Obese people will be denied some kinds of surgery on the NHS, as hospital managers struggle with financial restraints. The warning from senior health service figures comes as one local health authority in England announces it patients whose body mass index (BMI) is 30 or greater will now wait for a year for surgery for non-life-threatening conditions, including hip and knee replacements.
Unless patients lose at least 10% of their body weight before being referred for surgery, the procedure will be delayed for 12 months. Surgery will also be delayed if the patient has not stopped smoking for eight weeks.
To reach the required BMI, which measures weight in relation to height, a man of average height in Britain – 5ft 10in – would have to weigh less than 15 stone. A woman of average height, 5ft 5in, would have to weigh nor more than 12 stone 12lb.
Dr Shaun O'Connell of the Vale of York clinical commissioning group (CCG) said the decision had been made because: "There are no quick wins and that makes us look for mid- to long-term wins."
"We don't want to spend the NHS resources on avoidable illnesses – in fact, we can't afford to," Dr O'Connell told The York Press. "There's no doubt the population is getting older and getting fatter and it's an outrage that the local NHS is not shouting from the rooftops that people need to look after themselves."
Clare Marx, president of the Royal College of Surgeons, warned the Vale of York's plans could have negative implications for patients across the NHS.
"This policy from Vale of York is among the most severe the modern NHS has ever seen," she told The Telegraph.
"Leaving patients waiting in pain for treatment longer than is clinically necessary cannot be accepted. In the last month alone, the Royal College of Surgeons has learnt of at least three clinical commissioning groups that are planning to introduce policies that deny or delay patients' access to surgery as a means to cut spending.
"At this rate, we may see brutal service reductions becoming the norm, rather than just being exceptions."
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Shaw Somers, a bariatric surgeon based in Portsmouth, said the move would save money, but was short-term and discriminatory.
"They are trying to lose weight in the vast majority of cases and to deny them treatment that they need on the basis of their weight, without then offering them effective help to help them lose weight is rather like discriminating [against] a segment of the population on the basis of their colour or religious persuasion."
This is not the first time patients have been targeted on the basis of their BMI. An investigation carried out by GP magazine in March 2015 found that 83% of CCGs had denied patients treatment for infertility, joint replacements and aesthetic surgery as their BMI was considered too high.
Treatments had also been refused to patients based on their smoking status by 62% of CCGs.