Obese and smokers denied NHS treatment to save money
The NHS has been accused of trying to save money by blocking access to surgery for smokers and obese patients as new figures show how they are routinely being denied treatments.Data shows that more than a quarter of Primary Care Trusts in England have brought in new restrictions based on patients’ lifestyle criteria in the last year.
It reveals that people are being denied IVF treatment, breast reductions and fat-loss operations based on their weight and whether they smoke.
In the case of one trust, NHS Hertfordshire, a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery.
The new Hertfordshire policy, introduced in January, makes exceptions only for neurology, cardiac and cancer operations.
Freedom of Information responses from 91 PCTs, obtained by Pulse the doctors’ magazine, show 25 have brought in new restrictions on treating obese patients or smokers since April 2011.
Dr Clare Gerada, head of the Royal College of GPs, said some of the restrictions, particularly for IVF, were “dreadful”.
She added: “It’s becoming the deserving and the undeserving. I think it’s discriminatory and I find it astonishing. The Government should determine what should be applied universally.”
The figures showed that the Peninsula health technology commissioning group, covering Cornwall, Devon, Torbay and Plymouth, is now banning both men and women from undergoing IVF treatment unless they have been non-smokers for at least six months.
Men and women must also have a BMI of between 19 and 29.9 before they will be given certain fertility drugs.
The two PCTs covering County Durham and Darlington will not treat people for varicose veins unless they have a BMI of 30 or under, the figures also show.
The figures also showed that the three PCTs covering North Essex must not accept referrals for joint replacement surgery from people with a BMI of 40 or over.
Furthermore, all patients who smoke in the region must be referred to stop-smoking services before they will be considered for stomach surgery, breast reconstruction, breast reduction, scar revision surgery or nipple inversion treatment.
In Lincolnshire, as of June last year, patients must have had a stable BMI of 18 to 25 for at least a year before they will be considered for breast reductions.
Meanwhile, hip and knee replacements will not be given to patients who have a BMI greater than 35, or current smokers.
In Bedfordshire, access to hip and knee replacements is denied to patients with a BMI of 35 or over until after they have lost 10% of their initial body weight or moved below a BMI of 35.
Before July last year, there was no BMI cut-off in the region.
Steve Nowottny, deputy editor of Pulse, said: “Rationing in the NHS is nothing new – but PCTs and clinical commissioning groups are increasingly taking the decision to ration care based on patients’ lifestyle choices.
“In some cases there may be genuine clinical justification for rationing treatment on these grounds. But there is a growing suspicion that some PCTs are now blocking access to surgery for smokers and the obese simply to help achieve ever greater efficiency savings.
“Such a policy has disturbing implications – and GPs are increasingly uneasy about the NHS providing a second-class service to patients with less healthy lifestyles.”