Since its inception in 1948, the Flagship of the welfare state, the NHS has remained true to its founding principles – free for all at the point of delivery irrespective of income or lifestyle.
Well, that was true up until now anyway. Under the captaincy of the coalition, the NHS is leaving its normal shipping lane and is entering uncharted waters.
Under government reforms unaccountable appointed Clinical Commissioning Groups have been set up. Rules laid down by the new (CCG), mean that those needing surgery will first have to satisfy their GP that they have lost weight and attended smoking-cessation courses before they will refer them on to be seen by a surgeon. Patients have been told that they cannot have routine operations until they lose weight and stop smoking.
This controversy is not new – there have been numerous reports in the past of surgeons refusing to operate on patients until they gave up smoking or lost weight. But what is different here is that these are guidelines being imposed from on high, not an individual surgeon assessing a patient and deeming the risk to be too high to warrant an operation.
Unlike in the past, the surgeon who would perform the operation and the anesthetist responsible for keeping the patient alive will not be part of the decision-making process.
Under these guidelines, they don’t even get to clap eyes on the patient, let alone assess them.
What is really worrying is that this is contrary to National Institute for Health and Clinical Excellence (Nice) guidelines on treating, for example, arthritis. It clearly states that obesity should not be a barrier to referral for joint replacement surgery, and yet the CCG is doing precisely that.
I have no doubt that this is more about money than patient welfare. We all know that the NHS is under pressure to make financial savings, and introducing artificial barriers for access to treatments is a fine way of doing it – especially if you can hide behind the cloak of patient welfare.
It is one of the worst kept secrets that the Tories would like to dismantle the welfare state and this is a very slippery slope the NHS is heading down. The NHS is not there to enforce lifestyle choices or to judge the choices people make about their lives. It’s also not there to pick and choose whom it treats. Which groups will the CCG penalise next as pressure mounts to make savings and reduce waiting lists. What about people who engage in dangerous activities – such as horse riding, rock climbing or motorcycle track days for example? Shall we restrict the treatments they can receive as well?
Some may accuse me of scaremongering, but don’t bet against my predictions.
