NHS patients are being refused basic operations because primary care trusts want to save money, six leading surgeons revealed in a devastating letter that was published on Monday.
The representatives of six major surgeons’ bodies say operations for back pain and common hernias through to varicose vein removal are being scrapped.
The letter, published in Monday’s The Guardian newspaper, stated:
‘Primary care trusts are restricting patient access to many treatments in order to save money.
‘Across the country, thousands of patients attend their GP surgeries with conditions that can be effectively treated by surgery and are being turned away.
‘Some patients may not even be told that an operation could help their problem.
‘Those patients who are referred to a specialist may now find that they are refused funding for surgery by their PCTs, which have arbitrarily defined a number of operations that reduce pain, improve quality of life and prevent serious long-term complications as being of “limited clinical value”.
‘These service cuts are being made without public consultation and the responsibility for informing patients denied treatment is being left at the doors of doctors.
‘It is unfair to patients and NHS staff to maintain the facade that this is “business as usual”.
‘All who work in the NHS are aware of the serious financial crisis facing public services, but careful decisions need to be made to ensure patients get the chance to benefit from reliable treatments.
‘Currently the public is not being fairly or fully informed.
‘Alan Johnson President, ENT UK
‘Prof Michael Horrocks President, Association of Surgeons
‘Michael Bell President, British Orthopaedic
‘Michael Rhodes President, Association of
Past-president, Association of Laparoscopic Surgeons and president-elect,
Association of Coloproctology
‘John Black President, Royal College of Surgeons
In response to the appearance of the letter, Sir Bruce Keogh, medical director of the NHS, claimed: ‘It seems inconceivable that any PCT or even the Department of Health would unilaterally draw up a definitive list of apparently ineffective procedures without a clear consensus from surgeons who are experts in the field.’
However, the surgeons who wrote the letter, backed up their claims with evidence.
John Black, said the cuts mirror the procedures that management consultants McKinsey advised the Department of Health the NHS should ‘decommission’ to save money.
Black warned: ‘Some silly suggestions have been made and cuts are being made to appropriate routine procedures with complete medical ignorance of what might happen in the long term.
‘Cuts in basic surgery is a very dangerous place to start. There will be a long term price to pay.’
Michael Bell said people are being refused carpal tunnel operations, a simple treatment under local anaesthetic to relieve pain in the hand.
He said: ‘Somebody has decided it’s not of benefit, but the PCT should follow guidelines and not make arbitrary decisions.’
Alan Johnson said what would in the past have been considered routine surgeries for removing ear glue in small children and taking out tonsils have been ‘withdrawn effectively from the health service.
‘These procedures have been classified as of low clinical value. But a child who cannot hear has his or her development impaired.
‘Acute tonsillitis in the worst case can see patients admitted to emergency wards which is much more expensive than removing their tonsils.’
Earlier this month, ENT surgeons revealed that 30 trusts had restricted simple procedures ‘which they would not fund’.
In orthopaedics, common surgeries such as knee replacements and carpal tunnel syndrome are being habitually refused.
Michael Bell said: ‘Both conditions are treatable. But now we hear that knee replacements only relieve pain for 80 per cent of patients after six months.
‘Apparently that is not a good enough outcome. Same for releasing trapped nerves. The decision for what is clinically necessary is made without consulting surgeons.’
Last week the Department of Health announced that trusts would have to save £1.5 billion by reducing ‘unnecessary prescriptions and hospital referrals’.
l In Wales, Chief Medical Officer Tony Jewell has urged patients to use the NHS rather than spend up to £139 on health tests being offered by a US firm.
He spoke out as the US health privateers ‘Life Line Screening’ prepared to hold a testing session in Cardiff this week.
It sent out leaflets inviting them to come and pay £45 for a scan at Llanishen Baptist Church, which, it claimed, could prevent a stroke.
The leaflet also advertised a package of four tests it said were designed to identify a patient’s risk of suffering a stroke, heart and arterial disease, for £139.
Dr Jewell said: ‘The NHS has a comprehensive screening programme and we therefore do not see any benefit for patients of any other screening or for patients needing to pay for any additional screening.’
Joe Korner, director of communications at The Stroke Association, said: ‘There is very little evidence to suggest that routine screening for blockages in the carotid artery, where there are no symptoms, is effective in stroke prevention.
‘Our advice for people who may be worried about their risk of stroke is therefore to see their GP.’
Chairman of the British Medical Association’s Welsh Council, Dr Andrew Dearden, said: ‘I would always recommend people to see their GPs first on matters to do with their health, rather than spend money on tests and investigations they may not need and may not answer the questions and worries they have.’
• Three private firms have been shortlisted to take over an NHS hospital.
Circle Health, Ramsay Health Care UK and Serco Health have been selected from five who had applied to operate Hinchingbrooke Hospital in Cambridgeshire.
The firms will now have individual meetings with NHS East of England.
Dr Stephen Dunn, director of strategy at NHS East of England, said: ‘Potential partners have been sharing with us some really pioneering ideas about how they would make Hinchingbrooke sustainable, and secure its longer term future.
‘An expert team has been evaluating how robust these ideas are, whether the bidders have sufficient vision, experience and a solid financial platform.’
Hospital chief executive Mark Millar claimed bidders had to show proof of their suitability to run the hospital.
Millar claimed: ‘We know that patients will continue to receive NHS services, and we know that staff and assets will remain protected within the NHS.’
Hinchingbrooke, which has an annual turnover of £92 million and debts of £40 million, is set to be the first entire NHS District General Hospital, to be handed over to a privateer.