Making a better country.

[TIGHTCHOKE]

6 minutes ago, Vince Green said:

I liken the NHS to the magnolia tree in my in-law's front garden. Its grown so out of control over the years because they never would allow anyone to prune it 

Very good analogy Vince.  

[12gauge82]

6 hours ago, Lloyd90 said:

No, we don’t pay for the 40+ tests, because as you say, they don’t run them to begin with. 
 

I have experienced this myself recently. “It’s probably nothing, go away and take some Renee”. 

“Oh you’ve tried that? Try some buscopan!… it’s unlikely to be anything sinister at your age so we won’t bother with the tests.” 
 

I am aware that the NHS is paid for, but as you say they don’t do a lot of the stuff.
 

I am also aware of the tax burden, I pay a lot of tax, although probably consider myself to be in a fortunate position to be a higher earner / higher rate tax payer in the first place… it certainly beats the days when I had 3-4 low levels jobs I would bounce between just to try and make up £200 a week with no security or sickness etc. 

 

 

Unfortunately, There are many many people who are taking out of the system that don’t pay anything back in. 
 

There are also many many people who pay a small amount of tax, but the amount they pay doesn’t even come close to covering the amount of public services they have available to them or use.  
 

Someone not working will pay in nothing - £0 contribution. 

 

Someone who is 23+ years old on a minimum wage of £9.50 an hour will earn £18,278 a year (based on 37 hours per week). 
 

Out of that money they will pay £1,141.60 tax, and £1,112.74 national insurance. 
 

£2,254.34 total contribution. 
 

According to the OONS public expenditure data, 21.9% of peoples taxes goes towards health spending. 
 

So for that average minimum wage worker that’s under £500 a year. 
 

 

The system relies on the fact that lots of people pay in and don’t use the system, to cover the cost of the people that use it a lot. 

That is a bit of a over simplistic view point imo. 

Many of those on minimum wage ect could also be argued to be contributing more, they deliver goods and services that due to their wage are far cheaper than they otherwise would be, making them affordable to others who otherwise would be unable to pay for them.

Just look at what happened during the lock downs, most of the essential workers were certainly not higher earners, yet their industry's were deemed so essential they had to keep going. 

[Mice!]

8 hours ago, Houseplant said:

I've skimmed read the thread. 

Medicine is the ambulance at the bottom of the cliff. Prevention of disease, especially diabetes, hypertension and heart disease is a good thing for patients and public health service finances in the long run, but requires huge investment in the short term. We are not very good at it in the western world. Additionally, this is a much bigger issue of lifestyle factors such as diet, smoking and exercise which you may/may not believe is related to socioeconomic status depending upon your political stance. Either way, medicine cannot fix those things. 

Encouraging healthy lifestyles and preventative medicine is a good thing, but doing frequent blood tests on everybody would be a massive waste of resources for relatively little return. Every blood test result must be taken in context of the patient sitting in front of you. An abnormal blood test in isolation from clinical assessment is of very little value most of the time. 

Spot on, we all get to a certain age where we need to watch what we eat and drink, but most folk don't want to make the effort,  so if your already fat, overweight and smoke in your 20s or 30s your asking for trouble. 

40 minutes ago, pigeon controller said:

I was an avid blood donor and managed to release a hundred and nine donations prior to the age restriction, as a thank you they could test your blood as they do take test samples for matching etc. This would encourage people to give, also the blood is tested prior to storage so is in the system. 

109 donations is brilliant you'd get even more these days as you can now do 4 donations a year, but I think it may actually put some people off as well.

23 minutes ago, Vince Green said:

I liken the NHS to the magnolia tree in my in-law's front garden. Its grown so out of control over the years because they never would allow anyone to prune it 

Very apt. 

5 minutes ago, 12gauge82 said:

Just look at what happened during the lock downs, most of the essential workers were certainly not higher earners, yet their industry's were deemed so essential they had to keep going. 

More likely because the gov wanted the masses kept happy at home spending money online,  unless it was food shopping.

[Cosmicblue]

Mmmm kind of think Toxo's original post was a bit of a ramble without reason attached.

