Controversial surgery ‘rationing’ plan for smokers and obese people to be scrapped

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U-turn over proposal to force smokers and the obese off waiting lists

A controversial plan to put smokers or people who are too overweight to the back of the queue for surgery is to be scrapped.

The Examiner revealed last June that Greater Huddersfield Clinical Commissioning Group (GHCCG) was plotting a change in policy to block people who are too heavy, or those who smoke, from getting straight in the queue for routine operations.

The proposal said people requiring surgery must have a body mass index (BMI) of less than 30 to immediately go on the waiting list.

Those who were over a BMI of 30 would be put to the back of the queue and given between six months and a year to shed some weight.

Smokers were due to be put through a similar process of trying to quit before they would be put on any surgical lists.

But after pressure from Kirklees MPs and criticism from members of the council’s health scrutiny committee, health chiefs at the CCG are set to quietly drop the plan.

Documents for the CCG’s Governing Body meeting on Wednesday say they have listened to the opposition and decided to “discontinue” the plan.

The report admits that the idea was “contentious” and that it “would not gain full clinical and public support”.

A spokesperson on behalf of NHS Greater Huddersfield CCG and NHS North Kirklees CCG said the decision would be made by governing body members on Wednesday.

They said: “In making the recommendation to our governing bodies, we have reflected on the feedback received from clinicians in primary and secondary care, as well as some of the recent public debate.

“People who smoke or are obese experience more complications during and after surgery and can take longer to recover.

“We want to make sure patients are aware of these risks and are offered support to improve their health before an operation.

“The proposal offers people the opportunity of the best possible clinical outcome, as well as the longer term benefits of a healthier lifestyle.”

Much of the criticism about the plan centred on the choice of BMI as a measure of unhealthiness.

Many professional rugby players and heavyweight boxers breach the BMI of 30, and some health professionals do not consider it an accurate measure of fitness. The scheme would have also created a “postcode lottery” in West Yorkshire.

Paula Sherriff, MP for Dewsbury, Mirfield, Denby Dale and Kirkburton said: ‘I’m delighted that arbitrary and short sighted ‘health optimisation’ plans that would have restricted access to surgery for smokers and the overweight in Kirklees have been shelved.

“Having tabled and led a debate in Parliament calling for the plans to be halted, I’m glad that the CCG has now heeded the widely held concerns of patients and clinicians.

“Not only does rationing fail as a cost cutting measure, it’s unjust and morally wrong – and it’s patients who would suffer.

“In the face of a national funding crisis, our local healthcare commissioners have tough choices to make so I welcome the CCG’s strengthened commitment towards promoting education and patient choice as a means to improve the health of local people.”

At a meeting last year, the clinical lead of GHCCG, Dr Steve Ollerton, admitted that the proposal would leave Kirklees folk worse off as neither Wakefield or Calderdale had similar plans.

With Kirklees patients being seen at hospitals across West Yorkshire, the plan would have led to a two-tier system at hospitals in cities outside of Kirklees.

The CCG was also accused of “health rationing” by Prof Peter Bradshaw, a co-optee of the scrutiny committee and a former health policy advisor to the Margaret Thatcher government.

Health officials disagreed but another member of the commitee said the policy was a barrier to surgery, even if it was sanctioned in the end.

GHCCG and its North Kirklees counterpart say they will now look to adopt a programme dubbed ‘Supporting Healthier Choices’ which will be brought in by all the CCGs in West Yorkshire.

This will be an optional weight loss or smoking cessation scheme for people facing elective surgery such as knee or hip procedures.

A budget of £333,000 is set to be sanctioned to support those who need help with either issue.

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