Unfair cataract rationing needs DH intervention, experts warn

The government must take action against PCTs for unfairly restricting cataract surgery for cost reasons following further evidence of rationing, according to the Royal College of Ophthalmologists.

DH: urged to intervene to prevent unfair cost-based rationing of cataract surgery
DH: urged to intervene to prevent unfair cost-based rationing of cataract surgery

College president Professor Harminder Dua told GP there was now clear evidence of rationing 'driven by financial considerations' following a study by Imperial College London into the practice.

He urged ministers to keep their promise to take action against PCTs that do not follow national guidelines, which has led to thousands of elderly people denied surgery.

Professor Dua also accused former health minister Simon Burns of 'putting his head in the sand' by denying such rationing was taking place.

Talks between the college and the DH on the issue scheduled for this week had to be postponed until October following the cabinet reshuffle.

Professor Dua said: 'PCTs are not following government guidelines, not following what has been clearly stated. Nobody should be denied surgery if they need it. The point is, the DH's investigation says it is not happening, and they are ignoring every other investigation that says it is.

'What we are suggesting to them is that they should enforce their own guidelines across PCTs and bring them to task, at least some rapping of knuckles to those who are not [following guidelines].'

Researchers from Imperial College London published a study on Wednesday that showed half of PCTs have rationing policies for cataract surgery. Of these, 92% do not reflect national guidance or clinical evidence.

Professor Dua said these policies fail to acknowledge the burden cataracts can place on everyday life, such as stopping patients from driving or reading.

He added that failing to treat a second eye with cataracts can lead to poor depth perception, increasing the risk of falls, thereby raising costs to the NHS.

As cataracts do not clear up on their own and must eventually be operated on in most cases, the NHS could be storing up huge costs for the future, said Professor Dua.

'Around 270,000 falls a year are vision-related, costing on average £2,500 to sort out. At the end of the day, the NHS is paying a lot more to sort out problems patients are having as a result of poor vision.'

He added: 'These patients aren't going away. In another 2-3 years there will be a huge number of patients who will need surgery. It will come full circle.'

In July, former health secretary Andrew Lansley pledged to take action against PCTs proven to be rationing for cost reasons.

His pledge followed GP's investigation that found 90% of PCTs had imposed thresholds on referrals for procedures deemed 'non-urgent' or of 'low clinical value'.

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