The NHS, as originally conceived in 1948, functioned in a far simpler world than the one we have today.  Huge strides in technology from diagnosis capabilities, through surgical techniques to advanced drug therapies - all of which costs money, the bleeding edge of everything in life is expensive.   

The NHS is an absolute no-win situation, the medical technologies have improved vastly since 1948 so we live longer, or can be kept alive where previously we would long since died,  as the tech advances the life expectancy also increases along with the costs - repeat and repeat again.

We are fortunate that we can retire here in UK and get healthcare, funded by the tax payer until we die.  If you look to the USA people get health cover as part of their jobs - when they retire it stops hence finding so many elderly people in the workforce over there.  My brother has just retired at 63 over in Arizona - health insurance is $25,000 per annum for himself and his wife.

 

[discobob]

2 minutes ago, Cosmicblue said:

$25,000 per annum for himself and his wife.

Over here it could cost you millions depending on your house value if you want care (I know it would be the same in the USA  ). As was mentioned above, those that haven't contributed do get it all "free" from cradle to grave!

In that "free" statement, I include my brother who passed away last year aged 55 - the only contribution he made was 111 days service before being medically discharged with a war pension including time in hospital at Caterick and then awaiting the discharge - for an injury he got 2 weeks before joining up. Fathered at least 6 kids with 5 different women.

[Lloyd90]

41 minutes ago, 12gauge82 said:

That is a bit of a over simplistic view point imo. 

Many of those on minimum wage ect could also be argued to be contributing more, they deliver goods and services that due to their wage are far cheaper than they otherwise would be, making them affordable to others who otherwise would be unable to pay for them.

Just look at what happened during the lock downs, most of the essential workers were certainly not higher earners, yet their industry's were deemed so essential they had to keep going. 

It is simplistic, it’s just a bit of an example, but not accurate. To accurately measure and gauge someone’s contribution is far far more complex I do admit. 
 

Many jobs do have social value, not just a monetary value. 
 

A pet hate of mine though is how certain professionals are rolled out like Marty’s who went to war and didn’t have a choice etc. 

 

 

Ah essential workers who were absolutely needed to keep the country running. 
 

The list contained many many jobs that no one could argue were essential, became a bit of a joke really. 
 

Joe Rogan made fun of it in the USA because they deemed his podcast essential and he can drive around no bother. 
 

 

One thing it did highlight was just how essential some jobs were though. Lorry drivers, nurses, store workers. 
 

It was a prime opportunity (if they were that way inclined) to unionise and ask for better pay and conditions. 
 

Post lockdown nurses got the same usual pay increase, there was uproars, all over the news and TV saying what an insult it was, and still didn’t vote to strike. 
 

My mate, a MH nurse almost blew a gasket!! 
 

He said if the populace of nurses, couldn’t even be bothered to vote (very low participation in the voting) or didn’t bother to vote to strike after that event, they NEVER will. 

 

[12gauge82]

46 minutes ago, Lloyd90 said:

It is simplistic, it’s just a bit of an example, but not accurate. To accurately measure and gauge someone’s contribution is far far more complex I do admit. 
 

Many jobs do have social value, not just a monetary value. 
 

A pet hate of mine though is how certain professionals are rolled out like Marty’s who went to war and didn’t have a choice etc. 

 

 

Ah essential workers who were absolutely needed to keep the country running. 
 

The list contained many many jobs that no one could argue were essential, became a bit of a joke really. 
 

Joe Rogan made fun of it in the USA because they deemed his podcast essential and he can drive around no bother. 
 

 

One thing it did highlight was just how essential some jobs were though. Lorry drivers, nurses, store workers. 
 

It was a prime opportunity (if they were that way inclined) to unionise and ask for better pay and conditions. 
 

Post lockdown nurses got the same usual pay increase, there was uproars, all over the news and TV saying what an insult it was, and still didn’t vote to strike. 
 

My mate, a MH nurse almost blew a gasket!! 
 

He said if the populace of nurses, couldn’t even be bothered to vote (very low participation in the voting) or didn’t bother to vote to strike after that event, they NEVER will. 

