Monday, August 1, 2011

Bias against obesity 'cost me fight for gastric band'

A doctor checks a patient's weight Tom Condliff says the NHS stigmatises obese people more than smokers. Photograph: Dorling Kindersley/Getty

A 22-stone diabetic who could have just months to live after his health authority refused to pay for him to be fitted with a gastric band has attacked British society for stigmatising obese people more than smokers or heavy drinkers.

Tom Condliff, a 62-year-old former police officer who lives in Talke, Staffordshire, became the first man in Britain to take legal action against his primary care trust under the Human Rights Act.

Condliff argued that North Staffordshire PCT had an obligation to take into account article eight of the act – the right to a private and family life – when making decisions about whether to fund the ?5,500 operation, which has been shown to be more than 80% successful in treating diabetes. The government's Office of Health Economics says the operation pays for itself in a year.

However, three law lords sitting in the Royal Courts of Justice last week rejected the argument. The supreme court also declined to hear an appeal.

"I feel very disappointed by the verdict of both the PCT and the courts," Condliff said in his first interview with a newspaper since the judgment was handed down. "The operation represents very good value for money for the NHS and will save at least ?20,000 a year, given that there is a very good chance it would cure my diabetes."

Condliff became obese because of the drugs he has taken to treat his diabetes, rather than through overeating, according to his lawyers. "It makes me feel very angry," he said. "Until five years ago, I was a fit and healthy man. I have always been about 15 stones and I am 6ft 2in. It wasn't until I started suffering from diabetes that I put on all this weight. I don't overeat; I only have about 500 calories a day.

"In any event, it shouldn't matter. PCTs regularly treat people who have hurt themselves doing dangerous sports, falling over when drunk or after they have smoked all their life. It is ridiculous that obesity is stigmatised in a way that other illnesses aren't."

Condliff's case has shone a light on regional variations in the provision of NHS treatment. Guidelines from the National Institute for Health and Clinical Excellence stipulate that if a person has a body mass index of 40 or more and has sleep apnoea or type 2 diabetes, they should qualify for the operation on the NHS. Condliff's BMI is 43, but North Staffordshire PCT says it is too low to qualify under its own guidelines.

"It makes me feel very angry and upset," Condliff said. "I live less than a mile from Stoke-on-Trent PCT, which follows the Nice guidelines. If I lived there, I would have had this lifesaving operation years ago. I understand there is a postcode lottery, but I think all PCTs should follow the Nice guidelines. What is the point in having Nice if PCTs don't have to pay any attention to it?"

Medical experts who assessed Condliff in April said he had a year to live if he did not have the operation.

"His quality of life is going downhill rapidly," said Oliver Wright, his solicitor. "He's trapped inside his home and in a lot of pain. He can't sleep and can't take painkillers because his kidney function is so bad. A pain consultant said he should be on morphine."

"I have been holding out hope that somehow I would be able to have the operation that will save my life," Condliff said. "I have been battling with the PCT for years and all of the stress has had a big impact on my health and family life. I am very upset that the courts have rejected my case. I also feel very let down by the NHS. I have paid tax all my life, worked hard in service of my country, in the navy and the police, and now the NHS won't pay ?5,500 to save my life."

Condliff acknowledged that his case would have had important consequences for other people seeking treatment on the NHS if he had been successful. "This case was first and foremost a battle to save my life, but my wife and I were also hopeful that other people might benefit from social factors being taken into account when the NHS considers who to treat," he said.

Paying for private treatment is not possible because only an NHS teaching hospital has the skilled staff to carry out the operation, given his worsening condition. "I don't have the money and I cannot work because I am too ill," Condliff said. "I have tried to borrow the money, but it was simply impossible."

Wright held out the prospect of an appeal to the European court of human rights, but acknowledged that time was against them. "We are very disappointed. He's going to die unless he somehow gets the treatment," he said. "There is no longer uncertainty. The law is very clear. Social factors don't have to be taken into account."


View the original article here

No comments:

Post a Comment