Rationing of cataract surgery - is this a sign of things to come?

Steve has expressed concern about reports that NHS patients are being denied cataract surgery and left to wait until their sight problems deteriorate before receiving surgical treatment.


Last month, the Royal College of Ophthalmologists; College of Optometrists and the Optical Confederation and Local Optical Committee Support Unit issued a joint statement raising concerns over reports of a growing number of patients denied cataract surgery. It has been reported that patients in more than half of Primary Care Trusts (PCTs) in England are being denied the surgery unless their ability to read the optometrists’ test chart (visual acuity) falls below a certain level - by which time they might not be able to lead their normal lives.

There have also been reports that patients with cataracts in both eyes are being told their PCT will only treat one, despite substantial evidence in favour of treating both.

The former Secretary of State for Health, Andrew Lansley MP, publicly committed to ban ‘caps on operations that do not take account of the healthcare needs of individual patients’ in March 2012.  However, new evidence found that many commissioners are still imposing unfair restrictions on cataract surgery.

Steve asked the previous Secretary of State for Health if he had made any changes to the NHS guidelines for cataract procedures since the last General Election. He was told that the Department for Health had not made any changes to guidelines on cataract procedures. PCTs, which are being abolished under the Government’s changes to the NHS, are currently responsible for commissioning cataract services.

The Department for Health asked the National Institute for Health and Clinical Excellence (NICE) to develop a quality standard on cataracts but there is as yet no date for the completion of this work.

Steve said:

“It is unacceptable that PCTs are rationing cataract surgery, a procedure which can have a huge impact on a person’s quality of life. It is perverse logic if a person can only get surgery to treat a cataract after it gets substantially worse; surely it is better for all concerned if the problem is treated when it is identified

“If the Department for Health is really serious about banning caps on operations that don’t account for the healthcare needs of individuals then I urge the new Secretary of State to put pressure on NICE to develop a quality standard on cataracts and write to PCTs in England to advise them of his position.

“I have also consulted opticians in my constituency to hear of their frontline experience and the effect this is having on patients.

“National Eye Health Week commenced this week; so this is an apt time to be asking questions about a problem that can have a real effect on a person’s quality of life.

“I am very concerned that this is the shape of things to come. We cannot revert back to arbitrary rationing which the Government’s reorganisation is imposing on the NHS.

“There is an extremely worrying pattern emerging as waiting times for diagnostic tests are getting longer and an increasing number of operations are cancelled. Improvements in cataract operations were one of the successes of the previous Government and we can’t afford to lose such gains.”

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