Was this aimed at me particularily?

I was putting forward the argument for treating drug addicts etc. FWIW I've also got no problem with elective cosmetic surgery required for diagnosed physiological and psychological issues where the persons health and well being are suffering. I just don't think the NHS should pay for non-essential life style type surgery or treatment. ie) apronectomies/gastric band for the obese.

Again, low taxation, pro choice, small state, big individual, secular, meritocratic and deterministic. Make the first rung of the ladder in reach of all people. Up to them if they want to climb.

Ironically the managers were brought in during the 80's to address the wastage :-S

You aren't a doctor are you??...

Unfortunately, I hate to infrom you that to be obese is not always a choice...there are circumstances where a person's medical condition can affect this condition.

I respect your political stance, however, you come across as a Thatcherite dinosaur still living in the 80's....With this in mind, I'm pretty sure there is a position in the BNP awaiting you as we speak...

Surely in the case of an apronectomy the person involved has (in most cases) lost vast amounts of weight - which isn't an easy task - and has gone to great lengths to improve their health, which will in the long term probably save the NHS money in the treatment of obesity related illnesses. Therefore surely a bit of help to the person in "completing" the process isn't a major ask?

Yes it is. NHS isn't there to reward people. If the person was in physical pain and that was the correct procedure to cure them then fine otherwise no way!

Its not a reward at all though, it comes back to the psychological thing we were talking about before though and the mental effect that it would have on the person being left with the often unsightly flaps of skin.

Then of course there is the risk of ulceration with the skin in that condition - again which would require treatment and if it was to get infected could well lead to the need for emergency surgery.

I think the problem is some people are unable to see beyond the cosmetic benefits of such surgery and look at the bigger picture of the circumstances.

I've no problem with help being offered for theor mental problem with thier 'issues'
Properly cared for ulceration should be controlable.
I've no problem with people wanting any cosmetic surgery, it's their choice but the NHS shouldn't fund it. I feel the same about fertility treatment and sex change operations.

But thats the point apronectomy isn't just about the cosmetic side its a much bigger issue than that.

Anyway how much would a lifetimes worth of treatment for the ulceration cost? surely the cost to the NHS of one relatively straight forward, well planned operation is going to be less than that of a life times worth of care for something that often isn't controllable and can lead to a need for emergency surgery.

As I said its too simple to see things as just cosmetic and not look at the bigger thing, its up to the professionals to decide the best cause of action for each individual not up to people like you to judge with no proper facts about the person.

Lets say i started suffering with 'massive mansion syndrome' sound's frivolous but what if i really did, what if it caused me to be anxious all the time, panicing because i didn't have a country house with a pool. So much so that my stress levels meant i couldn't work anymore and became clinically depressed. Would you find it acceptable that the NHS gave me this mansion or should i receive councilling?
Your point about ulceration, i can't say i've heard about it being a problem with spare skin. More for people that are excessivly over weight, that the skin rubs and the person can't physically reach the area to clean it.

Your being daft now.

And it is a problem, of course it is you have large flaps of skin which obviously rub and sweat which can lead to alsorts of problems.

No i'm not. There are amny weird and wonderfull conditions out there, Androphobia for a start. Under your system, the NHS would be expected to provide a place where no man could enter.

What about the many people that have no suh ulceration, are they entitled to free cosmetic surgery?

As I have said (more than once) it needs to be taken on a case by case basis you can not have a one way fits all health service because everyone is different. Sorry if that doesn't fit in with your "x y and z" don't deserve treatment coz i said so model but thats how it is.

I agree with the case by case strategy. Is there a physical reason for surgey other than cosmetic then it's a no. If there is a good reason that the surgery would cure a physical problem then yes to the surgery.