YP Comment: Weighty issues facing the NHS – should obese be denied surgery?

Should the overweight be forced to wait for treatment?
Should the overweight be forced to wait for treatment?
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THE CONTROVERSIAL decision by NHS bosses in one area of Yorkshire to force the obese, or heavy smokers, to wait up to six months for routine surgery comes down to this fundamental point – is this a necessary public health measure or heartless cost-cutting?

Some will say doctors have been too tolerant of the overweight, hence Britain’s obesity epidemic, and such draconianism is required if patients are to reconsider their sedentary lifestyles. Others will say that a longer wait for a hip or knee replacement, for example, will be counter-productive because of unforeseen costslike pain medication and physiotherapy.

With one in five patients now subject to restrictions in Scarborough and Ryedale – areas where historic NHS debts have repeatedly compromised care and led to the downgrading of local hospitals – it now appears that this plan has the tacit approval of national policy-makers.

This is the only conclusion that can be drawn from a letter sent to clinical commissioning groups by David Black, the joint medical director at Leeds-based NHS England, in which he says these bodies should give at least four weeks’ notice of further restrictions. “We expect that many CCGs will be in the process of developing similar schemes. This is something we would encourage, where plans are well developed and clinically validated,” he says.

This last point is key. What is the definition of “clinically validated” and who decides – local CCGs struggling to balance the books, NHS England or the Department of Health? Patients and taxpayers have a right to know.

Equally this debate highlights the importance of preventative healthcare and the steps that need to be taken to encourage people of all ages to exercise regularly and eat healthier meals if they’re not to become an even greater drain on the National Health Service’s finances.

Yet, given GPs and local health centres are best placed to lead this work, how can they do so when staff shortages mean doctors can’t spend sufficient time with their patients? Without this, restrictions on surgery eligibility, however well-intended, are just a sticking plaster solution as the NHS simply lurches from one financial crisis to another.

Nuclear game of brinkmanship

IT is perhaps fortuitous that US vice president Mike Pence was beginning a 10-day trip to the Far East when reports emerged of North Korea’s failed missile test as tensions escalate still further in the region.

Though the attempt was no surprise as the rogue state’s nuclear weapons programme poses a growing threat to world peace, it affords Mr Pence a chance to assert himself as the White House’s chief diplomat.

Describing the Korean peninsular as a “frontier of freedom” as he addressed members of the US armed forces, his words will reassure South Korea as America intensifies its military operations in this region.

Yet, given the provocative weapons test came hours after North Korean ruler Kim Jong Un presided over a massive show of military strength in the capital Pyongyang to mark the 105th anniversary of the birth of his late grandfather Kim Il Sung, the dictator appears to be luring America’s president Donald Trump – whose unpredictable foreign policy is viewed as as a strength and weakness – into a game of brinkmanship that could have potentially terrifying consequences. As Mr Pence and others have intimated, China offers the best hope of diffusing tensions. The problem is North Korea still went ahead with this failed test in spite of Beijing’s request not to do so.

Lessons in stress

EVEN THOUGH Ministers mistrust the teaching unions, and vice-versa, it would be a dereliction of duty on the part of the Government if it ignored the latest report on classroom stress.

With teachers becoming increasingly reliant on caffeine, alcohol and prescription drugs according to the NASUWT, and others citing work pressures for the breakdown of personal relationships, Ministers need – at the very least – to ensure that the necessary support services are in place.

As four-fifths of school staff claim that their job has had a negative impact on their health and wellbeing in the past 12 months, the Government cannot ignore such disturbing findings, even more so at a time when the need for experienced teachers has never been greater as Britain prepares for Brexit.

This is one lesson that must be learned before stress impacts further on the education of children.