sugery

One in eight trusts will not fund these operations for smokers, instead offering them nicotine gum, patches and advice on how to quit, according to the Royal College of Surgeons (file photo).
Refusing surgery to obese people and smokers is "discriminatory and cruel", surgeons have said as they issued a landmark statement calling for the NHS policies to be halted.

The Academy of Medical Royal Colleges accused health authorities of taking decisions which are counter to the fundamental principles of the NHS.

The organisation - a coalition of 24 medical colleges and health faculties - said patients were increasingly being subjected to blanket bans on treatment, with lifestyle being used as an excuse to cut costs.


Comment: What surer way to coerce a populace into 'behaving'? And even better, you can keep moving the goal posts as your corrupt findings see fit.


Professor Derek Alderson, President of the Royal College of Surgeons told the Telegraph that patients were increasingly being left to suffer in agony, as a result of policies which were indefensible.

In recent months, clinical commissioning groups have introduced increasingly stringent restrictions - in some cases refusing all routine surgery to patients indefinitely, unless they lose weight or quit smoking.

Prof Alderson said: "Such policies are draconian and discriminatory, singling out specific groups of patients. They also keep patients from seeing the surgical specialists that can help them decide what the best treatment for them is."


Comment: Aren't doctors bound by an oath of 'first do no harm'?


He urged all areas who have introduced the restrictions to urgently think again, amid fears that more restrictions are likely to be introduced in coming months, as the NHS struggles to balance the books.

"It is cruel to keep patients who are in severe pain or, as in some cases, immobile and unable to work, waiting unnecessarily for treatment," he said.

The statement agreed by all the royal colleges says such policies are discriminatory, as they mean certain groups of people are being refused surgery, without even undergoing an assessment.

In many cases, patients who were overweight might struggle to lose weight until they had operations - such as hip and knee replacements - which would improve their mobility, they noted.

And they said the policies would widen inequalities in access to health care - counter to the duties of the Health Secretary to ensure fairness.

Research in 2016 found that at least one in three CCGs had at least one policy restricting access to surgery for smokers or those with a high body mass index. In many cases treatment was delayed, in a bid to encourage lifestyle improvements first.


Comment: Refusing these operations which are potentially life changing or life saving is more along the lines of coercion, not encouragement.


But recent policies have become even more sweeping. Last October, CCGs in Hertfordshire announced an indefinite ban on surgery for smokers and obese patients. Areas which have recently introduced delays for treatment for patients who smoke or are obese include Vale of York CCG, North Kirklees CCG and East Riding of Yorkshire CCG.

And three quarters of areas were last month found to be denying hip and knee replacement surgery to patients deemed not in "enough" pain.

Tam Fry, from the National Obesity Forum, urged health officials to heed the call from the royal colleges.

"It's deeply concerning that the NHS is increasingly choosing to play God and ration surgery on lifestyle grounds - inflicting years of pain and sickness on far too many patients. This is just a short-sighted attempt to cut costs," he said, describing the policies as "unethical, prejudicial and economic nonsense".

A Department of Health and Social Care spokesman said: "Decisions about whether a patient has an operation or not should be clinical, made between doctor and patient.

"Blanket restrictions on treatments are unacceptable and we expect NHS England to intervene if there is evidence of rationing care and the CCG is breaching its statutory responsibility to provide services that meet the needs of the local population."