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Patients should pay for some routine operations

Public health body says move would help NHS


A pair of scissors

NHS patients should contribute towards the cost of some routine operations, a body of leading public health experts said today.

The Association of Directors of Public Health (ADsPH) believes people should help pay for certain types of non-emergency surgery on the NHS including tonsil removal and hysterectomies.

The association argues that the idea is not so radical as some NHS patients already pay for dental work and prescriptions.

It says rising demands on the NHS as more treatments become available will lead to more rationing and that charges for minor surgery would help keep that demand in check.

Cosmetic surgery

Dr Tim Crayford, president of the association, which represents NHS trusts’ public health directors across the UK, said NHS operations which could be charged for included tonsil removal, hysterectomy for heavy menstrual bleeding and cosmetic surgery.

He said: ‘It is for a whole range of things which offer hardly any benefit. It is not a large amount of what the NHS does. It is just the margins.’

But ministers may oppose the call because it would undermine the idea that the NHS is free at the point of use.

Dr Crayford told the BBC Radio 4 Today programme that the ADsPH did not believe that procedures like cataract removals and hip replacements should be subject to charging.

Prescription charges

And he suggested that any extra income from charging for non-essential operations could be offset by lifting charges for some prescriptions.

NHS prescription charges are being abolished in Wales, and Dr Crayford suggested that the same could be done in England.

Asked what procedures should carry charges, he told Today: ‘I certainly wouldn’t be arguing for hip and cataract operations. That’s certainly not what we are suggesting.’

Instead, the ADsPH was arguing for charging to be considered for ‘those procedures that are of relative clinical ineffectiveness – procedures that people want but perhaps arguably don’t medically need.’

NHS treatment

These could include minor cosmetic surgery, such as removal of moles, which costs the NHS ‘many millions of pounds a year’, he said.

‘If you look at prescription charges or charges for dental care, those charges are arguably iniquitously applied,’ said Dr Crayford.

‘Why on Earth should you pay if you are an asthmatic benefiting greatly from your regular NHS treatment, but people undergoing minor skin surgery and all sorts of other minor surgery don’t have to pay?’

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