FINANCE: ‘Queues’ of clinical commissioning groups could have implemented controversial plans to restrict access to certain services had a high profile attempt at rationing in Devon been successful, a local commissioner has claimed.

David Jenner, chair of the eastern locality of Northern, Eastern and Western Devon CCG, said the group had been a “pit canary” for more radical NHS rationing, with CCGs around the country ready to follow suit if it had got its plans through.

In December NEW Devon announced plans to require obese patients to lose weight and smokers to stop smoking before they could have routine surgery.


The CCG ditched plans to require patients to stop smoking before they could have routine surgery

However, the proposals were ditched a few days later following outcry from politicians, members of the public and the Royal College of Surgeons. 

Plans to provide only one hearing aid for people with hearing loss in both ears were also shelved by the CCG in January.

Speaking in a personal capacity at a debate organised by the Nuffield Trust and the RCS on the “postcode lottery” in health last week, Dr Jenner said he had learnt from the episode that his CCG had tied its policies “too explicitly” to addressing its financial problems, rather than emphasising their merit in improving surgical outcomes.

The CCG had said the measures were needed to find £26m of in-year savings and to avoid finishing 2014-15 with a cumulative deficit of £30m.

“We were the pit canary, and if we had done it there were, I think, queues of CCGs waiting behind us to do exactly the same,” Dr Jenner said.

He added that the subject of rationing would “come up again, and not just in NEW Devon” unless politicians changed NHS funding, restricted access to services or fully relinquished spending decisions to local areas.

Dr Jenner said: “Politicians [need] to grasp the nettle of whether they are going to take some decisions about the availability of resource, and for me you either raise taxes, you limit what’s on the NHS menu, or you introduce [co-payment], or a combination of all three.

“Or you make a decision that actually you devolve that down to local bodies to make those decisions, and then if [politicians] do that then they can’t interfere if we start making the decisions.”