Monday, June 02, 2008

Break out more party poppers for the Wonder of the WorldTM

Your humble Devil has expressed outrage and disgust at the NHS co-payments policy before, when examining the case of Colette Mills.

Now we can chalk up another victory for the bureaucrats of NHS, as they help to make another dying woman's last months as painful and distressing as possible.
A woman dying of cancer was denied free National Health Service treatment in her final months because she had paid privately for a drug to try to prolong her life.

Linda O’Boyle was told that as she had paid for private treatment she was banned from free NHS care.

She is believed to have been the first patient to die after fighting for the right to top up NHS treatment with a privately purchased cancer medicine that the health service refused to provide.

Oh, very well done, you bunch of fucking shits.
This weekend Brian, O’Boyle’s husband, said he was appalled by the way she was treated. He recalled his wife as a woman with an infectious laugh who had given a lifetime of service to the NHS as an assistant occupational therapist. The couple, who had three sons and four grandchildren, lived in Billericay, Essex.

After she developed bowel cancer and began having chemotherapy, doctors told her she should boost her chances of fighting the disease by adding another drug, cetuximab. It is not routinely funded by the NHS.

When she decided to use her savings to pay for it, Southend University Hospital NHS Foundation Trust withdrew her free treatment, including the chemotherapy drug she was receiving.

The trust said yesterday: “A patient can choose whether to continue with the treatment available under the NHS or opt to go privately for a different treatment regime. It is explained to the patient that they can either have their treatment under the NHS or privately, but not both in parallel.”

Why the fuck not? This woman has spent her entire working life paying National Insurance which, I might remind you, is supposed to pay for medical treatment (amongst other things). It isn't your money to withhold, you cunts; it is her money that the government was supposed to invest in an insurance fund.

Of course, the government has never, ever done that: as I have pointed out before, National Insurance is a scam, it is a Ponzi scheme.
As for Employer's National Insurance... well... LPUK health policy is still under review, although you can find our outlined aims here, but I, personally, would favour the abolition of NICs anyway. Any health payments certainly wouldn't be going to the state in any case; NI is just a Ponzi scheme (as is the public sector pension arrangement). Does this sound at all familiar?
Ponzi was bringing in cash at a fantastic rate, but the simplest financial analysis would have shown that the operation was running at a large loss. As long as money kept flowing in, existing investors could be paid with the new money, but colossal liabilities were accumulating.

As with NI, the money was not actually invested: it was simply used as income and the liabilities were paid out of that income. The Ponzi scheme was a massive fraud, and so is NI. As with tax—or, as I prefer to call it, extortion with menaces—if it wasn't the state doing it, the whole scheme would be illegal.

It is time to do away with this centralised healthcare and it is time to do away with National Insurance Contributions. Let people make their contributions to private healthcare schemes (you can regulate them, as per Switzerland. Seriously, if one single commenter whinges about the evil American insurance, I'll go fucking apeshit), and private unemployment insurance and private pension schemes.

At least they know that their money will actually be invested and that they will be able to access their funds and pay for the treatment that they fucking want. Even if her insurance company would not fund the drug that Linda O'Boyle wanted, at least they wouldn't make her pay for all of her treatment.

Seriously, I hope that the fucks who continue to take these decisions get really depressed and then go home and hang themselves.

But never mind: Labour's on the way out, eh? Surely the Tories will right this wrong?
David Cameron, the Conservative leader, said in a statement that it was “tempting” to allow patients to pay for extra cancer treatments that were not funded by the NHS.

The party has been reluctant to express an opinion on the issue, fearing that it could be portrayed as favouring middle-class patients who can afford to buy themselves extra treatment.

Oh. That'll be a "no", then.

Look, you fucks; you aren't creating a two-tier NHS or favouring the middle classes: you are simply allowing those who decide that they would like to have a chance at a few more months of life to top up the NHS treatment that they have already paid for throughout their working lives.

It isn't your money, you bastards: it is our money.

And because the National Insurance scheme is so obviously a scam, you have to force us to hand it over to you using state-sanctioned violence. And then you don't even have the decency to invest it as was promised: in fact, no government has ever invested it, as was promised. The National Insurance fund is a lie: it never existed.

National Insurance: the greatest Ponzi scheme ever and quite probably the most prolific scam ever perpetrated.

The bureaucrats of the NHS: amongst the most evil people on earth. May their wombs rot and their balls moulder within their disintegrating, disease-riddled bodies, the foetid ichor of their rapidly liquidising organs causing them exquisite agonies whilst the stench of decay warns all around them of their depravity as the decay of their bodies mirrors the pus-soaked interstitices of their moral-free minds.

