Published: 10:01 EST, 22 April 2015 | Updated: 02:22 EST, 23 April 2015
831shares
336
View comments
Patients who are too fat could be denied routine operations to save money, a survey of health bosses has revealed.
More than a third of NHS trusts are considering rationing some types of surgery and other treatments.
Several have admitted they may impose 'eligibility' rules which could affect smokers as well as the overweight.
SHARE PICTURE
Copy link to paste in your message
+3
More than a third of health trusts are considering rationing some types of surgery and other treatments to save money, according to a new study
The criteria for accepting patients for operations would be based on their Body Mass Index, which measures obesity.
When senior managers at 67 Clinical Commissioning Groups – local health trusts – were asked, 39 per cent said they were planning to 'limit access' to routine treatment for financial reasons.
Procedures affected include varicose vein treatment, hip and knee replacement, and breast reduction surgery. Others said smokers might be denied some treatments, most commonly IVF.
Senior doctors criticised the plans and accused health managers of denying patients vital treatment simply because they were considered to be 'undeserving'.
Dr David Paynton, of the Royal College of GPs, said: 'Decisions about whether our patients are eligible for surgery or treatment need to be made on a case-by-case basis and by whether surgery will benefit a patient's long-term physical and mental health.
'It should not be the role of CCGs to impose blanket bans on patients' access to surgery, nor to decide who is and who is not deserving of potentially life-saving treatments based on their lifestyle choices.
SHARE PICTURE
Copy link to paste in your message
+3
Obese patients could be denied varicose vein treatment, hip and knee replacement, pictured, and breast reduction surgery, while smokers could be banned from having IVF on the NHS
'Of course, some procedures cannot be performed on patients who are above a certain weight.
'In these cases, a clinical decision needs to be made about whether surgery would be beneficial if the patient lost weight – but this is a separate issue.'
It is easy to target vulnerable patients and we must be very careful not to unfairly discriminate against people who aren't always able to speak out
Katherine Murphy, chief executive of the Patients Association
Katherine Murphy, chief executive of the Patients Association, said: 'Each case must be individually assessed and each decision must be ethical and in the best interests of the patient.
'It is easy to target vulnerable patients and we must be very careful not to unfairly discriminate against people who aren't always able to speak out.'
A Conservative Party spokesman said: 'If health bodies stop patients from having treatments on the basis of cost alone, then we will take action against them.'
There are 211 CCGs in England so the survey by the Health Service Journal covered just under a third.
Last year, a CCG in Devon threatened to ban all non-urgent treatments for anyone severely obese with a BMI above 35. This is equivalent to a 5ft 6in woman of 16st or a 6ft man being 18st 13lb. After an outcry, the policy was dropped.
A survey by GP magazine last month found that 80 per cent of CCGs ration at least one procedure to patients who are very obese.
DOCTORS: SUGAR, NOT LAZINESS, DRINKING OR SMOKING, MAKES US FAT
SHARE PICTURE
Copy link to paste in your message
+3
Doctors have blamed excess sugar and carbohydrates for the surge in obesity – not the lack of exercise.
They said poor diet was now recognised as being responsible for more disease than physical inactivity, alcohol and smoking combined.
Yet, said the experts led by cardiologist Dr Aseem Malhotra, the public wrongly believed that obesity was due to a sedentary lifestyle.
The doctors claimed that obesity has rocketed in the past 30 years, despite little change in physical activity levels.
‘This places the blame for our expanding waistlines directly on the type and amount of calories consumed,’ said Dr Malhotra.
‘Let us bust the myth of physical inactivity and obesity. You cannot outrun a bad diet.’
In the British Journal Of Sports Medicine, the doctors added that the ‘false perception’ on the cause of obesity stems from corporate marketing ‘chillingly similar’ to that used by the tobacco industry. They cited Coca-Cola associating its products with sport ‘suggesting it is OK to consume their drinks as long as you exercise’.
Dr Malhotra, who works at Frimley Park Hospital, Surrey, is an adviser to the campaign group Action on Sugar. Around two-thirds of Britons are overweight or obese.
The Government’s obesity adviser Professor Susan Jebb said the doctors failed to note that the best way to lose weight was combining a better diet with physical activity.
‘Rather than trade one off against the other – sugar vs fat, diet vs activity, individual vs population – we need to take action across the full range,’ she added.
