News that patients waiting for hip and knee replacements now have to wait longer and are in greater pain by the time they reach surgery raises questions as how to balance priorities within a strapped NHS service. Surgeons are apparently complaining that hip and knee surgery is now regarded as low priority, many operations had been put on hold and patients were being left in pain for longer. On the other hand we read that reducing delays in investigating and managing cancer has produced improving results despite survival rates in the UK being below many comparable European countries.The reality is that whilst the word ‘rationing’ is taboo among politicians talking about the NHS, our expectations of treatment exceed the resources available. At every level of healthcare is some form of prioritising: some needs are met quickly; others have to wait. So there will always be an issue as to whether our priorities are right. Tellingly the Guardian tucked this news away in a small space on page 8 whereas recent news about advances in breast cancer made it to the front page. Hip replacement stories do not grab the public’s attention the way breast cancer does and perhaps this also reflects the clinical priorities of our health system.Arthritis in the hip and knee is not a life-threatening condition. However the lives of many of these people are a daily battle against pain. With walking limited ordinary tasks are a struggle. Worn joints are a major source of real disability. My perspective is of course that of someone who sees the devastating impact of surgery which goes wrong and there is plenty of scope for that in these complex and (to my eyes) brutal operations.
But the truth is that advances in hip and knee replacement surgery have made an enormous difference in recent years.The government’s proposed changes to our health system may lead to changes in clinical priorities. However they will not change the fact that hard decisions will always have to be made about which treatments get priority and who has to wait.Paul Sankey is a solicitor specialising in clinical negligence. If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email email@example.com and one of our specialist clinical negligence team will be in touch.