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Saturday, 30 June 2018

Poor women with large tattooed breasts - 11 years on

Back in May 2007 I posted a piece titled "Poor women with large tattooed breasts will have to do the best they can" which has, over the years, attracted over 3,000 hits. I guess some 2,800 googlers or more will have been disappointed. There were no illustrations. It was about non-essential NHS procedures and I wrote
Whilst I also believe that funding decisions should be made at the local level by local bodies of health professionals and citizens, rather than from the State central health bureau, I think the NHS (or rather the NHS at its local level) should be allowed the power generally to ask for top-up fees for a whole range of medical procedures; a charge that is somewhere between free and the cost of a wholly private option.

Fertility treatments, breast enlargement or reduction, tattoo removal, elective caesarians for mums too-posh-to-push, varicose vein removal, cosmetic plastic surgery, piles reduction and many other minor procedures are now seen as a 'right'. This is never what the NHS was founded for. What next? Baldness treatment for men 'psychologically damaged' by being slapheads? Buttock implants for women who see a phat booty as a 'cultural necessity'?

Of course we're all happy to get something for nothing. But I'm sure if given the choice between spending money a year's gym membership or getting our piles sorted next week, we'll go for rectal comfort. 'Unfair to the poor' I hear some say; yes, perhaps. But not life threatening. And poor women with large tattooed breasts will just have to make out the best they can.
Well, NHS England have just caught on. Eleven years late and some £2bn wasted that could have been saved had they formulated policy from our blog posts in a more timely manner.

Of course, back then hardly anyone had gender reassignment treatment on the NHS whilst now there are thousands queueing for gender dysphoria counselling and hundreds waiting to have their tackle lopped at £16k a chop. But I doubt the NHS would dare face up to the Trans lobby - at least not for another eleven years.


JohnofEnfield said...

I was very struck when I had to visit my local hospital for about six weeks by all the notices in every ward on every wall saying essentially that “you mustn’t beat up our staff”.

It took me six months to realise that the root cause of this barbarity was because the perpetrators paid nothing for their treatment & so gave no value for it or to the angels who administered it.

Dave_G said...

As much as this area of NHS 'care' needs to be addressed (and I can't fault the conclusion reached) there are other areas that are in more obvious need for reform:

drug costs - manufacturers taking the piss (sue a couple and put a stop to it)
general purchases - suppliers taking the piss (centralise it and save costs)
freeloading - ban it (demand medical insurance at point of entry)
management - cut the excessive wages (suitable employees who bid for lowest wage)
MATRONS - bring them back to CONTROL wards and expenditure

There's too much talk of throwing more and more money at the NHS - who the hell wouldn't like to run a business that could rely on having endless amounts of money thrown at it whenever it had problems?

But the overall problem with the NHS is politics.

Anonymous said...

Entirely agree Raedwald.
No one lying in the road in a pool of blood after an RTA wants to wait 2 hours for an ambulance. This should come out general taxation and be a priority as should any emergency situation. Any lifestyle type treatments should be self funding.
A recent survey I filled out was asking if treatment should be limited for smokers and alcoholics. This is entirely the wrong emphasis - where would you draw the line for self inflicted shortcomings.

Raedwald said...

Anon - interesting point. In Austria, 'leisure' casualties who are injured and need helicopter airlift (very frequent in the mountains) are charged typically about €3k for being rescued -

"People who got injured during leisure activities on a mountain, e.g. hiking, climbing or skiing, face a completely different situation. When they need air rescue, their bill won't be small. The direct billing is based on the argument that the patients voluntarily went on the mountain and are therefore responsible for the costs of their rescue."

Treatments for smokers and alcoholics (about a third of the Austrian population) on the other hand are unrestricted and fully covered.

I think they've probably got it the right way round.

Cascadian said...

The only reduction in service required should be easy to implement-those who have not paid into the NH scheme get NO treatment until a secure surety is deposited.

Then tackle frivolous claims-mostly cosmetic surgeries.

