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  Comment number287.
  Sue Doughcoup
  The NHS is not there to treat self inflicted conditions such as drink and drugs and provide other treatments such as IVF and vanity cosmetic surgery. It is about time we accepted that the NHS is there for treatment of genuine conditions not the plethora of largely avoidable conditions. These should be paid for by the individual.
  

This was a comment by a BBC viewer to an article on the NHS.

If someone is ill with lung cancer or alcoholism, should the Government pay for treatment? If the person is poor, they would of course die otherwise.

I agree with Ms Doughcoup (who surely can't really be called that!) that people who want IVF or cosmetic surgery should pay for it. If Nature, God, or whatever you like to call it, has made a couple incapable of bearing children, I don't think we mere humans should interfere. They could always adopt a child. And vanity cosmetic surgery is absolutely out.

Lots of subjects raised here.

IVF and fertility treatment - I have a very low sperm count. Not so low that I cannot father children - I have two daughters - but low. My first wife's sister's husband had a lower SC than me and they do not have children. They have seemed quite happy in that, but I know of other couples who would move heaven and earth to have a sprog or several. Such conditions are not known often when couples get married, so should this be regarded as 'self-inflicted'?

What about people with a BMI over 30 (say)? I would say that that is mostly self-inflicted, but sometimes the treatment of other illnesses involves steriod treatment, for instance. Which will put on weight.

I would still treat most of these people, but not for free. Obese people, smokers, excessive drinkers, all should be charged for their treatment if it is a treatment related to their self-abuse. Not if it's a broken leg or whatever.

Which brings me to the next point - I played a lot of rugby - broke my collarbone twice on one side, once on the other - cracked my ribs a couple of times. Also was a racing cyclist - came off on a nasty lot of grit at the bottom of a hill in Swindon. Had to have a lot of time picking the grit out of my legs, arms and bum. Also lots of antibiotics. Are these self-inflicted? I needn't have played sports, or not played hard enough to injure myself.

There would have to be a large book of rules for an assessment as to whether it's a free treatment or a pay up-front thingy.

I would say cosmetic surgery, no. IVF, no. Drug OD, yes. Alcoholism, yes. Lung cancer, yes. Obesity related diabetes, yes.

Next ...

If a country has universal healthcare, I agree with Jingthing on this one. Drinking, smoking and eating are all legal activities.

If a country has universal healthcare, I agree with Jingthing on this one. Drinking, smoking and eating are all legal activities.

It is a slippery slope. What about STDs? That could be self-inflicted - no, I don't that way, I mean by not using condoms, etc.

Clearly sports-related injuries are not self-inflicted. If you took that line, you'd soon reach a state where you hardly dared go out-of-doors. Also, where there is an accident, the medical services will, and should, jump into action irrespective of the cause.

IVF I find a more difficult one. The health services pay to stop people having children (contraceptives, condoms, abortions, vasectomies); should they pay to help people have children? This becomes largely a political decision. Where the birth rate has fallen below replacement rate, as it has in Japan, much of Europe and, I think, Thailand, the country wants to increase births to correct the population imbalance. Japan, for example, is facing serious potential problems with a rapidly-ageing population, and insufficient people of working age to generate the money to look after the old people.

Yes, alcohol and tobacco are legal (in most countries), so is food! But tobacco even in modest qualities poses a health risk, whereas alcohol and food don't. Should people who over-indulge in either not have to pay for the health expense that causes? (Perhaps we'd better leave obesity out of this discussion; we did it to death in another thread not so long ago).

I think I'm right in saying that the NHS in UK does pay for IVF and for vanity cosmetic surgery.

For certain birth defects where cosmetic surgery can save a child from growing up an outcast I think cosmetic surgery should be covered, but that is only in extreme cases.

For certain birth defects where cosmetic surgery can save a child from growing up an outcast I think cosmetic surgery should be covered, but that is only in extreme cases.

So the surgery was done outside of this but the patient had complications, should the tax payer stump up the bill?

