Mark Hannaby The Politics Show Wales

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Surgery restricted to 'fit' BMIs

People are to be denied NHS operations in Wales because they are only slightly overweight.

From June 2006, essential plastic surgery, such as breast reduction for medical reasons, will be restricted to people whose Body Mass Index is under 25.

In other words, people of ideal body weight.

Criteria changed

Health Commission Wales, the agency of the Assembly Government which commissions specialist services, has changed the eligibility criteria for such operations.

The move has been slammed by some consultants and GPs who say it has nothing to do with patient safety or clinical need. They see it as rationing services to cut costs.

Swansea GP Dr Ian Millington said: "I think many patients will be excluded by this decision.

"And the decision does not seem to have been made on clinical grounds but on an arbitrary target."

Body Mass Index calculations are made by dividing weight in kilos by height in metres squared. A BMI of 20-25 is considered ideal.

A BMI of 25 to 30 is only slightly overweight. But if a person is as little as one pound over their ideal weight they will be denied an operation.

Form of rationing?

The operations affected take place at Swansea's Morriston Hospital.

In the main, they are for breast reduction to combat neck and back pain.

Men who have developed breasts through hormonal imbalance and people who need tummy tucks following weight loss will also be affected.

Secretary of the British Association of Plastic Surgeons Hamish Laing, who operates at Morriston, said:

"I think it is a form of rationing. And what concerns our Association is that its rather arbitrary.

"There is no clinical basis to it. We are very comfortable with clinically driven decision-making in healthcare.

"That is how it should be. And this does not seem to be like that."

Plaid Cymru's Health Spokesperson Helen Mary Jones says the Government is not listening to health professionals.

She said: "I am very concerned that the professionals have expressed their concerns and we are going to want to pursue this with the Minister.

"Because in the end these are the people who know what the clinical realities are.

"I am afraid this is another example of the Labour Assembly Government introducing what amounts to a kind of rationing by the back door."

Health Commission Wales told the Politics Show there is clear evidence that patients with a high BMI have a higher rate of surgical complications.

They say their criteria apply to conditions which are considered lower priority, not surgery following trauma, cancer, degenerative or other conditions.

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