NHS group considers charges for crutches and neck braces

[dutchman]

South Warwickshire CCG presents 'tentative' proposal to public participation group, prompting criticism from health unions



Patients could be asked to pay for their own crutches, walking sticks and neck braces under proposals drawn up by an NHS organisation to introduce charges for services that are currently free.

GPs in south Warwickshire have sparked controversy by examining how patients who are disabled or recovering from an accident or operation could be asked to contribute towards the cost of devices that are vital to their mobility.

Critics said the proposals were "the thin end of the wedge" and could lead to patients being charged to access core NHS services, hitting disabled and poorer people hardest.

If implemented, the proposals from the GP-led NHS South Warwickshire clinical commissioning group (CCG) could also affect patients suffering from whiplash, a hernia or sore hip or knee, or who have fractured their spine or who need help getting out of bed.

Sue Lear, a "service design and innovation" official working on behalf of the CCG, told its patient and public participation group last week that it was keen to reduce its annual £421,000 bill for devices that are known generically as orthotics. Its overall annual budget is £304m and it commissions and funds treatment for the 270,000 people within its borders.

Her presentation to about 20 elected patient representatives from different GP surgeries in the area posed questions about the viability of introducing charges. "Would it be reasonable to ask people to contribute to the cost of orthotics, aids and appliances? If so, which items and how could we agree this? If so, what criteria should be applied, eg low-cost items below a specified threshold?"

Lear also listed 15 different types of aids or devices to which charges, or contributions from patients, might be applied. They were: ankle foot orthoses, ie foot drop splints; wrist splints; trusses, eg for hernias; spinal supports; knee braces; hip braces; lumbar/sacral/abdominal supports; spinal support, eg for fractures; cervical support – collars; helmets; toilet aids & equipment; perching stools; walking aids – walking sticks, crutches, frames; bed mobility aids – sticks, beds, grab handles; and bath seats.

Many such pieces of equipment are never returned by patients once they have finished with them and so cannot be reused, increasing costs at a time when money is tight, Lear said. However, patient representatives told her that charges would deter some who needed such devices from obtaining them and that any means-testing would prove very complicated to administer.

The move, uncovered by the anti-cuts group False Economy, is thought to be the first time that any provider of NHS care has looked seriously into introducing charges. Two recent reports from the Reform and King's Fund thinktanks advocating charging for GP visits and hospital appointments or a £10 monthly fee to help the NHS cope with increasing demand for healthcare have prompted a debate about whether the NHS should abandon the key principle that it is free at the point of use.

Those present at the meeting said the proposal, which Lear described as "tentative", was given a hostile reception. The CCG wanted to gauge reaction to the possibility of introducing what she called "self-funding for orthotics", which suggests that it may expect at least some patients to pay the full cost of their device.

The CCG refused to answer questions about what it called a "very early-stage" proposal, including who had come up with the idea. In a statement it stressed its need to save money.

[rebbonk]

Scraping at the bottom of the barrel whilst there's an elephant in the room!

Stop treating those that have no right to be treated and start using the NHS for what it was designed for.