 

Absolutely agreed, there are many ways of looking at it. I've heard some argue in the past that those who work for the public sector don't really contribute as they're paid from taxes and that their pay is also artificially inflated. 

My take on it all, if your fit and able and you get out of bed in the morning and go to work (for those of working age) and your abiding by tax rules, your almost certainly doing your bit, if not more. 

[discobob]

I have commented before about my Wife's friend - managed to pay a house off while being a single parent, working maximum 18 hours a week, taking 3 holidays a year, driving a newish car, investing thousands into Harlequin to which she get the money back from the FCA (i.e. us) with 8% interest. Well, now here daughter is 19 and has lost out on certain benefits - is now working 30 hours a week - because she is still entitled to some benefits.

She only works 1 mile from her house - and she has got her daughter there as well (morrisons Pick and collect or whatever) - who is still classed as being at college and getting paid £50 per week for that as well

oh I - while I am at it - went to Edinburgh 2 weeks ago, by train at a cost of £360 to take her daughter to the Harry Potter whatsimajig up there.

Meanwhile, I am considering if I can afford to get my iphone screen fixed at a cost of £200 

[Walker570]

The NHS the Police Force and the Church of England are all irrepairably broken and for the same reasons.

[Bigbob]

14 hours ago, Mice! said:

Because you pay for a check up, your probably in and out in 3 mins and I think it was £17.50 last time I went.

Then any work needed goes on top, easy money for the dentists. 

Our dentist hasnt seem anybody apart from emergancies since covid started saved a fair bit of money and dont know when we will get back to 6 monthly check ups ?>

29 minutes ago, discobob said:

I have commented before about my Wife's friend - managed to pay a house off while being a single parent, working maximum 18 hours a week, taking 3 holidays a year, driving a newish car, investing thousands into Harlequin to which she get the money back from the FCA (i.e. us) with 8% interest. Well, now here daughter is 19 and has lost out on certain benefits - is now working 30 hours a week - because she is still entitled to some benefits.

She only works 1 mile from her house - and she has got her daughter there as well (morrisons Pick and collect or whatever) - who is still classed as being at college and getting paid £50 per week for that as well

oh I - while I am at it - went to Edinburgh 2 weeks ago, by train at a cost of £360 to take her daughter to the Harry Potter whatsimajig up there.

Meanwhile, I am considering if I can afford to get my iphone screen fixed at a cost of £200 

Commented on it before if you know how to work the system you can have a great easy life 

[Vince Green]

3 hours ago, Cosmicblue said:

  My brother has just retired at 63 over in Arizona - health insurance is $25,000 per annum for himself and his wife.

 

and its not bottomless. People in this country really have no idea

[Vince Green]

1 hour ago, Walker570 said:

The NHS the Police Force and the Church of England are all irrepairably broken and for the same reasons.

And the Civil Service

[Walker570]

1 hour ago, Vince Green said:

And the Civil Service

Agree 100%

[7daysinaweek]

Wouldn't that be wonderful!

Firstly, the clinical efficacy of such a test that would detect all malignancy, of which there are over 200 could be years away. I think someone has mentioned the 'Galleri' blood test which has been developed in the States. It promises to detect over fifty types of cancer with a single blood test from the information on it's own website site. The reason I mention this test is that it can demonstrate in some ways the ethical and financial decision-making that may or may not lead to a technology or medical intervention and a change of service for the patient.

The NHS gives the following information about this blood test on its own source sites:

The NHS is at present undertaking a pilot study of this test. " Research on patients with signs of cancer has already found that the test, which checks for molecular changes, can identify many types that are difficult to diagnose early, such as head and neck, ovarian, pancreatic, oesophageal and some blood cancers. If the NHS programme shows the test also works as expected for people without symptoms, it will be rolled out to become routinely available." https://www.england.nhs.uk/2020/11/nhs-to-pilot-potentially-revolutionary-blood-test/

 

"The NHS-Galleri Trial is a research trial to see how well the new Galleri™ test works in the NHS. The aim is to see whether the test finds cancer earlier when combined with standard cancer testing in people who don’t have any symptoms of cancer."https://digital.nhs.uk/services/nhs-digitrials/how-we-identify-participants-for-the-nhs-galleri-trial

 

The inclusion and exclusion criteria for the patient group in the study, shown below:

"People aged between 50 and 77 who live in a region of England where the trial is being run are being invited to take part.
People who have been diagnosed with or treated for cancer within the last 3 years, or those who are currently having tests (or waiting for tests) due to suspected cancer, cannot take part in the trial."

