Health is a lottery in out-of-control NHS, warns top surgeon

A postcode lottery has returned to the NHS with "a vengeance", the leader of Britain's surgeons warned yesterday, as hospitals look to secretly cut costs without consulting doctors or patients.

Professor Norman Williams, the new head of the Royal College of Surgeons, said some hospitals were now rationing operations that would have otherwise saved the NHS money in the long term, because of a short-term desire to cut costs.

"We are back at the moment to a postcode lottery with a vengeance," he told a fringe meeting at the Conservative party conference. "This is happening without any transparency of public debate and often without clinical involvement."

Today Andrew Lansley, the Health Secretary, will address the conference and highlight some of the progress the NHS has made in investing in frontline services by taking away "bureaucracy" from the NHS. He will also announce new mandatory language checks for NHS doctors to ensure only those who can speak "a good level of English" are allowed to practise.

Highlighting some of the problems thrown up by the Government's reorganisation of the NHS, Professor Williams said some health authorities were now unilaterally restricting operations which had significant clinical benefit.

Some were refusing to give gastric bands to morbidly obese patients while others who needed hip or hernia operations were also being denied them.

The Independent revealed earlier this year that two-thirds of health trusts in England were rationing treatments for some "non-urgent" conditions as part of efforts to save £20bn over the next four years.

Professor Williams said: "We are seeing trusts acting unilaterally to save this £20bn that the Government has asked us to find over the next five years.

"We are seeing procedures like hernia and hip (operations) not being done in certain places which is an enormous waste of money because those operations stop complications happening later on which cost even more money.

Professor Williams also warned that unless the Government backed a hospital reconfiguration programme involving closures, patients would continue to be put at risk by substandard care.

"There is huge variation in care in this country," he said. "We recently conducted an audit around emergency surgery. Depending on which hospital you go to, you can have a risk of up to 40 per cent of dying having an emergency abdominal operation, which is horrific. If you can centralise services you can improve quality, improve training and the results are so much better."

Health Minister Anne Milton admitted that care in some hospitals at weekends was unacceptable. "The NHS still works nine to five Monday to Friday," she said. "Saturday and Sunday are not a good day to be ill."

Today Mr Lansley will tell conference that real progress has been made on the Government's reform agenda.

"We are slashing bureaucracy to invest more in the front line," he will say. "That is why, since the election, we now have 1,500 more doctors and 5,000 fewer managers in the NHS."