Thousands of men left in agony as NHS rations hernia ops

THOUSANDS of men are being denied life- changing hernia operations unless they are in so much pain they cannot work.

More than half the health boards in England refuse NHS funding for the 45-minute procedure unless patients are in enough agony to ‘impede working life’ or ‘everyday activities’.

Leading surgeons last night described the rationing rules as ‘an absolute disgrace’ and stressed that in some cases patients’ lives could be endangered.

Some clinical commissioning groups (CCGs) have even insisted that men must prove their hernia is growing from month to month before they permit an operation. An audit by industry bodies the Royal College of Surgeons and the British Hernia Society reveals 57 per cent of CCGs in England have imposed some form of restrictions to groin hernia operations.

That is nearly double the 29 per cent with restrictions in place at the last audit in 2014.

Some 52 per cent now say a patient must be in such discomfort that their work or everyday activities are impeded.

And 5 per cent say there must be proof that the hernia is growing or ‘incarcerated’ – the medical term for a severe hernia which remains protruding even under pressure.

Some 78,700 groin hernia operations are performed annually.

It comes days after the Daily Mail highlighted the difficulty men face convincing the NHS to treat them for a hernia. Writing in this paper last Thursday, Ross Clark described how he had been refused the operation by his GP because his hernia ‘ wasn’t bad enough’.

From last Thursday’s Mail A groin hernia occurs when a nat- ural gap in the muscle widens, allowing tissue to poke through and cause a lump in the groin.

Over their lifetime, 27 per cent of men experience a groin hernia. About 3 per cent of women suffer them, but they are nine times more common among men.

The treatment is relatively straightforward and available privately from about £2,500. A patient is given local or general anaesthetic, the tissue is poked back through the gap, the hole is stitched back to its normal size and a small piece of mesh is inserted to keep everything in place. But cost-cutting means increasing numbers of health boards are now adopting a policy of ‘watchful waiting’.

This means patients are assessed for their pain levels and no action is taken until the problem has progressed. This has led to more patients having to cope with extreme pain until it has a significant impact on their lives.

The report cited a 2014 study which found putting off a hernia operation increases the chance of needing a later emergency op by 59 per cent, increases the risk of injury from 4.7 per cent to 18.5 per cent, and raises the risk of death from 0.1 per cent to 5.4 per cent. Susan Hill, vice president of the Royal College of Surgeons, said: ‘It is an absolute disgrace that some patients have to demonstrate what could be a life-threatening complication of a hernia.

‘Instead of asking patients to prove their pain, ministers and NHS England should immediately intervene to allow patients to talk to their surgeon about whether they need an operation. Allowing commissioning groups, not patients with their surgeon, to make a decision is putting patients at unnecessary risk.’

John Kell, of the Patients Association, said: ‘The stress for these patients mustn’t be overlooked. To be told you have to demonstrate what could be a life-threat- ening complication of a hernia in order to receive treatment must be horrendous.’ A Department of Health spokesman said: ‘Blanket restrictions on treatments are unacceptable and we expect NHS England to intervene if there is evidence of rationing care.’

Dr Amanda Doyle, co-chairman of NHS Clinical Commissioners, which represents health boards, said: ‘Unfortunately the NHS does not have unlimited resources and ensuring patients get the best possible care against a backdrop of spiralling demands, competing priorities and increasing financial pressures is one of the biggest issues CCGs face.

‘They are forced to make difficult decisions that balance the needs of the individual against those of their local population … which we appreciate can be difficult for some patients.’

‘Life-threatening complications’ I pay £6,000 a year in tax to the NHS, so why am I refused a hernia op?