England Begins Rationing Health Services
July 28, 2011
The Independent
July 28, 2011
Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money.
Two-thirds of health trusts in England are rationing treatments for “non-urgent” conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.
Examples of the rationing now being used include:
* Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.
* Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.
* Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.
* Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.
* Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.
* Funding has also been cut in some areas for IVF treatment on the NHS.
The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.
Doctors are known to be concerned about how the new rationing is working – and how it will affect their relationships with patients.
Birmingham is looking at reducing operations in gastroenterology, gynaecology, dermatology and orthopaedics. Parts of east London were among the first to introduce rationing, where some patients are being referred for homeopathic treatments instead of conventional treatment.
Medway had deferred treatment for non-urgent procedures this year while Dorset is “looking at reducing the levels of limited effectiveness procedures”.
Chris Naylor, a senior researcher at the health think tank the King’s Fund, said the rationing decisions being made by PCTs were a consequence of the savings the NHS was being asked to find.
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