The study suggests it targets 140,000 participants of a defined age group of 50-79 years without any symptoms. A smaller group of 25,000 participants with malignancy suspected will be offered the test to aid in diagnosis and further treatment. It goes on to say. Results of these studies would be expected by 2023, and if outcomes are positive, then they would be 'expanded to' involve around a million participants across 2024 and 2025.

'Expanded to' would imply that this appears only an extension of the trial and not a fully fledged core commissioned  service level agreement for all patients of that age range. There are presently around fifteen million people in the UK in the age range of 50-79 years. I note that from the information given on the NHS sites that people with 'signs' of cancer without 'symptoms', so this could be someone who has a routine blood test that throws up a raised parameter, that would not be clinically expected to a greater extent within that pt given their history of conditions, age and sex. The patient without symptoms being that the individual has not noted any changes in their wellbeing. Similar to how blood tests throw up anaemia among other maladies when having target bloods done if you are being screened for hypertension. Making an assumption of that would lean towards that the criteria for access to this test is for people with 'signs' of malignancy, possibly on a pre-trial blood test. 

I have done a quick search and the only cost for this pilot drug I found was around the $900 mark, what is that in pounds? If the NHS does adopt this a part of a core service it would be at a lower negotiated price, how much lower, who knows.

The above pilot scheme if adopted says numbers of up to 1 million by 2025 so that is the possible proposed capacity that the NHS would from a governance point be able to capacitate for treatment. Patients with 'signs' but not symptoms of a suspected malignancy who are already picked up on traditional bloods should be referred for investigations. From what I can gather, the test if shown to be beneficial would help for some cancers to be picked up/targeted earlier at a less aggressive staging, improving patient outcomes.  

 
It is not unusual for the NHS to commission a pilot study with a non-payment to assess 'the value for money prospect' which the proposed advance would possibly bring before rolling it out as a fully commissioned core service. The NHS funds very little of its own research, so it is very plausible given the costs of the pandemic weighing heavy on the NHS public purse that no funding was given from the public purse for this pilot. The developing company will be hoping to get their test, assay equipment adopted as part of the core treatment services for cancer care.

Lots of things are considered as part of the process on deciding to fund fully or even partially, how effective will the change be in patient quality outcomes, what exactly would the nature of these benefits bring. The levels of presumption of overall proposed benefit, the actual ability and confidence to deliver that minimum service level agreement.
It must consider the cost implications and take into account that commissioned services should not disproportionately affect other group services and establish what overall impact it would have on other services, both positive and negative. Would the planned addition improve access to the service, or would it be overwhelmed and reduce access.

The NHS is very clear in that it 'does not hold budgets that meet all the needs of its patients that fall within it's remit of care.' I am sure we all agree with that.

I have thrown in a couple of the NHS commissioning principles which would directly question as part of the process the cost-effectiveness of such a level of service provision, which Toxo suggests from the point of sheer numbers. 

Principle 6
The NHS Commissioning Board should only invest in treatments and services
which are of proven cost-effectiveness unless it does so in the context of well-designed and properly conducted clinical trials that will enable the NHS to assess
the effectiveness and/or value for money of a treatment or other healthcare. 

Principle 10
The NHS CB should strive, as far as is practical, to provide equal treatment to
individuals in the same clinical circumstance where the healthcare intervention is
clearly defined. The NHS CB should not, therefore, agree to fund treatment for one
patient which cannot be afforded for, and openly offered to, all patients with similar
clinical circumstances and needs.

