British National Health Service Extends Rationing to Surgeries

International   |   Steven Ertelt   |   Jul 28, 2011   |   12:20PM   |   London, England

The National Health Service in England is increasingly rationing standard operations that patients may have normally taken for granted — in a move that worries bioethicists in the United States.

A new report in The Independent reveals how hip replacements, cataract surgery and tonsil removal are among the many operations that two-thirds of health trusts in England are now putting on a “non-urgent” list in an attempt to help save the government-run health care program $20 billion over the next four years. The newspaper reveals one third of health trusts have already expanded the list of rationed procedures in the last 12 months and others are expected to follow suit.

Some of the example of rationed surgical procedures include limiting hip replacements to those experiencing severe pain, cataract operations are on hold for those whose eyesight problems don’t yet affect their ability to perform on the job, and patients with varicose veins will only be allowed operations if they are experiencing pain or internal bleeding.

The figures come from a new survey of 111 hospitals by an industry magazine and the survey also showed doctors are concerned about the effect the rationing will have on their relationships with their patients.

Birmingham and east London are reportedly the areas where rationing has expanded the fastest but Medway and Dorset are moving in that direction as well.

Chris Naylor, a senior researcher at the health think tank the King’s Fund, told The Independent that the rationing is related to the cost-savings the NHS asked medical systems to find.

“Blunt approaches like seeking an overall reduction in local referral rates may backfire, by reducing necessary referrals – which is not good for patients and may fail to save money in the long run,” he said. “There are always rationing decisions that have to go on in any health service. But at the moment healthcare organizations are under more pressure than they have been for a long time and this is a sign of what is happening across many areas of the NHS.”

The survey found 64 percent of the 111 hospitals have or will be implementing rationing policies for non-urgent treatments and those of limited clinical value.

A Department of Health spokesman said: “Decisions on the appropriate treatments should be made by clinicians in the local NHS in line with the best available clinical evidence and Nice [National Institute for Health and Clinical Excellence] guidance. There should be no blanket bans because what is suitable for one patient may not be suitable for another.”

American bioethicist Wesley J. Smith, bemoaned the news, saying, “The UK’s National Health Service continues its collapse. And it is only going to get worse, considering the trajectory.  Imagine the screaming here if HMOs did any of that.”

“The continuing collapse of the NHS is not only an indictment of single payer health care: It is a warning to the U.S. about centralized control of health care,” he said. “The continuing collapse of the NHS is not only an indictment of single payer health care: It is a warning to the U.S. about centralized control of health care.”

“Adding injury to injury, how easy it is for the bureaucrats to lard on the goodies on the private insurance companies’ dimes–as is already happening.  What makes us think that a too strained and bureaucratically suffocated private sector won’t eventually end up in a collapse–further harming the economy–and unable to provide for patients properly?” he said. “Once that happens (with malice aforethought?) Obamacarian class warriors will give a war whoop of triumph for having destroyed the dreaded private sector–and force us into single payer.  See, “NHS Meltdown” posts.  Lose. Lose. Lose.”