NHS prepares to ration painkillers and routine operations

NHS bosses are drawing up national rationing guidelines for routine operations and prescription medicines after getting only a third of the money they asked for in the Budget.

They will meet next week to consider widespread restrictions to hip and knee surgery, IVF, antidepressants and painkillers. The drastic measures follow Wednesday’s Budget, which allocated £2.8 billion to the NHS over a two-year period. Health leaders – including NHS boss Simon Stevens – had asked for £8 billion.

Widespread restrictions on hip and knee surgery, IVF, antidepressants and painkillers are being considered by NHS leaders. One NHS boss told the Health Service Journal: ‘This level of funding still means we’ve got to decide which of the children to shoot first.’

Officials at NHS England are compiling a list of non-urgent operations and drugs which they claim the health service cannot afford to fund. These include 18 prescription medicines such as painkillers, antidepressants and thyroid pills which are currently issued to almost a million patients.

An NHS boss told the Health Service Journal that the level of funding ‘still means we’ve got to decide which of the children to shoot first’. Other medicines at risk include strong painkillers such as tramadol-paracetamol combination tablets, which are used for cancers.

A common drug for arthritis pain – Co-proxamol – is also on the list, as is Fentanyl, which is given to relieve pain in cancer sufferers. NHS England officials say these treatments are expensive and there are cheaper alternatives.

But charities point out that for some patients they are the only medicines which work.

Hip and knee surgery, gallstone operations, hernia removal and IVF are also at risk of being tightly restricted. Patients are likely to be refused procedures unless they are in severe pain, immobile or can prove their quality of life is severely diminished.

Couples may be offered only one IVF cycle – giving them an average 25 per cent chance of having a baby. In Scotland, couples are offered three cycles. The list will be presented to senior officials at NHS England – including Mr Stevens – at their board meeting in South London next Thursday.

Over the coming months they will decide which procedures and drugs will be rationed and where the limit will be set. Health secretary Jeremy Hunt said last month that some hospitals were paying 47 times over the odds for stethoscopes, plasters and rubber gloves

The NHS is struggling to cope with the toll of the growing, ageing population and the effects of lifestyle-related illnesses such as obesity and diabetes. Although its budget has gone up every year, health experts claim it hasn’t kept pace with the soaring demand.

However, some critics have accused the NHS of inefficiencies and of wasting money by over-paying for everyday items. Earlier this month, Health Secretary Jeremy Hunt said some hospitals were spending up to 47 times over the odds for stethoscopes, plasters and rubber gloves.

Rachel Power, chief executive of the Patients’ Association, said: ‘More cuts, more rationing and longer waiting times now seem inevitable.

‘These cuts have mostly spread out on the basis of a postcode lottery, but we can expect them to become more like the norm than the exception.

‘Many more people will be left having to battle the system, often in pain or dealing with other effects of illness such as reduced mobility or sight, all as a direct result of the Government’s decisions on NHS funding.’

Labour’s shadow health secretary Jonathan Ashworth says the Tories have ‘failed the NHS’ in the budget

Siva Anandaciva, chief analyst for the King’s Fund think-tank, said: ‘While the Chancellor provided more money than expected for the NHS, it still fell a long way short of what the service needs to do everything required of it next year.

‘Everyone agrees it is important to reduce hospital waiting lists, meet A&E targets, improve quality of care, and invest in mental health, primary care and community services.

‘But the reality is that the NHS cannot afford to do all of these things within its current funding. It has got to the point where some really difficult choices have to be made.

‘It is important that both the NHS and the Government are clear and open with the public about what these difficult choices are, so that the people who rely on its services are at least able to contribute to the debate.’

Jonathan Ashworth, Labour’s shadow health secretary, said: ‘It’s clear the Tories have failed the NHS in this budget and the consequence is likely to be escalating waiting lists and more rationing of treatment.

‘With millions waiting too long in A&E or stuck on trolleys in hospitals for hours on end, Theresa May had an opportunity to finally give the NHS the sustainable funding package it needs. Instead Tory ministers let down patients and their families again.’

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