# At long last



## A3DFU (May 7, 2002)

something is starting to move!!

_28 Nov 2005

Heavy drinkers, smokers and obese people could be denied hospital treatment

The chair of the National Institute for Health and Clinical Excellence (NICE), Sir Michael Rawlins, has said that doctors could be issued with new guidance permitting them to refuse to treat patients with illnesses deemed to be â€˜self-inflictedâ€™.

Heavy drinkers, smokers and the obese could be denied treatment but there is also concern that the definition of self-inflicted illness could stretch to conditions such as sport injuries if not clearly outlined.

Speaking to The Sunday Times, Sir Michael said that the new NICE guidance would ensure that the limited National Health Service (NHS) budget was well spent.

Using alcoholics as an example, Sir Michael said that NICEâ€™s new social value judgements would make it clear that, if a patient continued to drink, they would not be given a liver transplant as it would not be â€œa sensible use of resourcesâ€. He further asserted that this would not be punishing alcoholics, rather that it was â€œpointless spending all that money and using a liver that could be used for someone elseâ€.

NICE, which merged with the Health Development Agency earlier this year and exists to provide national guidance on promoting good health and treating illness, published a draft set of code guidelines in September.

According to the draft, care cannot be withheld simply on the grounds that a condition is self-inflicted. The draft states: â€œNICE and its advisory bodies should avoid denying care to patients with conditions that are, or may be, self-inflicted. If, however, self-inflicted cause(s) of the condition influence the clinical or cost effectiveness of the use as an intervention, it may be appropriate to take this into account.â€

The draft of the report is due to be debated next week while the final NICE report should be published within a couple of weeks. Today, NICE would not comment further on Sir Michaelâ€™s interview and declined to offer any further information about self-inflicted illness guidelines.

Sir Michaelâ€™s comments follow last weekâ€™s announcement by the East Suffolk Primary Care Trust (PCT) that obese patients would be no longer be able to have knee and hip replacement operations on the NHS. Consultants and GPs agreed not to refer anyone with a body mass index of more than 30 to a specialist until they have lost weight.

According to a recent poll of more than 400 doctors by Doctors.net.uk, one in five doctors admitted that he or she has already denied patients treatment because they are obese, smoke or drink heavily. Details: www.nice.org.uk or www.patients-association.org.uk_

Source: Register of Exercise Professionals, today's news letter


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## R6B TT (Feb 25, 2003)

Dani,

I'm very surprised at you! Alcoholism is an illness, which can be treated. If treatment has been given but the subject chooses to continue drinking to excess then I can see the point (George Best for example) but many of those suffering are less fortunate that you and I and don't have ready access to the same resources - and the last thing I want to see is a 2 or 3 tier health service.

Smokers and Alcoholics probably contribute far more in tax proportionally than those who don't.

Yours, not an alcoholic but enjoy a drink and a smoker - but with 17% Body Fat and an increase in lean mass of 1.2 kg according to my test today


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## saint (Dec 6, 2002)

It's also last weeks news & nothing of a surprise either - it's not new!


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## Private Prozac (Jul 7, 2003)

So, as a smoker, will I have to pay less National Insurance then so that I can buy more **** to enjoy? I bloody doubt it!

And I can sleep easier at night knowing that my money is going towards all those obcessive 'sporty types' who clog up hospital waiting rooms with their injuries from pursuing the sports they enjoy!


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## YELLOW_TT (Feb 25, 2004)

so will any one who takes part in a track day or rides a motor cycle be classed as putting them self at risk and denied treatment 
I think that the amount of tax paid by people who smoke (by the way i don't) and drink will out way what the NHS spends on them and what if all these people stopped smoking and drinking and lived an extra 10/20/30 years the goverment would have an even bigger pension problem on there hands


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## coupe-sport (May 7, 2002)

> so will any one who takes part in a track day or rides a motor cycle be classed as putting them self at risk and denied treatment


 :roll: - sports injuries not accidents - unless you suffered RSI from excessive gear changing...


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## saint (Dec 6, 2002)

same sort of thing applies to those without kids - still pay for education.... still pay for child support payments etc etc...


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## YELLOW_TT (Feb 25, 2004)

coupe-sport said:


> > so will any one who takes part in a track day or rides a motor cycle be classed as putting them self at risk and denied treatment
> 
> 
> :roll: - sports injuries not accidents - unless you suffered RSI from excessive gear changing...


but as with smoking or drinking when you go out on a track day or motor bike you are put yourself at unnessesary risk :!: don't get me wrong I am all for track days motor bikes


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## Hannibal (Dec 1, 2003)

Why not just privatise the NHS, then you could choose to do dangerous things and just pay for it when it goes tits up.

