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Why Should Healthcare Be Free for Everyone

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In this essay I will be evaluating why should healthcare be free whether or not individuals with self-inflicted diseases or illnesses should be provided with free healthcare under the NHS (National Health Service) or if they should be required to pay for the treatment they are in need of, from their own pockets due to the never ending burden they are on healthcare in the UK. It costs the National Health Service billions of pounds a year to care for individuals in desperate need of treatment due to alcohol abuse, smoking, obesity and drug related problems.

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Whilst doing my research I came across a source that questions whether or not the NHS, who are already struggling to meet healthcare demands, can afford to even treat self-inflicted diseases based on research carried out by a team at a well-known respectful university. Dr James Martin Research Fellow at the Programme on the Ethics of the New Biosciences, argued that ‘The NHS should not treat self-inflicted illness’. Martin’s point of view was supported by research completed by his team at Oxford University. This Information was key to support my argument around spending costs and due to the clear evidence gained through the University it make the source reliable. However, the source is 10 years old and since 2009 there have been many changes within the NHS and in individuals’ health. Therefore the source may be too outdated to use by itself to evaluate my question as the figures and statistics most likely will have changed over the years. Although bearing this in mind the source was still used due to the clarity of genuine evidence collated as the article was written by a popular educational institution which aims to educate people.

Another source I came across whilst carrying out my research is an article by the Daily Mail written by Kate Pickles which mentions that ‘the vast majority of people believe alcohol abusers should pay for their own treatment rather than get it free on the NHS’ . This is supported by the results of a survey/report carried out by the Benenden National Health Report in 2015. This report aimed to find out the opinions of the British public on whether treatment as a result of a person’s own actions such as excessive eating leading to obesity, regularly taking recreational drugs or regularly consuming alcohol should be funded by the NHS or if those individuals who put themselves at risk should be charged according to the treatment they are in need of. In the report, whilst it is clear that most of the results show that most people ‘feel that they should not have to pay the price for the consequences of the poor choices of others’ the Medical Director of Benenden, Dr John Giles, states the other side of the argument which makes the report reliable as there’s a much more of a holistic approach as opposed to presenting a one sided argument. This ultimately will make it a lot easier for me whilst researching my question. The source is from 2015 instantly making it a lot more useful for my research compared to the previous source on research completed by Oxford university which was from 2009. This means that this source has statistics and figures which will be a lot more accurate to those of current, compared to the other source which is over a decade old. By studying both sources together, I can see whether there’s been a significant change over time in healthcare demands for treatment for self-inflicted diseases or if the demand has remained consistent over the years. However, the credibility of this source is limited due to the nature of the Daily Mail, which is a tabloid that doesn’t offer in depth analysis on issues such as what I am researching and it instead focuses more on celebrity gossip and scandals. Whilst bearing this in mind, the source on the Daily Mail website does have some clear evidence supporting my point of view helping me progress with my research.

Furthermore, I came across an article published by ‘The Guardian’ written by Clare Marx; ‘The NHS must treat smokers and the obese fairly’. The article portrays the idea that those individuals, who require treatment as a result of obesity or smoking, should be treated equally to patients who have no control over their health. This source is reliable for my research as the author; Clare Marx is a well-known former orthopaedic surgeon who was the former President of the Royal College of Surgeons of England which is a prestige and trusted institution. As she was previously a surgeon under the NHS, she will have first-hand experienced the struggles and frustration the NHS went through and without doubt, she would’ve met/treated patients with self-inflicted diseases. Therefore, the viewpoint given by Marx in the article can be trusted due to her experience and wisdom on the issue I am researching. Another aspect that improves the credibility of the source is that like the two sources I have mentioned above, a report supports Clare Marx’s viewpoint. The report published by the Royal College of Surgeons states that ‘One in three areas in England is denying or delaying surgery to patients who are obese or who smoke.’ Also, the origins of the source ie ‘The Guardian’ helps improve the reliability of the source and what Marx writes, because it is a Broadsheet meaning the article comes from a more reputable source that offers a more in depth analysis as opposed to the previous article  published on the ‘Daily Mail’.

