Should smokers, drinkers, drug users and obese people be charged to see the doctor?

Maybe an example of "Do as I say not what I do". I was a smoker but still advised patients not to smoke, was I wrong to give advise I found difficult to follow or right because I understood the difficulties?

Totally agreed with you sir!

I have simply asked a question, to get a debate going. And, I am warm hearted.

YES YES YES AT LAST SOME SENSE. NO EXCLUSIONS, FREE AT THE POINT OF NEED. WHEN I WAS A YOUNG KID I REMEMBER MY FATHER TALKING ABOUT BEVAN AND WHAT A GREAT MAN HE WAS. I WAS ABOUT 3 YRS OLD AND IT STAYED IN MY MIND SO THAT WHEN I WAS OLDER I GOT BOOKS FROM THE LIBRARY, AND SOON UNDERSTOOD WHY THE NHS WAS AND IS STILL THE BEST THING THAT A LABOUR GOVERNMENT GAVE TO THE UK POPULATION, I REMEMBER AS A CHILD HEARING ABOUT CHILDREN IN MY SCHOOL WHO WERE ILL WITH POLIO AND OTHER AWFUL DISEASES. SOME OF THEM WERE IN HOSPITAL FOR OVER A YEAR BUT DID RECOVER. I HAVE BEEN LIVING IN EIRE FOR OVER A YEAR NOW AND THANK GOD I AM NOT AWARE OF ANY ILLNESS AT PRESENT BUT I AM IN MY 70s SO WILL BE GOING BACK TO CORNWALL AS SOON AS I CAN SELL UP, I HAVE BEEN SO BLESSED WITH AMAZINGLY GOOD HEALTH BUT THINGS COULD CHANGE AND I WANT TO BE IN A COUNTRY THAT HAS THE VERY BEST HEALTH SERVICE IN THE WORLD. THE LONGER I LIVE THE MORE I REALISE WHAT A FABULOUS COUNTRY THE U.K. IS.

So agree with you Lionel and I wish more people would try and understand the problems the NHS experience and it isn't 'too many chiefs and not enough indians'!

Leo, I wonder what you haven't done in your long life, pig farmer, nurse, geologist...the list goes on...

If you have wrecked your health, the NHS should not be free at 'the point of need.'
Man up, for heaven's sake, take responsibility for your life.

Lionel, I'm not sure how to answer your question! I don't really know what the solution is to managing the NHS although I agree it makes things difficult when the Government only appear interested in setting targets that will get them elected. A number of people would consider 196 billion pounds a year of tax payers money a lot of money and wonder why that isn't enough. But when considering the cost of care it is estimated that Type 2 diabetes alone costs the NHS one million pounds a day without considering everything else that is provided. However, people will blame everything but the obvious - the NHS is a business like any other, it's the largest employer in the UK. It wasn't set up to function as a profit making business but they have to pay for services, utilities, VAT etc. like any other business including drugs companies that are also profit making. Drugs companies are rarely altruistic although they would argue that they are.

The problem with estimates, they are just that and can not be accurate enough to account for all eventualities. I recall blowing my total whole months drugs budget on one patient in one day to save her life as she had reacted to her illness in a way no one had witnessed before, but I wasn't given extra money to account for that. I just had to try and adjust my units costs to accommodate the unexpected.

I believe that until the public understands the true cost of health care we will continue to have a problem in providing everything people expect regardless of who manages the NHS. When a Government talks about how they have given an 'extra' so many million pounds to the NHS someone needs to ask the question as to how that breaks down for each and every NHS facility, I doubt if they would be able to answer and if they did people would realise the addition income was insufficient to meet the overall needs.

When considering the cost of providing health care it may give some understanding as to why celtwitch may have raised the question of who pays! I don't have the answer but I could never discriminate against the vulnerable or needy just because they may have contributed to their ill health, that is not why I made a career in the NHS. As to funding, I don't think there will ever be enough as medical science moves forever forward and demands increase.

I'm not against the principle of what you suggest but I'm not sure people are truly informed and thus understand all the issues health care throws up. There are always going to be those who willing participate in the decision making process and those who will only see what effects them. There are number of areas of health that are already a postcode lottery. You only have to read the comments made after celtwitch started the discussion and according to her a number of us should be excluded from receiving 'free' care. Therefore I think the NHS will always be state controlled until people demand change and understand what that means. Roll on the day that happens.

Thank you Lionel and I could certainly tell some stories that the Health Minister would find difficult to comment on as could many a nurse.