H


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## phodge (Sep 1, 2002)

saint said:


> same sort of thing applies to those without kids - still pay for education.... still pay for child support payments etc etc...


But don't we DINKYs pay for education so the little darlings have somewhere to be rather than be out burgling our houses while we hard working taxpayers are out contributing to the economy?


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## Dr_Parmar (May 10, 2002)

oooh pandoras box..

those NICE guidelines are bloody rubbish anyway!


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## Hannibal (Dec 1, 2003)

Dr_Parmar said:


> oooh pandoras box..
> 
> those NICE guidelines are bloody rubbish anyway!


LoL....aren't they there to be ignored when it suits and quoted at the management when you want a new toy 

H


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## garyc (May 7, 2002)

And why not also refuse maternity care to single mothers who can't seem to stop breeding excessively while we are at it?

NHS is about cradle to grave health care for all, NOT the making of moral decisions on whom gets what treatments by either the adminstrators of the public service or the highly paid consultants who all do so well out of it. Public servants should remember exactly who they are AND that they are there to serve - like it or not. :x

The collective reponsibility for public health lies with the Government, and the individual responsibility lies with all of us.


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## Private Prozac (Jul 7, 2003)

I bet you're glad you started this one now aren't you Dani!!!


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## jampott (Sep 6, 2003)

All fat people should be locked up and made to lose weight.


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## genocidalduck (May 19, 2005)

I think ive payed the government enough from cigarettes to pay for any smoking related illnesses i need treated for.

TBH i wonder if its about time the NHS should be abolished. Except for those that can't afford private medical care.....But then no government would have the balls to do that asit would be political suicide.


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## phodge (Sep 1, 2002)

jampott said:


> All fat people should be locked up and made to lose weight.


You'd better build some more prisons then as you won't have enough room to get many in a cell sharing with me! :wink:


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## Private Prozac (Jul 7, 2003)

jampott said:


> All fat people should be locked up and made to lose weight.


Off you go then Jam Pot!! :wink:


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## genocidalduck (May 19, 2005)

auditt260bhp said:


> jampott said:
> 
> 
> > All fat people should be locked up and made to lose weight.
> ...


Do they have supersize cells :wink:


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## A3DFU (May 7, 2002)

Hannibal said:


> Why not just privatise the NHS, then you could choose to do dangerous things and just pay for it when it goes tits up.
> 
> H


Sounds like a good idea



auditt260bhp said:


> I bet you're glad you started this one now aren't you Dani!!!


Yup. I like a healthy debate 



jampott said:


> All fat people should be locked up and made to lose weight.


my idea is to have a set of scales in front of every restaurant and, if a person is too heavy for his/her height they will be turned away :wink:


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## ADB (May 7, 2002)

> Alcoholism is an illness, which can be treated


Erm, yes by stopping drinking? It kills me that alcholism is classed as an illness - FFS do people have no willpower?

Why isn't this in the Flame Room yet????


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## genocidalduck (May 19, 2005)

ADB said:


> > Alcoholism is an illness, which can be treated
> 
> 
> Erm, yes by stopping drinking? It kills me that alcholism is classed as an illness - FFS do people have no willpower?
> ...


It's easy just to say willpower but it isnt as simple as that....There are alot of other battles to be won. I'm a stubborn ass b'stard but i was caught up with an addiction which i couldnt believe i got myself into and no matter how much i tried to stop i couldnt....Eventually i got myself off it but there were reasons why and it wasnt just down to willpower alone.


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## YELLOW_TT (Feb 25, 2004)

I am trying a new diet you can eat any thing you like but you have to eat in naked in front of a mirror
It is working well I have been chucked out of Mc Donalds 5 times so far :lol: :lol:


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## genocidalduck (May 19, 2005)

YELLOW_TT said:


> I am tyrying a new diet you can eat any thing you like but you have to eat in naked in front of a mirror
> It is working well I have been chucked out of Mc Donalds 5 times so far :lol: :lol:


I'd chuck you even if you was fully clothed


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## YELLOW_TT (Feb 25, 2004)

genocidalduck said:


> YELLOW_TT said:
> 
> 
> > I am tyrying a new diet you can eat any thing you like but you have to eat in naked in front of a mirror
> ...


 :-* you wish :wink:


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## saint (Dec 6, 2002)

ADB said:


> > Alcoholism is an illness, which can be treated
> 
> 
> Erm, yes by stopping drinking? It kills me that alcholism is classed as an illness - FFS do people have no willpower?
> ...


You obviously have no experience of alcoholism and therefore should not even enter this debate.


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## ADB (May 7, 2002)

saint said:


> ADB said:
> 
> 
> > > Alcoholism is an illness, which can be treated
> ...


