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Medical treatment to be
denied to certain groups
Malcolm B, Truro

I have been following reports from the National Institute for Health & Clinical Excellence which are pointing to Doctors being able to make decisions as to whether or not certain groups of patients should receive treatment. Here the proposals make no divide between rich and poor, or age or gender. They simply revolve around the fact that those patients suffering from complaints that they have inflicted upon themselves by smoking, drinking heavily, abusing drugs, and over-eating should be denied treatment unless they can prove that they are actively engaged in seeking to change their destructive habits.

Put simply why should a heavy smoker expect to receive a treatment like heart bypass surgery when it is a fact that the chances of success are severely compromised if the patient continues to smoke. The risks of smoking are well known and there is no justification for the feigning of ignorance. I would gladly see cigarettes quadruple in price and their sale be much more restricted for the taxes raised on tobacco products do not go anywhere close to the costs of treating smokers various self-inflicted ailments or the health problems they inflict on others around them.

In the same vein, why should the morbidly obese expect any treatment at all save for those procedures that will ensure that they lose enough weight to resume a healthy life ? Knee and hip replacements should be reserved for those who wish to maintain an active life, not for those whose lack of self control and exercise has led to the destruction of their joints. Yes, obesity is one of the scourges of our age and yes, in some cases there is a medical reason for it. But for the most part, Doctors agree it is the result of sheer inertia, pure greed and low self esteem. Let us not forget though that as many as one in three obese individuals will develop type 2 diabetes and put further strain on health care resources. Sadly also that the numbers of obese children and teenagers are rising all the time due to poor parental supervision and lack of proper diet and exercise.

The same rule over access to healthy care must be applied to the alcoholic who blithely continues to drink in the certain knowledge that to do so will result in permanent and irreversible liver damage. Liver transplants are known to be of limited effectiveness in alcoholics and this complex surgery should be reserved for genuinely sick patients.

The recent brouhaha and glorification surrounding George Best’s final days and eventual death may well have served a positive purpose in broadcasting the message that alcoholism kills, fuels violent and irrational behaviour, and destroys the lives of the alcoholic’s family. Without the infamy what was this person ? Simply another hopeless alcoholic who had no regard whatever for the efforts of the surgeons, doctors, counsellors and friends who tried to help him to overcome his addiction. In short a complete waste of space, time, effort and money. It matters not whether the surgery and hospital care that this person received was funded from his own resources or by the NHS ….. it was a criminal waste that could and should have been diverted to more deserving recipients.

As you will have gathered, I am completely in favour of allowing our medical professionals to make decisions that ensure that self destructive individuals who are unwilling to help themselves go to the bottom of the waiting list. I’d also like to see age discrimination completely phased out as there is more logic to me in giving good healthcare to the older generation to enable them to continue to live fulfilled, pain free lives. And I’d much prefer to see the money I contribute to the health service via income tax and NIC deductions (and the various stealth taxes) spent on improving the quality of life for those of all ages and backgrounds that value, deserve and have respect for the treatment they receive.