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Life or Death: Spending œ2 Billion Isn’t Easy

2nd March 2015

The NHS is widely renowned as one of the best healthcare systems in the world, government funded and available to all who require its care.

Free healthcare for all comes at a price – the NHS is facing a huge deficit of around œ30 million in the next 10 years.

Take into consideration the ever-increasing poor lifestyle choices, the growing price of prescription drugs and an aging population, the NHS is currently spending around œ2 billion a week.

A new programme by Channel 4 examines the decisions and choices NHS officials make every day, which begs the question – how would you spend œ2 billion?

The first episode of a four part series followed three stories – a woman who needs a breast reduction, an alcoholic who requires a liver transplant and an elderly man who requires dementia care.

Can cosmetic surgery on the NHS be justified? Kim lives in constant pain due to her 36KK breasts. Funding for her operation had previously been rejected, citing that weight loss was required to ascertain whether this would have an effect on the size of her breasts. After losing over five stone, Kim’s application was rejected once more.

The cost of Kim living with constant pain is apparent. Visits to her GP and the cocktail of drugs she is currently taking and the impact that this will have on her future health all mounts up and could end up costing the NHS more in the long run. How much will not having a breast reduction cost the NHS? However, with breast reduction surgery costing the NHS around œ3,000 – what else could the money be spent on?

  • Inhalers for 800 children with asthma
  • 66 visits to a GP
  • Five weeks dialysis treatment

The next story highlighted a transplant quandary – do you give an alcoholic a liver transplant after his own had started to fail? NHS staff needed to assess how likely it is that Marc was going to return to drinking – after all alcoholism is not just a physical issue but also a psychological issue which a transplant will not cure. Without a transplant, Marc would not have long left to live. Due to the donor/recipient ratio, he could be on the transplant list for a long time. Marc has been warned that if he were to receive a new liver, he would have to be teetotal.

The hardest decision comes through transplant cases, the doctors cannot decide who lives and who doesn’t due to their previous lifestyle choices, and Marc’s transplant story becomes a story of life and death – if he does not get a new liver he will die. The cost of the operation to the NHS is around œ70,000 but what else could this money be spent on?

  • 10 hip replacement operations
  • A nurse for two years
  • 52 hospital beds for a year

The last story was that of Ros and Barrie. Barrie is one of 800,000 people in the UK living with dementia. Ros has applied for funding to support her as she cares for her husband in the form of a dedicated dementia nurse. This will cost œ350 a year to the NHS but will be of incredible value to Ros as she struggles to care for her husband.

Dementia care is a growing problem in the UK and contributes to 1 in 9 deaths in this country. With an aging population, it is only expected to rise in the next 10 years.

What else could this money be spent on?

  • Two meningitis vaccines for children
  • Two ambulance call outs
  • One dose of chemotherapy

As you can see from the examples provided, it is far from an easy decision to allocate funds. These are decisions that NHS officials have to make every day. There will always be people that believe the decisions made were the wrong ones but essentially, what it comes down to is a consequences game. It is life or death. You may not agree with giving an alcoholic a new liver but would you want to explain to his partner that you are just going to let him die?

If you compare the relative amounts that each of these cases would cost, Marc’s operation would fund 194 dementia patients care for a year. It would fund 23 patients to have a breast reduction. However people who require a breast reduction are much less likely to die than Marc due to their condition.

It goes a long way to explaining the stresses that the NHS faces every day. There simply is not enough money in the system and choices do have to be made.

So the 2 billion pound question is – what would you choose?



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