Doctors warns NHS has to start rationing treatment

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NHS treatment should be rationed to save money, according to the BMA

NHS treatment should be rationed to save money, a British Medical Association review will report tomorrow.

Free fertility courses, plastic surgery and operations for varicose veins would be denied in some cases, along with treatment for minor childhood ailments.

In a fundamental shift, the BMA is questioning this week whether the Health Service can afford to continue universal care.

It has been free "at the point of clinical need" to all patients since 1945.

But in a letter to BMA members, senior official Dr Michael Wilks said a panel had concluded that "while the service should remain universal, the challenges raise questions about how comprehensive it can continue to be".

A BMA report to be published tomorrow will recommend for the first time that some NHS procedures should be limited.

The proposals have already brought a furious response from patient groups, who say denying treatment can be more costly in the long run.

But BMA chairman James Johnson will warn that, despite record investment, the NHS can no longer afford to carry out operations not considered essential.

Instead, the association will propose two lists of procedures: one that all patients should be entitled to and one down to the discretion of health chiefs.

It believes this would tackle the problem of postcode lotteries, where a patient living in the "wrong" area is denied a treatment available on the NHS in another part of the country.

Hospitals and trusts have been criticised for refusing to prescribe breast cancer drug Herceptin or carry out stomach-stapling operations on obese patients, though these are available elsewhere.

Dr Wilks outlined the organisation's thinking in a letter to 139,000 members. He said: "Rationing of healthcare has always existed but has not been discussed.

"A debate might, for instance, address whether current inequities caused by pressures to balance the books are preferable to one alternative, which is to set a limit on the availability of some procedures."

Health Minister Andy Burnham said the report was a welcome contribution to the debate over the future of the NHS.

But he added: "I would resist any call to make the NHS a slimmeddown, emergency service because that's what it would become if we started saying 'you can't have this' and 'you can't have that'.

"It should continue to be comprehensive and universal."

Katherine Murphy, of the Patients' Association, said: "Treatment should never be denied when it is deemed necessary by a medical practitioner.

"Even though varicose veins are unsightly, they can have a severe impact on quality of life."

 

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