Sunday, May 13, 2018

So, if this family does raise the money, will the NHS

forbid them to go?  Or will it be "We said 'amputation', and that's what you're getting."


Dan said...

This issue isn't even debateabla. In the US we ROUTINELY successfully treat
this condition. The UK NHS decision to amputate is based SOLELY on the issue
of COSTS. It will cost many times the $$$ to save this child's leg than to
hack it off. And in FORMERLY 'Great' Britain ALL that matters in regards to
healthcare decisions is "WHAT DOES IT COST".

markm said...

The NHS does normally allow its subjects to travel abroad and seek better treatment if they pay for it, and occasionally will even pay for treatments not available in Blighty, assuming the patient doesn't get too sick to travel before the paperwork comes through... Since this girl isn't in a hospital and is medically fit to travel, there should be no problem in leaving.

The issue with that dying kid was that bureaucratic "logic" reached full insanity. First, he was admitted to a hospital, and so needed a release from the hospital. (Taking a kid from the hospital without this release is considered child abuse - sometimes it is also considered this in the USA, but FGB seems to have removed this decision from a judge and given it to a clerk.) And he was "too sick to travel" - the risk of dying before reaching another hospital was rather higher than the NHS could endorse. Too sick to travel is a real thing - I learned that in a small northern Michigan town where the hospital would send most serious cases to a city 200 miles away, but first they had to get them well enough to travel... The insanity is when the regulation makes no exception for someone who was going to die for sure if he didn't travel.

And the NHS did have a treatment for this kid - conventional radiotherapy, but his parents thought the side effects were too severe. (I don't know what the NHS regulations are about "too sick to treat".) What they wanted was proton-beam radiotherapy; this ionized beam can be focused and steered by magnets or electric fields, so I guess it achieves better precision and kills off less healthy tissue. The kid was very likely to die in any case, but that doesn't mean the proton therapy wasn't worth a try. Most times a doctor tells you that an outcome is certain, he's full of shit.

markm said...

The other odd thing is that someone paid quite a lot for three British physicians to travel to the USA and learn the limb-lengthening procedure, but then they decided not to use that training. "We don't have enough cases to stay proficient" is a legitimate and not uncommon reason for not doing a procedure locally, but couldn't they have determined this up front? I suspect that to pay or this junket, several procedures that are routine even for NHS - like knee replacements and cancer diagnostic tests - were delayed for months. You save so much money when the patient dies while on the waiting list...