I would say yes so long as a concerted effort was being made to stop the situation from recurring in the future. This could be easily be cross threaded with the attacks on US interests overseas, Both Libya and Egypt have have been given freedom yet chose to not want it. Should others feed support to take care of those afflicted as a result of this choise? I say no.

For certain birth defects where cosmetic surgery can save a child from growing up an outcast I think cosmetic surgery should be covered, but that is only in extreme cases.

This is not vanity cosmetic surgery. Obviously things like harelips, cleft palates are not covered by this topic.

Notmyself, I'm sorry but I have absolutely no idea what you're talking about; could you please explain?

Notmyself, I'm sorry but I have absolutely no idea what you're talking about; could you please explain?

If people get in to trouble doing an unnecessary procedure outside of the NHS (UK) they should be given treatment (from NHS) but an awareness canpaign should also be undertaken to reduce the chances of it happening again.

Let us just say you are sitting on a red hot steel bar and you say it hurts. How many times should I or we offer you pain killers before we demand you just stand up?

There is no free "vanity" cosmetic surgery in the UK.

Not even sure what you mean? Facelifts, breast augmentation? No chance on the NHS.

Notmyself, I'm sorry but I have absolutely no idea what you're talking about; could you please explain?

If people get in to trouble doing an unnecessary procedure outside of the NHS (UK) they should be given treatment (from NHS) but an awareness canpaign should also be undertaken to reduce the chances of it happening again.

Let us just say you are sitting on a red hot steel bar and you say it hurts. How many times should I or we offer you pain killers before we demand you just stand up?

Thanks. I got that bit; it was the second paragraph which had me stymied.

There is no free "vanity" cosmetic surgery in the UK.

Not even sure what you mean? Facelifts, breast augmentation? No chance on the NHS.

Glad to hear it!

Clearly sports-related injuries are not self-inflicted.

I disagree with this. Sports injuries are completely self-inflicted.

Clearly sports-related injuries are not self-inflicted.

I disagree with this. Sports injuries are completely self-inflicted.

I'd rather treat sports injuries than take part in gastric banding operations.

Participation in sports is directly tied to physical fitness and probably has greater positive effects on health than negative ones so I think the injuries treated are an acceptable cost.

Participation in sports is directly tied to physical fitness and probably has greater positive effects on health than negative ones so I think the injuries treated are an acceptable cost.

I have no opinion either way on sports injuries per se but claiming that they're not self inflicted is wrong.

Participation in sports is directly tied to physical fitness and probably has greater positive effects on health than negative ones so I think the injuries treated are an acceptable cost.

I have no opinion either way on sports injuries per se but claiming that they're not self inflicted is wrong.

They're no more self-inflicted than those you get through taking a fall in the bathroom. Life cannot come to a full stop for fear of injury!

Just a question, as I head off to Udorn Immigration...

Does the NHS pay for circumcisions?

Does the NHS pay for circumcisions?

A few PCTs do (for religious reasons) but for the most part no. This is another example of why we cannot have freedom FROM religion alongside freedom OF religion. There is nothing ligically wrong with both being able to exist alongside each other yet they cannot... Why is that do you think?

Religion propagates by way of force, this could be via the inculcation of children or via the sword. It cannot continue to exist on a mass scale unless it has some means to do so and given it is 'faith' (belief for no logical reason) it cannot use reason to propagate. Person 'x' can believe what they want and I have no problem, if they expect me to respect the actual view rather than their right to have it then no.

To get back fully on topic, if someone is injured doing something stupid then they should be treated by the NHS but if they are informed repeatedly that they should not do it but continue then fuc_k you. Within the context you mentioned a consideration should also be taken into account, that being that ALL operations no matter how slight carry a risk. There is no 100% when it comes to surgery so though some people may want someone to blame if things go wrong it could be the surgery itself which was to blame. Someone chooses elective surgery on a minor which results in the said minor dying then the chances are (mostly in the UK) I'm involved at some level.