Need op but cannot get it on NHS

[Nozza]

Last year I went to the doctors because of pain in my low abdomen on my left side. I was eventually referred to a consultant surgeon who instantly diagnosed an inguinal hernia. He said I needed surgery and went about setting this up. I heard back from his secretary saying they'd done their end and were now referring it to the funding body.

 

Then this week I get a call from my doctor telling me that they will not be operating because the NHS doesn't pay for such operations any more. Apparently it's not affecting my life enough. The hernia means I cannot run and so I asked my doc "so you're telling me, at 43, that I will never run again. Her only answer, after a significant pause was that I should try swimming instead! I can't do that either because of a shoulder injury that they've also haven't treated properly yet. I cannot afford the money to get it done privately.

 

Is there anything I can do about this? It seems insane that I've being paying money into the NHS for 25 years yet I cannot have an operation that they tell me I need.

[Nozza]

there is i'm afraid i big difference between want and need.

yes the doctor said "to get it fixed you will NEED an operation"

this is not life threatening and so the operation is not NEEDED but Wanted. sorry but the NHS only has limited funds every one that pays Tax and NI pay into the NHS in some form or other i think spending money on a cancer drug to prolong somones life is more important than RUNNING

 

Your personal views on NHS spending don't really constitute advice to be honest. If you can't help with consumer advice then please don't bother to chip in.

 

For the record:

 

The surgeon says I need it not me.

They are operating for free on all those women who's breast implants might be dodgy despite lack of evidence of harm and the fact that they had them done for cosmetic purposed.

In the hospital my wife gave birth to my last child, she was, according to the nurse, the only UK resident in the entire post-natal ward. The other 9 women had in her words "turned up from god knows where to have their baby's here" So don't tell me it's about me being able to run vs people dying of cancer!

So the NHS is now only providing treatment for "life threatening" illnesses? That is clearly not remotely true.

[Conniff]

I'm afraid it is bunk, A few months ago I had my gall bladder removed, that wasn't life threatening, just painful.

[Nozza]

Why does it seem this is a new citizen in the UK and thinks its his or her right ?

 

Me? As I said I've been paying tax for 25 years. How could I possibly be a new citizen?

 

The surgeon told me this wouldn't have cropped up a year or so ago and differs from PCT to PCT. So it's new and location dependent. It's nothing to do with me or any other tax payer thinking they have a right to all and any treatment.

 

I'm in pain all the time, I cannot run for a bus, I cannot do most exercise. A surgeon says I need an op.

[citizenB]

http://www.nhs.uk/conditions/hernia/Pages/Introduction.aspx

 

[ATTACH=CONFIG]41107[/ATTACH]

 

Some interesting information in these two items.

 

I have to admit, I am surprised that a GP woud say that you require surgery and then just accept that funding cannot be obtained.

 

It is fairly obvious that surgery is being carried out on the NHS so perhaps you should persist with your GP to obtain this. Perhaps you could find out at what point the NHS or is it just the Funding department of your area, ceased paying for this ?

 

In England, during 2010-11, just under 71,000 surgical operations were carried out to repair inguinal hernias.

 

It was also my understanding that postcode lottery for health care was to cease !!

[BazzaS]

Me? As I said I've been paying tax for 25 years. How could I possibly be a new citizen?

 

The surgeon told me this wouldn't have cropped up a year or so ago and differs from PCT to PCT. So it's new and location dependent. It's nothing to do with me or any other tax payer thinking they have a right to all and any treatment.

 

I'm in pain all the time, I cannot run for a bus, I cannot do most exercise. A surgeon says I need an op.

 

Ask the GP's practice manager how you can appeal to the "Independant Funding" section of the PCT.

If they aren't as helpful as you'd like then try the secretary of the hospital consultant or the PALS section of the hospital.

 

Your likely grounds for appeal are : the degree of pain, and the restriction in your (healthy) lifestyle [your running].

