Couples who smoke, and fatties, banned from IVF treatment by NHS Fife

[Hibbyradge]

http://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-19676570

[Phil D. Rolls]

http://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-19676570

Well that's slashed the IVF Budget by around 99.5%!

[Pretty Boy]

To be honest I agree with banning women who are smokers. Smoking whilst pregnant is massively discouraged, as is smoking whilst trying.

Smoking is potentially harmful to an unborn baby and if someone is serious about having a child they should be giving up anyway.

[One Day Soon]

Its quite right.

[Johnny0762]

Too right, smoking should be illegal.:cb

[Hermit Crab]

Too right, smoking should be illegal.:cb

You're joking right? The amount of money the government make on tobacco through tax is unbelievable. Smoking will never be illegal, same goes for alcohol. That also makes the government plenty through tax.

[Johnny0762]

You're joking right? The amount of money the government make on tobacco through tax is unbelievable. Smoking will never be illegal, same goes for alcohol. That also makes the government plenty through tax.

No I'm not joking. Why not just legalise drugs and tax them? That seems to be your idea, that if it's taxable it's a good thing, no?

On second thoughts, maybe you aren't saying that smoking shouldn't be illegal, but are saying it cannot ever be illegal? I'd agree but I still stand by my point that smoking SHOULD be illegal.

After squandering absolute £millions on bombing farmers and nomads in foreign mountain passes, the NHS is no better off with the heavy tax on smoking.

[Bishop Hibee]

Good. Extend the ban to NHS Lothian please.

[easty]

You're joking right? The amount of money the government make on tobacco through tax is unbelievable. Smoking will never be illegal, same goes for alcohol. That also makes the government plenty through tax.

Thats the reason it won't be made illegal, but thats not to say it shouldnt be.

What really amazes me is that, when even the biggest idiots in society know the damage it does, so many people still take up smoking nowadays. I've never even tried a cig, the smell/cost/health issues attached to it make it seem pointless to me.

[Jay]

To be honest I agree with banning women who are smokers. Smoking whilst pregnant is massively discouraged, as is smoking whilst trying.

Smoking is potentially harmful to an unborn baby and if someone is serious about having a child they should be giving up anyway.

I think smoking affects male fertility too and a pregnant woman passively smoking through her partners habit can also damage the baby.

Both should stop but if the NHS is taking these steps then where does it stop? Should smokers be offered ANY operations involving a GA? Huge can of worms.

[Phil D. Rolls]

This illustrates many of the dilemmas that face the NHS. Whilst it would be nice to provide every intervention to everyone that wants it, is it possible when there is a limited amount of money to do that.

Some might say that if we accept the principle that people can be excluded from the NHS because they don't take enough care of their own health, that there are many other situations where obesity and smoking could be used as a reason. There can be few illnesses where these are not contributory factors.

On the other hand, would it be fair to exclude sporting injuries, or drug induced mental illness from the NHS as well? After all these are also optional items that mean the person has brought the problem on itself.

Likewise should we allow people to access alternative therapies through the NHS? In some cases there is as strong an evidence base for their efficacy as there is for those provided by the medical profession.

Finally, some might argue that if people didn't smoke, then there would be less of a strain on the nations resources. Same for drinking alcohol. Both of these legal highs, are responsible for a large amount of preventable illness. The sickness they cause also impacts on the welfare budget. Maybe its only right that they are taxed.

When dealing with people's freedom to choose, and what can be provided, there are many grey areas. I don't have any answers, but there are many questions that we need to address as a society.

[Eyrie]

I would think that both smoking and obesity would reduce the chances of a successful IVF cycle, so I don't see the issue here. If people want their own child that badly, then what is wrong with expecting them to take steps to improve their chances of success?

I'm sure that the inability to conceive naturally is very distressing for any couple affected, but at the end of the day IVF treatment is an elective procedure and not treatment for a threat to someone's health.

[Phil D. Rolls]

I would think that both smoking and obesity would reduce the chances of a successful IVF cycle, so I don't see the issue here. If people want their own child that badly, then what is wrong with expecting them to take steps to improve their chances of success?