In addition, as part of my research I wanted to look at specific facts and statistics on the taxes individuals are legally required to pay by law on alcohol and tobacco products. The website Gov.uk provided me with the useful information I was searching for as part of my investigation. (GOV.UK 2018) is the UK Government’s website. The website is maintained by the Government Digital Service (GDS). The website is reliable as it is a professional website owned by the Government and its main purpose is to provide up to date information on government and policy for both professionals and the general public. This means that I don’t need to look at other sources to support or question the credibility of this source based on the information it provides. Therefore, this indicates that the information that Gov.uk provides in regarding to the VAT charged on alcohol and tobacco products is up to date and relevant to use as part of my research regarding whether or not individuals with self-inflicted diseases should be entitled to free healthcare under the National Health Service.

Another article I used as part of my research investigating the issue on if individuals with self-inflicted diseases or illnesses have the right to free healthcare in the UK was an article published in 2017 by ‘The Telegraph’: ‘When it comes to smokers’ burden on the NHS, they may well contribute more in tax than they take’. The article is written by Ashley Kirk who is a senior data journalist at ‘The Telegraph’. Kirk questions whether or not smokers pay more in tax than they take off the taxpayer and if they really are as big of a burden on the National Health Service as society makes them out to be. The source is valid as it was written recently only two years ago and it also provides information on both sides of the argument by giving reasons on why smokers are a burden but also why they aren’t a burden. Also, the origins of the source improve the source’s reliability and the information that the source provides because it is published on ‘The Telegraph’ which has a reputation of providing quality and authentic information regarding current worldly affairs. The Telegraph is a broadsheet newspaper which has a reputation to aim to educate individuals on current affairs. This therefore improves the credibility of the source as it reassures me that the information that it provides is trustworthy. However, on the other hand the source’s credibility can be questioned because I cannot find any background information on the senior data journalist Ashley Kirk. This slightly decreases the value of the source because I do not know anything about the Journalist who wrote the article and what their reputation is. Therefore, in comparison to the article that I have mentioned above which is published by ‘The Guardian’ written by Clare Marx; ‘The NHS must treat smokers and the obese fairly’.  this article is less reliable because for the previous article, there is background information provided online on the Journalist Clare Marx which increases the validity of the source.

The NHS is forever struggling to cope with the increasing healthcare demands of the British public due to an increasing population and constantly facing budget cuts whilst at the same time, still trying to provide good quality healthcare. The treatment for self-inflicted diseases such as those caused by obesity, recreational drugs, regularly smoking and excessive amounts of alcohol consumption is purely an unnecessary burden for the National Health Service which should not be their issue to deal with. The NHS’ crucial time, money and energy deserves to be spent on those individuals who require treatment due to illnesses that weren’t caused by their own careless actions and who therefore don’t have any control over their suffering. However, there is reason to believe that all NHS patients should receive the same quality of healthcare no matter what the cause of their illness is because of the role the NHS plays in Britain. The reason the National Health Service was initially created in 1948 after World War Two was to provide free healthcare to all members of the British public regardless of their illness/disease. Therefore, it could be argued that if the NHS was to restrict those with self-inflicted diseases from receiving free healthcare, then the NHS wouldn’t be fulfilling their role in the nation and would be defeating the reason the institution was founded in the first place. But, without doubt there needs to be a system where the treatment provided by the NHS must be restricted for those who require expensive and time consuming treatment due to their own poor life choices which led them to the unfortunate position they are currently in.

According to officials, illnesses associated with lifestyle cost the NHS £11 billion each year. This shocking figure shows that a large part of the NHS’ budget is spent on treating patients who have caused themselves harm which could have been avoided simply through better lifestyle choices. According to the Action on Smoking and Health group, smoking costs the NHS in England approximately £2bn a year for treating smoking related diseases. Excessive smoking is directly linked to lung cancer. About 80% of lung cancer deaths are caused by smoking and smokers are constantly reminded about the side effects and risks associated with their bad habits. For instance, by law there is a clear and brutal warning at the back of every cigarette packet which warns individuals about the effect of regularly smoking cigarettes. But, smokers instead choose to ignore these signs and lead themselves to severe health complications. If they hadn’t smoked inordinately in the first place, they wouldn’t have been in need of expensive treatment such as lung transplants. Although in most cases, the majority of individuals requiring lung transplants due to lung cancer are smokers, it is only fair for non-smokers requiring lung transplants such as cystic fibrosis sufferers to always be prioritised in receiving the treatment however currently, this isn’t the case in the UK.

