IN MY VIEW... I FEAR WHERE RATIONING WILL LEAD

AS A medical student, I was concerned about the length of NHS waiting lists for surgery.

My father, then a consultant anaesthetist, explained that funding in the NHS (just 20 years old at the time) was limited and waiting lists were a method to ration expenditure.

The crowning glory of the NHS was the concept of free healthcare for all at the point of delivery but, with the population pushing at an open door, there would inevitably have to be a way of controlling and limiting demand in a tax-funded, but notionally free, service.

The debate about waiting lists soon became toxic, politically unacceptable, and more subtle ways of reducing demand and capping costs gradually evolved. In this game of musical chairs, the music has now stopped — though we see the sense of procedures being banned due to little evidence of benefit, such as injections for lower back pain, surgery for carpal tunnel syndrome, arthroscopy for knee arthritis and removal of benign skin lesions, we now face the rationing of treatments that undoubtedly benefit patients.

Some have been permitted only to have one of two cataracts removed; others are declined funding for knee or hip replacement surgery.

And now, in some parts of the country, men are being told they can’t have vasectomies. We should be concerned about this creeping form of rationing. Where it will lead? How long before we are told that, at a certain age, NHS care is not worthwhile?

My fear is that, just as now there are those using an electric buggy, rather than walking again, because the NHS will not fund a knee or hip replacement, some older patients will in future remain chair or bedridden, rather than undergo heart surgery or other restorative treatment, as the NHS prioritises treatment of younger, more productive, tax-paying members of the population.

It raises the question: will some of us be seen as expendable?