'Patient limit' to meet NHS targets

MPs have raised concerns that the NHS is meeting its efficiency targets by rationing patients to services.

There are "widespread" fears that NHS organisations, which are all in the middle of a productivity drive, are achieving savings by limiting access to treatments such as cataracts surgery or bariatric procedures, the Public Accounts Committee (PAC) said.

The committee said that while such treatments are deemed to be of "low clinical value" they can make a big difference to the quality of life of patients and may also lead to greater costs in the long run if left untreated.

The health service has been set the "Nicholson challenge" of making £20 billion in efficiency savings in the four years to 2015. But the PAC report states that most of the savings to date have been achieved through staff pay freezes. The report also raises concerns that many financially-troubled trusts are simply cost-cutting rather than finding "genuine efficiency savings".

The report criticises the Department of Health and the NHS Commissioning Board, the new body set up under the health reforms charged with the running of the health service, saying they are "not doing enough" to help organisations reform services.

In 2011-12, the health service reportedly made £5.8 million in efficiency savings, but the report states that only 60% of the savings could be substantiated through national data.

"The NHS appears to have made a positive start but we cannot be fully confident in the savings figures reported," it states. "At local level, primary care trusts measure and report savings in different ways. For example, the often significant costs associated with generating savings are not consistently taken into account in reporting the savings achieved. Using national data the Department can substantiate only £3.4 billion of the savings reported for 2011-12."

MP Margaret Hodge, chair of the committee, said: "The NHS has achieved its financial savings target, but this has in large part come from freezing wages. We are concerned that other savings are being achieved by rationing patients' access to certain treatments."

A Department of Health spokesman said: "We have been absolutely clear that access to NHS services should not be restricted on the basis of cost. Decisions on treatments should be made by clinical experts based on the needs of each patient. With an increasingly ageing population, we expect the NHS with local government to look seriously at how improvements to care can be made, focusing on better integration, closer to the patient's home."

Labour's shadow health minister Jamie Reed said: "This is the third time this week that the Government has been told by experts that its cuts to the NHS are hitting patients. Ministers cannot go on ignoring these warnings. The committee is right to highlight the increasing numbers of patients now being denied treatment in a shortsighted bid to cut costs. Patients will find this particularly galling in the same week that George Osborne's Budget took £2.2 billion away from the Department of Health."