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Fears over ‘NHS rationing’
Draft report detailing ailments not to be treated is ‘the thin end of wedge’
CANCEROUS skin conditions may be the first victim of a new list of low priority treatments banning GPs from referring some patients to hospital specialists.
Patients groups and doctors fear those needing varicose vein or or a specialist opinion on asthma or skin conditions could have to pay for their own treatments at private hospitals when the plans come into force.
GPs will be overruled if they refer patients that fall under the new low priority list to hospital specialists. Camden PCT revealed the list at a board meeting on Monday.
The list includes: asthma, grommet surgery, carpel tunnel surgery, minor skin surgery, various cosmetic surgery, gender reassignment surgery, viral warts, eczema, acne and psoriasis.
Some dermatologists fear that under these new rules some skin cancers will be missed and some hospitals are already charging patients to treat these conditions.
Royal Free patient forum chairman Arthur Brill said: “It’s odd that a GP who’s undergone training and years of experience is no longer capable of deciding on treatment for a patient.”
Dr Jacky Davis, founder member of the Keep our NHS Public Campaign, said: “It’s the thin end of the wedge. It looks like a huge amount of bureaucracy. It’s the beginning of a very explicit rationing. While some of it may be appropriate who knows where it will end?”
She added: “It’s going to be much more difficult to get a specialist opinion for any of these things. It used to be that if a GP thinks you deserve a second opinion they just referred you, now they have to jump through all these hoops.
“If your GP can’t argue your case strongly enough you could end up having to go private.”
GPs have been told the procedures were singled out because either there is little evidence they are effective, or other treatments should be considered first to delay the need for surgery, or because it may be cheaper to treat only certain patient groups.
Last week the New Journal revealed how the Royal Homeopathic hosptial in Bloomsbury is under threat because of the new rules.
Cosmetic surgery, including treatment for alopecia (hair loss) and correction of some facial deformities, are deemed inappropriate for NHS provision.
PCT chief executive Rob Larkman told Monday’s meeting: “Our view is that this is a clarification of widely accepted general practise so we don’t see that there’s a requirement to consult.”
Under the new plans, GPs will have to justify all referral decisions to a panel and if unsuccessful, patients will have to either see a nurse or GP with specialist knowledge in their condition. Patients unhappy with this may turn to private medicine to get a second opinion.
Dr Adam Wander, of Ampthill Surgery, Eversholt Street, believes the list may be a sensible move.
He said: “In some ways it could be good to avoid unnecessary referrals. Some things like skin conditions could be treated by a GP. ”
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