AUGIS adds its voice to NHS ‘access to treatment’ debate

AUGIS President Bill Allum was a signatory to a letter which appeared in the Daily Telegraph on June 21 calling for all patients to be treated according to their need and not compromised by financial pressure ( The letter followed reports that operations were being rationed by the NHS due to financial pressures.

As well as Mr Allum, the letter was signed by Professor John MacFie, President, Association of Surgeons of Great Britain and Ireland, Professor Norman Williams,
President, The Royal College of Surgeons of England, Alberic Fiennes, President, British Obesity and Metabolic Surgery Society and Professor Joe Dias President, British Orthopaedic Association.

The full text of the letter read as follows:

SIR – Restricted access to surgery is of great concern to surgeons who believe that patients’ treatment should be driven by need based on clinical assessment, and must not be compromised by financial pressure. Most methods to restrict access to surgery use unproven and arbitrary thresholds, which unfairly deny patients some of the most successful operations that improve quality of life.

Delaying patient access to hip and knee replacements and other orthopaedic operations can affect the outcomes of surgery, with evidence that patients are less mobile and suffer more pain if their operation is delayed or denied. Also, any hernia left untreated puts the patient at serious risk should the hernia strangulate, meaning that they would require emergency surgery to address the potentially life-threatening problem.

The compelling evidence that weight-loss surgery (bariatric surgery) is one of the most cost-effective treatments in acute health care cannot be ignored. Severe obesity is a new disease of epidemic proportions and bariatric surgery improves lives and reduces overall health care costs. Restricting access to surgery by raising the threshold on Body Mass Index above the recommendations of National Institute for Health and Clinical Excellence is not in patients’ best interests.

While we recognise resource constraints faced by NHS commissioners, we must not cut front-line services. Decisions about whether to put patients forward for surgery are best left to patients with direct support from their surgeon.

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