No hip replacements for obese patients

A DOCTOR has criticised the introduction of new thresholds that must be met before patients suffering certain conditions are offered surgical treatment.

A DOCTOR has criticised the introduction of new thresholds that must be met before patients suffering certain conditions are offered surgical treatment.

Dr Paul Thomas, of the Gipping Valley Practice in Barham, near Ipswich, said he was amazed health bosses would consider leaving a child in pain for six months before inserting grommets.

He also claimed they had implied doctors across the country agreed with their plans for the new thresholds when many of them did not.

A group made up of senior clinicians at Ipswich Hospital and local GPs has come up with a list of ten conditions where surgical treatment or investigation will not be considered unless it meets an agreed degree of severity.


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The move has been born out of the crippling financial situation the NHS in Suffolk finds itself in, with health chiefs concentrating on ways of reducing demand for NHS services.

The new guidelines mean that hip and knee replacement surgery will not be performed unless the patient has a Body Mass Index (BMI) below 30 and other means, such as physiotherapy, have failed to alleviate pain.

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It will also mean the insertion of grommets will not take place unless the child has had a period of at least six months of watchful waiting from the onset of symptoms.

But Dr Thomas said: “A BMI over 30 is not obese by any means. That's not clinical grounds to refuse treatment because although the anaesthetic risks are greater these are the very people that need the operation.

“Children are being denied treatment for their grommets for at least six months. I'm amazed they would consider leaving a child in pain for six months before considering operating.

“I am very annoyed because it makes it look like doctors are colluding with these people. Most GPs are appalled by the way the NHS has been dismantled.

“They're all clinical managers employed by the PCTs. It's a management group not a medical group.”

But Dr Brian Keeble, director of public health for Ipswich Primary Care Trust, said the thresholds had been drawn up by doctors.

“We are making public what has already been operated by doctors at the hospital,” he said.

“The thresholds have all been written by consultants at the hospital. They have been written by people who do the operations so we can be fairly confident they know what they are talking about.

“All GPs were invited to a meeting to discuss the thresholds. Some concerns were expressed. GPs wanted us to publicise this so patients could be aware of this before coming to see them.”

Dr Keeble added that a BMI of 30 was considered as obese and in relation to the insertion of grommets in children, he said: “It's genuinely accepted we go through this period of watchful waiting to see if the hearing improves before we take it a step further. That's been around for 10 years. What we have done is make it public.”

Other conditions affected by the new thresholds are varicose veins, rectal surgery/investigation, carpal tunnel syndrome, Dupuytren's Disease, trigger finger, ganglion, prostatism or inguinal hernia.

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