RCS warns on 'backdoor rationing' in NHS

John Black said the “backdoor rationing” of non-emergency operations for conditions such as hernias, cataracts and arthritic joints, would lead to patients suffering unnecessary pain and long-term health problems.

He also claimed that the practice, which is increasingly being adopted by primary care trusts across the country, made no medical sense.

Speaking to The Guardian, Mr Black said: “More and more NHS trusts are introducing more and more of this sort of backdoor rationing by imposing longer and longer waiting times for surgery on patients, or indeed stopping doing certain procedures altogether. This is a dangerous path for the NHS to be adopting, because of the long-term health problems that will inevitably be built up if operations designed to prevent long-term harm are delayed or stopped.”

He continued: “By reducing elective surgery you can immediately save money, but at the cost of pain, reduced quality of life and deterioration of health.

“If the NHS continues to save money in this way, we will pay later in terms of future suffering of patients.”

The senior medical figure said growing numbers of PCTs are temporarily postponing or ending the provision of dozens of procedures, including hip and knee replacements and those for gallstones and tonsil problems.

The NHS in north east Manchester has recently decided to stop providing 57 types of surgery, at least until April.

He added: “Patients who aren’t operated on won’t see their symptoms go away; they won’t magically get better. Their hip or knee will just degenerate.”

He called for a debate on exactly what the NHS could offer under its new budget constrains, and added: “The immediate need to save money by going for the soft targets of elective surgery will leave a lot of people with unpleasant symptoms and build up future health problems. Medically that makes no sense.”

Katherine Murphy, chief executive of the Patients Association, said she had been contacted by patients whose planned operations had been cancelled but not rescheduled.

“Why are patients having to suffer in order to balance the books?” she said.

“I would say to the NHS: think again and think hard, don’t make patients the victims of budget cuts and save the money elsewhere.”

Mr Black’s comments come days before the government announces the biggest overhaul in British healthcare provision for more than five decades.

The flagship Health and Social Care Bill will be published on Wednesday, proposing changes that include handing GPs power over commissioning treatment worth £80bn.