I'm sure that the inability to conceive naturally is very distressing for any couple affected, but at the end of the day IVF treatment is an elective procedure and not treatment for a threat to someone's health.

Could it not be argued that inability to have a child might have a detrimental affect on someone's well being, with possible consequences such as depression? Maybe IVF would save money in the long term.

(Sorry, not being smart here, just trying to open up the debate.)

[Eyrie]

Could it not be argued that inability to have a child might have a detrimental affect on someone's well being, with possible consequences such as depression? Maybe IVF would save money in the long term.

(Sorry, not being smart here, just trying to open up the debate.)

A fair point, but then surely the couple involved will be willing to do what it takes to improve their chances?

[Phil D. Rolls]

A fair point, but then surely the couple involved will be willing to do what it takes to improve their chances?

That depends on the couple. It's possible that the stress of infertility might make it harder for them to stop. Having a baby might be just the incentive they need to clean up their act.

I'm a bit uneasy with the evidence that it makes a difference. Are they saying that someone on 20 a day is the same as someone on one a day? What other lifestyle changes might the couple be expected to make - will the NHS insist that they are in bed by 10 o' clock at night, or that they drink 5 litres of water a day, or that they only eat organic food?

The irony is that someone can go to the papers and say it is totally unfair that they are not getting a particular drug due to cost and be treated sympathetically. This might be despite the fact that giving them the drug means that possibly four other people don't get the drugs they need, due to a limited budget. Yet, if your lifestyle choice is politically incorrect, then it is OK to deny you what other people can take for granted,

[s.a.m]

That depends on the couple. It's possible that the stress of infertility might make it harder for them to stop. Having a baby might be just the incentive they need to clean up their act.

I'm a bit uneasy with the evidence that it makes a difference. Are they saying that someone on 20 a day is the same as someone on one a day? What other lifestyle changes might the couple be expected to make - will the NHS insist that they are in bed by 10 o' clock at night, or that they drink 5 litres of water a day, or that they only eat organic food?

The irony is that someone can go to the papers and say it is totally unfair that they are not getting a particular drug due to cost and be treated sympathetically. This might be despite the fact that giving them the drug means that possibly four other people don't get the drugs they need, due to a limited budget. Yet, if your lifestyle choice is politically incorrect, then it is OK to deny you what other people can take for granted,

I get what you're saying, and if there was a good chance IVF would result in a baby for them, and enable them to sort out their other health-damaging behaviour, then it may be possible to make that argument (although you would have to justify that to those couples denied treatment who have taken whatever steps they can, in order to improve their chances, and are having to accept limited resources being spent on couples who haven't made those sacrifices).

I think I'm right in saying that IVF is in very short supply, and the general success rate is disappointingly very low (though subject to quite a bit of variation from centre to centre). Given the limitations, and that rationing already takes place, I think it probably makes sense to prioritise those couples for whom the chance of success is higher. I may be wrong, but I don't think it's so much to do with 'politically correct' lifestyles, as likely effectiveness of treatment.

[Phil D. Rolls]

I get what you're saying, and if there was a good chance IVF would result in a baby for them, and enable them to sort out their other health-damaging behaviour, then it may be possible to make that argument (although you would have to justify that to those couples denied treatment who have taken whatever steps they can, in order to improve their chances, and are having to accept limited resources being spent on couples who haven't made those sacrifices).

I think I'm right in saying that IVF is in very short supply, and the general success rate is disappointingly very low (though subject to quite a bit of variation from centre to centre). Given the limitations, and that rationing already takes place, I think it probably makes sense to prioritise those couples for whom the chance of success is higher. I may be wrong, but I don't think it's so much to do with 'politically correct' lifestyles, as likely effectiveness of treatment.

Good point there, for me it would come down to the evidence that backs up the decision. I question how smoking, say, two cigarettes a day could make much difference. It seems like an easy way to sift people out of the pool. Personally I think each case should be judged on its merits - and excluding a whole group of people is more about expediency than delivering health care.

That said, I have to acknowledge I haven't seen their evidence, and that is the thing that should be addressed.

[--------]

To be honest I agree with banning women who are smokers. Smoking whilst pregnant is massively discouraged, as is smoking whilst trying.

