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More than two thirds of doctors forced to ration care

NHS treatment like a lottery, survey reveals

Jo Carlowe

Thursday, 15 September 2016

More than two thirds of doctors have had to ration care due to NHS cash constraints. 

The survey of over 1,000 doctors, which comprised 367 GPs and 672 hospital doctors, conducted by Wilmington Healthcare for ITV News, revealed that a raft of treatments and medications were being restricted, including hip and knee replacements, cancer drugs and mental health provision for children. 

Other common clampdowns included cutting access to breast reductions, varicose vein removal, IVF, and the removal of benign lumps and bumps. 

“Some patients pay for restricted cancer treatments by re-mortgaging their house," said one doctor surveyed, who described rationing as ‘inevitable.’

In some cases, patients developed complications before getting the treatment they needed, with one doctor giving the example of "large inguinal hernias that are 'not bad enough' to merit treatment, forcing the patient to wait till complications set in before treatment will be considered.” Another doctor said varicose vein surgery was being "deferred until actual ulceration occurs.”

The survey also uncovered cases of children being denied access to care, with one child ending up in A&E after taking an overdose having failed to get support from mental health services. While a girl under 10 years-old was left at risk of developing a large scar on her face, because the cyst on her cheek had to ‘grow bigger’ before doctors would remove it. 

Mental health doctors surveyed, said patients with dementia or depression had been sectioned, when this could have been avoided with more regular care in the community.

Key findings included:

  • Seven out of 10 doctors had witnessed restrictions to NHS services and treatment in the past year, and 84% of those surveyed blamed financial reasons. 
  • 23% said they had witnessed ‘drug rationing,’ often for cancer drugs, painkillers and arthritis medicines.
  • 71% said cuts were increasing anxiety among patients trying to access treatment.
  • Two thirds said restrictions increased the chance a patient would need to go private.
  • 22% said patients were more likely to need an emergency admission to hospital if their condition worsened. 

The majority of those surveyed, some 94%, perceived more rationing as inevitable. Eight out of 10 supported rationing to ensure the financial viability of the NHS. 

Gareth Thomas, managing director of Wilmington Healthcare UK, said: "Our research suggests that rationing is already widespread within the NHS for a variety of services and treatments, and with budgets under increasing strain, it is likely that more patients will be subject to restrictions in future.

"One of the key issues that comes across from comments made by doctors who took part in our survey is that currently it can seem like a lottery as to who is eligible for NHS treatment for certain conditions and who is not.

"To make the system clearer and fairer for patients, the NHS at local and national level would benefit from defining and creating a more level playing field on what it will fund in the current economic climate.”

Commenting, Dr Mark Porter, chairman of the British Medical Association, said: "The rationing of vital health care not only causes delay and distress to patients, but can ends up costing the NHS more money in the long run. This is especially true in the area of public health spending.

"Inevitably, it will be patients who suffer as the NHS, its doctors, nurses and other staff are forced to choose between which patients to treat and the type of treatment they receive. The Government must realise that the answer lies not in rationing essential services but in addressing the funding shortfall and investing in the future of the NHS.”

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