Smokers and fat patients thrown off NHS waiting lists
Smokers and overweight patients in need of major operations could be thrown off hospital waiting lists under “desperate” cost-cutting plans.
Any smoker referred for ‘non-urgent’ operations will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit
Patients’ groups described the tactics as an “appalling scam” to enable NHS bosses to claim waiting times are far shorter than they are, simply by denying a place in the queue to many of those referred for surgery.
Under the plans drawn up by NHS bureaucrats in Kent, any smoker referred for “non-urgent” operations – such as hip replacements or cataract surgery – will not be allowed to join the queue until they have either given up smoking, or completed a 12-week course to help them ditch the habit.
Those who are seriously overweight will also be denied a range of operations until they have completed a three month NHS diet programme.
Although every patient has a legal right to be treated in 18 weeks of being referred for treatment by their GP, the protocols agreed mean different rules could be applied for anyone with a body mass index of more than 30, or those who smoke.
Patients groups said delays getting a place on 12-week “smoking cessation” and “weight loss” programmes could leave many patients waiting even longer than 30 weeks implied by proposals drawn up by NHS West Kent Primary Care Trust (PCT).
Katherine Murphy, from the Patients Association, said: “This is an appalling kind of scam – it is a clear device to manipulate the waiting lists simply to cut their deficit. It smacks of desperation, and it is patients who will suffer.”
The plans, seen by The Sunday Telegraph, explicitly say the rules have been introduced to save money by the end of the year.
The document says: “PCTs across the country are making decisions on prioritising treatments in order to match demand to the financial resources available to the economy as a whole and to individual trusts.
“Unfortunately this does not take us far enough: we need to take additional activity to reduce activity in this financial year if we are to be in a position to hand over a balanced budget.”
Under the proposals, smokers already on waiting lists will now be taken off until they have either been on the courses or given up smoking. New referrals will not be allowed on the lists until they have done the same.
All patients with a BMI of 30 or more who are referred for several types of surgery including hip and knee operations will also be cast off the lists until they have been on a three-month diet programme.
Many primary care trusts already try to encourage patients to stop smoking or lose weight before operations, in order to reduce the risks to them.
But patients’ groups said the use of tactics to delay even putting patients on the waiting lists was a far more draconian step.
Mrs Murphy said: “This is a clear way to keep these patients off the lists in order to cut costs, while the PCT can officially claim its waiting times have not lengthened.”
Simon Clark, director of the smokers’ lobby group Forest, accused the PCT of discriminating against smokers and creating a “two-tier” system.
He said: “Of course patients should be told that smoking could have an impact on the success or recovery from an operation, but given that they have paid huge sums in taxation on cigarettes over the years, the question of whether or not they have the surgery should be one for them, not the NHS.”
A letter sent out by the PCT tells local GPs: “There is good evidence that stopping smoking prior to surgery reduces length of stay and infection rates, and improves healing time; it is also a time when people are often highly motivated to give up.”
Kent doctors accused managers of being dishonest about the real reasons why patients were having their treatment delayed.
Dr Stephen Meech, a GP from Maidstone, said: “Patients are going to be told that they cannot have an operation because they smoke or need to lose weight, when that is not actually true – it is because the health authority can’t afford to pay for it.”
Dr John Allingham, a GP from Hawkinge, said: “The plan is extremely contentious and it is a way of extending the waiting times.
“If you’ve got to do a 12-week smoking cessation course before you can have your hernia fixed, or before you’ve even gone on the waiting list to have your hernia fixed, it immediately makes those waiting lists another 12 weeks longer.”
The PCT said it was in talks with local doctors over the proposals. Marion Dinwoodie, its chief executive, said she regretted the need “to take measures in the short term that may have an impact on local people”.
She said no one with a compelling clinical need for treatment this year would miss out.