Shadow Health Minister Phil Hunt on why restrictions in NHS care are starting to bite
From all around the country, reports are starting to emerge of increasing restrictions on people’s access to NHS treatments. This gets a vital airing in the Lords today when Baroness Masham will press Ministers to explain just what is happening, how the Coalition government would define surgical and medical exceptional care and who makes the decision to fund or not.
Behind all of this is a specific concern about a patient in North Yorkshire who has had funding refused for treatment for a total pancreatectomy and islet cell transplant. The local Primary Care Trust (PCT) rejected the application because they claimed the operation is experimental, and that the patient case is not exceptional enough.
This is disputed by the patient concerned but the case also raises a much bigger issue about how much the NHS is currently restricting much needed patients treatments. Recent research carried out by the Labour Party has shown that crude, random rationing by health bodies goes far wider and deeper than first believed, with 125 previously free treatments restricted or even stopped altogether in the past two years. These restrictions are linked to arbitrary caps on the number of treatments provided. But there are also examples of decisions being entirely cost-based.
There have previously been restrictions on some treatments, but the scale and pace has drastically increased since the last general election. Yet, Health Minister Simon Burns has said it is unacceptable for the NHS to impose blanket bans for treatment on the basis of cost alone.
Some restrictions are even being introduced which diverge from NICE guidelines and cover a number of serious treatments affecting patients’ levels of pain, mobility and quality of life.
Twenty two treatments or services were stopped altogether by at least one PCT or Clinical Commissioning Group. Patients in parts of England have been left facing charges for essential treatments such as cataracts, knee surgery and hip replacements as they were forced to go private.
No one disputes that ineffective or unnecessary treatments should be looked at more closely. But surely the government should initiate a public debate on whether or not these treatments are provided nationally by the NHS rather than allowing them to be restricted in a random fashion.
Ministers should initiate an immediate review of rationing in the NHS and act immediately on new evidence showing treatment restrictions on grounds of cost alone. And they should reverse rationing decisions which leave patients in severe pain, restrict mobility, and limit their ability to live independently, pending the outcome of this review.
Lord Phil Hunt of Kings Heath is a Shadow Health Minister and Labour’s Deputy Leader in the Lords