Rationing cataract surgery on the NHS

Do you think you can get your cataract surgery done on the NHS when you require it? You may think the answer to this is yes but its not I’m afraid.

The NHS faces huge financial challenges and its up to our clinical commissioning groups to budget for the healthcare we receive in the public sector.

Take my 67 year-old gentleman who came to see me last week for problems with blurred vision, especially for driving. This chap had been driving quite safely at night until he noticed problems with haloes around street lamps. He went to see his opticians who told him he had cataracts and needed cataract surgery.

He came to the eye clinic and was diagnosed with cataracts affecting his driving at night and was recommended cataract surgery to treat his symptoms.

Did he undergo surgery – no? Why?

His vision measured 20/20 on the vision chart (6/6 is the equivalent on the UK vision chart) and his local clinical commissioning group had a policy in place whereby it refuses to pay for his surgery if his vision better than 20/40 (6/12 UK equivalent).

I really feel for patients like this, as I had to explain why he was not eligible for surgery. He took the wise decision not to drive at night for his own safety and the safety of others on the road – not too easy a decision since he relied on his car to visit family and the problem that the dark winter nights were drawing in.

I am not going to challenge the issue of rationing in the NHS – we have a finite pot of money and we do have to prioritise more pressing need.
The NHS is free at the point of delivery – it’s just that the NHS doesn’t deliver to certain addresses.