Health Rationing In England: Obese And Smokers Banned From Routine Surgery

For those who extol the virtues of socialized medicine, and protest that it could never, never, ever lead to rationing, here’s a wake-up call from Great Britain.

Health care experts in Great Britain are warning that obese people and smokers will be routinely refused operations all across Great Britain in the very near future. The latest case in point comes from North Yorkshire, where patients having a BMI of 30 or higher and smokers will be refused routine surgery for over a year for non-life-threatening conditions.

That means standard hip and knee operations are out.

Vale of York Clinical Commissioning Group (CCG) stated:

The local system is under severe pressure. Hospitals are being warned they will not be paid for surgery if they carry out operations on obese patients who are not exempt from the policy. This work will help to ensure that we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it.

Clare Marx, president of the Royal College of Surgeons, condemned the decision, asserting:

This policy from Vale of York is among the most severe the modern NHS has ever seen. Leaving patients waiting in pain for treatment longer than is clinically necessary cannot be accepted. In the last month alone, the Royal College of Surgeons has learnt of at least three clinical commissioning groups that are planning to introduce policies that deny or delay patients’ access to surgery as a means to cut spending At this rate we may see brutal service reductions becoming the norm, rather than just being exceptions.

Chris Hopson, the head of NHS Providers, warned, “I think we are going to see more and more decisions like this. It’s the only way providers are going to be able to balance their books, and in a way you have to applaud their honesty. You can see why they’re doing this — the service is bursting at the seams.”

The Telegraph reported:

The decision by Vale of York Clinical Commissioning Group (CCG) comes amid increasing limits across the NHS on surgery for cataracts as well as hip and knee operations. Under the latest restrictions, patients in the catchment area who have a BMI of 30 or more will be barred from routine surgery for non-life-threatening conditions for a year, although they may secure a referral sooner if they shed 10 per cent of their weight.

Smokers’ operations will be postponed for six months, but they can get on surgeons’ waiting lists earlier if they offer evidence they have stopped smoking for least eight weeks. A spokesman for NHS England stated:

Major surgery poses much higher risks for severely overweight patients who smoke. So local GP-led Clinical Commissioning Groups are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their hip or knee operation. Reducing obesity and cutting smoking not only benefits patients, but saves the NHS and taxpayers millions of pounds. This does not and cannot mean blanket bans on particular patients such as smokers getting operations, which would be inconsistent with the NHS constitution.

Cancer patients and those with life-threatening illnesses are excepted from the surgery ban.

BMI restrictions have already been imposed in Hertfordshire, the North West and London; in June, St. Helens CCG in Merseyside announced that all non-essential hospital referrals by GPs might be temporarily suspended

In May, NHS England revealed its provider sector overspent by £2.45 billion in 2015-16.

The ideal BMI is reputedly between 18.5 and 24.9; 25-29.9 is considered overweight; 30-39.9 is considered obese, and 40 and over is considered very obese.