On the other hand, it could be argued that even smokers, alcoholics and obese individuals all have the right to free treatment under the NHS. They are all just as entitled to free healthcare as everyone else because of the NHS’ original values that it would meet the needs of everyone, it would be free at the point of delivery and that it would be based on clinical need, not ability to pay. By refusing to provide individuals with treatment based on their life choices or charging them for the treatment they require to live a good quality of life would defeat the whole purpose of the existence of the NHS. The National Institute for Health and Clinical Excellence (Nice) which advises on the clinical and cost effectiveness of treatments for the NHS said that in some cases the ‘self-inflicted’ nature of an illness should be taken into account. But the report bars any discrimination against patients on grounds of age alone. Nice stressed that people should not be discriminated against by doctors simply because they smoked or were overweight. All individuals must pay standard rate VAT at 20% on alcohol and tobacco products. In terms of cigarettes, 16.5% of the retail price of the cigarettes is paid in tax in addition to £4.57 on a packet of 20 cigarettes. This could be seen as being one of the reasons as to why alcoholics and smokers requiring treatment should be provided with 100% free treatment under the NHS as they pay tax on the products they purchase. The Government receives an estimated twelve billion pounds a year from direct tax revenues as a result of smokers who are required to pay a large amount of tax on the cigarettes they choose to purchase. Similarly, individuals are also required to pay sugar tax which was introduced in 2018. As well as that, most of the NHS’ budget is paid through general taxation (approximately around 80%) and National Insurance. It could therefore be argued that tax payers are entitled to free treatment under the NHS even if they have self – inflicted diseases because it is one of their basic rights as they contribute towards the bulk of NHS’ income. If people don’t agree with this, then taxes should be reduced and people should turn to private healthcare where every individual is responsible for paying for their own healthcare however, if this was to be introduced in Britain, it would come with both its advantages and disadvantages and would have a large impact on the British Public.

Moreover, according to an article published by The Independent in 2017, it could be argued that the National Health Service is already doing everything in their power to cut down on the burden that individuals who are suffering from obesity or smoking related health problems in particular, have on the British Healthcare system. The Article: ‘NHS under fire after announcing obese patients will not get non-urgent surgery until they lose weight’ written by Social Affairs Correspondent May Bulman explores the issue of whether or not the NHS have made the right decision by denying healthcare to obese patients who require non-urgent healthcare treatment until they prove that they have lost weight. Patients with a Body Mass Index (BMI) of over 40 will not be referred for routine surgery unless they are able to reduce it to under that number over a nine-month period. Alternatively they will be required to shed 15 per cent of their weight, according NHS Herts Valley Clinical Commissioning Group (CCG) and NHS East and North Hertfordshire CCG. Smokers will also be required to have quit for eight weeks before they are referred for surgery. A breath test will be used to detect the levels of carbon monoxide in their blood. The article mentions that the Royal College of Surgeons scrutinizes the decision made by NHS clinical commissioning groups and argue that “Singling out patients in this way goes against the principles of the NHS,” said Mr Ian Eardley, senior vice-president at the Royal College of Surgeons. “While it is right that patients are supported to lose weight or stop smoking, this should not be a condition of them receiving surgery.

“This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort. It can even lead to worse outcomes following surgery in some cases.” In particular, denying patients in need of minor treatments could have a detrimental impact on their health and cause their illness to worsen over time whilst they are trying to change their lifestyle choices and waiting for treatment. This could therefore cost the National Health Service more money as they will now be required to provide treatment for a more serious and complex problem due to initially refusing to treat the individual. However, this new policy could encourage individuals to change their lifestyles whether that would be to stop smoking, drinking excessive amounts of alcohol or consuming unhealthy food and to not rely entirely on the NHS to help them recover and become healthy. This could lead to individuals not requiring expensive treatment. A spokesperson from Herts Valleys CCG said: “This policy is designed to improve patient safety and outcomes, both during and immediately after non-urgent surgery. “Being fit and healthy before surgery can reduce the risk of serious complications, shorten stays in hospital and help patients recover better. We also hope to improve the long-term health of our residents through the targeted stop-smoking and weight-loss support on offer to patients. This indicates that the policy introduced by the national health service is to help aim to preserve individuals lives and decrease the risks of complications during or after treatment which would decrease the chances of an individual recovering as soon as possible after receiving treatment.

A survey conducted by BUPA, found that almost one in three British people want penalty charges imposed for NHS treatment on those who smoke, drink and are obese.  Treating these self-inflicted illnesses is stretching NHS resources to breaking point who needs to prioritise other illnesses which haven’t been caused as a result of the patient’s own life choices. 

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