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In the Independent newspaper today ...
Overweight people needing hip and knee replacements will be denied them on the National Health Service in East Suffolk.
Rationing of operations in the region is hoped to save 47.9m because of "pressing financial problems". Dr Brian Keeble, director of public health for Ipswich Primary Care Trust, said: "We cannot pretend that this work wasn't stimulated by the pressing financial problems of the NHS in east Suffolk."
He headed a group that concluded that cost-cutting thresholds should be placed on nine other procedures, including inserting 'grommets' for children with glue ear. Children who do not display educational or behavioural problems will not be eligible for the operation, which reduces childhood deafness, under the NHS. Operations will also be restricted on varicose veins, trigger finger and haemorrhoids.
Patients with a body mass index (BMI) of 30 or more - the clinical definition of obese - will not be eligible for the joint replacement operations, even if they are suffering intense pain.
Dr Keeble said: "There is some good science behind this. We know that patients who are overweight and obese do worse after operations, particularly bigger and longer operations.
"People need to take much more responsibility for trying to look after their health, in partnership with their doctor. If a patient starts to develop symptoms, the first thing they need to think about is how to reduce weight rather than waiting until you are immobile. It may be that their symptoms will diminish and they won't need the operation, which after all is not without risk."

There's something very wrong here. Do fat people not pay the same National Insurance as everyone else? Is Dr.Brian Keeble proposing to give them a discount because he's not going to give them the same service as the rest of us?
And is Dr.Keeble suggesting that it's children's fault they get glue ear? And what about varicose veins and haemorrhoids? If the old wives' tales are to be believed, you get varicose veins through being on your feet too much and piles from sitting down. What does Dr.Bloody Keeble expect us to do - hover?
It's easy to see what's going to come next. Smokers are going to be denied treatment because their ailments are self-inflicted. After that, drinkers. Then motorcyclists will be barred from A&E because everyone knows they're reckless. And if you have a car accident, the ambulance won't come because everyone knows motorists are all idiots.
And why restrict this new world order to medicine? How about the police refusing to arrest criminals because they're too naughty? Or the Fire Brigade refusing to turn out to anyone with a thatched roof? Or teachers refusing to teach children who are too ignorant?
These bloody know-alls need to be reminded that they are paid by the public to provide treatment to those who need it, not to make moral judgements - though of course this isn't really a moral judgement, just an underhand device to help them out of the financial hole they've dug for themselves.
And, Dr.Bloody Keeble, never mind people taking more responsibility for looking after their health - how about you taking responsibility for the money we've paid you to do the job we employed you for? Tell you what - you could resign. I bet your fat salary would pay for a few hip replacements.
The NHS is weighed down with administration - and pretty poor administration at that. There are more administrators in the NHS than there are doctors and nurses, because as anyone who has worked in a large public organisation knows, the main purpose of management is to proliferate. How many grommets could we put in kids' ears if we sacked a couple of useless pen-pushers, I wonder?
The GOS has a solution. We need to conduct a cull of NHS administrators. This might be an attractive activity for members of the East Suffolk Hunt, if there is such a thing. Bring the GOS the head of an NHS administrator, and you win a grand prize - an all-expenses-paid date with Felicity Kendal. The GOS hasn't actually asked Felicity Kendal yet, but she can hardly refuse such a good cause, can she? And if she does, Mrs.GOS says she'll gladly step into the breach - she could do with someone to help her clear out the cupboard under the sink.
So come on, all you sporting types. It's open season on desk-jockeys. But don't fall off your horse, because the local A&E department don't approve of blood sports ....

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