Bubbsie
Well-Known Member
- Relationship to Diabetes
- Type 2
Well said Jangles...should never be about blame irrespective of the condition...yes...she was a powerful advocate for the patient.
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Obesity: How prejudiced is the NHS? - BBC2, 9pm 11/4/2017
- Thread starter Northerner
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Amigo
Well-Known Member
- Relationship to Diabetes
- Type 2
Spot on Bubbsie. In times of financial shortage, people look for scapegoats and move into judgmental mode to drive and legitimate their decisions. Clinical risks are one thing but I've seen first hand how the elderly, vulnerable and powerless lose out without sound advocates. It's not just a fat issue you're right.
When my very elderly mum was taken to hospital, the doctor wanted to simply send her home the next day with no investigations or treatment. I've even heard the expression, 'they only have a bed to chair existence'. I rang the Ward and asked to be advised of all the tests they'd carried out and the clinical care plan. Amazingly the doctor changed his mind and kept her in for another 4 days which uncovered a serious problem they resolved!
On the subject of Bariatric surgery, it can be risky and lead to long term complications and I've seen people regain weight because it doesn't educate or change the mindset or issues that cause overeating. Nor does it educate but the NHS seem very outdated in their advice.
Bubbsie
Well-Known Member
- Relationship to Diabetes
- Type 2
Amigo unbelievably sad anyone would categorise another in those terms... 'they only have a bed to chair existence'...not entirely sure what that would mean in the context of a doctor/patient relationship...possibly no time or care invested in them...no more treatment...no social interaction...not worth the time...or the cost...incredulous a professional ( I assume it was a professional...use the term advisedly) would utter those words...thank goodness you were there to support your mother...no coincidence the doctor changed his mind once you'd asked for the clinical care plan...I do wonder what would have happened if you hadn't intervened...doesn't bear thinking about...does it?...like you I strongly believe it's not just about the fat/obese issue...where certain groups are identified as being too costly to be cared for adequately (or its felt its their own fault)...is it sheer chance...these are usually the most elderly...vulnerable...socially & economically deprived members of our communities?...I somehow doubt it.
mikeyB
Well-Known Member
- Relationship to Diabetes
- Type 1
I've just finished watching this programme, and there are three things that I took away from it.
Firstly, the gut hormone changes that occur with this form of surgery in contrast with simple gastric banding, which change the physical desire for food, so there is far less chance of relapse. This is a clear benefit to those who have it, and it is a clear cost benefit to the NHS with the reduction of future illnesses. Of that there is no doubt.
Secondly, it is the pernicious effect of CCGs that is rationing these treatments. These CCGs are an unnecessary and costly intervention in the passage of money to local health services. They don't exist in Scotland. This is a money thing. Preventing future health expenditure does not seem to drive cost benefit analysis in NHS England.
Finally, the one thing that was brushed aside, as in not mentioned at all, is that a completely redundant stomach remains sitting in the abdomen, where it can quietly grow a cancer to a completely inoperable stage without any symptoms whatsoever. It's not a common cancer - 7000 diagnosed every year, and symptoms are vague even in normal people- chronic dyspepsia, nausea, etc. so it often presents late in any event. This bariatric surgery makes sure it presents late and terminal. That'll lose weight even quicker.
Sorry to end on a downer, I thought this programme was very non-judgemental, didn't hammer the Diabetes thing, and made its points well.
Firstly, the gut hormone changes that occur with this form of surgery in contrast with simple gastric banding, which change the physical desire for food, so there is far less chance of relapse. This is a clear benefit to those who have it, and it is a clear cost benefit to the NHS with the reduction of future illnesses. Of that there is no doubt.
Secondly, it is the pernicious effect of CCGs that is rationing these treatments. These CCGs are an unnecessary and costly intervention in the passage of money to local health services. They don't exist in Scotland. This is a money thing. Preventing future health expenditure does not seem to drive cost benefit analysis in NHS England.
Finally, the one thing that was brushed aside, as in not mentioned at all, is that a completely redundant stomach remains sitting in the abdomen, where it can quietly grow a cancer to a completely inoperable stage without any symptoms whatsoever. It's not a common cancer - 7000 diagnosed every year, and symptoms are vague even in normal people- chronic dyspepsia, nausea, etc. so it often presents late in any event. This bariatric surgery makes sure it presents late and terminal. That'll lose weight even quicker.
Sorry to end on a downer, I thought this programme was very non-judgemental, didn't hammer the Diabetes thing, and made its points well.
MikeTurin
Well-Known Member
- Relationship to Diabetes
- Type 2
Just watched the programme.
The main thing seems to me that the prejudice against obese people in NHS, in politicians and general population is making the problem far worse than that it could be.
Bariatric surgery is not an easy therapy, has an high cost and, like every surgery is quite dangerous, I think that should be used as a last option afer having tried and failed other therapies.
It's like electroconvulsive therapy, that is still used in some rare cases of depression, but nowadays it's better to try Prozac before.
Seems to me that due to the stigma associated, fat people are denied a proper treatment and consuelling: instead they are normally receiving a boilerplate diet advice from NHS the eatwell plate that surely could work on some people, maybe is a good diet for non-fat and non diabetic people, or some commercial "special" diet.
In most cases filled with blame and saying that is a self inflicted problem, because people is not exercising or is eatin too much. Of course, not helping people to get back in shape could only worsen the problem.
The main thing seems to me that the prejudice against obese people in NHS, in politicians and general population is making the problem far worse than that it could be.
Bariatric surgery is not an easy therapy, has an high cost and, like every surgery is quite dangerous, I think that should be used as a last option afer having tried and failed other therapies.
It's like electroconvulsive therapy, that is still used in some rare cases of depression, but nowadays it's better to try Prozac before.
Seems to me that due to the stigma associated, fat people are denied a proper treatment and consuelling: instead they are normally receiving a boilerplate diet advice from NHS the eatwell plate that surely could work on some people, maybe is a good diet for non-fat and non diabetic people, or some commercial "special" diet.
In most cases filled with blame and saying that is a self inflicted problem, because people is not exercising or is eatin too much. Of course, not helping people to get back in shape could only worsen the problem.
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