Tackling obesity without addressing physical activity was ‘tying one hand behind our backs’ said the professor. ‘It makes good sense to seek to change both diet and activity behaviours.’
Some hospitals are demanding up to £2,700 for treatment on just one eye, as the cash-strapped health service attempts to ration the procedure.
Currently, the NHS prioritises cataract surgery for those who are struggling to carry out daily tasks because of the condition.
But a report published today suggests as many as half of hospitals offer patients the chance to pay up front for treatment in order to skip the queue.
Freedom of Information figures obtained by the Daily Mail from 78 hospital trusts in England show 41 allowed patients to self-fund the straightforward 45 minute operations.
It found that trusts were charging up to three times more than the standard cost of between £800 and £900 per eye.
Charity bosses have slammed the practice as “shameful”, amid claims cataract operations were becoming "harder to access" on the health service.
It's shameful that people are being asked to consider funding their own treatment when they are entitled to it for free, and in a timely manner, on the NHS
Clara Eaglen, RNIB
The NHS offers surgery for cataracts, a clouding of the eye's lens causing impaired vision, once a person struggles to read or drive and more than 300,000 procedures are performed each year.
According to the paper, the figures showed hospitals offering paid-for operations typically charged between £700 and £1,000 per eye but Frimley Park Hospital in Surrey charged £2,552 and Maidstone and Tunbridge Wells NHS Trust in Kent billed patients £2,700.
One hospital, University Hospital Southampton, said patients could opt to pay for the surgery if they did not qualify for it on the NHS.
Clara Eaglen, of the Royal National Institute of Blind People, said: "It's shameful that people are being asked to consider funding their own treatment when they are entitled to it for free, and in a timely manner, on the NHS.
“We strongly believe that everyone who has a sight-threatening condition deserves early access to treatments."
Caroline Abrahams, of Age UK, added: "In the last few years it has become harder to access cataract surgery as people are forced to wait for their sight to significantly deteriorate before getting help.
"It is extremely worrying if people whose sight is starting to fail feel the only way to get help quickly is to pay for it."
Data released by health analysis firm Dr Foster in 2013 suggested the number of cataract operations started dropping in 2009 - in 2008 there were 326,456 compared with 321,957 in 2012.
NHS guidelines state: “There are no national guidelines stating what your level of vision needs to be before cataract surgery is carried out, although individual NHS clinical commissioning groups may have their own criteria outlining when cataract surgery should be offered.”
In details on University Hospital Southampton's website it said: "Our cataract choice service offers a new option, between the traditional private sector and the NHS, bringing private healthcare within the reach of many more people.
"Surgery will be offered much sooner than the usual NHS wait and we predict that the wait will come down even further as more people take advantage of this service.
Well, this is England's National Health Insurance program, not ours......yet. But this is the problem with national healthcare in general - or any type of government interference. Insurance needs to remain a private product on the free market.
__________________
LawyerLady
I can explain it to you, but I can't understand it for you.
Because the mentality of "it'll never happen here" is too wide spread.
__________________
A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
I have several family members that work in the NHS. They despise it. My BIL, two cousins, and MIL are all nurses in the NHS. My MIL was doing home care on a man with cancer. One day they took him to the doctor and the doctor said his treatments were too expensive for his age. They stopped his cancer treatments and put him on hospice. My MIL took it really hard. My BIL and his wife are both nurses. The NHS couldn't afford to pay them for three weeks once. They were still required to come to work even though they weren't getting a paycheck. And they never got that money back. My BIL's wife had to jump through hoops to be able to stay home during that time because they have six kids and with no income coming in they couldn't pay a sitter. I keep hearing people on this board talking about how wonderful Obamacare is but it's just the first step into a single payer system where people will lose all say in their health care.
__________________
“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!” ― Maya Angelou
When I graduated from HS, my mom and I took a trip to England. She wound up hurting her knee. Because she was a cash payer, she went to the head of the line.
Because the mentality of "it'll never happen here" is too wide spread.
Better than "the sky is falling" a dozen times a day.
IMHO
flan
A mentality of willful ignorance (aka "it'll never happen here") is not better.
I agree. History has PROVEN it can happen. Ignoring that is just putting your head in the sand.
You have no idea how much I hear this. People praise Obamacare on one hand and on the other say "Single payer system? It'll never happen here." We're already on our way there!
__________________
“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!” ― Maya Angelou