Thousands could lose their sight as NHS cuts cataract surgery by a quarter



22:55 GMT, 15 July 2012

A vital intervention: Cataract surgery could be cut

A vital intervention: Cataract surgery could be cut

The eyesight of thousands of elderly people has been put in jeopardy as NHS trusts place harsh restrictions on cataract surgery.

Last year the number of operations being carried out on the Health Service fell by more than a quarter in some areas.

And more than half of the NHS trusts in England have imposed their own criteria for the surgery which are tougher than national guidelines, according to research by the Royal National Institute of Blind People.

MPs will hear today that, for many trusts, the number being treated for cataracts fell dramatically despite an ageing population.

Labour health spokesman Andy Burnham, who will raise the figures in Parliament, said cutting back on cataract surgery was a ‘false economy’, as untreated patients are more likely to suffer falls or need social care.

Campaigners say elderly people are increasingly having to wait until their eyesight deteriorates to the point where they are no longer able to drive before they can have cataracts removed. Others are told they can have only one affected eye treated.

Cataracts are cloudy patches on the lens of the eye that cause loss of sight. They affect a third of people aged over 65 and can be effectively treated by surgery, in what is traditionally one of the most common procedures carried out on the NHS.

A surgeon makes a tiny incision and uses a small probe to break up the cataract using ultrasound waves. When the cataract is gone, the surgeon inserts a small replacement plastic lens.

However, research by the RNIB suggests that primary care trusts (PCTs) – the bodies that manage the NHS – are rationing access to operations, even though the Coalition pledged to protect the NHS budget.

The number of cataract operations had been rising gradually in line with the ageing population, and reached 350,602 in 2010. However, Freedom of Information requests by the RNIB found that this fell to 338,565 in 2011.

In Worcestershire, there were just
3,188 cataract operations carried out last year, compared with 4,388 in
2010 – a fall of 27 per cent. Nottingham City saw a drop of 25 per cent
to 1,287, while Brighton and Hove had a 24 per cent fall to 1,566.

57 per cent of PCTs confirmed they had set their own criteria for
access to cataract surgery, beyond that recommended by the Department of

The RNIB said many now had ‘very restrictive’ policies.

Winyard, head of policy at the charity, said: ‘We are desperately
concerned about what is happening. These new figures show for the first
time what we thought was happening, which is that the numbers of
operations being carried out is falling.

Cataracts affect a third of people aged over 65 and can be effectively treated by surgery, in what is traditionally one of the most common procedures carried out on the NHS

Cataracts affect a third of people aged over 65 and can be effectively treated by surgery, in what is traditionally one of the most common procedures carried out on the NHS

‘Clearly, we would expect to see a gradual rise, given the ageing population.

‘But a lot of PCTs are putting in place restrictive policies. It’s elective surgery, so they just tell opthamologists they can’t carry out as many operations.

‘People’s sight then has to fall an awfully long way before they qualify. It’s short-termism of the worst kind.

‘We are already seeing some evidence of more falls among elderly people because of poor sight. A cataract operation costs the NHS 932, while repairing a fractured hip costs 9,000. It doesn’t make sense.’

Mr Burnham said: ‘David Cameron promised not to cut the NHS, but he’s now cut it two years running.

‘His unnecessary 3billion re-organisation threw it into chaos and we’re now seeing crude random rationing across the system.
‘Older people shouldn’t be made to pay with their independence and quality of life.

‘They’ll also have more accidents and need more support – it’s a complete false economy.

‘Of all treatments, it makes no sense to restrict this one. I will be challenging ministers in the Commons to reverse it immediately.’
Professor Harminder Dua, the president of the Royal College of Ophthalmologists, has said restrictions on cataract surgery are ‘regrettable’.

‘They are arbitrary and are a response to financial pressures, not clinical needs,’ he added.

Ministers have promised to take action against trusts stopping patients from having surgery on the basis of cost alone.

Health minister Simon Burns said: ‘Last year we made it clear that it is unacceptable for the NHS to impose blanket bans for treatment on the basis of costs.

‘That is why we banned PCTs from putting caps on the number of people who could have certain operations.
‘Decisions on treatments, including suitability for surgery, should be made by clinicians based on what is most clinically appropriate for the patient and take the individual patient’s needs into account.

‘No right-thinking person could possibly understand how anyone could delay a patient’s treatment unnecessarily.

‘If patients need treatment, they should get it when they want it and where they want it.

‘If local health bodies stop patients from having treatments on the basis of cost alone we will take action against them.’