Fuck them all. With a rusty nail-encrusted stick.

UPDATE: you really should go and read this post by Prodicus. Here is the preamble...
The following letter was leaked to our Fuck Me You're Joking Oh My God You're Not Are You correspondent.
Dear Customer,

It has come to my attention that you have broken our rules by purchasing medicine from a supplier who is not me. Your treatment is therefore cancelled with immediate effect.

What you should do now.

You should fuck off and die.

Thank you for using the National Health Service, and may I take this opportunity to wish you the best of luck with the rest of your... oh.

Yours sincerely,

Her Majesty's Secretary of State for Health

It just gets better...

UPDATE 2: Unity looks into the whole thing a little more carefully and specifically the efficacy of the drugs involved. His take is definitely worth reading, although it doesn't really alter my opinion on co-payments. As John Redwood points out, we all use co-payment all the time.
The government’s visceral hatred of co-payment for health is as absurd as it is dangerous. Practically everyone who uses the NHS practises co-payment. The very system Labour set up more than half a century ago soon required co-payment in the form of prescription charges. It always allowed private sector pharmacies to offer over the counter drugs to people for self treatment, or for treatment under the advice of the pharmacist.

33 comments:

Rob F said...

The absolute, fucking bastards. There are flatfish with more morals than them.

I'm willing to believe that there are managers who work within the NHS who this description wouldn't apply to, and who hate the system as much as we do (and as much as she did, before she died in agony).

But how many of them went out of their way to try to find a loophole for her though, or if they couldn't, raised the issue publically in order to try to help her and others like her?

Not many, I'll bet. Most of them probably shrugged their shoulders, wrote her off as "just another patient who'll probably die anyway", and then went home to watch the X-Factor or something.

But hey, they're not suffering from cancer or have a spouse who does so they can forget about the whole thing until it affects them. Then, hopefully, they can rely on the generosity of people much better than them.

They know that those people are out there. After all, they were the ones who attacked them for being inhuman and uncaring in the first place...

Forget flatfishes. I think I saw a cockroach at work who might serve as a willing moral advisor to these people.

wonkotsane said...

There was a bloke on the news last night who now has to pay for all his NHS treatment because he paid for a cancer drug free in Scotland but refused to him because he's English.

Apartheid: just another service New Liebour provide.

captain nuclear penis said...

Alan Johnson is a murdering evil cunt.

the a&e charge nurse said...

Devil - your item seems to highlight x3 main themes

The first easy is easy to deal with - withdrawing NHS care for 'topping up' privately is simply an abuse.
It is morally bankrupt, even if patients opt for toxic and expensive drugs that MAY make things worse, rather than better.
For example some cancer drugs have unpleasant side effects and do little (or nothing) to stop disease progression.
I know that you endorse such choices no matter how futile, and I would probably tend to agree if it takes the mind of dying for a few minutes.

The Colette Mills case (as I remember it) centered on a dispute with the PCT about her entitlement to an anti-cancer drug that was not licensed in the UK (or in the USA for that matter) - maybe the drug was worth a shot but the principle of making unlicensed drugs available to everybody on the NHS is harder to principle defend ?

The denouement of course is that the NHS is the worst system in Europe, and perhaps we should be more like the Swiss, whose model of health care is often presented here as some sort of holy grail.

Well, my Devilish friend, despite being the most expensive system in Europe even the Swiss are now rationing health care - google Santos-Eggiman, [Is there evidence of implicit rationing in the Swiss Health Care System, 2005] - it's an interesting paper.

It is said that a third of us will die from cancer.
I have seen it in my family and at work - doors start to rapidly close once metastatic spread has occurred.
Maybe we should be pumping more money into prolonging the final stages of these diseases - but these drugs are not cheap and given the current financial climate it seems likely this could only be achieved by reducing health services elsewhere ?

Blue Eyes said...

On the news they quoted a government spokesperson who said something along the lines of "the principles of the NHS come before patient care".

Windy Blow said...

There is no place in hell more deserved than for the selfish fuckers who toyed with Linda O'Boyle's life and condemned her and all who lived her to agony and despair.

Even our greatest enemies might imagine they are killing innocents for some greater good, but to allow people to die like this for the sake of a few quid to uphold a "principle" of bureaucracy is beyond belief.

And the people who took this decision to make Linda O'Boyle's final time with us into a living hell (and at the same time condemn her family and friends to more misery than you would inflict on a rabid dog) will be going to work today and thinking about their holidays and what wine to drink this weekend and whether they can get that pay rise they so richly deserve.

