Health authorities have started to “ration” major operations to save money as NHS budgets begin to be squeezed.
The result is a new postcode lottery of care, say critics, with health trusts across the country making different decisions on what operations they will do depending on what their books look like. Hip and knee replacements are among those affected.
Jane Copson, a 41-year-old teacher, was due to have a hip replacement yesterday (FRI) at University Hospital Coventry and Warwickshire.
Ten days ago she heard the operation had been deferred and she would have to start the process all over again with a referral from her GP.
She recieved a letter from her primary care trust (PCT), NHS Warwickshire, telling her: “It is not expected that you will receive your treatment before April 2011.”
That is the start of the next financial year, when all trusts receive a fresh injection of funds. Total hip replacements cost the NHS from £4,000 to £7,000.
Miss Copson, from Nuneaton, Warwickshire, said: “My postcode is CV11. If I had lived 20 minutes’ drive away, in a street with a CV1 through to CV6 postcode, I would have been in Coventry and I would have had my operation.
“Instead, ‘my operation’ has gone to a lady who does live there. That was my slot. And, for no good reason, it’s gone.”
Fifteen years ago she broke her left pelvis in five places. It was pinned back together, but she was told she would need a replacement in a decade. Last year she developed arthritis in her hip, which has steadily got worse.
Miss Copson, who has a two-year-old son called Ben, said of the deferral: “To say I was devastated when I heard is an understatement. I spent the whole weekend in tears.”
She is now on a powerful opiate-based painkiller but said she woke up frequently at night in pain.
Surgeons say the practice of delaying such operations is a new but growing trend.
One said: “Other PCTs are watching to see if Warwickshire get away with this and will use this as a way to postpone even making a decision on operations – not actually doing them – until the start of their next financial year next April. It’s a way of rationing operations.”
NHS Warwickshire has blamed the deferral on an “unexpected rise in demand” for surgery, which would lead to a £10 million overspend if it continued to fund operations at the same rate.
A spokesman said it must “by statute” balance its end-of-year books.
“About half is being saved by reconsidering some referrals; the rest by use of reserves and making other savings,” he said.
He argued the situation had arisen because the Labour government had created an “inflationary system” in which all health bodies expected receive more and more money each year.
Hospitals increased their budgets by carrying out more operations quicker, he said, but this relied on PCTs to pay for them.
Now that the NHS budget had essentially been frozen, the system was being forced to adjust.
“We have seen sustained levels of growth for years,” he said. “Now we are in a different world.”
However, he said of Miss Copson’s hip replacement: “If she needs it now, we will do it now.”
Stephen Adams
Telegraph UK