Smoking is potentially harmful to an unborn baby and if someone is serious about having a child they should be giving up anyway.


:agree:

Smoking and drinking both cause harm to the unborn child.

NHS resources are limited, and people die because the resources aren't there to treat them quickly and effectively.

People die because there aren't enough MRI scanners, because certain effective drugs are 'too expensive' to be provided on the NHS, because waiting-times for surgery are still too long, or simply because they don't get seen and heard by a doctor soon enough for effective treatment to be given.

I appreciate how hard it can be to want a child, yet be unable to conceive, but if a couple are looking for treatment to enable them to have a child, it's THEIR responsibility to do everything they can to increase their own chances of doing so.

Stopping smoking; the woman moderating her alcohol consumption, or even cutting it out entirely for the duration of her pregnancy; eating sensibly and healthily; taking exercise as advised by the health professionals treating her...

That's not 'political correctness gone mad' - it's simple common sense.

But if someone I loved was denied - or even delayed having - an MRI scan while seriously ill to accommodate a pregnant woman experiencing complications due to her bad lifestyle - smoking drinking, using drugs, overweight, etc - I think I'd be seriously ticked-off about it.

Which is the bottom line, really, given the limited resources available in Scotland today.

[One Day Soon]

:agree:

Smoking and drinking both cause harm to the unborn child.

NHS resources are limited, and people die because the resources aren't there to treat them quickly and effectively.

People die because there aren't enough MRI scanners, because certain effective drugs are 'too expensive' to be provided on the NHS, because waiting-times for surgery are still too long, or simply because they don't get seen and heard by a doctor soon enough for effective treatment to be given.

I appreciate how hard it can be to want a child, yet be unable to conceive, but if a couple are looking for treatment to enable them to have a child, it's THEIR responsibility to do everything they can to increase their own chances of doing so.

Stopping smoking; the woman moderating her alcohol consumption, or even cutting it out entirely for the duration of her pregnancy; eating sensibly and healthily; taking exercise as advised by the health professionals treating her...

That's not 'political correctness gone mad' - it's simple common sense.

But if someone I loved was denied - or even delayed having - an MRI scan while seriously ill to accommodate a pregnant woman experiencing complications due to her bad lifestyle - smoking drinking, using drugs, overweight, etc - I think I'd be seriously ticked-off about it.

Which is the bottom line, really, given the limited resources available in Scotland today.


Spot on. The NHS is all about rationing, never openly discussed but it is. People with all sorts of conditions are expected to change their behaviour in relation to diet, exercise, lifestyle etc to give themselves a better/longer life. Why wouldn't those wanting IVF - and there is high demand for it - be expected to alter their lifestyles by losing some weight and ceasing smoking?

We live in a 'you can have it all society' - except that you can't. The sooner we get towards a position where people begin to appreciate that we all have to make a contribution too, rather than simply feeling that we can take and deserve constantly the better.

[Phil D. Rolls]

Spot on. The NHS is all about rationing, never openly discussed but it is. People with all sorts of conditions are expected to change their behaviour in relation to diet, exercise, lifestyle etc to give themselves a better/longer life. Why wouldn't those wanting IVF - and there is high demand for it - be expected to alter their lifestyles by losing some weight and ceasing smoking?

We live in a 'you can have it all society' - except that you can't. The sooner we get towards a position where people begin to appreciate that we all have to make a contribution too, rather than simply feeling that we can take and deserve constantly the better.

I tend to agree with this. I think there has been too much copping out of clinical decisions, maybe due to the chance that an unhappy person will seek publicity for their own case.

I think, that in turn means society being much more prepared to accept that professionals be allowed to make the decisions. It seems to me that in Britain we train people, and pay them to be experts in their field, yet at the same time we reserve the right to go against their considered opinions.

It's important that the debate goes beyond health. There needs to be more debate in Britain, we are too apathetic, and sleep walk into crisis after crisis. The start of that is a recognition that we get the politicians and health and social care that we deserve.

We are too quick to look for people to blame when things go wrong, and too slow to think about the big issues. Thatcher truly has created a Me society. And subsequent governments have bought into that.