I have often found that those people with first hand experience of the NHS are often coming from the direction of chronic conditions, haemophilia, chronic renal failure etc. and therefore often do not understand the issues that may face people with acute health problems, never the less they make a valid contribution to debates. I agree we need more assertive people with understanding of grass roots issues before change can take place but I doubt I will see it happen.

If you driven dangerously, then yes.

But then you'd have to wait for the decision of a court case in many cases, so payment couldn't be taken until after the verdict has been decided. That could take years in some cases!. And people who are judged by a court to have caused an accident have to pay a hefty fine as well (quite rightly), so it would get terribly complicated to administer, and who will be paying for that? The rest of us.

And what about people who take part in sports and other activities where they could be injured, should they pay too? Or some pedestrians....the very elderly, the very young, the disabled, the hearing impaired, the sight impaired, for example, who might cross a road less carefully? It's a choice to play sport or cross a road.

If you extrapolate this out to everyone who takes any kind of everyday risk, we'd all be paying for our own treatment!

Totally agree Fruitcake13, you take a risk by getting out of bed or even by staying in it!

Exactly, jeanmark.

Both of my parents worked for the NHS for their entire working lives, my father in radiography and radiology and my mother as a nurse (that was how they met) and they believed totally in the NHS. Both of them could have worked in private health care and earned much bigger salaries, but they refused to as they were old enough to remember what it was like before the NHS when the rich could access healthcare and the poor couldn't.

Although born after its introduction I, like your parents Fruitcake13, worked in the NHS my entire working life also as a nurse and therefore fully support it. However, I also realise Bevan could not have foreseen how rapidly health care would progress and at what cost.

True, but a high proportion of the costs of health care today are the result of the greed of pharmaceutical companies.

I can't argue with that.

I agree with you we need to legislate sugar like we do cigarettes and drugs. We also need to ban it from a lot of foods that would sort out many of the issues with obesity

I think that a token charge to see the doctor, say, £ 5.00 and £10.00 for hospitalisation seems reasonable to me?
Anyone who thinks the NHS is a right should read James Bartholomew's 'The Welfare State We're In.'

We 'choose' to become addicts, so man up and take control of your life,

Celtwitch, try reading Cutting the Lifeline - the fight for the NHS edited by John Lister, London Health Emergency. Forward by Frank Dobson, MP. Printed 1988.

NO we do not choose to become addicts - we choose to drink too much or take drugs, the addiction comes later - how many can't get through a day without a cup of tea/coffee or chocolate or whatever the "want" is - that's addiction, but of course we can't be addicted to tea or coffee oh yes we can - addiction is addiction - not chosen or sought because we all suffer from the "it won't happen to me" syndrome. Goodness what it must be like to live in an ivory tower.

Well said duckkers.

I dont think you are right about unsympathetic people. I went through a stress filled time in my early 30s. I started practicing yoga in a town hall with other people and to be truthful I felt much better after a couple of classes and it was not just the yoga but it was meeting other people who were going through a time of stress and some of us went to a nearby coffee bar after the class and we all agreed after a month that we were more positive and happier. Staying indoors and not having any contact with positive outgoing people is I believe why so many get depressed in the first place. Just a walk to a park, talk to a young Mum and her kids, stroke a dog and the owner will be happy to chat, especially about their beloved dog. Your problems are mainly physical ie diabetes, hiatus hernia ( my youngest had that at age 2yrs she had an operation and didnt have any trouble again (she is now over 50) ulcers are medical illnesses which usually curable with medical care. I have known people who have also suffered these problems but they dont have to be for life. My friend who has had diabetes for many many years enjoys life and just keeps her appointments at a clinic where she has check ups. I am a vegetarian and she noticed that I am blessed with very good health, so I suggested that she could try vegetarianism, she said she would try but being a meat and two veg girl thought she would not be able to give up meat. After two months she had given up meat and ten years on she never eats meat at all. She never thought she could do it but now she cant bear to look at a butchers shop or adverts on tv for beef burgers. lol. I am not a true vegetarian as I eat fish sometimes but I have not touched meat for 30 years. Thank God I am so far extremely healthy apart a cold once a year. I am now 79 and dont feel any different from when i was 40. Depression is one of the most debilitating conditions, which can make one have symptoms of just about every illness. My Father had a manic depressive illness from about age 47 years of age and that was horrible especially for my Mother. Please join a group that are involved in something you may like, ie theatre group, either watching or actually taking part. If you like animals help out in a Rescue centre.I did that and it is so rewarding but be careful you dont adopt half a dozen dogs or cats. If you havent a pet then get one or pet sit for friends now and then. I think your last remark is sad, I can honestly say I do not know anybody who has not been depressed at some time in their lives, i have friends who have lost parents, or lost small children - life throws up some bad stuff, but I would advise you to sit down in a nice park or on a beach and think how lucky you are to be sitting there. Please join some group, or my favourite which is to help out in a charity shop a few hours a week, and meet some positive thinking people.We are not here for eternity, just less than a hundred years, or much less some times. I will say a prayer for you, I often speak to my "special Angel" something I started when I was a child and I have really experienced miracles several times in my life. I will pray that you will start to "live", and that your life will be enhanced and filled with love and happiness starting from tomorrow. love alice x

