A survey by www.pulsetoday.co.uk, a leading UK based website and magazine for healthcare professionals, surveyed some 300 GPs and the results demonstrate that rationing of treatments has become widespread within the National Health Service in the UK.
The UK National Health System is run by Primary Care Trusts (PCTs) who administer funds for health and social care in their local region.
Since April 2011, with Government cutbacks and austerity measures in place PCTs are receiving less funding than previously. Clearly one of their simplest options to save money and remain within their reduced budgets is to reduce the number of patients they treat.
Pulse states that restrictions on GP referrals have been so dramatic that in one area in the UK, the number of patients referred from GPs to hospitals has dropped by 37% in the first quarter of 2011/12 compared with the previous year.
The survey asked local Doctors to select services they felt were being restricted, choosing from a list of 20 different treatments. The most popular for restrictions were:
- 55% Varicose Vein Surgery
- 36% Nutritional Supplements
- 29% Infertility Treatment
- 22% - Operations for Uncomplicated Hernia
- 17% - Hip and Knee Operations
- 11% - Vasectomy or Female Sterilization. Other examples of restrictions include:
- 25% - Obesity Treatment and Prevention
- 16% - Routine Blood Glucose Testing for Diabetes
- 13% - Direct Access to MRI and CT diagnostic scans
The Pulse analysis reveals that areas that have setup the controversial "referral management centers" or simply installed caps on the number of patients that can receive the same treatment in a given time frame, have shown alarming drops in numbers. Whilst the drops may be good for the bottom line and from the accountant's point of view, they have clearly gone far beyond offering any reasonable service to patients, who have paid taxes in good faith towards a Nationalized Government Health Care Program that is now failing them.
The most aggressive example can be found in South West Essex, an area just outside London, where GP-run private firm Fortis Healthcare runs a referral management centre. In this area of the country GP referrals have withered by 37% over the last year, although Dr Brian Balmer, chief executive of Essex local medical committee, seemed to think the fall was due to the PCT's stringent referral cap implemented at the start of this year.
Dr. Balmer said:
"This massive drop was simply because the PCT stopped dead all referrals in the early part of 2011. It was done centrally - they told the acute trust that they wouldn't pay for referrals and activity dropped. It does not reflect GP behaviour."
Dr Balmer continued by explaining that GPs in south-west Essex had seen a 'huge' number of NHS treatments rationed from March. NHS South West Essex currently restricts access to hip and knee replacements, cataract surgery, varicose vein treatment and hernia repair.
Dr. Balmer said:
"PCTs' number one priority is
Elsewhere in the UK referrals saw a:
- 15% drop at NHS Manchester with its referral management centre run remotely by Harmoni
- 14% drop at NHS Hounslow, West London, where UnitedHealth began overseeing GP referrals in May after signing a deal with one of the first GP Pathfinder Consortia
"We are seeing significant postcode variation, which is not compatible with the Government's commitment to provide equitable access to healthcare."
Richard Hoey, editor of Pulse, said:
"Both the current government and the last one claimed it would be possible for the NHS to deliver £20 billion of efficiency savings without harming frontline services, and both of them were wrong."
It's clear that the financial position of many PCTs is now severely wanting, with the Trusts only receiving a tiny real-terms increasing in funding in April. Obviously that was not going to be enough to cope with the aging baby boomer population, and despite political promises being made, the reality of NHS managers has now become very clear, and is most certainly one where they are being forced to take financial rather than medical and compassionate decisions.
With the US plunging itself into a similar nationalized system under 'Obamacare' it would be interesting to assess the amount of taxes a typical UK patient has paid towards healthcare over his lifetime, and compare the kind of arbitrary denial of service he is receiving under the UK's NHS, with the type of service he might have received having invested a similar amount of money into a private health plan.
It would be wise to remember that the NHS is far from "free" although it must appear that way to someone who suddenly needs hospital treatment in the UK.
At the end of the day, it's all very well to bicker at the Government run system, and certainly the NHS has not been short of scandals and inefficiencies over the years, but the general public might do well to remove themselves from the illusion that the Government can provide some kind of silver bullet to take care of all their needs and woes.
The very fact that the NHS has installed private health contractors in creating its "referral management centers" is indicative of the fact that Government Healthcare simply represents an arbitrary form of private healthcare, funded by obligatory taxes instead of voluntary insurance payments. While this might have worked in the past, clearly its flaws, inefficiencies and lack of oversight are beginning to become apparent, and one has to think back to the famous phrase from Margaret Thatcher : "The problem with socialism is you run out of other people's money to spend."
Written by Rupert Shepherd BSc