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Religious Dick

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'Patients to lose weight before NHS treatment'
« on: January 01, 2008, 01:03:33 PM »
 'Patients to lose weight before NHS treatment'

By James Kirkup Political Correspondent
Last Updated: 12:39am GMT 01/01/2008

Patients could be required to stop smoking, take exercise or lose weight before they can be treated on the National Health Service, Gordon Brown has suggested.
# Health premiums slashed for gym users

In a New Year message to NHS staff, the Prime Minister indicates people may have to fulfil new "responsibilities" in order to establish their entitlement to care.
    
Women smoking;
Conditional treatment: Smokers are one group of patients that may be asked to change their habits



The new conditions could be set out in a formal NHS "constitution", Mr Brown says.

In his open letter to doctors, nurses and other health workers, the Prime Minister promises to press on with Tony Blair's reforms of the NHS, pledging more personalised care for all patients.

He adds: "We will also examine how all these changes can be enshrined in a new constitution of the NHS, setting out for the first time the rights and responsibilities associated with an entitlement to NHS care."

Creating formal conditions for treatment would build on recent controversial developments in health policy.

Despite the NHS commitment to provide free universal care, it is already common for doctors to set conditions on patients seeking treatment.
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The National Institute for Health and Clinical Excellence already considers so-called self-induced illnesses in setting the criteria that determine which patients should qualify for new or expensive health treatments.

And this year Leicester City Primary Care Trust was given Government approval to ask smokers to quit before they are given places on waiting lists for operations such as hip replacements and heart surgery.

Obese people also face more conditions from doctors who say being very overweight unnecessarily complicates many procedures.

For example, fertility doctors have argued that very obese women should be denied access to IVF treatment.

Mr Brown has promised more "personalised" services from the NHS.

He makes clear that his reforms will rest on people being more accountable for their own health, too.

"We will describe how we will achieve our shared ambition of an NHS which is more personal and responsive to individual needs," the Prime Minister writes.

"Personalised not just because patients can get the treatment that they need when and where they want, but because from an early stage we are all given the information and advice to take greater responsibility for our own health."

Katherine Murphy, a spokesman for the Patients Association, raised fears about the spread of conditions in the NHS.

She said: "We would have concerns about this. Patients do have a right to access to care and we would be very concerned if people were to be denied access to care.

"Is this being done for the patient, or is it just another way of saving money?"

Since becoming Prime Minister, critics say Mr Brown has sent mixed messages about his plans for NHS reform.

But Mr Brown makes clear the NHS must change to respond more quickly and directly to the wishes and needs of its patients, just as businesses respond to their customers.

"I believe these are steps vital to securing the health of the NHS for the next 60 years," Mr Brown says.

"They will require a broadening and a deepening of reform to ensure that the NHS as a whole attaches the same priority to a personal and ?preventative service as many of you already reflect in your own day-to-day decisions."

Information appearing on telegraph.co.uk is the copyright of Telegraph Media Group Limited and must not be reproduced in any medium without licence. For the full copyright statement see Copyright

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/01/nhealth201.xml
I speak of civil, social man under law, and no other.
-Sir Edmund Burke

Religious Dick

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Re: 'Patients to lose weight before NHS treatment'
« Reply #1 on: January 01, 2008, 04:07:40 PM »
Not a Doctor's Decision

by Jonathan Rosenblum
Jerusalem Post
December 27, 2007

A Winnipeg case currently winding its way to its grim conclusion pits the children of Samuel Golubchuk against doctors at the Salvation Army Grace General Hospital. According to the pleadings, Golubchuk's doctors informed his children that their 84-year-old father is "in the process of dying" and that they intended to hasten the process by removing his ventilation, and if that proved insufficient to kill him quickly, to also remove his feeding tube. In the event that the patient showed discomfort during these procedures, the chief of the hospital's ICU unit stated in his affidavit that he would administer morphine.

Golubchuk is an Orthodox Jew, as are his children. The latter have adamantly opposed his removal from the ventilator and feeding tube, on the grounds that Jewish law expressly forbids any action designed to shorten life, and that if their father could express his wishes, he would oppose the doctors acting to deliberately terminate his life.

In response, the director of the ICU informed Golubchuk's children that neither their father's wishes nor their own are relevant, and he would do whatever he decided was appropriate. Bill Olson, counsel for the ICU director, told the Canadian Broadcasting Company that physicians have the sole right to make decisions about treatment - even if it goes against a patient's religious beliefs - and that "there is no right to a continuation of treatment."