Sorry but you are wrong there - I have been very close to people who have had this 'alleged' disease; one who died recently. Although friends, in my view these were weak people who knew what they were doing but didn't have the willpower to stop and look.
I am sure it will offend but there are a lot of people who share the same view about drug addicts and smokers?

This should really be in the Flame Room :?

Andy


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## Hannibal (Dec 1, 2003)

saint said:


> ADB said:
> 
> 
> > > Alcoholism is an illness, which can be treated
> ...


Being Scottish, you would.....or is that just a sweeping generalisation?!?!

H


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## saint (Dec 6, 2002)

Hrmmm nationallity - being Scottish means I was born in Scotland - don't see your point - unless of course it's the usual narrow minded stereotypical view.

Any hoo.... I'm sure I'll think of something to say once I've sobered up.



> You obviously have no experience of alcoholism and therefore should not even enter this debate.


Maybe I should have worded that statement as " ..... don't have an understanding...."

Being a drinker is not a disease - suffering from the effect of prolonged drinking and being alcohol dependant IS!!


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## vernan (May 27, 2002)

I had that Patricia Hewitt in the back of my cab once. And another thing .....


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## saint (Dec 6, 2002)

vernan said:


> I had that Patricia Hewitt in the back of my cab once. And another thing .....


ooooooo scandal.... sell your story to the papers!!!

PS - was she any good?


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## Hannibal (Dec 1, 2003)

saint said:


> Hrmmm nationallity - being Scottish means I was born in Scotland - don't see your point - unless of course it's the usual narrow minded stereotypical view.


Perhaps you'd like to read the Scottish Executive's view on the subject...



> Scottish men and women are more likely to have drunk more than twice the recommended daily benchmarks than those in England. Men living in Scotland were more likely than those living in England to have consumed more than eight units of alcohol on at least one day the previous week (24% compared with 20%). Similarly, women in Scotland were more likely to have consumed more than six units on any one day during the previous week (12% compared with 8%).
> [General Household Survey 1998, ONS]


so you guessed right it was the usual narrow minded stereotypical view ...

H


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## saint (Dec 6, 2002)

Hannibal said:


> saint said:
> 
> 
> > Hrmmm nationallity - being Scottish means I was born in Scotland - don't see your point - unless of course it's the usual narrow minded stereotypical view.
> ...


Atleast give me the choice...... shame it's a bit out of date - am sure the "Unofficial Non-Driving TTOC" have contributed enough to have increased these figures. Still means nothing though - does drinking more than the recommended daily ammount mean that you are an alcoholic?
Also going by the figures it seems slanted to "binge drinkers".


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## TTotal (Aug 12, 2002)

ADB said:


> saint said:
> 
> 
> > ADB said:
> ...


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## genocidalduck (May 19, 2005)

vernan said:


> I had that Patricia Hewitt in the back of my cab once. And another thing .....


  Another cab driver..........And there was me thinking i was the only one on the Forum.

Looks like TT's drivers are Hairdressers, Estate agents and Cabbies


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## TTotal (Aug 12, 2002)

And old gits who sell advertising :?


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## YELLOW_TT (Feb 25, 2004)

TTotal said:


> And old gits who sell advertising :?


And people who make drugs  legal drugs I might add


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## Hannibal (Dec 1, 2003)

saint said:


> Still means nothing though - does drinking more than the recommended daily ammount mean that you are an alcoholic?


I belive the defintition of an alcoholic is someone who drinks more than their doctor.... :wink:

H


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## A3DFU (May 7, 2002)

Hannibal said:


> saint said:
> 
> 
> > Still means nothing though - does drinking more than the recommended daily ammount mean that you are an alcoholic?
> ...


 :lol: :lol: :lol:


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## saint (Dec 6, 2002)

Hannibal said:


> saint said:
> 
> 
> > Still means nothing though - does drinking more than the recommended daily ammount mean that you are an alcoholic?
> ...


lol


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## YELLOW_TT (Feb 25, 2004)

Hannibal said:


> saint said:
> 
> 
> > Still means nothing though - does drinking more than the recommended daily ammount mean that you are an alcoholic?
> ...


  Is it possible to drink more than your doctor


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## TTotal (Aug 12, 2002)

YELLOW_TT said:


> Hannibal said:
> 
> 
> > saint said:
> ...


Not in my case :roll:


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## jampott (Sep 6, 2003)

TTotal said:


> YELLOW_TT said:
> 
> 
> > Hannibal said:
> ...


I didn't know Oliver Reed was a qualified medical professional?


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## TTotal (Aug 12, 2002)

jampott said:


> TTotal said:
> 
> 
> > YELLOW_TT said:
> ...


Thought he'd popped his clogs...


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## Hannibal (Dec 1, 2003)

jampott said:


> TTotal said:
> 
> 
> > YELLOW_TT said:
> ...


I believe he was an amateur gyneacologist...

H


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