Overweight patients to be refused hip replacements

Overweight patients to be refused hip replacements

	Published : Thu, 24 Nov 2005 12:05 By : Richard Owen Print this Story

Obese people will not be eligible for hip and knee replacements on the National Health Services (NHS) in East Suffolk. General Practitioners (GPs) and consultants will not refer anyone who falls in the category of obese to a specialist. This is a measure employed to save the trusts money worth £47.9 million earmarked for this area.

According to the World Health Organisation (WHO), people having a body mass in excess of 30 are classified as obese.

This decision was agreed upon by local doctors in the areas of Suffolk Coastal, Ipswich, and Central Suffolk. It is also considered risky to anaesthetise patients who are overweight. Public Care Trust, which manages three-quarters of the NHS budget, has given the go-ahead. This body issues guidance to doctors on treatments as and when required.

Doctors have the option to decide to not treat patients if a particular procedure could place them at more risk or wouldn’t be beneficiary at all.

Dr Brian Keeble, the Director of Public Health for Ipswich PCT said: “Patients who are overweight and obese do worse after operations. Lighter people tend to do better in terms of hip replacements not failing.” Dr. Keeble, who is the head of the cost-cutting measures that also included nine other procedures, added: “We cannot pretend that this work wasn't stimulated by pressing financial problems.”

But, this is going to raise hackles of approximately 20 per cent of men and 25 per cent of women who are fall under ‘obese’ category, in addition to their relatives and close friends. That the decision was taken more for financial reasons than clinical ones has irked quite a few people.

The Patients Association protested saying that it is unfair if patients are rejected treatment on any grounds other than medical.

A spokesperson for Department of Health said: “It is the role of primary care trusts to ensure that taxpayers' money is used for maximum clinical effect and to best serve the needs of their local patients. Any actions that trusts take to manage to reduce deficits should not lower the quality of care provided to NHS patients.”

A poll held this week by BUPA, the private health provider, which questioned 2,000 persons, revealed that over 33 per cent felt that people who are obese or either smoke or drink should be charged for medical treatment. Eight per cent said these people should be denied treatment altogether.

This scenario may be ideal for the 33% who show little compassion however for the public who this affects then questions must be asked as to why pay tax and national insurance contributions to a government or NHS who then, if and when is required to pay out, refuses. It also questions whether smokers should be treated, alcoholics, drug addicts? where does it end.

The explanation given is that people need to lose weight in order for the operation to have a better chance of success; the same can easily apply to drug addiction, alcohol addiction, car accident victims, after all they didn't have to go shopping in the car, they can order online! Well, if they shop online, they get no exercise by walking to the car so better ban the internet too.. Why introduce 24 hour drinking laws, why encourage people to drink if this too will cost the NHS more as weekends at any A&E are always busy; if alcohol was banned then one would assume that the £ billions it costs the NHS would be massively reduced.

Of course these are extreme arguments, hopefully bordering on silly and things, which simply won't happen but can be applied to many scenarios; the issue though that tax payers cannot get treatment after contributing for decades in some cases seems equally extreme.

It seems ridiculous and another example of how a poorly managed and funded health service is attempting to simply save money from a group who are easy targets with little public sympathy.

What would happen in these Trust areas or in the UK if the public adopted a solidarity style approach and stopped funding the NHS by withholding tax and taking them to Court? Perhaps a system of private only healthcare needs to be investigated where the public fund their own medical bills, therefore not paying tax and seeing their money going into a health service, which seems to get worse, not better, despite increases in funding.

The underlying issue is management and of course funding of the NHS, policies such as this, contrived because the Trusts involved are so heavily in debt have been condemned by many. How much do asylum seekers, non UK nationals and immigrants cost the NHS? If a British Citizen needs a hip replacement or knee replacement they should get it. If funds are unavailable then the NHS as a whole needs to be looked at, as it is not a National Health Service at all.