Local NHS rationing go-ahead greeted with dismay

The decision of Enfield NHS commissioners to go ahead with cutting access to a list of NHS operations and other procedures has been strongly criticised by Monty Meth, president of the Enfield Over 50s Forum, and by the watchdog body Healthwatch Enfield.

As expected, the governing body of Enfield Clinical Commissioning Group (CCG) approved stricter criteria for a list of 11 procedures and treatments at its meeting on 20th September.  Interviewed after the meeting by the Enfield Independent, Mr Meth pointed out that almost all respondents to a 4-month consultation on "Adherence to Evidence-Based Medicine" felt that the proposals were either unfair or were unsure whether they were fair.

The list covers treatments for hernias, gallstones, cysts, vasectomy, skin grafts, breast reconstruction and several other problems.  These will only be provided for particularly serious cases or after waiting for up to a year to see whether "conservative" treatments, such as exercise and physiotherapy, will work, meaning that some patients will have to endure pain for many months.

Enfield Healthwatch CEO Patricia Mecinska commented as follows:

"Despite our advice to the CCG that they suspend their flawed consultation process and despite strong public opposition, the CCG has approved changes to services that are available to people in Enfield. It is likely that further changes will be introduced next year."

The Enfield Independent reports that the CCG decided that two procedures on the original list will continue to be provided - hearing aids for mild and moderate hearing loss, and knee replacement surgery.  However, Dr Martin Blanchard of Defend Enfield NHS has pointed out that the knee operations "reprieve" is only temporary until the CCG considers that better arrangements are in place for patients to access physiotherapy and be helped to lose weight.  As Dr Blanchard says, "The CCG have said they will decide when the right arrangements are in place and there will be no consultation about this.  They could do that at any time."

The decision to go ahead with service cuts in order to save money was made only a few days after five North London council leaders wrote to the chief executive of the NHS, Simon Stevens, complaining in strong terms about "service cuts and rationing".