Why should granma with varicose veins who has paid into the scheme all her life be denied just to fulfil some misguided agenda.

Attlee would not have tolerated the freeloading, the NHS was never meant to be a service free to everybody who turned up. Nor was it meant to incur enormous expenses of stupid people contracting Ebola and flying home for treatment. A few well publicised deaths would help to curtail these practices enormously.

Anonymous said...

I've never suffered from either varicose veins or piles, but I hear that they are both painful.

I think the NHS should treat painful conditions, and I don't mind my taxes being spent on such treatment.

Don Cox

JS said...

"Fertility treatments, breast enlargement or reduction, tattoo removal, elective caesarians for mums too-posh-to-push, varicose vein removal, cosmetic plastic surgery, piles reduction and many other minor procedures are now seen as a 'right'. "

A mixed bag here.

Varicose Veins and piles are painful and can seriously hamper activity. Other than them being the source of humour, (mainly enjoyed by people who haven't had either condition) I don't see the justification for ruling them out if we aren't also ruling out treating any other similarly painful and incapacitating conditions.

The weight of very large breasts can cause serious back problems and great physical pain. That seems a reasonable justification for funding reductions - enlargement for cosmetic purposes, no.

Yes, there are great efficiencies that should be made and some treatments which shouldn't be funded. (Can't conceive? Adopt or learn to live with it.)
But while ever we aren't talking about ever-increasing immigration everything else is tinkering.

Raedwald said...

Whilst the NHS proposals are to cease these procedures altogether, I think my option of "a charge that is somewhere between free and the cost of a wholly private option" answers the very valid comments above.

Thus tattoo removal could be at close to full cost whilst breast reduction or vein stripping could be charged at far lower rates.

Part of the great hurdle we face with the NHS is to get their staff thinking commercially - and once they realise their own costs, it's a good start.

Health measures that improve the productivity of working people should of course be subsidised from tax.

Anonymous said...

Health tourism is a larger problem in our NHS than TPTB are prepared to admit.
Working in the NHS in London I see:

Chronic and terminally ill patients from around the globe “visiting” relatives here
and “suddenly” taken ill. They receive the best treatment and meds before returning to Africa or the Far East.

Post-op patients arriving after surgery , sometimes within 24 hours for further post op care , courtesy of a bung
to get on the plane. Stitches bursting and other post op complications. Step up mug NHS to treat.

Moonlight flit after treatment at 0200 hrs when tired nurses ,understaffing or threats of violence means they aren’t stopped or
challenged. Usually with a goody bag of meds.

This is where the money goes.

Anonymous said...

On the other hand, many of the nurses, nursing assistants and doctors who treat these freeloader in the NHS come from overseas too.

Do we have a right to poach large numbers of medical staff from other countries, and then refuse treatment to people from those countries ?

Don Cox

Anonymous said...

Not exactly poached from overseas .
Many of the Aussie Paramedics are currently here because there are very few jobs in Aus after graduation.
Do they sit on their arses waiting for a job to come up ?

Don’t conflate medical personnel from overseas doing a great job with medical parasites sucking the life blood from the NHS.

We are treating the world at the moment and word is spreading.

Dr Evil said...

Dave G got it right. This is blindingly obvious. Plus £20 for a GP appointment non refundable. that would get a tiny bit of skin in the game and stop winetasters completely.

wiggiatlarge said...

"Health tourism is a larger problem in our NHS than TPTB are prepared to admit.
Working in the NHS in London I see:"

I got the picture first hand when at St Mary's Paddington three years ago when my mother was in there and dying.

The stories from staff about Africans in particular arriving on the Heathrow Express in full knowledge they would get treatment often for serious conditions and walk out without payment even when they were rarely presented with a bill were legion.
The one where a Nigerian woman after three operations and expensive treatment was presented with a bill for many thousands of pounds and she simply laughed and walked out is I am sure not rare in that hospital from what I was told.

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