Reports have indicated that NHS leaders intend to extend the rationing of treatment for smokers and obese patients.
A leaked letter has been acquired by the press, with NHS bodies across England seemingly forced to implement restrictions on access to treatment.
The plan is outlined in a letter sent on 15th March by Dr David Black, NHS England’s medical director for Yorkshire and the Humber, to Rotherham Clinical Commissioning Group.
Within the letter, Black praises the GP-led group that controls the NHS budget for introducing what has been described by critics as ‘lifestyle rationing’.
“We are very supportive of your work to best manage resources for the benefit of all patients and understand that this may mean that difficult decisions need to be made,” Black writes.
The letter goes on to suggest that the scheme could be extended to other aspects of the NHS system in the coming months.
“We expect that many CCGs will be in the process of developing similar schemes and initiatives to deliver plans for 2017-19. This is something we would encourage, where plans are well developed and clinically validated.”
There has been huge opposition to curtailing NHS treatment on the basis of lifestyle issues.
And ex-health minister Norman Lamb has been one of the critics of this notion, suggesting that it is inimical to the ethos of the NHS.
“This is yet more evidence of the creeping advance of rationing. Guidance based purely on medical judgment on weight loss is fine, but what is happening around the country goes well beyond that in practice. It will inevitably result in those people with money paying for speedy treatment, while everyone else is left waiting,” Lamb commented.
Lamb went as far to suggest that the Conservatives are presiding over the destruction of the NHS.
“We are seeing, bit by bit, the destruction of the solidarity that this country has been so proud of with the NHS – the idea that whatever your income or wealth, you get access to the care you need, in your hour of need.”
Jonathan Ashworth, the shadow health secretary, suggested that the Tories have failed to fund the NHS adequately, and now healthcare bodies are consequently forced to make tough decisions.
“This secret memo from NHS chiefs reveals the truth of what’s happening to the NHS under the Tories – more and more rationing of treatments. People will be waiting longer and longer in pain and discomfort for surgery such as hip and knee replacements. There is now a very clear choice in this election. Cuts, longer waiting times and restrictions on treatment under the Tories, or Labour, who will return our NHS to its founding principle of universal provision, free at the point of need, with best quality of care for all.”
A recent survey conducted for The Guardian newspaper outlines the true extent of the rationing of healthcare in the NHS.
Figures acquired by the newspaper indicated that the majority of hospital doctors and general practitioners believe that rationing is occurring within the health service for financial reasons.
As many as 86 per cent of the 749 doctors who participated in the survey indicated that monetary issues are driving this rationing process.
Meanwhile, 39 per cent indicated that rationing played a significant role in managing demand within the NHS.
Only 28 per cent of those surveyed offered what could be considered a legitimate reason for such a policy, suggesting that clinical evidence for certain treatments had changed and so they were no longer recommended.
The figures painted a sobering picture of the state of the health service, but other data generated by the survey was of equal concern.
Significant minorities of medics had seen restrictions on the removal of benign lumps and bumps (36 per cent), breast reduction or enlargement (31 per cent), varicose vein treatment (31 per cent) and cosmetic surgery (28 per cent).
Nearly 25 per cent of medics surveyed had experienced drugs are being rationed due to costs, with cancer treatments being cited by 13 per cent of doctors.
Nearly one in four of those surveyed had witnessed fertility treatment being rationed due to cost reasons, and 18 per cent had seen mental healthcare being withheld.
Yet despite this already alarming picture, rhe individuals participating in the survey for the Guardian are almost unanimous in the impression that the situation will decline further still.
Nearly 95 per cent of doctors who completed the survey agreed that rationing will inevitably increase in the future owing to the rising demand for care and the existing financial situation of the health service.
Perhaps the only crumb of comfort for the government with regard to its existing NHS policy was the opinion of doctors on whether rationing can be justified in at least some circumstances.
Nearly three-quarters of those surveyed opined that the NHS is correct to ration streatments because it helps the service survive financially, or because not all treatments should be funded by the service, or due to the fact that free NHS services can be abused by patients.
What can be said in mitigation is that the first of these three ideas should not necessarily be considered an acceptable justification.
It could rather be asserted that this is an indication that the NHS needs to attract much greater funding from the government.
The findings follow closely on the back of a National Audit Office report which suggests that the most basic GP services are now failing.
During 2014-15, 27 per cent of patients said it was not easy to speak to their practice by phone, up from 19 per cent in 2011-12.
In a time of great political division and conflict in the United Kingdom, it is increasingly clear that the NHS will be a battleground for the remainder of this Parliament and probably beyond.
As numerous rows about the future of the NHS continue to unfold, new evidence suggests that patients are increasingly being denied major surgery as healthcare is effectively rationed.
Evidence in The Guardian newspaper indicates that patients are frequently denied such critical services as mental healthcare, hip and knee replacement operations, and vital medicinal drugs.
The NHS is seemingly resorting to every conceivable approach in order to overcome its growing cash crisis.
Indeed, the situation is so serious that it is not at all unreasonable to describe the existing policy as one of rationing healthcare.
When doctors in the NHS where surveyed recently, over 75 per cent indicated that they had experienced care being rationed in their particular region of the NHS over the last 12 months.
Treatments rationed included speech therapy, operations to remove varicose veins, Botox to help children with cerebral palsy move more freely, and even potentially life-saving stem cell transplant surgery.
Commenting on these worrying figures, Dr Mark Porter, leader of the British Medical Association, commented: “The NHS is being forced to choose between which patients to treat, with some facing delays in treatment and others being denied some treatments entirely. This survey lays bare the extreme pressure across the system and the distress caused to patients as a result.”
The survey, conducted by Binley’s OnMedica, a healthcare data and intelligence provider, painted a picture of massive problems across the health service as organisers and frontline workers attempt to cope with an increasing convergence of massive infrastructure problems.
Following this survey, debate about the future of the NHS will only intensify.
The Conservative government has attempted to defend its position, and suggest that the health service itself must spend money more efficiently and effectively.
And the findings from the survey prompted comment from the Parliamentary Under-Secretary of State for Health in the House of Lords, David Prior.
Prior even suggested that NHS organisations may be breaching the law by rationing healthcare.
“Treatment decisions should only be made by doctors based on a patient’s individual clinical needs. Local health bodies have a legal responsibility to provide services meeting the needs of their local population, and we expect NHS England to act if there is any evidence of inappropriate rationing of care,” Prior commented.
The NHS is facing numerous problems, with staffing related to junior doctors proving to be a particular issue.
Meanwhile, the health service also faces a deficit of around £30 billion between now and the end of the decade, while also being expected to make serious efficiency savings.
Add in the fact that the Conservative government has opined that the NHS must switch to a true seven-day culture, and the existing situation is pretty much a perfect storm.
There are huge demographic problems for both the NHS and the government to address in the coming years, and it is clear that the time of writing that these are not being tackled satisfactorily.