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View from the Street: Plan to limit treatment for elderly is 'discriminatory' and undermines our wellbeing

PUBLISHED: 12:30 04 April 2019

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Local pensioners are very concerned about recent proposals to limit access to a number of medical procedures. This would apply to patients living in five boroughs of North Central London (NCL): Barnet, Camden, Enfield, Haringey and Islington. The restricted treatments include hip and knee replacement surgery and surgery for cataracts; they are called Procedures of Limited Clinical Effectiveness (PoLCE).

Adopting this policy will disproportionately affect older people, removing treatments that are life sustaining and leaving many in pain. Born in the late 1920s up to the 1950s these people have paid their share of NHS funding throughout their working life and in retirement. Is this fair?

The PoLCE restrictions contradict advice of the Royal College of Surgeons and the Royal College of Opthalmologists. National Institute of Health and Care Excellence (NICE) guidelines are also ignored.

I know many people who have had these treatments and found their life transformed. They were able to get back to a normal active life. What will be the cost if these restrictions are implemented? Certainly those refused treatment will be prevented from regaining their independence and would be unable to continue, as many older people do, with volunteering and caring for others. Cost savings are in doubt as those not treated could suffer a deterioration in their health and this could result in more costly NHS treatment.

Citizens get little say in how health services are organised by NHS England. Very few issues get debated or scrutinised in Parliament. One glimmer of democracy is the Joint Health Overview and Scrutiny Committee (JHOSC) on which local councillors from all five boroughs can question and call to account those responsible for NCL services.

At the JHOSC meeting on March 15, a deputation from a group called NCL Watch, an umbrella group of health campaigners, gave a presentation on PoLCE. Very strong objections were made to the abrupt implementation of PoLCE; just three weeks’ notice had been given with inadequate consultation. It was questioned how the five Clinical Commissioning Committees (CCGs) who under law are responsible could have delegated this important decision to the Joint Commissioning Committee. Justification for the decision was demanded from the proponents of PoLCE with an assessment of how many patients could be affected, with cost savings expected.

With local NHS commissioners pressing ahead, Hornsey Pensioners Action Group acted quickly. At our meeting on March 20 we endorsed the text below of an emergency motion put to Haringey Over 50s AGM.

“Haringey Over 50s Forum is alarmed to find that the NHS commissioning body in North Central London proposes no longer to offer vital medical services including cataract surgery, hip and knee replacements, as normally available procedures but rather to restrict them as ‘procedures of limited clinical effectiveness’.

We regard this as a discriminatory, unfair and retrogressive step which undermines health and wellbeing strategy, and can only add to fear and uncertainty and affect the confidence of older people in our access to health. We therefore call urgently for the withdrawal of this proposal.”

It appears that austerity is still calling the tune for decisions on the NHS but we shall not be quiet.

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