The NHS is planning to ban obese patients and smokers from having surgery unless they lose weight or kick their habit, setting a ‘dangerous precedent’.
Under controversial plans drawn up in Hertfordshire, the NHS say obese patients ‘will not get non-urgent surgery until they reduce their weight’, unless their circumstances are exceptional.
This harsher criteria comes despite an existing policy which delays surgery for up to nine months for those with a high BMI, requiring them to lose at least 10 per cent of their weight.
The restrictions mean those with a Body Mass Index of 30 or more will be set targets to reduce their weight by 10 per cent over nine months, while those with a BMI over 40 will be told to cut their weight by 15 per cent, report The Telegraph.
The new criteria also means smokers will only be referred for operations if they’ve quit smoking for at least eight weeks and will introduce a forced breathalysed test before their referral.
The plans will also see cuts in IVF provision and provision of medicines, causing concern the wealthy will simply pay for treatments while those on lower incomes will simply have to go without.
East and North Hertfordshire CCG and Herts Valleys said they hope to encourage people ‘to take more responsibility for their own health and wellbeing, wherever possible, freeing up limited NHS resources for priority treatment’.
This policy is designed to improve patient safety and outcomes, both during and immediately after non-urgent surgery.
No financial savings are expected as a result of these measures.
We do however, hope to improve the long-term health of our residents through the targeted stop-smoking and weight-loss support on offer to patients.
In exceptional circumstances, clinicians will allow surgery to go ahead even if the smoking and weight loss criteria are not met.
Exceptions would be made when waiting for surgery would be more harmful for the patient.
The controversial criteria, drawn up by clinical commissioning groups (CCGs) in Hertfordshire, has been criticised by the Royal College of Surgeons, who raised concern as such policies might mean patients are refused a referral without seeing the specialist who should take such decisions.
Ian Eardley, senior vice president, said:
Singling out patients in this way goes against the principles of the NHS. This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort.
It can even lead to worse outcomes following surgery in some cases. There is simply no justification for these policies, and we urge all clinical commissioning groups (CCGs) to urgently reverse these discriminatory measures.
West Hertfordshire Hospitals Trust medical director Michael van der Watt weighed in.
He wrote to the CCGs warning of ‘significant opposition’ to the proposals at the trust, citing, ‘a wealth of evidence that does not support the theory that worst outcomes occur in patients with a BMI greater than 30’.
Joyce Robins, from Patient Concern, said:
This is absolutely disgraceful – we all pay our taxes and the NHS should be there when we need it; we did not agree to a two-tier system.
Around 15 per cent of the population smoke, while 22 per cent of adults are obese, according to estimates put forward in the report.
With an ageing population, cuts to budgets for social care and severe staff shortages, the NHS are facing a crisis and a £550m health and social care funding gap by 2021 unless they take action.
Clearly something needs to be done but it seems these cuts to provisions for the public go against the very foundations the NHS was built on.