Jeremy Laurance: Ditching these operations could save the NHS a fortune

Medical Life

Have you recently been in hospital or to see your GP? Was your treatment – truly, deeply, seriously – necessary?

When I think back over my own medical history, I am struck by how few of the interventions I have had over my life have made a significant difference – or indeed any difference – to my wellbeing. That is, of course, in the nature of medicine – most diagnostic tests, for example, come back negative, providing reassurance that the symptoms that triggered the test are benign. Still, an awful lot of what the NHS does is not worth doing. I had my tonsils removed when I was four, and my son had grommets inserted for glue ear at the same age. Both operations have since fallen out of fashion.

Yet many are still performed unnecessarily. Three years ago, the Government's chief medical officer, Sir Liam Donaldson, claimed billions of pounds of NHS cash were being wasted on outdated treatments. He suggested changes to the NHS tariff system to encourage some operations and penalise others, and announced that the National Institute for Clinical Excellence (NICE), which normally judges the worth of new treatments, would also advise on "disinvestment from interventions of no proven value".

One of the operations singled out by Sir Liam was tonsillectomies, where he estimated savings of £6 million might be made. So what has happened since he made his recommendation? 'More4 News' decided to find out by surveying NHS trusts. The results, to be broadcast on Wednesday night, showed that among the 99 trusts who replied to the survey the number of tonsillectomies actually rose by 330 between 2006/7, when Sir Liam's report was published, and the following year. There were 39,472 operations carried out in 2007/8 at a cost of just under £40 million, and it remains one of the commonest surgical procedures in England.

When times are hard in the NHS and the talk turns to rationing, the usual suspects lined up for execution are cosmetic surgery and IVF. But these would yield peanuts in terms of savings. The serious money lies elsewhere, in the myriad outdated treatments to which doctors remain unaccountably wedded. NICE needs to act fast if it is to spare the NHS – and its patients – unnecessary pain.

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Union leaders may bluster, but there is no reason why doctors, nurses and other public sector employees should be protected from the bitter winds blowing through the rest of the economy. Salaries in the private sector are frozen or falling, while those in the public sector are continuing to rise.

But this tells only half the story. Public sector staff enjoy a level of security of employment of which their privately employed counterparts can only dream. Their final salary pensions are untouched by the recession while those in the private sector have seen their pensions radically reduced.

With the financial outlook as uncertain as ever, the benefits of working in the public sector are magnified. A freeze on NHS pay, after the, in some cases, eye-watering rises of recent years, would be unlikely to cause an exodus to the private sector in these straitened times.