NHS-An Impossible Choice

Recently the headlines have been alight with news of new cancer drugs being rejected by the NHS regulatory body NICE. In two weeks, two new cancer treatments have been rejected as they are “too expensive”. This has caused uproar, with charities and scientists condemning the decision by the organisation. Prostate Cancer UK said the drug provides victims with extra time with their loved ones. Surely you cannot put a price on that. Surely the technological advances we make should be freely available on the NHS no matter what the cost, we shouldn’t have to worry about this in Britain right. Wrong. For several years now the NHS has been under significant strain due to relying on medical advances that are supposed to make it able to extend peoples lives. But the problem is not that these advances haven’t worked, it’s that they have, astoundingly well. This amongst other unique situations, is piling pressure on the NHS.

What we are seeing with these kind of decision is the NHS and it’s associated bodies trying to deal with a build up of factors that are making our health services physically and financially unsustainable. First of all, we are facing a growing population Britain. The UK population increased by 400,000 last year alone. That is the equivalent of adding a city the size of Bristol and it’s a trend set to increase. Recent figures show that births have now overtaken deaths and accounted for 212,000 new people last year. This is a direct result of the advances in medical technology that stops people from dying in old age. That does not men that those people should be denied those life saving treatments but it does put a significant strain on the healthcare budget, leading to the decisions over the past few weeks.

The NHS is facing a double edged sword on population growth. We have in the last 5-10 years seen immigration and illegal immigration figures soar past what even the Labour government, with their liberal border policy, expected to see. Net immigration last year was 183,400 and that figure does not count those claiming asylum, who also use the NHS. The population increase is one thing, but because a lot those migrants have not grown up in a country which provides our kind of healthcare, they need to know how to use the system properly. At present there are many migrants who will check themselves into an emergency room for something that they could go to their GP for. There is a lack of education on how to use the NHS. This is not just a problem with immigrants, there are many people born in Britain who use the A&E for non emergencies too. This problem could be solved in a number of ways. Advertisement campaigns encouraging people to use their GPs, efficient service on the NHS direct line and turning away at the counter of those who enter A&E with a non emergency. Tough times call for tough measures and many A&E departments are under strain from an influx of non emergency patient.

It is not only population growth which is a problem in the UK. Self inflicted injury and illness accounts for a large percentage of NHS funding also. It is hard to define a self inflicted injury or illness. Common barometers on which to judge this would be illegal drug use and alcohol abuse. 27 percent of the UK population drank more than the weekly recommendation for units of alcohol in 2012. This is a cultural issue and something that, if allowed to continue, will likely cripple the NHS further in years to come. Statistics for smokers in recent years have shown signs of improvement, but smoking related illness is still one the largest costs to the health service annually.Can we really justify giving treatments to smokers, who have inflicted their own illness through an irresponsible lifestyle, and then deny life saving treatments to those who haven’t.

Those who smoke, drink, take drugs and are obese cost the NHS the money that could be spent on revolutionary new treatments such as abiritone (prostate cancer treatment) which was denied by NICE, money that could be spent reducing waiting time for patients waiting for life saving operations, who never make it to the operating table.

If those who inflict harm on themselves (smokers, drinkers, drug users) and others (namely, the alcohol and tobacco companies) were to pay for the healthcare they cause, or at least a proportion of it, would that not be a fairer system? Would denying healthcare to health tourists from abroad be ethical? Can we turn someone away from A&E because they don’t have a basic understanding of their own health?

Unfortunately, as the NHS progresses further into the 21st century, these are the types of question that will arise time and time again. It’s time for our political leaders, indeed our generation, to face some difficult decisions in the coming years. Can we face the moral challenges ahead, to preserve the NHS for future generations?

Thomas Kavanagh

Tips for Cambodia Travel

So you’re planning a big trip to South East Asia. You want to see Angkor Wat and experience The Killing Fields right. Of course you do. Cambodia is a spectacular, unmissable South East Asian treasure, no trip would be complete without it. The beautiful landscape, hilarious (sometimes pushy) tuk tuk drivers, mental nights in Sihanoukville and pub street Siem Reap, stunning southern coastline and eccentric bar owners (shout out to Bunna), Cambodia has everything you need for a unique travelling experience. But, be wary, you are not in Kansas anymore, here are some tips to make your life a bit easier while you’re there.

1) First and foremost, DO NOT get into a heated argument with a Cambodian. They are some of the nicest people on the planet, but if you get into a confrontation, I guarantee you will come out of it worse. It does not matter how small they are, or how much they have tried to con you (it will happen), stay smart and deal with it firmly, but not angrily.