That position was supported by Dr. Jeff Blackner, executive director of the office of ethics of the Canadian Medical Association. He told Reuters: "[W]e want to make sure that clinical decisions are left to physicians and not judges." Doctors' decisions are made only with the "best interest of the individual patient at heart," he said, though he did not explain how that could be squared with the undisputed claim that this patient would oppose the doctors' decision. Meanwhile, an Angus Reid poll of Canadians showed that 68% supported leaving the final decision with the family.

The claim of absolute physician discretion to withdraw life-support advanced by the Canadian doctors would spell the end of any patient autonomy over end-of-life decisions. So-called living wills, which are recognized in many American states, and which allow a person to specify in advance who should make such decisions in the event of their incapacity, would be rendered nugatory.

EVEN THOSE who would not wish to be maintained in a state of unconsciousness, and who do not share the religious beliefs of the Golubchuk family should fear the claim of moral omniscience made by Canadian doctors - and not just because Josef Mengele was a doctor. As Professor Richard Weikart chillingly details in From Darwin to Hitler: Evolutionary Ethics, Eugenics, and Racism in Germany, Mengele's experiments on "inferior" Jewish children for the benefit of the Master Race have to be viewed in the context of German Social Darwinism in the seven decades leading up to the Nazi takeover.

In Weikart's estimate, a majority of German physicians and scientists subscribed to the naturalistic Darwinian world view and ideas that constituted a sustained assault on the traditional Judeo-Christian concept of the sanctity of life. Among those ideas are the claim that there is no fundamental distinction between humans and animals; human beings do not possess a soul that endows them with any rights or superiority to any other species; within the species homo sapiens, there are "inferior" and "superior" individuals, and inferior and superior races; and it is the iron will of nature that the species should evolve through the survival of the superior members and the death of the inferior.

Darwin's cousin Francis Galton founded the modern eugenics movement on the basis of Darwinian arguments, and nowhere did eugenics catch on with greater enthusiasm than in Germany (though many prominent intellectuals in the United States, England and France were also enthusiastic supporters.) In Germany, many took the next step - from eugenics to involuntary euthanasia for the mentally ill and other defectives.

Ernest Haeckel, one of the most influential 19th-century German biologists, whose faked drawings of developing human embryos allegedly recapitulating the evolutionary path still feature prominently in college biology texts, argued for the killing of the mentally ill, lepers, those with incurable cancer, and cretins. As a safeguard, he too recommended a committee of physicians to pass judgment. Alfred Hoche, a professor of psychiatry at the University of Freiburg, justified shortening an inferior life if the insights gained would save better lives. "By giving up the conception of the divine image of humans under the influence of Darwinian thinkers," writes Hans-Walter Schmuhl, mainstream German thinkers came to view human life as "a piece of property" to be weighed against other pieces of property.

JUST AS Nazism gave anti-Semitism a bad name, so too did it discredit Social Darwinism. But just as anti-Semitism has reappeared, so has the assault on the concept of the sanctity of life. That assault is not limited to Princeton ethicist Peter Singer's defense of infanticide, euthanasia and bestiality on explicitly Darwinian grounds.

Global warming activists speak of the duty not to reproduce, and view human beings as the enemy of nature's order. So much for the view of man as the crown of creation. In place of the sanctity of life, we now speak of the "quality of life" - a term that explicitly assumes that some lives are worth more than others.

There is even talk of the "duty to die" and clear the way for higher-quality lives, which is why the American Association of People with Disabilities has been actively involved in so many cases dealing with the doctors' right to terminate medical care. The rage for medical rationing in Canada, of which the Golubchuk case is but one example, derives from a desire not to waste resources on low-quality lives.

It would be a bitter irony if Percy Shulman, a Jewish judge in Winnipeg, were to grant Dr. Bojan Paunovic the right to end Samuel Golubchuk's life on the grounds that it lacks the requisite quality.


http://jewishmediaresources.com/article/1166/
I speak of civil, social man under law, and no other.
-Sir Edmund Burke

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Re: 'Patients to lose weight before NHS treatment'
« Reply #2 on: January 02, 2008, 05:29:50 PM »
NHS patients told to treat themselves

By James Kirkup, Political Correspondent
Last Updated: 8:50am GMT 02/01/2008

Millions of people with arthritis, asthma and even heart failure will be urged to treat themselves as part of a Government plan to save billions of pounds from the NHS budget.
# Britain 'has four different NHS systems'
# Waiting times target 'will be missed'
# Your view: Should the unfit lose access to NHS care?

