NCPA - National Center for Policy Analysis

NHS Turns to Rationing

August 1, 2011

Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save Britain's National Health Service (NHS) money, reports the Independent (U.K.).

  • Two-thirds of health trusts in England are rationing treatments for "non-urgent" conditions as part of the drive to reduce costs in the NHS by £20 billion ($32.9 billion) over the next four years.
  • One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.

Examples of the rationing now being used include:

  • Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.
  • Cataract operations being withheld from patients until their sight problems "substantially" affect their ability to work.
  • Patients with varicose veins only being operated on if they are suffering "chronic continuous pain," ulceration or bleeding.
  • Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.
  • Grommets to improve hearing in children only being inserted in "exceptional circumstances" and after monitoring for six months.
  • Funding has also been cut in some areas for in-vitro fertilization treatment on the NHS.

Doctors are known to be concerned about how the new rationing is working -- and how it will affect their relationships with patients, says the Independent.

Source: Oliver Wright, "Cataracts, Hips, Knees and Tonsils: NHS Begins Rationing Operations," Independent (U.K.), July 28, 2011.

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