Ban on surgery for patients who are overweight or who smoke?

I've just looked up my CCG's policy on hip replacements.

It states that the following should be tried before surgery:

'NSAIDs, paracetamol, aspirin or narcotics analgesics at regular
doses during 6 months with no pain relief; weight control management if overweight, physical therapies done.'

BUT

'Advanced age and obesity (BMI 30-39.9) are not a contra-indication to surgery.'

There's a footnote about smoking:

'Patients should be aware that their smoking status may need to be determined if they are being referred to secondary care for treatment. The CCG recommends that patients are non-smoking for a minimum period of 8 weeks prior to any surgical operation taking place, especially if under general anaesthetic. Patients should be made aware that there is strong evidence that smokers are more likely to have lung, heart and infectious complications and remain in hospital longer after their operation. Support is available through the Health Promotion Team to help patients who wish to stop smoking.'

Obesity and smoking aren't an automatic bar to surgery, but doctors wouldn't be doing their job, if they didn't warn people of the dangers. It looks as though the health authority in the OP is going a step further.

How many have talked with a person eho is obese, and I do not mean a chat at the bus stop. When you hear a human being say - I have no one cares if I jumped in the river, no family, I don't want to be fat like this but when I feel so alone , I think of the food I am going to eat so don't think how unloved I am , if only for a short time it takes the pain away .

Would you say, you need more self control , make better life choices , your fat because you are a glutton

I thought this was happening anyway.

We know someone who could not have a knee operation for nearly three years because she was deemed 'overweight'. She had difficulty losing any weight because her painful knees made her practically immobile.
We know someone else who was told to stop smoking and drinking before the surgeon would operate even thought the surgery could have been considered an urgent priority.

Rationing occurs.
Old people are disposed of in one way or another.

Don't believe it doesn't happen or that it is something new.

Who did you mean by "and those who have not paid a penny into the system"? There are very few adults in the UK who have never paid a penny in tax of some sort.

Eloethan - I knew you would respond and in the tone you indeed have. Deny children and the disabled ?? Of course not. I was pretty clear who I think should pay and stand by my views. Oh yes, and I voted Leave.

It is desert on medical grounds only that is being mooted.

Well said, dd. I was just thinking how quickly the comments from many posters have polarised. The principle that it might be better, on financial grounds, to treat the person who will most benefit from a procedure, if there is a limited supply of funding, is not totally unreasonable. And that was the point at issue, not desert on moral grounds.

I agree with you, Caroline, that overeating is a form of self-harm, because people are unhappy and aren't motivated by the concept of delayed gratification.

It's ironic really that people label fat people as lacking willpower, gluttonous and with all sorts of other negative, 'naughty but nice' is an advertising slogan.

This is nothing to do with 'fault'. Doctors aren't introducing the idea of 'blame' or 'judging' - people on this thread are. It's no wonder that people are becoming defensive.

So shall we refuse to treat alcoholics,cyclists,car accident victims who were at fault, ski ers motorbikes if the cache the was their fault,rugby players,football players boxers,walkers who fall over,diyers who have accidents.The list is endless.there is an element of judgement herepeople get fat,smoke and do other self harm things because they are unhappy or it's a coping mechanism.we need to stop judging people.we can all make poor choices....

Agreed lizzypopbottle re diabetes.

Supersizers was just the name of a TV programme, Ruth. It wasn't commenting on obesity or weight issues. It was meant to be lighthearted and funny but some interesting facts came out too.

Well reasoned post Stella .

Supersizers,bariatric obese etc just means overweight and fat. Give a medical name and it gives people a 'legitimate' reason to make an excuse for over indulging ! When are we all going to be honest about this issue?

And here's another:

www.theguardian.com/lifeandstyle/2014/jun/23/truth-about-obesity-10-shocking-things-need-to-know

Stupid comment really!

Here's a link:

news.bbc.co.uk/1/hi/uk/7048763.stm

JessM I was going off evidence from a series of TV shows several years ago called, 'Supersizers go (a particular period in history)' starring Giles Coren and Sue Perkins. They followed the way of life of that period for a week, having every possible health check both before and after. Even in the 60s, their health stats all improved and they lost weight because their lifestyle was healthier. Neither of them smoked so I didn't count smoking, which anyway, is a lifestyle choice people still make today. Add in our sedentary lifestyle, poor food choices etc. and we may live longer but obesity and type 2 diabetes are increasing alarmingly.

Free at the point of use available to everyone who needed it - Nye Bevan

Well, it seems they've got their wish - everyone arguing with everyone else about who is "worthy" of treatment. It is the same method of dividing people that they use when cuts to welfare and public services are made.

As an example, Hattiehelga says "start charging health tourists and those who have not paid a penny into the system". Apart from emergency treatment, people from non-EU countries who want to access the NHS have to pay. Presumably those who haven't paid a penny into the service are either children, permanently unemployed people or people unable to work through disability or chronic illness. I certainly wouldn't deny any of these health care.

Much human behaviour carries a degree of risk, including - as anniebach said those who engage in sports, especially contact and extreme sports, and those who drive, ride motorcycles or bicycles. Being overweight is a risk factor but it is not inevitable that people who are overweight will have a bad outcome. A friend of my mum's - a lady in her early 80's - was fairly overweight when she had her hip operation. This was partly caused by the fact that her painful hip and a heart condition stopped her riding her bicycle and walking as much as she used to. However, she has recovered very well from the operation and is now able to walk more.

I agree that people with addictive behaviour - whether it be smoking, drinking, eating, etc. - should be encouraged and helped to give up their addictions but I don't think it is right that they should be denied treatment unless there is, in the unanimous opinion of the relevant doctors, a very high risk of danger to the patient or of a very poor outcome generally. I don't think cost should come into it.

Several famous and successful sportspersons have been smokers by the way. And jockeys tend to smoke to keep their weight down.

I do think that so far as weight is concerned there are some people who are just unfortunate in putting on weight very easily. (and I'm not saying that as a defence for myself - I am overweight but not significantly so). It is easy to be smug and self-congratulatory if you are one of those people for whom weight has never been a problem. I also think that these days a lot of people have a very unhealthy relationship to food - with increasing numbers of people being overweight at the same time as increasing numbers of people suffering from anorexia and bulimia. So it is a complex issue with no simple answers.

I'm not a smoker or a heavy drinker but don't you think that the taxes charged on these items must go somewhat towards the nhs costs if things go wrong?

Don't you just hate those supposed motivational words people come out with?
Too bad! Here's one ?

Willpower is like a muscle. If you don't exercise it, it gets weaker!

The only way to lose weight is to eat healthily and to cut down on what you eat and drink, it's, as simple as that. Exercise is good for us all, but doesn't help much on the weight loss front unless you're a fitness fanatic, which most of us aren't! As well as medical help, people simply have to help themselves where obesity (unless it's caused by ill health) and smoking are concerned, if they want the medical profession to help them.

Barmyoldbat you're not so barmy ? A similar thing happened to my auntie. Everyone begged her to give up smoking but she reckoned it was her only pleasure. When she was diagnosed with lung cancer she gave them up, cold turkey. They gave her a year but she was incredibly lucky because the Freeman Hospital in Newcastle gave her laser treatment and she lived another 30 years!

Complex and complicated are the most overused words in health and social care, these words mean nothing!