Smokers cut from some operations in England

Clinical Commissioning Groups (CCG) in England are denying medical treatments to high numbers of people who are obese or smokers, according to a story by David Millett for GP Magazine.
Eighty three percent of CCGs restrict access to surgery and treatments based on a patient’s BMI [body mass index], and at least one blocks all routine surgery for obese patients unless they lose weight.

Sixty two percent will not allow patients to receive certain treatments based on their smoking status.

The General Practitioners Committee deputy chairman Dr. Richard Vautrey condemned the “rationing of services” as unfair, unethical and unacceptable. He said CCGs hid behind “spurious clinical reasons” to discriminate against some groups to cut costs.

One CCG was quoted as saying that, given the limited resources available to the National Health Service, the CCG considered it would not be appropriate for some treatments to be routinely available to all patients.

Another said it applied restrictions to ‘ensure that limited resources available to the CCG are applied to those with most health need’.

More than 100 CCGs would only allow non-smokers to access fertility treatments and IVF. Many said their decision was underpinned by NICE (National Institute for Health and Care Excellence) guidance, but the guidance recommends only that patients ‘should be informed that smoking is likely to reduce their fertility’, not that they should be denied treatment.

“It’s blatant rationing,” said Vautrey. “CCGs should be open and honest. If we’re going to ration a service we should ration it for all people, not just those in particular groups and pretend it’s for clinical reasons.”