2) Respect the fact that things are done differently, and mainly without luxury. So if you find yourself on an 8 seater minibus which you have paid $5 for, and there are 15 people inside and bags, with 2 Cambodian children on your lap, embrace it. Who knows you may be able to use it as subject material one day.

3) Cambodia is a 3rd world country. The people here are poor, so please don’t argue with them over 10p, it doesn’t make a difference to you, but it will to them. Forget what the Budget travel websites tell you, being overcharged a small amount is actually common, even the locals pay it, think of it like tipping culture.

4) Be sure to visit Koh Rong Island in the south. You can get a ferry there from Sihanoukville. Endless beaches, shotgun bars, untamed jungle and bioluminescent plankton, it is complete paradise. But beware, there is a cost; when you find yourself waking up at 6 in the morning because your bamboo hut is roasting you alive you will notice that the electricity on the island shuts off around 2am; that is if you didn’t notice when you stumbled back drunk in the pitch black.

5) Beware of the dogs. So you’re in Sihanoukville. You are walking back from the farm party (DEFINATE MUST). You notice a group of dogs curiously walking behind you. Run away, immediately. The dogs in Cambodia ain’t soft and at that time they don’t want you to stroke them.

6) Please be respectful at the Killing Fields. Don’t talk, whisper. There is an amazingly insightful audio tour to compliment your walking tour. Make sure you prepare yourself for an emotional day. On a side note, if you have limited time in Phnom Penh, you can easily see The Killing Fields and Tuol Sleng Prison in one day, any Tuk Tuk driver will take you for $10-$15 for the whole day.

7) The Russian market in Phnom Penh is the best market in the world. The best. I know by the time you’ve been through Thailand to Cambodia, you have lost all the clothes you brought with, and if you’ve been to Utopia bar in Laos your flip flops too. Don’t worry about it! The Russian market has everything you need, bring your bargaining hat, but remember tip 3.

8) Full moon party!!! Now your thinking, that’s in Thailand right? Wrong. The full moon party on Koh Rong Samloem is much better than Koh Phangan. The music is awful, the buckets are ridiculously strong and the speedboat over from Koh Rong at 11pm is packed and gets really messy. What more could you want?

9) Siem Reap is a beautifully hectic city. This is your base for your Tomb Raider experience. Here are some Angkor Wat basics:

-Don’t go hungover, I know pub street is tempting.
-If you have to choose, do sunset, not sunrise.
-It’s huge, and your driver is going to tell you to walk around and he’ll wait for you somewhere, don’t worry, he’ll find you when he wants to.
-It’s absolutely boiling, bring water, lots and lots of water.
-In the event that parts of the temple are closed, just bribe a police officer $10 and you will get a guided tour of the area.
-You must wear suitable clothing, cover your knees and shoulders. Girls cover up the belly, there’s plenty more time to show off your beach body in the south.
-If the lure of pub street is too great, in the event of the inevitable hangover, it’s ok to take a quick nap in the temple. Just find a comfy slab.

10) Careful at the border. You will hear many horror stories from the Cambodian border along your travels, they are all true. Police try to rip you off, bus companies leave you stranded, health VISAs that don’t exist, the list could go on and on. Keep your wits about you, and make sure you have spare dollars, because there are no cash machines. You’re in bandit country now.

11) Yes you can shoot a cow for $300 with an RPG. Don’t do it. The same gangs who own the illegal shooting ranges, kidnap girls and force them into sex slavery, so while it may seem appealing to splat one of your bovine friends, think of the consequences. Plus it’s expensive and you’ve probably had all your money ripped off at the border if you didn’t follow these tips.

12) Keep your Passport close, especially on bus journeys. This is no joke, a friend of mine had his Passport stolen and sold back to him by the bus company. Watch out.

13) Enjoy the people. Have a laugh with the Tuk Tuk drivers, do some Khmer boxing, play pool with the locals (you will end up buying them a drink) and go to a street party, there’s ALWAYS a street party in Cambodia, so when you hear funny music at 3am in the morning, follow your ears. I promise it’s worth it.

14) Roll with the punches. In Cambodia, hardly anything works the way you want it to, but that’s the beauty of it, embrace it, they are the stories you will tell your children, nobody remembers when a plan comes together.

These tips should help you get the most out of a Cambodian experience. Prepare yourself to be shocked and surprised more than a few times. Cambodia is an eye opener for even the most well travelled people. Enjoy it, you’ve never been to a place like this before.

Thomas Kavanagh