You can also see if your surgeon can advise on the degree of urgency of the op (can they offer an opinion on the likelihood of it "obstructing", the likelihood of it "incarcerating", and the risk of you ending up needing the procedure as an emergency).

[Nozza]

Thank you the last two posters. That's somewhere for me to start.

[Feebee_71]

The other part of the PCT funding department you may wish to appeal to are the 'exceptional circumstances' team who can agree on funding - usually though, your gp would have to appeal to the PCT against the refusal to fund this surgery.

 

While not a life or death condition all hernia's have the potential to strangulate and become an emergency situation!!

 

Feebee_71

[Sali]

Nozza

 

As your GP seems particularly unhelpful it may pay you to do a little prep.

 

Just a quick search brings up numerous reports supporting your case.

 

www.royalberkshire.nhs.uk/pdf/hernia_repair_may11.pdf

www.ouh.nhs.uk/patient-guide/.../files%5C100628herniarepair.pdf

www.ouh.nhs.uk/patient-guide/.../files%5C100628herniarepair.pdf

 

Write your own report and send it to your GP and the PCT.

 

It does rather stick one's craw that the NHS is quite content to deny treatment to British nationals, but conversely happy to spend millions on language translation and lose millions by not pursuing foreign nationals who fail to pay for treatment they are not entitled to. Quite apart from the amount that drains down the plughole through its own incompetence.

 

Time for us to wave goodbye to the NHS before it waves goodbye to us.

 

Anyway, good luck to you. It may be a bit of a battle, but persevere.

Edited January 30, 2013 by Sali

[citizenB]

Some posts have been removed from this thread - not only were they of no value to the question asked, they were IMHO, quite rude.

[marcus6]

HI there, im not sure if im going to be of any help!

 

you may well get it done in the end, but you will have to wait a long time, if its not "life threatening"

 

Please dont tell you are trying to say you need this op! as you can not go running any more, can you walk do you work can you stand can you sit if its yes to all them!

then you will have to wait, as "life threatening" will all ways be at the top! of the list

 

as for the" implants" if they leak they then become "life threatening"

 

Please dont use the word you being able to run V dying of cancer

 

you are here for help, so please dont point out why some are geting ops and you are not! it all comes down! if what you have is "life threatening"

 

Me! i have been in/out of hospitl for 11 months now! test for this test for that! i have had full X-rays done, i have had CT,s done MRI,s, CT-Biopsy, CT-PET sacn, then more MRI,

 

and they still dont know whats up with me, all i have been told i have "enlarged Thymus" if you dont know what "thymus" is look it up then you come back and tell me if you need your op more so then i do. all im doing here is trying to make you understand!

 

 

 

 

 

so please dont tell me you should be geting a op ASAP justl so you can run! im not saying you dont need one! but you will have to wait like the rest that need op,s that are not life threatening

 

like some else said keep on to your GP about it he/she is the only one that can get the ball rolling.......

 

 

Your personal views on NHS spending don't really constitute advice to be honest. If you can't help with consumer advice then please don't bother to chip in.

 

For the record:

 

The surgeon says I need it not me.

They are operating for free on all those women who's breast implants might be dodgy despite lack of evidence of harm and the fact that they had them done for cosmetic purposed.

In the hospital my wife gave birth to my last child, she was, according to the nurse, the only UK resident in the entire post-natal ward. The other 9 women had in her words "turned up from god knows where to have their baby's here" So don't tell me it's about me being able to run vs people dying of cancer!

So the NHS is now only providing treatment for "life threatening" illnesses? That is clearly not remotely true.

[BazzaS]

HI there, im not sure if im going to be of any help!