Bastards indeed.

James said...

Labour don't have a clue where to go with this. Here's a statement by Baroness Thornton, a Labour peer, in the House of Lords from a couple of weeks ago: "If a private patient seeks help from the NHS, he or she is entitled to NHS services on exactly the same basis of clinical need as any other patient. Our guidance is quite clear on this. There should be no question of people ever being refused NHS care." Hmmm.....but not exactly the rhetoric coming from Mr Johnson yesterday?! By turning away from top-up fees the NHS is enshrining inequity; you can have the treatment but only if you're rich and have the money to go private for everything in that course of treatment. Here's an alternative option that I wrote of in the BMJ last month: Should patients be able to pay top-up fees to receive the treatment they want? Yes.

Anonymous said...

All I can say is that these cunts had better hope to fucking god that something like this doesn't happen to one of my few remaining loved ones, as I'm not too far off of breaking point with this government and it's army of little hitlers. I WOULD track down the doctors and politicians responsible and give them a taste of the pain, a big fucking taste.

Devil's Kitchen said...

A&E,

Thorn in my libertarian side though you might occasionally be, I appreciate your comments: I shall have a look for that paper.

However, since medical care -- both through state agencies and insurance companies -- appears to be being restricted, surely it can only be a good thing to allow people to use their own savings (if they feel that it is worth it) in addition to the other two methods...

Re: metastases. I believe that there are new drugs coming to the market which rely on restricting blood flow to the tumour (which is heavily implicated in enabling the metastatic spread): it will be interesting to see how effective they are.

I am always amazed at how primitive our cancer treatments are: they mainly seem to consist of "let's poison the body and hope that the cancer dies before the patient does"...

DK

ade said...

DK: I am always amazed at how primitive our cancer treatments are: they mainly seem to consist of "let's poison the body and hope that the cancer dies before the patient does"...

Isn't that because cancer, being a product of the host rather than an invasion by a foreign body, is rather hard to target at anything other than a genetic level?

Of course, with genetic research being (wrongly) such a taboo & prone to overzealous religionist propaganda, is it really any surprise that only medieval treatments are generally available?

cornishgiant said...

In this instance lets not blame the doctors or managers. This isn't thier policy, it is the governments.

What we need to do is start spending less on treating diseases that are, unfortunately, uncureable, and more on prevention and early detection.

I would like to take isue with these so called wonder drugs though. The reason they are not funded by the NHS is that they really are not, at a whole systems level, worth the money. Should however someone wish to pay for them themselves in addition, they should be able to.

lost_nurse said...

The reason they are not funded by the NHS is that they really are not, at a whole systems level, worth the money. Should however someone wish to pay for them themselves in addition, they should be able to.

Bang on. Withdrawing ancillary treatment in such cases is indefensible. Of course, bureaucrats rarely have to deal with such desperation at first hand.

Anonymous said...

Reference 3rd para of DK's 11.19 response:
Google: Dr Judah Flokman
He 'reasoned that tumours could attain only a certain size in the lab without the growth of new blood vessels, so he began seeking means of starving tumours into submission. The logical outgrowth of that reasoning was that blocking the recruitment of new blood vessels could starve tumours into submission, converting cancer into a manageable, chronic disease.
His ideas were disparaged and even ridiculed for more than a quarter of a century by his scientific peers and he was denied research funding for going against the ‘consensus’ and the received wisdom (that tumours did not eventually need a fresh blood supply).

Anonymous said...

This should be headline news in every paper and every TV station.

drunken tory said...

I work in the NHS (not for much longer - notice handed in etc). Everyone has been complaining about how un just this poor woman's case is. Lots of people very upset.

C Powell said...

I doubt whether this is lawful. Remember: the NHS has to pay for your care abroad (one of the better judgments to come out of the ECJ) so if you could get the necessary care in France, say, I don't see why you can't insist that the NHS pay for exactly the same care here. Also if Scots get the drug for free and we don't why not challenge it on discrimination grounds? Or move pronto to Scotland? What these shits are relying on is the fact that cancer patients simply will not have the energy or time to fight the system. Personally, if I were ever in this position I would threaten any doctor proposing to refuse me treatment with referral to the GMC. Doctors are meant to act in the best interests of their patients and to refuse treatment on these grounds is not a medical decision and must surely amount to a breach of their obligations.

This is a morally squalid policy and we should bombard Johnson with letters/emails (or ideally paving stones) asking him why he thinks it OK to allow people to die or be forced into penury. Ask him whether if I buy my own paracetamol at Boots rather than go to the GP for a prescription when I have a cold I can therefore no longer expect NHS treatment if the cold develops into pneumonia.