 

Let us assume from  he proposition of this thread that we would test everyone for the many types of cancer.
Here are some of the current blood tests and diagnostic procedures available for helping diagnose breast cancer alone. One of the many types. Not all will be required, but all have an impact both in financial cost and resources when utilized.

bone scan
breast cancer genomics
breast cancer tumour analysis
breast cyst and nipple discharge fluid analysis
breast ductal lavage
breast scintigraphy
breast ultrasound
CA 15-3
CEA
cell culture drug testing
chest xray
CT of the liver
ductoscopy
Estrogen receptor assay
Genetic testing
Mammography
MRI scan of the breast
PET scan
Progesterone receptor assay
Sentinel lymph node biopsy
Stereotactic biopsy

The treatments available after diagnosis.

Surgical intervention
breast mastectomy
conserving breast tissue
Adjuvant therapy: radiotherapy, chemotherapy, endocrine therapy

post treatment surveillance
family screening
physiological and psychological support

Each of the above cost from pounds, to hundreds to thousands.

As plenty have pointed out, the sheer resources required would 'inhale' the NHS. The resources of doctors, nurses, non-professional and professional allied to health staff needed would be staggering. Where would they come from, training takes time and money, how would them staff be retained. The cost of the testing and treatment would break the current business model, which is already broken in many, many ways. The NHS is buckling as it is and can barely cope.

Years of developing services for virtually every conceivable condition for an ever-growing  populace, the pot is not bottomless.

Once a blood test gave rise to a malignancy, there would be ethical expectations for further investigations and to initiate treatment in most cases, not to just diagnose.

Yes there are advances being made in some areas and let us hope that technology will continue to bring advances in treatment that hopefully and eventually lower costs which then allow for the saving to be offset into human resources and expanding and developing further services. However, screening 50-60 million from the age of eight that would take money and resources that we currently do not have.

I am sure that all of us have been touched in some way or another by cancer, and its dreadful effects. Some points I have made may seem harsh, however that is the reality with the current system, technology and economy.

Cancer is not the highest cause of old told mortality worldwide, but it is a significant one. Sepsis, heart attack and stroke are the greatest burden, then respiratory conditions, then malignancy but who can put a cost on any treatment.

A government's job is to mandate reducing suffering by tackling the most overarching societal health burdens overall, and also to reduce the economic impact of those health burdens. Another is to optimize health, enabling individuals to make meaningful health and economic choices. That takes money and as @mungler said in another thread that money has to come from somewhere. It is not an endless pot of dosh in the NHS.

 

[mel b3]

56 minutes ago, 7daysinaweek said:

Wouldn't that be wonderful!

Firstly, the clinical efficacy of such a test that would detect all malignancy, of which there are over 200 could be years away. I think someone has mentioned the 'Galleri' blood test which has been developed in the States. It promises to detect over fifty types of cancer with a single blood test from the information on it's own website site. The reason I mention this test is that it can demonstrate in some ways the ethical and financial decision-making that may or may not lead to a technology or medical intervention and a change of service for the patient.

The NHS gives the following information about this blood test on its own source sites:

The NHS is at present undertaking a pilot study of this test. " Research on patients with signs of cancer has already found that the test, which checks for molecular changes, can identify many types that are difficult to diagnose early, such as head and neck, ovarian, pancreatic, oesophageal and some blood cancers. If the NHS programme shows the test also works as expected for people without symptoms, it will be rolled out to become routinely available." https://www.england.nhs.uk/2020/11/nhs-to-pilot-potentially-revolutionary-blood-test/

 

"The NHS-Galleri Trial is a research trial to see how well the new Galleri™ test works in the NHS. The aim is to see whether the test finds cancer earlier when combined with standard cancer testing in people who don’t have any symptoms of cancer."https://digital.nhs.uk/services/nhs-digitrials/how-we-identify-participants-for-the-nhs-galleri-trial

 

The inclusion and exclusion criteria for the patient group in the study, shown below:

"People aged between 50 and 77 who live in a region of England where the trial is being run are being invited to take part.
People who have been diagnosed with or treated for cancer within the last 3 years, or those who are currently having tests (or waiting for tests) due to suspected cancer, cannot take part in the trial."