 

you may well get it done in the end, but you will have to wait a long time, if its not "life threatening"

 

Please dont tell you are trying to say you need this op! as you can not go running any more, can you walk do you work can you stand can you sit if its yes to all them!

then you will have to wait, as "life threatening" will all ways be at the top! of the list

 

as for the" implants" if they leak they then become "life threatening"

 

Please dont use the word you being able to run V dying of cancer

 

you are here for help, so please dont point out why some are geting ops and you are not! it all comes down! if what you have is "life threatening"

 

Me! i have been in/out of hospitl for 11 months now! test for this test for that! i have had full X-rays done, i have had CT,s done MRI,s, CT-Biopsy, CT-PET sacn, then more MRI,

 

and they still dont know whats up with me, all i have been told i have "enlarged Thymus" if you dont know what "thymus" is look it up then you come back and tell me if you need your op more so then i do. all im doing here is trying to make you understand!

 

 

so please dont tell me you should be geting a op ASAP justl so you can run! im not say you dont need one! but you will have to wait like the rest that need op,s that are not life threatening

 

like some else said keep on to your GP about it he/she is the only one that can get the ball rolling.......

 

I'm not sure your post does help.

It is clear you are frustrated with your own situation, but that shouldn't affect your assesment of THEIR situation.

 

The OP said

I'm in pain all the time, I cannot run for a bus

 

Not being able to run for the bus sounds like a significant impairment to activities of normal living, not just "running for fun".

"Pain all the time" is even more reason (IMO) for intervention.

 

I'm aware that the site team have already had to step in on this thread, and hope my comments are constructive, reasoned, reasonable, and "fair comment".

[Jimmy99]

I am sorry to say that it is an outrage that this is happening.

 

The NHS are being screwed out of millions a year by crooked dentists (for example i had a false tooth, cost the top rate. They then tried to get me to have a private scale and polish but I got it on the NHS at the lowest rate. It should have been included)

 

Then there are prescription cost dodgers

 

Then there is mental health provision or lack of it

 

We deny people basic care that will improve their health and quality of life yet deny the terminally ill the cheap painkillers such as morphine or diamorphine.

We give IVF but leave people to die from rheumatic heart disease

 

It is privatisation by the back door (labour were as bad they wasted millions by paying private hospitals to perform NHS operations to reduce waiting lists)

Only the people with either money of healthcare can get what they need when they need it

[marcus6]

I'm not sure your post does help.

It is clear you are frustrated with your own situation, but that shouldn't affect your assesment of THEIR situation.

 

The OP said

 

 

Not being able to run for the bus sounds like a significant impairment to activities of normal living, not just "running for fun".

"Pain all the time" is even more reason (IMO) for intervention.

 

I'm aware that the site team have already had to step in on this thread, and hope my comments are constructive, reasoned, reasonable, and "fair comment".

 

i sorry you miss my point! im not frustrated with my own situation!! as i know things take time!! i will tell you what frustrates me is someone " come out and says i need an op as i can not RUN FOR THE BUS, are you sure!!

 

if he is in "Pain all the time" its more reason for intervention" but the only place that can help him is his GP

 

My post was just trying to make him understand! the op he wants is not at the top of the list, as there are alot more life threatening! ops that come before they will think about doing his.

 

Thanks

[BazzaS]

i sorry you miss my point! im not frustrated with my own situation!! as i know things take time!! i will tell you what frustrates me is someone " come out and says i need an op as i can not RUN FOR THE BUS, are you sure!!

 

if he is in "Pain all the time" its more reason for intervention" but the only place that can help him is his GP

 

My post was just trying to make him understand! the op he wants is not at the top of the list, as there are alot more life threatening! ops that come before they will think about doing his.

 

Thanks

 

The frequency of exclamation marks peppering your replies is what I base my assesment of your frustration on.

 

I never saw the OP comparing his situation with a cancer treatment as your earlier reply seemed to suggest, though they do say

So don't tell me it's about me being able to run vs people dying of cancer!

.

which is not the same as saying "mine is as important as people dying of cancer" : quite the opposite, in fact!

