Thursday, February 09, 2006

Fancy a State Sponsored S'**g? Suits You Sir

The NHS never ceases to amaze me. Dr Crippen has an interesting 'entry' today on impotence. This is the flaccid version. If you wish to see the 'full length' version click HERE.

Viagra has been one of the most successful and effective drugs introduced during Dr Crippen’s lifetime as a doctor. In the old days, pre-Viagra, treating impotence was a depressing business. One went through a rather protocol driven formula of “if it is not physical, it is psychological”. When we could not find a physical cause of impotence, we packed the customer off to the psycho-sexual counsellors who would provide therapy and a course of homework that sounded a lot more fun than what Dr Crippen was given at school. Post-Viagra, it is much easier. Assuming there are no contra-indications, you give them all a trial of Viagra, and very successful it is to. The commonest cause of impotence is aging, which may or may not imply underlying atherosclerosis. Pure psychological causes are rare. So, sorry guys, no more homework, take a tablet.Viagra caused a real problem for our caring, sharing new Labour government. The then Secretary of State for health was Frank Dobson. He was a kindly sort of man and very much old Labour. Even Frank baulked at the idea of Viagra being freely available on prescription. The simplest solution would have been to make all patients pay for it. But that was too much for Frank’s old Labour views. He decided to allow some people to have it on prescription. He drew up eligibility criteria for Government approved bonking. Dr Crippen was very much hoping he would introduce a weekly limit of tablets. “Labour approves two bonks a week” would have been fun in the manifesto. Sadly, it was not to be. Instead, Frank drew of a list of conditions that qualified a man for free Viagra. So those who have, for example, diabetes, renal failure or have had prostate surgery are entitled to state sponsored shags. And not just two a week. There is no limit. Dr Crippen prescribes them on demand. He is too cowardly to go into the minefield of how many tablets a week is reasonable. Sometimes, as mentioned in the diary, he pauses for thought. He is currently prescribing shed loads of Viagra for a diabetic and at the same time treating the patient’s wife for depression. One of her big worries is that her husband has lost interest in sex. Today, Dr Crippen saw a man who has had a prostatectomy. He qualifies for Viagra on prescription. It has not worked. So now he has asked for a prescription for a vacuum pump. These cost over a hundred pounds. Sounds a lot but, on the other had, two Viagra a week for a year costs five hundred pounds. The fact that this man is a highly paid successful barrister and could easily afford to buy a pump is not relevant. That is not how the NHS works. Sex is an important part of life. Is the prescription of vacuum pumps a reasonable use of tax payers’ money? Dr Crippen does not know. I do know that making the taxpayer provide Viagra gives a whole new meaning to the concept of treatment being “free at the point of entry.”

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