Every time these Labour buffoons go on about the NHS we should remind them of this appalling piece of spite. Not so much "The NHS is not safe with the Tories" but rather "Labour's NHS will kill you".

I believe some doctors are already raising a fighting fund to challenge this through the courts.

Vicola said...

Utter, complete and total twats. How the hell do the bastards who made this ridiculous decision sleep at night, knowing that they essentially condemned a woman to death. As it was thought about and debated beforehand does that not technically make it murder? Added to which, what the fuck business is it of a bunch of middle bloody managers what Mrs O'Boyle spends her savings on? She earned the money and if she then wanted to spend it on drugs that her PCT wouldn't supply because they were spending all their money patching up pissed chavs then surely it was up to her. I am truly truly appalled that this government would let a woman die in pain for their principles.

the a&e charge nurse said...

Thank you, Devil - have you looked in on 'Ministry of Truth' (a mephistophelian bargain) ?

A more detailed (and thoughtful) analysis of the background to these cases than the stories being presented outside of the blogsphere ?

In fact, if you want to learn anything about anything these days, who else is providing better commentary than the likes of your good self, Ministry, Guido, TimWorstall, Wat Tyler et al ?

Unity said...

DK:

I should say that I didn't expect that my piece would change your views on the principle of the co-payment issue.

Whether it might make you feel a little differently about the specific cases that are being used to drive this agenda is a rather different matter and on on which I do think there are other questions that should be asked.

For one, given that neither of the drugs in question have, as yet, been properly evaluated for their clinical effectiveness, one might reasonably argue that Big Pharma should be taking on a bit of responsibility here and the the immediate solution would be for them to incorporate people like Collette Mills into the clinical effectiveness trials that they need to be doing to get the drugs into the market properly.

Dr John Crippen said...

Unity is absolutely right to suggest that we are fighting the right battle on the wrong grounds. The question of experimental chemotherapy makes good press, but is a straw man. The government, rightly in my view, is not going to spend thousands of pounds on chemotherapeutic wild goose chases.
That is no way detracts from the DK’s main point, that the government’s stand on co-payment is an obscene cock-up. It is wrong economically; it is wrong doctrinally; it is wrong on grounds of human compassion. It is, I have to say, a classic Gordon Brown dither.
All the needs to say is the these drugs are of unproven efficacy. Let’s spend the money on something else, but if YOU want to pay for this treatment yourself, that is a matter for you.
May I comment to you all Unity’s long but outstanding post on this matter, and on the mire behind Doctors for Reform at the Ministry of Truth.



John

Patrick said...

This is a very depressing post... Indeed the Govt is a corrupt robbing bastard... But the pretence that they have of helping us at our most vulnerable is utterly disparaged by this action (or inaction), by the NHS regarding this poor ladies dilemma.. If you never thought a gun was being pointed at your head regarding the paying of your taxes, then this would be time to think again.. We are a long way from freedom and this post only highlights the iniquities of a cruel, greedy and endemically corrupt state that we live under...

Anonymous said...

All this moral outrage against the NHS for not treating a patient would have a little more conviction if it came from people who weren't opposed to the NHS in its entirety. In effect, you don't think the NHS should treat anybody do you?

I wonder why the ever reliable and benevolent forces of the free market were unable to help Ms Mills?

Patrick said...

anonymous... you are a moral relativist socialist piece of dog muck... your kind are a sickening example of blindness... When you come out of the fog, do let us know...

Devil's Kitchen said...

You are quite right, Anonymous; I don't think the NHS should exist. This is for a number of reasons, not least that it would stop politicians making decisions like this.

They are quite simply sacrificing people's lives on the altar of ideology, which is about the only thing that the Left does even vaguely efficiently.

DK

the a&e charge nurse said...

Patrick - you have major problems with the state, or "socialism", fair enough.

But 'anonymous' raises a legitimate point, i.e. would patients be any better of if health provision was left entirely to market forces ?

As we now know these new cancer drugs are very expensive - not everybody has £17k to pay for them (without selling your home, assuming you have one to sell, of course).

Even the libertarians prefer the checks and balances of state intervention (albeit on a much smaller scale, and with a greater onus on individual responsibility) - both very commendable ideas IMHO.

But the first rule of health care (given the relationship between increasing treatment costs and increasing demand) is that somebody, somewhere will suffer because there is simply not enough to go round.

The insurers, or fat cats cannot alter this unpalatable, but self evident fact, I'm afraid.

