Gastric bypass refusal denying human rights?

[AndyHB]

A patient in the N. Staffs PCT area is taking the PCT's refusal to pay for a gastric bypass on the NHS to the courts, claiming that it is denying his human rights.

I am aware that, in the long-run (and not that 'long' when all is said and done), the expenses of such an operation is balanced by the savings on other health problems that the operation helps to counter.  Should NICE advice be that these operations take place much, much earlier?

[EliB]

I don't think that it's a case that "these operations" should take place sooner as all they're really doing is dealing with the symptoms of a problem and not the REAL problem, which is why the person is obese in the first place. YES, some people are in that position due to hormones etc, not always due to over-eating, but if it's a gastric band that's being talked about then that IS due to overeating and it should be examined FAR earlier WHY the person is over-eating as most of the time it's due to a psychological problem.
If the root cause was looked at then there may well be no need for gastric bands (seems to me a 'quick fix' type of op instead of dealing with the real issue!!)

As for the costs to the NHS, it's like all the treatment folk get for stopping smoking (in a lesser way) but still, wtih all the people attending smoking cessation classes and getting patches etc on the NHS (granted some pay for their own patches!!) when that is a self-inflicted situation, WHY is the NHS paying for such a situation...people CHOOSE to smoke knowing they will be addicted. It's NOT the same as drugs where some people literally take them to block out sometimes - that again goes back to the psychological problem, but smoking is different!!!!

Basically, I wouldn't support gastric band ops on the NHS.....there are other options before it gets to that stage - which would be FAR more effective (ie the band is on but the original problem still exists! Pointless!!!!!!)

As for the Human Rights issue - seriously??? This is another situation where people jump on the bandwagon of the Human Rights legislation....now if it were talking about the Human Rights of cancer sufferers who were being denied the required treatments due to the 'postcode lottery', then that's a whole different thing - but for them to bandy about HR for this is hardly the same thing! The difference being that I don't think MANY if ANY areas would sanction these ops on the NHS, so not discriminatory, whereas depending on where you live, you MAY get the right cancer treatment!

[Jan]

[EliB]

Had typed out a reply to this already but lost it all!!! 

ANYway.....I think this is a totally different situation - as you say, Jan, there are other options available for weight loss other than gastric band ops (LOTS of them!) but this is the ONE and ONLY chance this man has got of saving his sight! A committee are refusing it because there's not ENOUGH evidence to say that it works. Therefore there must be SOME evidence to say that it does....if you're facing losing your sight then you'll try anything, no matter how low the odds!
And if there IS some evidence to say that it works, then that should be sufficient. This could get taken to ridiculous degrees....unless something is 95+% going to work then we're not going to fund it!!! How many people get treatments, for all kinds of illnesses, which are administered more in hope than anything else?
This is a situation that ANY of us could find ourselves in - and that's scary!!! Not to mention unacceptable!!!

I don't know whether refusal of medical treatment falls under the actual legislation of the HR Bill (as opposed to the "that's against my human rights" chant that too many folk come out with these days!!) but it is SURELY against the principle of the NHS!

[ecuworrier]

will be interesting (in a faraway sort of way) for what comes out of this...

the op is fairly simple but the actual implications are pretty severe... there are the usual things that can go wrong during op as well as all sorts of complexities that can happen subsequently like slipped bands etc... the aftercare is very important as is the whole change in lifestyle of the patient... to adapt to the new smaller stomach space for food entry....  and what one can or can't eat... 

i have met one person who has undergone this op on the NHS ... and i was quite shocked at all the palaver... still in their case they were determined and after other options had been looked at.... in their case intensive exercise was not an immediate option due to serious injury that caused loss of movement ability and consequent comfort eating ....  deemed an appropriate patient for this course of action that at least in the medium term has hopefully been life saving and certainly has been life changing....

the gastric band is not usually the first port of call though if someone rolls up to some clinic in the private sector eg abroad it may well be

as for human right well will be interesting!

don't know what other ops come into this kind of circumstance...


GOD BLESS!

Peace and Love,

[Jan]

Therefore there must be SOME evidence to say that it does....if you're facing losing your sight then you'll try anything, no matter how low the odds!

Yes exactly. Obviously I am no specialist but I found this article which is encouraging

Improvement in visual fields in a patient with melanoma-associated retinopathy treated with intravenous immunoglobulin.

How many people get treatments, for all kinds of illnesses, which are administered more in hope than anything else?
This is a situation that ANY of us could find ourselves in - and that's scary!!! Not to mention unacceptable!!!

It is very scary indeed - and totally unacceptable.  As you say, there are treatments given in the hope that they will work. Generally they are termed as clinical trials (for treatments  such as cancer).

[EliB]

Therefore there must be SOME evidence to say that it does....if you're facing losing your sight then you'll try anything, no matter how low the odds!

Yes exactly. Obviously I am no specialist but I found this article which is encouraging

Improvement in visual fields in a patient with melanoma-associated retinopathy treated with intravenous immunoglobulin.

How many people get treatments, for all kinds of illnesses, which are administered more in hope than anything else?
This is a situation that ANY of us could find ourselves in - and that's scary!!! Not to mention unacceptable!!!

It is very scary indeed - and totally unacceptable.  As you say, there are treatments given in the hope that they will work. Generally they are termed as clinical trials (for treatments  such as cancer).

Yes, Jan, but even beyond clinical trials, many cancer treatments, for example, are administered not knowing exactly what the outcome will be. And yes, there is obviously evidence that the treatment for the eye condition works, even if just in SOME cases - THAT should be sufficient!!!

[Jan]

[EliB]

[Boudi]

if we were to lock people up and give them what they need, to simply survive and lose weight at the same time, would this be giving them their human rights or denying them ?

[AndyHB]

[Jan]

[EliB]

[AndrewF]

Jan & Eli, while I deplore it, the fact is that the NHS is cash-limited. Much as I would like it not to be the case SOMEONE does have to make decisions based on the money they have available. The money has to be used for the best benefit of the greatest number - which is not to say I would not move hell & high water to try to get it if it were me in this position, but nevertheless there IS a limit to the cash available... This is precisely why NICE was instigated.
I don't know how much evidence there is for this eye op working, but if it is experimental it does not fall within 'clinical trials' criteria to allow it for one random patient.
My suggestion would be to persuade a medical business (BUPA or or a surgeon in private practice) to do the op as a 'pro bono' in the hope of (if a private surgeon, making a name for himself and) amassing enough evidence for it to become approved so they can make a lot of money doing it for other patients!

Boudi - a very good question.... - I guess it rather depends on what level of consent is granted in the first place!

[Jan]

Andrew - I do understand what you are saying regarding cash issues (as I am sure Eli does also).

It does seem unfair however that there is 'cash' for some 'ops' or treatments and not for others and generally this can depend on location location location (postcode lottery)

http://news.bbc.co.uk/1/hi/programmes/panorama/7563701.stm

The eye op thing - I put a link on earlier with more info about the treatment.

It seems a shame that someone might only consider doing an op to help someone in order to 'make a name for himself/herself' :(