Instead of going to hospital or consulting a doctor, patients will be encouraged to carry out "self care" as the Department of Health (DoH) tries to meet Treasury targets to curb spending.
    
NHS patients told to treat themselves
NHS patients could be expected to administer their own medication

The guidelines could mean people with chronic conditions:

? Monitoring their own heart activity, blood pressure and lung capacity using equipment installed in the home

? Reporting medical information to doctors remotely by telephone or computer

? Administering their own drugs and other treatment to "manage pain" and assessing the significance of changes in their condition

? Using relaxation techniques to relieve stress and avoid "panic" visits to emergency wards.

Gordon Brown hinted at the new policy in a message to NHS staff yesterday, promising a service that "gives all of those with long-term or chronic conditions the choice of greater support, information and advice, allowing them to play a far more active role in managing their own condition".

The Prime Minister claimed the self-care agenda was about increasing patient choice and "personalised" services.
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But an internal Government document seen by The Daily Telegraph makes clear that the policy is a money-saving measure, a key plank of DoH plans to cut costs.

Critics claimed the plan would provide doctors with an excuse for ignoring the elderly or those with debilitating, but not life-threatening long-term conditions, and would not work without significant investment in community health services.

The Arthritis Research Campaign said it risked providing health managers with "an excuse for neglecting elderly patients".

Jane Tadman, a spokesman for the charity, said: "Arthritis is already too low down the priority list and the fact that this is being mooted as a money-saving measure is very worrying.

"Some GPs don't take arthritis seriously enough, and the result of this could be to give them another excuse to tell arthritis patients just to go away and take their tablets."

The Patients' Association welcomed more moves to empower patients, but warned against using self-care systems to save money.

"We are all for better-informed patients," said Katherine Murphy, a spokesman. "But it is a concern that financial pressures will take precedence over clinical needs."

Peter Weissberg, the medical director of the British Heart Foundation, said: "People affected by heart disease need specialist care. Whilst we support changes that empower people to look after their own health, we would be very concerned if they led to any reduction in the availability or quality of expert care for those who need it."

After years of record spending, the health service is facing a sharp slow-down as Mr Brown tries to curb soaring government borrowing.

In the Comprehensive Spending Review last year, it was announced that the health budget will grow by four per cent a year over the next three years, down from the seven per cent annual growth rate between 2002 and 2007.

The Treasury also demanded that the DoH achieves three per cent "efficiency savings" over the next three years, equivalent to ?8.2 billion.

The department's "Value for Money Delivery Agreement" - an internal document drawn up with the Treasury and circulated to NHS trusts over the Christmas holiday - sets out how the NHS will meet the savings target.

In a section on chronic conditions, it says the key to greater efficiency in the management of patients with long-term illnesses is a reduction in the need for "expensive" interventions by the NHS.

"Reductions in the use of NHS (GP consultations, outpatient appointments, inpatient admissions, length of stay, emergency care and prescribing) can be achieved through increased support for self care (for example through education and skills training, information prescriptions, or self care devices)," it says.

The DoH has told the Treasury that NHS officials are drawing up "good practice guidance on care planning including support for self care". The advice is expected to be published next month.

The emphasis on self care was inspired by the success of the Expert Patients Programme, an NHS pilot scheme that offers a six-week training course for people with chronic or long-term conditions.

About 30,000 people have completed the course and reduced their hospital attendances by up to 16 per cent, a result NHS managers hope to repeat across the service.

Health budgets face pressure from the cost of caring for people with chronic conditions, including 8.5 million with arthritis, 3.4 million with asthma, 1.5 million diabetics and 500,000 with heart failure.

Opposition politicians questioned whether the Government could save money without reducing services. But an Asthma UK spokesman said: "Our focus is on the clinical benefits of self-management.

"If the Government implements procedures to ensure more self management and save money, we would support that."

Information appearing on telegraph.co.uk is the copyright of Telegraph Media Group Limited and must not be reproduced in any medium without licence. For the full copyright statement see Copyright

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/01/02/nhs102.xml
I speak of civil, social man under law, and no other.
-Sir Edmund Burke