Patrick said...

a&e charge nurse,

Agreed, in it current state neither the state nor corporatism can achieve these aims, whether in tandem or on the states behest...

My objection is that we have a state at all. A state that serves no ones purposes except its own masters..

The gun that lurks behind the veil of sensibility is quite 'clear' in the states manipulation of our health..

The trouble is with peoples thinking, that the state is somehow the great benevolent father to all our needs... That it seeks to help us maintain a long and happy life.. barth..

As for the libertarian (minarchists) view of smaller govt.. I merely liken that to a woman who is lucky enough to get bashed by her husband only once a year, rather than the full pounding daily bashing of big govt... Both views are contemptible on moral grounds…

Health is an important issue for which we all bear responsibility for as individuals.. The idea that forcing me to pay for someone else’s health expenditure is somehow moral in nature is clearly ignoble to its core. We should all have the right to excellent care. But equally we should all bear the responsibility for our own personal health and provision thereof..

I’m quite aware my view is more philosophical than currently practical in present culture. But the removal of govt will be the first steps towards better health care for all…

Anonymous said...

Unity "Big Pharma should be taking on a bit of responsibility here and the the immediate solution would be for them to incorporate people like Collette Mills into the clinical effectiveness trials"

Unsure of my facts - but don't these trials need to be accurately designed - double blind etc.? How would co-option of random individuals fit in ?

Dunno if you're guilty of this, but I think the regular cheap shots by all and sundry against "big pharma" should be challenged. The bulk of our modern drugs have been developed by private industry - how many originated from the old Soviet Union, for example ?

Anonymous said...

There is no money in the kitty for the pensions, so everyone the NHS can kill on the cheap is a bonus. Which is why MRSA is allowed to run rampant and seemingly 'hard to fix' and cancer and other drugs are so strictly rationed, or often not permitted.

Besides that, note that the NHS wasn't interested in healing her before that either? All they offered was snake oil... now why do you think this could be?

Jolly said...

This is just unbelievable. The only possible grounds I can see for this decision is believing it to be inadvisable for a patient to be undergoing to separate treatment regimes at the same time, though this could have been easily overcome by asking her to sign a disclaimer.

It's just a thought but I wonder how the government would respond to people suddenly acquiring Scottish addresses on diagnosis. I'm not suggesting people actually move but a few months staying with a friend or relative to obtain treatment could be an option for some. It might put enough pressure of the system north of the border to force a change.

Gina said...

"We should all have the right to excellent care. But equally we should all bear the responsibility for our own personal health and provision thereof.."

I don't understand how that would work. I don't know a huge amount about libertarianism and its principles with regard to healthcare. Sorry if I sound a bit anencephalic, but if we should all be entitled to excellent care but also responsible for providing it, then does that mean we're all entitled to massively high wages or gold doubloons or something? Healthcare is so expensive, I just can't see how people could ever pay for it entirely themselves. It really would get like America then. My grandfather had a cardiac bypass a few years ago in the States. He had some of it covered by his insurance from when he had been working for a certain company, but still was expected to pay about 20,000 dollars himself. This is an elderly man on a pension. That's just not right. What are the models of healthcare provision that would stop Stalinesque control of resources but also prevent charging the old, weak and chronically ill (by definition those who use the most of the health services) exorbitant rates?

Patrick said...

Gina,

Nope... It just means WE ARE responsible for it, full stop... And no amount of FORCING me or you to pay taxes to pay for it, when I can pay for it myself and get a better service... (except you cant in said NHS now).

Your poor grandfather had probably 40 - 50% of his wealth robbed from him throughout his life in tax... I have no doubt that he could have provided the cost of his health quite adequately from these taxes and insurances etc..

The other fact is that there is little or no incentive for current health professionals to perform beyond their basic function. The state has made us all equal in the eyes of the doctor and nurse... So we wish on lady luck to help us through.

What sickens me about these pious dickheads in govt is how they try to convince us that universal health care is feasible, when clearly it is not.. We are at the mercy of state led programs, which we all know will never work..

Frederick Davies said...

http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2008/06/09/heckley109.xml

"[T]he principles and values of the NHS" are about to kill somebody else.

cookie, forget the doc to you dickweed said...

'NHS employee gets treated like a conservative on a social worker's 'in service' training day.'
The failure of the current Labour government to raise standards of health provision for those who are only slightly less marginally likely to support Labour than social workers is no surprise at all, except to those who took such support for granted.
It's delightful to me that that support is proving of less worth than a sand-tinged shit from a three month old puppy. Such NHS employees have been sold an absolute load of bollocks. Will we finally learn the real lessons of economics?