Monday, August 29, 2011

This Is The True Face Of The Tory NHS Reforms

 I warn you not to be disabled; I warn you not to be female: I warn you not to be Young; I warn you not to be Old; I warn you not to be unemployed;

All these groups  now find themselves discriminated against when  it comes to being treated fairly in Tory Britain in 2011.

However, I now also warn you not to smoke; I warn you not to drink; I warn you not to be overweight;  In a little known or reported policy "initiative" GPs are now acting more like health fascists than doctors and this is only part of the most unpleasant face of what the Tories are doing to the NHS and it is still happening under our very noses.
GPs have signed off a series of sweeping referral restrictions by NHS managers that will bar smokers and overweight patients from being referred for surgery, as PCTs across the country bring in new cost-saving restrictions

Doctors from 50 GP practices in Hertfordshire providing care to 450,000 patients have agreed to block those who smoke or have a BMI of more than 30 from being referred for routine hip or knee replacement surgery, without first being referred to a weight management or smoking cessation scheme.

Treatments being limited are those to deal with cataracts and acne scarring, scans to detect osteoporotic bone fractures and treatment for obstructive sleep apnoea. Perhaps someone could explain why cataracts and those unfortunate enough to be scarred by acne are being termed as low priority on the same list as the "overweight smoking drinker"? So if you are fat, spotty, blind and drink, just crawl away and hide somewhere, because the Tories and Dr Kostick now say you cannot be treated on the NHS (the NHS you have probably paid into by the way!) Is this Dr Kostick truly serious when he suggest that those (usually women) who suffer from bone injuries due to osteoporosis, should not be diagnosed and hence not be treated? That they should be forced to live with excruciatingly painful fractures and that they should be left to heal themselves and all the inherent dangers to the patient this would mean, just because the person is overweight? And may only be overweight because they have seriously restricted mobility due to their osteoporosis? What kind of world is Dr Kostick residing in and what kind of world does he want us to live in? 

The restriction, introduced in May, is to be extended to all routine surgery over the next few months. Similar moves to ration care are being debated by family doctors across the country, in fulfilment of Health Secretary Andrew Lansley's plan to move the bulk of the NHS budget from managers, who don't spend resources, to GPs, who do.

This is exactly what campaigners have been warning against. Which group will next be discriminated against? Perhaps the elderly because they are old? After all they are a soft target, many are frail and can hardly fight back. Why not stop treating children because being a child means that you are likely to pick up childhood diseases. It is ludicrous, Dr Kostick is ludicrous.

Commissioning GPs will be working to a finite budget so some will discover in order to enforce the budget constraints they will be unable to treat everyone on their list, so being forced because of lack of funding to restricting the number of people they can treat could become the norm. I believe this is very likely to be one of the biggest problems  facing GPs when they are forced to take up commissioning yet it has hardly been touched upon! But here we can clearly see how it is already starting to take shape under Kostick's implementations. Very soon GPs will have no choice but to ration the number of people they are *able* to treat who fall into certain categories and they are likely to be the elderly, disabled, or those who drink, smoke or are overweight,  in fact practicing it is already in practice in Hertfordshire and the practice is spreading to other parts of the country. We are shortly going to see certain "patient groups" of people without a regular GP, they will probably be able to be seen as emergencies, but will not be able to find themselves a regular GP and this will be down purely to funding issues. So people will be forced to go from doctor to doctor in order to get their medication or be seen, they will have no continuity of care which is so vitally important.

 GPs should be acting as advocates for their patients, not as rationers of NHS service. The NHS was founded to be delivered "free at the point of need", Why are GPs who are in effect *private* businesses being allowed to ration treatment on the NHS when the NHS is not a private concern? (Not yet anyway!)
By being selective and  rationing treatment and in certain cases denying treatment altogether is in fact discriminating against certain groups of people, who some GPs say cannot be treated judged on the basis of their "apparent" lifestyle choices! Surely this undermines the whole ethos of the NHS? This not only appears "unethical" it also appears "illegal", doctors may very well be healthcare practitioners however,  this does not give them the right to sit in judgement over who can and cannot be treated, The question has to be asked why GPs are being allowed and encouraged by the Conservative government reforms to sit in judgement over who can and who cannot receive treatment?

