Catch 22 for the elderly with bad knees

Yesterday I strolled down the town to do some shopping when I met a friend hobbling along the street. She had just come from her doctor with some bad news. From April 1st the new rules had been introduced in Hertfordshire covering knee and hip replacements and because she was over-weight she would not be put on the waiting list until she had lost sufficient weight.

This is a catch 22 situation for many elderly people whose joints are being to wear out. Walking becomes difficult, so you walk less to ease the pain, and the resulting lack of exercise means you put on weight. The extra weight puts strain on your legs - so the joints wear out faster and you become even less mobile. If you get depressed over the situation you may take to compensatory eating  - such as nibbling biscuits, and the situation deteriorates further.

    Having been the official public observer on a National Health Service commissioning board I know how such things work

    It's all a slight of hand resulting from the way Government statistics is calculated. Hospitals have to fill in a box in their returns showing how long their waiting lists are and may be penalised if they don't meet the targets. No problem - all you do at the local level is to redefine the criteria for the operation to restrict the numbers of patients who "need" treatment now.

    The result is that the Government can claim that, despite the cuts, all the people who "need" the operation get it. The hospital saves money by doing less operation and meet their waiting list targets. They can all claim that the N.H.S. is not "going to pieces" - just look at the excellent statistics to prove it.

    What is actually "going to pieces" are the knees and hips of those who are now on the unofficial waiting list to get on the waiting list. They will stick in the queue until they have lost weight, become even more seriously disabled, or (a great saving never to be admitted in public) have died.

See BBC report on the subject.