Smokers will be denied life-changing operations unless they agree to kick the habit, it was revealed today. Many cash-strapped hospitals say that they will not treat patients for hip and knee replacements until they are going to give up on smoking. Those who do not stop the habit could also be denied treatment.
Smokers are at a big risk of complications and this move might help save some money for further care. Some critics have accused the trusts of putting the finances in front of the health of the patients and have warned that this could lead to some surgeons breaking the Oath.
This move which is to be implements in the Norfolk Primary Care Trust will affect the patients. The trust is £50 million in the red and is presently providing healthcare services to the residents of Norwich and surroundings. Newcastle-Under-Lyme PCT which is £1.4 million in debt, has also taken a similar decision.
Last year, it was the turn of obese patients to reduce their weight if they had to be treated in east Suffolk The urgent operations are not covered by these policies.
The treatment for smokers were more expensive and they have longer stay in the hospitals for recovery hence this move was taken Also they are at increased risk of complications By quitting the habit the cost of hospital care is reduced. A simple saliva test can prove if the person is a smoker.
Dr John Battersby, the trust's director of public health, said 'The situation across Norfolk is that one in four people smokes and that is the same for the proportion of people coming through for surgery. There is increasing evidence that smokers have three times the number of complications as non-smokers. What we are proposing is that if someone who smokes is being referred for surgery, we would instead want them to be referred to a smoking cessation clinic and give them three months to stop smoking.'
'What we are doing is asking people to have a stab at giving up for three months and at the end we would review the situation. Some people will have stopped and will go on and have a referral for surgery. Others will not have stopped.' Dr Battersby went to add.
The PCT informs that if a person tries hard to kick the habit and needs the surgery, they may get it. But if the authorities felt that a strong effort was not made that they may not be referred for the operation.
Dr Battersby says,'I am not saying there is an absolute block on smokers getting surgery but there is evidence that if they successfully stop smoking they have a much lower risk of developing complications and there will be a better outcome for them. There is a cost implication in terms of those complications. If they stop, it is going to have a positive impact on the health system.'
The National Institute for Health and Clinical Excellence is the Governments medical body which guides them when taking a decision on the treatment for patient depending on the patient's lifestyle.
However the smokers claim that they are being discriminated against. Neil Rafferty of the pro-smoking group Forest says, 'This is blackmail, pure and simple. Smokers pay their taxes like everyone else. In fact, because of the very high duty on tobacco, they probably pay a lot more tax than the average person. They are entitled to free healthcare and health trusts do not have the right to make up conditions.'
Some other critics mention that the finances should not play a part in the decision of a treatment or operation, while there may be medical reasons for doing so.
Micheal Summers of the Patients Association said, 'Finance has got nothing to do with making sure people are made well and every effort should be made to do it the best one can. Managers, Doctors could be forced into breaking the Hippocratic Oath, under which they pledge to treat the ill to the best of their ability.'
He said, 'The patient is the responsibility of the doctor or surgeon, not that of the manager of the PCT. The responsibility is a moral one. Many of those doctors and surgeons will have taken the Hippocratic Oath and therefore they shouldn't be brow-beaten by managers over whether a patient should or should not have an operation.'
Liberal Democrat Health Spokesman Steve Webb said: 'If it is about making surgery more effective that is quite legitimate. But if it is a back door way of trying to reduce demand and save money, it is picking on smokers. We all do things that are bad for our health and we shouldn't discriminate against one particular group.'
'Clearly the PCT believes it has got to act as quickly as possible because of its financial position but I think GPs would be very concerned about this idea. GPs refer people when they think people need to have things done. Most people who smoke wish to stop anyway and we really do not think it appropriate that they should be disadvantaged by being forced to wait for important operations,' said Simon Lockett, secretary of the British Medical Association's Norfolk committee for GPs.
This comes in as the NHS is struggling to cope with mounting debt. The Official debt figure is £512 million for the last financial year. However it is claimed that the true figure of debt is much higher.
If the trusts cut down staff turn-over and also cut down on the time a patient spends in hospital that health services could save close to £2.2 billion yearly.