The Price of Good Health

The sick “have misguidedly become soft targets for NHS savings”, the Royal College of Surgeons (RCS) has said.

Growing rationing of healthcare is forcing more doctors to plead with the NHS to fund treatments patients in need.  The restrictions being placed on non-emergency treatment were "unfair" and meant patients spent longer in pain or were going without treatment.

GPs and hospital consultants in England submitted 73,927 exceptional requests on behalf of patients in 2016-17 in a bid to persuade the NHS to fund drugs or surgery they were initially denied, an investigation by the BMJ has found. That was almost 50% more than the 50,188 individual funding requests (IFRs) doctors put in to clinical commissioning groups (CCGs), the bodies that hold the NHS budget in local areas, in 2013-14. Just over 50,000 IFRs were submitted in both 2013-14 and 2014-15. But that suddently rose by almost 20% to 60,425 in 2015-16 and then by about a fifth yet again to last year’s total of 73,927.

Doctors said the trend was a clear indicator that care was being rationed. For every case where an exceptional argument has been made, there will be plenty more where patients will have gone without care and their doctor has not appealed.

“Hip and knee replacements are some of the most clinically effective and economical treatments available on the NHS. Unfortunately, patients needing hip and knee surgery have misguidedly become soft targets for NHS savings,” said Stephen Cannon, vice-president of the RCS. He addeds local health managers were "unfairly and unnecessarily prolonging the time patients will spend in pain, possibly immobile and unable to carry out daily tasks or to work".

Ruth Robertson, a fellow in health policy at The King’s Fund, said: “With financial pressures growing, we can only expect to see more of this. It is unrealistic to expect the NHS to maintain the current level of services within the current budget, and so the government needs to either find more money for the NHS or be honest with the public about what sort of healthcare it can expect in the future.”

Helen Lee, of the Royal National Institute of Blind People, said restricting access to cataract treatment was a "false economy". "Patients with cataracts are at risk of social isolation, depression, and fall-related injuries," she added.