Dr Tony Kostick, chair of the north east Hertfordshire clinical commissioning group,(new consortium) said: "This is about GPs accepting a greater gatekeeping role. The NHS spends a fortune on treatments of limited clinical value. We trawled through the evidence and found outcomes were poorer for smokers and the obese. They are in hospital longer, have more complications, more post-operative infections and do less well." Limited value to who? Dr Kostick or the patient who was in pain and is now out of pain thanks to surgical intervention? This is a prime example of a doctor looking at someone, not as an individual patient but as a walking talking £ sign! this is where the rot sets into the NHS and from where it will start its journey to the point of no return and full-scale privatisation.
Dr Kostick continued: "We are trying to get GPs to understand that if we spend money on one patient, that money is not available to spend on the next. If an obese patient loses weight they may not need surgery. We are not saying no to anybody but there are things you can do for yourself which will make you healthier before you have treatment. That is rationing but on the basis of the best clinical practice."  As I explained above, best practice for who? The patient or Dr Kostick?

However, who is Tony Kostick to make that decision? Who invested in him the as a private business the power to weild over the will of the people? He should remember he is a doctor, he is not God! However, what does one expect from a Government lackey who thinks that competition in the health service is a good thing? It is obvious that Kostick is a proponent of the government's reforms of the NHS and if this is what is going to come from them and they have doctors like Kostick prepared to do their dirty work for them, then the NHS is in very serious trouble.

However, Dr Mike Ingram, a member of the county’s local medical committee, said: “I’m very worried about denying people care on the basis they are fat.

Worried Dr Mike Ingram should be because if this is allowed to go unchallenged then where will it all end?  Fitness fanatics and sporting enthusiasts follow dangerous pursuits, they climb, they race bikes and cars, they white water raft, they run over extreme terrains. Children climb, they ride bikes, they do scary things on off-road bikes and their skate boards, they roller-blade etc, are we to deny all these people treatment if they become injured doing something they knew could injure them?

The obese, smokers and drinkers are not the only ones to use the NHS, no doubt all these groups also pay into the NHS, who is Dr Kostick to say they cannot be treated?

I have no doubt that Dr Kostick is a doctor because he wants to help people however, this is a classic example of one GP helping to spread inequality in healthcare throughout an entire region and also to opening it up to private practice. Patients desperate to control their weight, or stop smoking or drinking in order to have NHS surgery may feel they have little choice but to turn to expensive alternate therapies like "Hypnotherapy". I am not going to advertise for them, but I know of several hypnotherapy practices that has used Dr Kostick's policies and words to attach their practices to them so they come up in searches, this is unscrupulous behaviour. it is the kind of behaviour that can only increase as measures implemented by Dr Tony Kostick and his ilk become more frequent. It is becoming beyond ridiculous when doctors like this are allowed to foist their prejudices onto their patients when their patients are at their most vulnerable, ridiculous and dangerous to health and to a decent society. I say this a non smoking and non drinking former health care practitioner so my opinions are completely unprejudiced.

These kind of decisions may go down well in the Telegraph and Basket cases Sun, Express and Mail newspapers or in the shires or between the "chattering classes" in the "Chipping Norton set", but they are wholly impracticable and open to legal challenge in the real world.

This is but one example, but people need to wake up, this is now happening all over this country, people are being cast out of healthcare. The Tories so called "listening exercise" was nothing but a big sham, privatisation of our NHS is still happening at pace.

Health secretary, Andrew Lansley is hiring a special team of spin doctors to spin his reforms to the public in a favourable light and people need to be aware of this because this conservative government is not going to stop until it sees the NHS privatised!


DavidG said...

As many disabilities, and treatments for disability, have obesity as a side-effect, it's entirely possible any doctor applying this policy could be guilty of disability discrimination under the Equality Act, 2010.

Gracie Samuels said...

Thank you David. It looks very much like we are going to have to fight on all fronts.

Carol Laidlaw said...
This comment has been removed by a blog administrator.
Gracie Samuels said...

Sorry Carol, I can't allow posts like that. I am not sure why if you offer such a service that it has to be for donations of any kind, if people are on benefits they are hardly likely to be flush with cash. Of course you are probably genuine and above board but the onus is on me to protect my readers and I make a point of not entering into anything that involves money, even in the form of donations.

Lucy said...

Thank you for such an informative post.

This kind of exclusion has been going on for years and years. You will find examples of people being refused badly needed operations/treatments for any number of excuses, the ones you have listed and including - "you are too old" This happened to my Mum (she died) It has happened to me. Currently our GP practice will only make referrals to the Mental Health Team if a person is in need of a section or is going through a severe crisis where they may harm another person. Currently I am having to rely on a charity for therapy, which I have to pay for myself. Luckily the counsellers are highly qualified and specialists in the field. Others aren't so lucky. I see a future where only the insured and the well will be able to find a GP.

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