IELTS FOR
ACADEMIC PURPOSES
TEST 1 (READING)
READING
READING PASSAGE 2
You
should spend about 20 minutes on questions 14-26, which are based on Reading
Passage 2 below.
CHANGING
RULES FOR HEALTH TREATMENT
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People who are
grossly overweight, who smoke heavily or drink excessively could be denied
surgery or drugs. The National Institute for Health and Clinical Excellence
(NICE), which advises on the clinical and cost effectiveness of treatments
for the National Health Service (NHS) in the UK, said that in some cases the ‘self-inflicted’
nature of an illness should be taken into account.
NICE stressed
that people should not be discriminated against by doctors simply because
they smoked or were overweight. Its ruling should apply only if the treatment
was likely to be less effective, or not work because of an unhealthy habit. The
agency also insisted that its decision was not an edict for the whole NHS but
guidance for its own appraisal committees when reaching judgements on new
drugs or procedures. But the effect is likely to be the same.
NICE is a
powerful body and the cause of much controversy. It is seen seem by some as a
new way of rationing NHS treatment. Across the UK, primary care trusts (PCTs)
regularly wait for many months for a NICE decision before agreeing to fund a
new treatment. One group of primary care trusts is ahead of NICE. Three PCTs
in east Suffolk have already decided that obese people would not be entitled
to have hip or knee replacements unless they lost weight. The group said the
risks of operating on them were greater, the surgery may be less successful
and the joints would wear out sooner. It was acknowledged that the decision
would save money.
NICE said no
priority should be given to patients based on income, social class or social
roles at different ages when considering the costs effectiveness of a
treatment. Patients should not be discriminated against on the grounds of age
either, unless age has a direct relevance to the condition. NICE has already
ruled that IVF should be available on the NHS to women aged 23 to 39 as the
treatments has less chance of success in older women. It also recommends that
flu drugs should be available to over -65s, as older people are more
vulnerable.
But NICE also
said that if self-inflicted factors meant that drugs or treatment would be
less clinically and cost effective, this may need to be considered when
producing advice for the NHS. They state that ‘if self-inflicted cause of the
condition will influence the likely outcome of a particular treatment, then
it may be appropriate to take this into account in some circumstances’. They acknowledged
that it can be difficult to decide whether an illness such as heart attack
was self-inflicted in a smoker. ‘A patient’s individual circumstances may
only be taken into account when there will be an impact on the clinical and
cost effectiveness of the treatment.’
Prof Sir
Michael Rawlins, the chairman of NICE, said; ‘On age we are very clear – our advisory
groups should not make recommendations that depend on people’s ages when they
are considering the use of a particular treatment, unless there is clear
evidence of a difference in its effectiveness for particular age groups. Even
then, age should only be mentioned when it provides the only practical ‘marker’
of risk or benefit. NICE values people, equally, at all ages.’
But Steve Webb,
the Liberal Democrat health spokesman, said there was a danger of primary
care trusts following the same course of action. ‘There is no excuse for
cash-strapped hospitals denying treatment to people whose lifestyle they disapprove
of’ he said. ‘Treatment decisions involving people’s lifestyle should be
based on clinical reasons, not grounds of cost. The NHS is there to keep
people healthy, not sit in judgement on individual lifestyles.’
A spokesman for
NICE said; ‘We want to reassure people that in producing our guidance we are
not going to take into consideration whether or not a particular condition
was or self-inflicted. The only circumstances where that may be taken into
account is where that treatment may be less effective because of lifestyle choices.’
Jonathan Ellis,
the policy manager at Help the Aged, said it was pleased NICE had finally
shown an understanding of the importance of tackling age discrimination. ‘While
this is a major feat, there is still some way to go to banish the evident
inherent age discrimination that exists within health care service,’ he said.
‘The NHS now has much to learn, it will ensure a fairer deal all around for
older people using the NHS.’
|
Questions 14-16
Choose THREE letters A-H
NB Your answers may be given in any order
Which THREE of the following statements
are true of NICE, according to the text?
A
|
It feels that people with bad health habits should not receive
treatments
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B
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It is an agency that offers advice to the NHS
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C
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Some of the
reports they produce discriminate against the elderly
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D
|
It insists its decision should only be applicable in certain
situations
|
E
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It is an
agency that controls all NHS policy regarding treatments
|
F
|
Its powers are not as extensive as those of NHS
|
G
|
Many PCTs
base their decisions concerning funding on ones made by NICE
|
H
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It has made a statement that overweight people will not receive new
joints
|
Questions 17-19
Choose the correct letter, A, B, C, or D.
17
|
NICE argues that
|
A. rich people should not be given special
consideration over the poor
|
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B.
only patients from certain classes should be considered for treatment
|
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C. social roles should be considered when deciding
treatment
|
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D.
cost of treatment would depend on patient’s income
|
|
18
|
What recommendations has NICE made?
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A. to
provide older women with IVF treatments
|
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B. to make flu drugs accessible to women under 40
|
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C.to
give people between 23-39 flu drugs
|
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D.to allow certain women to have IVF treatments
|
|
19
|
NICE
admits that
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A. some drugs used by his NHS were not clinically
effective
|
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B.
their advice is sometimes ignored by the NHS
|
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C. it is often hard to determine if a patient has
caused his or her condition
|
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D.
they are more concerned about cost effectiveness than patients
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Questions 20-26
Look at the following statements
(Questions 20-26) and the list of people below.
Match each statement with the correct
person A-C
20
|
This person was happy that NICE realised age
discrimination needed dealing with
_____________________________________________
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21
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This person holds a very high position in the NICE
agency
_____________________________________________
|
22
|
This
person is a member of a political party
_____________________________________________
|
23
|
This person says their policy regarding age is precise
and easy to understand
_____________________________________________
|
24
|
This
person does not agree with the position taken by NICE
_____________________________________________
|
25
|
This person feels the NHS must further improve its
relations with the elderly
_____________________________________________
|
26
|
This person
says that NICE does not discriminate on the grounds of age
_____________________________________________
|
A
|
Michael Rawlins
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B
|
Steve Webb
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C
|
Jonathan
Ellis
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ANSWER
KEY
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