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Last Updated: Wednesday, 23 November 2005, 10:25 GMT
Obese patients denied operations
Image of an operation
Obese people are to be denied surgery in a bid to cut NHS costs
Obese people are to be denied some surgical procedures in a bid to cut costs in the NHS.

Three Suffolk primary care trusts have ruled patients with a body mass index (BMI) over 30 will not get operations like hip and knee replacements.

A person of average weight would have an BMI of between 18.5 and 24.9.

Dr Brian Keeble, a director of Ipswich PCT, said: "We cannot pretend that this work wasn't stimulated by pressing financial problems."

Under new guidelines surgery will not be performed unless "the patient has a body mass index below 30 and conservative means have failed to alleviate the patient's pain and disability".

This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30
Dr David Haslam, National Obesity Forum

"Pain and disability should be sufficiently significant to interfere with the patient's daily life and/or ability to sleep."

Hospital consultants and GPs in East Suffolk came up with a list of 10 conditions for which there must be a threshold in order for surgery to be performed.

Included in the procedures for which there are conditions are such things as varicose veins and grommets for glue ear in children.

Dr Keeble said: "Our work on clinical thresholds has been a key part of this process.

"We started from the idea that operating on some conditions, either at an early stage or before other treatments have been tried, could actually be detrimental to the patient because of the risk of side effects from the procedure."

To deny someone surgery because they are obese, unless there is a clinical reason, is unfair
Patients Association

But he admitted financial pressures were a factor in the decision.

"I believe that these thresholds will produce some clear benefits in that both patients and their GPs will know when these procedures will be performed," he added.

The clinical director of the National Obesity Forum, GP Dr David Haslam, said that he was alarmed by the level being set at a body mass index (BMI) of 30.

"This level condemns a quarter of the population to misery - there's a huge number of people with a BMI of over 30.

"The argument that the life of joints is reduced because people are overweight is more relevant to those with a BMI of above 40.

Ruling 'unfair'

"But I think that the trusts would be better off treating obesity or getting people to lose weight rather than introducing a blanket ban," Dr Haslam said.

A spokeswoman for the Patients Association said: "People are obese for all sorts of reasons.

"Unless there is a clinical reason for not carrying out surgery they should be entitled to have an operation as anyone else would be.

"People who are obese need education and help about healthy living. To deny someone surgery because they are obese, unless there is a clinical reason, is unfair."

A spokeswoman for the Norfolk, Suffolk and Cambridgeshire Strategic Health Authority said: "Patients will be assessed according to their clinical needs, as is the norm, and if necessary advised to lose weight before treatment, which will reduce the risks and improve outcomes for surgery.

"The message is that patients who need clinical treatment will get it."

NHS trust on why it is introducing the new rule

Q&A: Obesity op ban
23 Nov 05 |  Health
Obesity surgery doubles in size
10 Nov 05 |  England
Healthy challenge to cut obesity
21 Sep 05 |  Southern Counties

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