Thank you for your comments. You miss my point. Without the NHS I couldn't afford the medication I need so therefore I wouldn't have be here. Some comments left on this forum have been totally unsympathetic.

Pussk2, some of the comments may appear unsympathetic but I believe a few have been made tongue in cheek. I think you will find a large number of us could say we wouldn't be here if it wasn't for the NHS. Indeed, the number of times 'old people' (and I am one) are blamed for all the problems in the NHS demonstrates how successful it has been in keeping us all alive!

I agree and health tourists should pay too, our Government should Invoice the Embassy of their country. This revenue could be used to hold classes to educate people to look after themselves better, sometimes I think people do not realise the damage they do to their body, so they need it spelt out.

Tourists do usually have to have health insurance as we do. Not all get it free, however, it is a service that is 'free at the point of delivery', would you refuse to treat a child if, while visiting this country, they are injured or become ill but their parents haven't payed into the system? I agree it should not be a free for all but there are systems in place to try and prevent abuse.

Also embassies will pay the bill for certain diseases and under certain conditions will also pay for specialist treatment but it is usually pre-arranged. A great deal of the 'abuse' of the NHS is by people British by birth who believe they have a right to 'free' treatment.

There is plenty of education about to inform people of the harm certain lifestyles can cause but a large number of people think it doesn't apply to them and it isn't just the young; neither is it just smokers, drinkers, drug users and obese people!

There was an article the other day in the Times where a group of researchers have been testing drugs at festivals this summer. the police keep a blind eye to it. They found cement dust, talcum powder and dental anaesthetic added to the drugs . And still people take them???

Most obese people blame illness or medication, really they are stuffing their faces, look around cafe's those with fullest plates are the overweight ones. They cost the NHS a lot more than any smoker or drinker, all their joints go and their treatment never ends! The fac they are unfit to work means they pay nothing in, so yes these people should pay!

Phoenix122, I'm sure your action regarding your bursitis was fine and yes, pain is natures way of telling us something may be wrong but try telling someone who has bursitis of the shoulder or other major joint that they shouldn't take the 'easy' option even though the pain prevents them from working in manual labour employment and they are on a zero hours contract and won't get paid if they are 'off sick'.

You use the term 'addiction' and imply people shouldn't 'indulge themselves' in harmful behaviour. Do you have full understanding of the term 'addiction' and how many times have you had to watch a drug or alcohol addict in withdrawal? I fully agree they shouldn't start in the first place but there are many things we all think we have control of until it's too late. I have already mentioned in this stream that I never nursed a drug addict who told their careers master they want to be an addict when the grew up! Have you never made a 'wrong' decision in your life?

Wilf, I agree it is horrifying to see what 'suppliers' mix with the illegal drug they are selling but the average addict usually believes it is 'good stuff' but are also so addicted they will take it anyway. Illegal drug 'suppliers' are only interested in the money.

I do believe we all have a responsibility to care for our own health but that is easy to say when you have the ability to do so. The whole question is should only certain people pay for their care and treatment - those deemed responsible for their ill health - so where does that stop, why only pick on certain conditions when most peoples lifestyles may contribute to developing illnesses?

jeanmark, whilst I do agree with you in some respects, it is very difficult to generalise given such a wide range of situations. My personal experience with bursitis worked for me but I am not stupid, I do realise I can't speak for everyone but there are those who will always go for the quick fix when there are alternatives.
I do also understand what addiction means and I see how it can destroy lives, but there are enough warnings around about what can happen if you start. Some folks have perhaps turned to an addictive substance thinking it would help them over a sticky patch in their lives and they could control it or use it as a way of escape. When it comes to indulging in it for sheer pleasure then they must be fully aware of how it could end up. I see young folks, no work, no hope of working try to get enough money to pay, going from one fix to another. Borrowing from family because they've spent the rent money on drugs and no matter how you try to help, it never seems to work.
I think the society we live in now is a lot to blame. Many parents don't take the same responsibility for their families and the families are now so independent because of the generosity of the welfare state.
When I was younger it was almost impossible for a single young person to get social housing. They were expected to live with their parents or rent a room somewhere. Now many of them are getting homes of their own but without guidance on budgeting, respect for neighbours and property. Don't tell me I don't know about that either, I lived with that as a neighbour. The constant drunken parties, unbelievable noise from extremely loud music but finally I put up with it long enough and contacted the authorities. The officers came out, heard the racket and gave them £100 on the spot fine. They needed to have a whip round from their friends to pay it but it more of less stopped after that. The nicely, nicely approach doesn't always work. It hit their pockets in this instance and it worked.
The NHS doesn't have the money and to get enough to try to sort everyone's problems out, NI and income tax contributions would need to be raised substantially. They are already supplying methadone to drug addicts because it's cheaper to the NHS than what treatment without it would be. Unfortunately even that is being abused, some are taking methadone and drugs so are already funding their habits.
There's no one answer fits all.

