Just had a doctor tell me

On the leaflets/ membership card of the health insurance policy is usually a helpline you can call. Explain the situation to them & they will probably arrange an admission anyway. Make sure you put in a formal complaint about the gp. jude "Cacoethes scribendi" http://www.judesworld.net

My doctor is like that. Her answer to everything is, "Yo're fat and lazy. Go do excercise."

"Her answer to everything is, "Yo're fat and lazy. Go do excercise." Despite the fact that you might find this insulting, it's probably got more than a few grains of truth in it. A HUGE range of health problems can be prevented/alleviated by exercise and not shovelling crap food down their gullets. Most people don't do nearly enough of either, and then wonder why they look/feel like shit.

This is the kind of thing I am considering doing my bioethics thesis on. Allocation of resources and should people be entitled to free treatment for self inflicted conditions (smoking, bad diet etc.). There is a tension in the ethics of healthcare because it developed from a Hippocratic (pagan) tradition but evolved in modern times in a Christian environment and now, in this country operates in a secular capitalist arena. Many of the papers I have read take morality and human dignity as a starting point as to how we should make decisions on giving or witholding treatment but we must ask the question ' and who's going to pay for it?' It seems wrong to me that the law under this government states that a doctor must always act in the best interest of the patient and that might mean saving the life of a profoundly disabled child. Yet that same government is not then willing able to provide the life-long high level care that person will need often leaving parents to give up their jobs to become cares and then struggle financially. Her answer to everything is, "Yo're fat and lazy. Go do excercise." possibly true but as a physician her job is to heal not to pass moral judgement. that healing of course can include suggestions of a change in lifestyle. Finally back to Camilla's original dilemma (glad he's getting the IV antibiotics btw) - people like us who have private health insurance are doing the NHS a favour by relieving the pressure and not taking up a hospital bed. So I would most definitely complain if a GP was too ignorant or lazy to do the referral. As I said, put in a formal complaint - you can make a formal complaint about administration as well as the healthcare itself through the NHS complaints procedure. It might at least make him think again about his (IMO piss-poor) attitude. jude "Cacoethes scribendi" http://www.judesworld.net

My father, who is 81, was admitted to hospital with a relatively minor bladder infection. They treated him like a child and then, when he objected, like a naughty child. He went twenty four hours without a drink because they 'ran out of water jugs' and because he was in isolation, the ward stuff forgot to bring him a cup of tea. Three months later he is still in a community rehab unit with repeated bouts of CDifficile, and still being treated like a naughty child. The doctors finally prescribed Brewers Yeast as a way of controlling the bug; it took four days to get it from the hospital pharmacy, and it only arrived after both my mother and I turned up with pots of it from a local health food shop and started giving it to him ourselves. We were then (probably rightly) bollocked for possibly mucking up his treatment. Deep breath. Rant over. I only know that after a lifetime of refusing to take private health care on principle, I am now looking into private schemes for me and the kids, and in my old age will chain myself to something immovable rather than let them take me to an NHS hospital.

"Allocation of resources and should people be entitled to free treatment for self inflicted conditions (smoking, bad diet etc.)." I don't think it's up to doctors to make the moral judgement about the extent to which conditions are self-inflicted. That takes us down a very dodgy route. People could argue that they have a bad diet because: they're poor, they've never been taught to cook, there are now local shops selling fresh produce etc. Whether or not those you accept those arguments in any individual case, it's very hard to have a clear cut definition of what self-inflicted means.

I find resource allocation a fascinating topic because it brings in elements of sociology, economics, politics, philosophy and if inclined theology. I believe that healthcare is not a 'right' but something that is beneficial to society as a whole and it is therefore good to have free for all. I also think a compassionate society should have a good standard, free health service. Evaluating self-inflicted conditions is, as you say, a very dodgy route but nonetheless one that has to be looked at. However, the important question for me is not 'is a condition self inflicted' but is treatment part of 'standard' healthcare and should it therefore be free? As far as I am concerned (and this is in the news a lot at the moment) IVF is definitely not part of what should make up free healthcare. I am also still considering whether in light of my beliefs about healthcare, high-tech advanced treatements such as chemo always fall under the banner of standard healthcare that should be free. If we take the line that any condition or disease should always be treated free, if treatment exists and has a reasonable chance of success, that is equally a dodgy route. If for example we develop neuro-regenerative and cell anti-aging technologies that can treat the condition of 'old age' and its associations but costs £20k a year, will that be everyone's 'right'? Or just if you have a disease such as Parkinson's or Alzheimers? Are you going to tax ad infinitum to pay for ever increasingly sophisticated technologies? jude "Cacoethes scribendi" http://www.judesworld.net