The study suggests it targets 140,000 participants of a defined age group of 50-79 years without any symptoms. A smaller group of 25,000 participants with malignancy suspected will be offered the test to aid in diagnosis and further treatment. It goes on to say. Results of these studies would be expected by 2023, and if outcomes are positive, then they would be 'expanded to' involve around a million participants across 2024 and 2025.

'Expanded to' would imply that this appears only an extension of the trial and not a fully fledged core commissioned  service level agreement for all patients of that age range. There are presently around fifteen million people in the UK in the age range of 50-79 years. I note that from the information given on the NHS sites that people with 'signs' of cancer without 'symptoms', so this could be someone who has a routine blood test that throws up a raised parameter, that would not be clinically expected to a greater extent within that pt given their history of conditions, age and sex. The patient without symptoms being that the individual has not noted any changes in their wellbeing. Similar to how blood tests throw up anaemia among other maladies when having target bloods done if you are being screened for hypertension. Making an assumption of that would lean towards that the criteria for access to this test is for people with 'signs' of malignancy, possibly on a pre-trial blood test. 

I have done a quick search and the only cost for this pilot drug I found was around the $900 mark, what is that in pounds? If the NHS does adopt this a part of a core service it would be at a lower negotiated price, how much lower, who knows.

The above pilot scheme if adopted says numbers of up to 1 million by 2025 so that is the possible proposed capacity that the NHS would from a governance point be able to capacitate for treatment. Patients with 'signs' but not symptoms of a suspected malignancy who are already picked up on traditional bloods should be referred for investigations. From what I can gather, the test if shown to be beneficial would help for some cancers to be picked up/targeted earlier at a less aggressive staging, improving patient outcomes.  

 
It is not unusual for the NHS to commission a pilot study with a non-payment to assess 'the value for money prospect' which the proposed advance would possibly bring before rolling it out as a fully commissioned core service. The NHS funds very little of its own research, so it is very plausible given the costs of the pandemic weighing heavy on the NHS public purse that no funding was given from the public purse for this pilot. The developing company will be hoping to get their test, assay equipment adopted as part of the core treatment services for cancer care.

Lots of things are considered as part of the process on deciding to fund fully or even partially, how effective will the change be in patient quality outcomes, what exactly would the nature of these benefits bring. The levels of presumption of overall proposed benefit, the actual ability and confidence to deliver that minimum service level agreement.
It must consider the cost implications and take into account that commissioned services should not disproportionately affect other group services and establish what overall impact it would have on other services, both positive and negative. Would the planned addition improve access to the service, or would it be overwhelmed and reduce access.

The NHS is very clear in that it 'does not hold budgets that meet all the needs of its patients that fall within it's remit of care.' I am sure we all agree with that.

I have thrown in a couple of the NHS commissioning principles which would directly question as part of the process the cost-effectiveness of such a level of service provision, which Toxo suggests from the point of sheer numbers. 

Principle 6
The NHS Commissioning Board should only invest in treatments and services
which are of proven cost-effectiveness unless it does so in the context of well-designed and properly conducted clinical trials that will enable the NHS to assess
the effectiveness and/or value for money of a treatment or other healthcare. 

Principle 10
The NHS CB should strive, as far as is practical, to provide equal treatment to
individuals in the same clinical circumstance where the healthcare intervention is
clearly defined. The NHS CB should not, therefore, agree to fund treatment for one
patient which cannot be afforded for, and openly offered to, all patients with similar
clinical circumstances and needs.

 

Let us assume from  he proposition of this thread that we would test everyone for the many types of cancer.
Here are some of the current blood tests and diagnostic procedures available for helping diagnose breast cancer alone. One of the many types. Not all will be required, but all have an impact both in financial cost and resources when utilized.

bone scan
breast cancer genomics
breast cancer tumour analysis
breast cyst and nipple discharge fluid analysis
breast ductal lavage
breast scintigraphy
breast ultrasound
CA 15-3
CEA
cell culture drug testing
chest xray
CT of the liver
ductoscopy
Estrogen receptor assay
Genetic testing
Mammography
MRI scan of the breast
PET scan
Progesterone receptor assay
Sentinel lymph node biopsy
Stereotactic biopsy

The treatments available after diagnosis.