 

 

 

You also conflate two different concepts : "funding" and "urgency".

 

If the op isn't funded it will never happen, not even on a "non-urgent" basis until the situation decompensates, and becomes an emergency.

 

If the OP is funded, that doesn't mean it will happen ahead of emergencies : just that it can happen, and then hopefully that will avoid it becoming an emergency. So, it isn't that the OP wants to "jump ahead of emergencies"

 

As for "the only place that can help him is his GP" : you are misguided.

My earlier reply suggested the GP's as the most appropriate resource : not the only resource. The OP (on his own) can approach the PCT directly (or its successor, the CCG, soon to take over).

 

However, getting the appeal to the right place, and couched so as to be most likely to succeed is best done with the support of a clinician : ideally the GP, but potentially the surgeon. Hence my advice to try (in order if preference) : GP, then surgeon via their secretary, then surgeon, via PALS.

 

Note that I say "support of a clinician" : the clinician can't start the formal "Independant Funding" appeal process, the OP (or their proxy / "attorney") has to do so.

(See, for example : http://pamelanorthcottfund.org.uk/pdf/Appeals-leaflet-for-patients-March-2007.pdf

which notes :

2. The appeal must be made in writing by you or a representative that you appoint,e.g.family member, Independent Complaints Advocacy Service*. It may not be made by any of the doctors involved in the funding request.

 

and

 

5. You may submit with your letter of appeal supporting letters or statements from other people, including doctors, if you think they are likely to be helpful.

 

(Sorry for the lack of spaces in "Theappealmustbemadeinwritingbyyouorarepresentativethatyouappoint" : iPhone issues!)

 

ICAS can help advise on the process if 'local resolution' has failed : since I don't know which region the OP is in I can't give them a definitive contact, but

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4090775.pdf

may help them determine the relevant ICAS contact.

Edited January 31, 2013 by citizenB
spacing

[Nozza]

Thanks again for the information provided. Some of this is going to be very useful.

 

I also appreciate the early posts being removed because frankly I was a bit shocked when I first read them. I'm not asking for validation of my needs in the context of other treatments or people's personal opinions. I'm asking specifically for consumer help. Feels like I went to the parking ticket forum and was told to pay up and shut up!

 

Again, I'd appreciate it only those with actual advice would contribute. The other posts are unhelpful and pointless.

Edited January 31, 2013 by Nozza

[Jimmy99]

I have to say that I didn't see the removed posts and probably a good thing.

I am sorry if you felt attacked, this should be a non judgemental forum alas it is not always the case.

 

Just as with disabilities, health issues are very personal. It is easy for me to say , do not give that 80 year old a heart op that will maybe give them a few more years, but that is not my parent or me for that matter. If it was my parents I would move heaven and earth to get them what I thought they needed.

 

Sadly we are becoming a selfish nation and I believe that this government is fostering that

[389shell]

Wow! There are some very rude and ignorant people joining CAG.

 

The way the NHS is managed in some areas is a joke, no private business would put up with it. From local PCT's right the way up there is a shameful waste of resources.

 

No advise OP, but would like to offer my support to you, this is disgraceful.

[Jimmy99]

Ditto

[Conniff]

Please report any offensive or flaming post as soon as they are noticed by clicking the little black triangle down on the left.

[whitenight]

quietly privatised from 1st April 2013. The BMJ is doing the work that hardly any media organisation in the UK is doing – informing us of upcoming changes to the NHS in a clear

[honeybee13]

Whitenight, please don't spam the forum to build up your post count.

 

You can PM the document to me if you want it put up.

 

HB

[whitenight]

im sorry you think like that i wanted to show the whole article but couldnt, never mind im sure you will all read it in the news papers soon,

[honeybee13]

It's not me, whitenight, it's not what we do on the forums at CAG. Anyone from the team who spotted this would have said the same.

 

I'm trying to help, if you want to PM me a link, I'll post it for you.

 

HB