I totally agree Pheonix122 and that is my argument, you can't discriminate against certain sections of society with regard to health care, but we should try and act responsibly. I am also aware some people will always take an easy option for treatment but maybe it isn't easy for them, who are we to judge? There are some who believe in natural childbirth and others who want some help in coping with the pain, are they taking the easy option?

I certainly agree that society has a lot to answer for with alcohol, tobacco and illicit drugs being so easily available and for many young people are now considered the norm. Those taking drugs for recreation never appear to learn of the dangers despite education. When parents seem to think it is amusing to get drunk, why should children consider it wrong!

My specialised field was Tropical Medicine, Infectious Diseases and HIV and I worked with drug addicts for 13 years, some eventually came off drugs never to return to them and some would abuse their methadone and continue to do so. I would never blame them for not being able to conform even though it was very frustrating to continually treat them. Having worked in the NHS for 47 years and being a budget holder for a good many of them I know the NHS does not have the funds to constantly treat everyone regardless of what they need. However, I do believe it is a dangerous path to take to suggest only certain 'illnesses' perceived as being self-inflicted mean an individual should pay for care and treatment because where would that end? I'm not sure we can afford the NHS as we know it if we continue to try and meet everyones health needs, I think that is the bigger question.

I don't think we actually disagree about the bigger question.

I have no time for those joggers, what with their pert breasts and tight glutes, whizzing past me when I'm taking an arthtitic stroll with my dog, they make me sick. I just hope they have done the right thing and bought the correct insurance, so that when their knees are knackered I don't have to subsidise their treatment.
Fashion shoes! Ye gods, what's wrong with blacking your feet and lacing your toes up, it's much healthier than FASHION SHOES and the bunions they cause.
Can't have children...what's that all about,m and who would want the little blighters anyway? Children are nothing but noise with dirt on it, greedy, selfish little oiks that no sane person could possibly WANT?
And 'gender change' for heaven's sake, what is the world coming to Pauline, I said to my husband?

How do you define 'disproportionate user', do you just assume that anyone who is unfortunate enough to develop a chronic condition should buy a 'season ticket' just incase they require regular care and attention?

No, I mean anyone who is never away from the doctor, or the hospital.

Someone has to keep the NHS busy..........

I have a friend who visits the doctor for every little thing and yes I think they should be charged. If she hears a friend has say blood pressure or any other complaint she goes and gets hers checked.

Your friend is probably one of the increasing 'worried well' GP's have to deal with but their fears shouldn't be ridiculed because to them they are real. There only has to be one person who calls 'wolf' once too often and is thus ignored when there is something seriously wrong with them, if they come to harm the media (and many of the public who are so critical now) will be all over the 'failing' NHS.

I wonder what the real cost would be if one serial abuser of NHS services their clogs, I mean, who would care?

That should have been 'popped their clogs' I think that the moderator has problems with some words.

The problem is celtwitch society (and the media) always seem to have to find someone to blame and its often the NHS when such people do 'pop their clogs', unfortunately it does happen and there are people who care. At least the 'abuser' doesn't have to worry!

i think that some people believe that they have an undisputed right to NHS treatment when their nett worth to the country is nil. I know people who have not done a day's work in decades but are never away from the doctors. Wouldn't it be reasonable to put them down?

That's against the law and who would decide?

I could decide, then I would weed out the freeloaders.

Would you want a second opinion just to ensure you were being objective?

Katie Hopkins would be a good second opinion.

Unbiased then!

I worked in the NHS for 47 years but I don't expect to get better service as a result of both paying into the system and providing a service to it. It does raise an interesting question - do we penalise those people who may have been unable to work, what do you think celtwitch?

Interestingly, there are NO eating disorders in countries where food is scarce, so are these acquired disorders genuine?