Smokers and obese patients to be denied surgery – do they deserve this and is it the thin edge of a wedge that politicians cannot accept?

Most doctors will support this decision, and the fact that a Trust in “special measures” was forced to reverse a similar decision last time it was mooted is relevant. Now the minister and his team have to decide whether to step in and block “deserts based rationing”. If it is accepted in principal in Harrogate it should alter the whole of the Health Services…. They are ethically caught between a rock and a hard place… enough to make them smoke?

Image result for smoking deprivation cartoon

Brittany Vonow in The Sun 7th October 2016 reports: SURGERY BAN: Smokers and obese patients to be denied surgery until they make a change under new cost cutting measures

The Royal College of Surgeons is appealing for NHS England to step in and challenge the policy

SMOKERS and obese patients will be banned from surgery for six months to cut costs.

The NHS Harrogate and Rural District Clinical Commissioning Group has announced that smokers and patients with a BMI of 30 or more will instead be offered a referral to a stop smoking service or a weight management programme for six months before even being considered for an operation.

The move is part of an £.84 million savings plan.

But Royal College of Surgeons vice president Ian Eardley said: “The Royal College of Surgeons is very supportive of encouraging patients to join programmes that help them lose weight or stop smoking before surgery.

“However making it a condition of receiving that surgery, no matter how sick they are or how much pain they are in, is wrong. NHS England has already said that denying operations to a particular group – such as smokers – is ‘inconsistent’ with the NHS constitution.”

He said that “singling out” a group of patients was not the way to save money in “very challenging times”.

The move comes after NHS England intervened to stop the neighbouring NHS Vale of York CCG from imposing a similar policy after the Royal College of Surgeons raised concerns.

St Helens CCG was also forced to abandon plans to save money by stopping all non-urgent referrals for found months.

Mr Eardley said: “”The policies for smokers and overweight patients that Harrogate and Rural District CCG intend to impose ignore the public outcry that surrounded similar plans announced by neighbouring Vale of York CCG in September.

“They fly in the face of the intervention made by NHS England to prevent those plans from going ahead.”

Harrogate and Rural District CCG chief officer Amanda Bloor said: “The CCG has undertaken a thorough review of all the services it commissions based on clinical evidence to support the decision making process and I feel the measures we are taking encourage patients to take a greater responsibility for their lifestyle choices.

“It is vital that patients are given the skills and knowledge to take accountability for their own wellbeing to ensure we all lead healthier lifestyles. ”

She said that the move was not denying patients the surgery but instead “encouraging and supporting patients” to make a lifestyle change.

She said: “The NHS spends around £9bn a year on patient care for those living with diabetes and with spending on obesity related ill-health and smoking related illness increasing year on year, these measures will help protect the future finances of the CCG and the wider local health economy.”

The policies on smoking and BMI will not apply to certain groups including those undergoing surgery for cancer, children and elderly people.

This entry was posted in A Personal View, Commissioning, Rationing, Stories in the Media, Trust Board Directors on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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