I think I understand what you mean now, you wasn't saying there is no money saving but rather there is also things that can be changed to free up resources, so it can be managed better?

[estellyn]

Sorry I think I understand what you mean now, you wasn't saying there is no money saving but rather there is also things that can be changed to free up resources, so it can be managed better?

 

Yes, that's right - less pointless referrals earlier in the financial year, and maybe people with real need would get their referrals in March. Both mine and husband's referral could have been dealt with by GP - did anyone have a delay in referrals come year end in my surgery, I don't know, but we couldn't have been the only ones referred who could have been dealt with by the GP.

 

It's poor resource management, and poor knowledge on the part of the GPs. I'm sure there are some very good GPs, but it is a lottery.

[fletch70]

The info I came up with came from an inside source, someone I would trust with my life .

GPs are placed under almost intolerable strain with 10 minute appointments . I saw mine this week who spent some time waiting for the test results to come up on the PC, nothing he could do while waiting

In my opinion another issue is how GPs are expected to defer to hospital Drs when drugs and treatment are concderned