Surgical intervention
breast mastectomy
conserving breast tissue
Adjuvant therapy: radiotherapy, chemotherapy, endocrine therapy

post treatment surveillance
family screening
physiological and psychological support

Each of the above cost from pounds, to hundreds to thousands.

As plenty have pointed out, the sheer resources required would 'inhale' the NHS. The resources of doctors, nurses, non-professional and professional allied to health staff needed would be staggering. Where would they come from, training takes time and money, how would them staff be retained. The cost of the testing and treatment would break the current business model, which is already broken in many, many ways. The NHS is buckling as it is and can barely cope.

Years of developing services for virtually every conceivable condition for an ever-growing  populace, the pot is not bottomless.

Once a blood test gave rise to a malignancy, there would be ethical expectations for further investigations and to initiate treatment in most cases, not to just diagnose.

Yes there are advances being made in some areas and let us hope that technology will continue to bring advances in treatment that hopefully and eventually lower costs which then allow for the saving to be offset into human resources and expanding and developing further services. However, screening 50-60 million from the age of eight that would take money and resources that we currently do not have.

I am sure that all of us have been touched in some way or another by cancer, and its dreadful effects. Some points I have made may seem harsh, however that is the reality with the current system, technology and economy.

Cancer is not the highest cause of old told mortality worldwide, but it is a significant one. Sepsis, heart attack and stroke are the greatest burden, then respiratory conditions, then malignancy but who can put a cost on any treatment.

A government's job is to mandate reducing suffering by tackling the most overarching societal health burdens overall, and also to reduce the economic impact of those health burdens. Another is to optimize health, enabling individuals to make meaningful health and economic choices. That takes money and as @mungler said in another thread that money has to come from somewhere. It is not an endless pot of dosh in the NHS.

 

That is both , reassuring,  and frightening,  in equal measure.  

A very informative post . Thankyou. 

[7daysinaweek]

9 minutes ago, mel b3 said:

That is both , reassuring,  and frightening,  in equal measure.  

A very informative post . Thankyou. 

No problem Mel

Hope it supports some of the thoughts and points of the posters.

Got a bit 'frazzled' penning that. 

[Mice!]

1 hour ago, 7daysinaweek said:

No problem Mel

Hope it supports some of the thoughts and points of the posters.

Got a bit 'frazzled' penning that. 

A bit?? You need to go shoot some rats 😉

[Lloyd90]

Here’s the real issue.

Does the Government, or anyone for that matter, want everyone to be fantastically healthy and live into really old age? 
 

If everyone has really good medical care, and everyone lived into their 90’s - 100’s what would that achieve? 
 

No one wants to die but we all have to go eventually. 

I’ve supported and helped many people to find care and nursing homes in my job. 

Some of the most blunt but realistic conversations I had are from the very old, who are genuinely just waiting to go (pass away). 
 

One bloke I sat with for hours, we just chatted, he’d outlived his wife and both his children. 
 

He sat and told me about WWII, he was apparently steering / driving one of the landing crafts that hit the beaches during D-Day. The description of the day will stay with me forever. 
 

He couldn’t manage at home any longer, but didn’t want to go into a care home. 
Worked with him for a few weeks to sort out something he was happy with. 

 

 

 

Guy Wallace does a fantastic, but very sobering little speech / rant in the documentary “The End of the Game”, where he says how he hates growing old and being unable to do the things he could manage as a young man. He says how awful it was seeing his parents lose their cognitive ability and suffer away in nursing home and then says when things really start falling apart he intends to put a 416 Rigby through the roof of his mouth! 
 

 

 

To be blunt, we could spend trillions, for what? 
 

To extend the live’s of people who are probably going to die a few years down the line regardless. 
 

I do appreciate this is a very blunt view. 

[Houseplant]

People aren't allowed to die any more! Common sense and compassion got lost along the way.