The NHS is rationing operations and treatment for patients deemed too fat . An investigation has found that four in five health trusts refuse to fund some procedures for patients classified obese . These include hip and knee surgery , IVF , joint replacements and in the case of one organisation , all routine operations . Details obtained from Freedom of Information requests also show that two thirds of trusts deny some procedures for smokers . Senior doctors have described the policies as ‘ blatant rationing ’ and say they are ‘ immoral ’ and ‘ unfair ’ . An investigation has found that four in five health trusts refuse to fund some procedures for patients classified obese . Meanwhile two thirds of trusts deny some procedures for smokers . But managers said that given their increasingly limited budgets , it was inappropriate to offer certain non-urgent treatments to patients for which they might not be effective . The NHS as a whole is under severe financial strain and is struggling to meet the demands of the rising and increasingly ageing population . Last year its Chief Executive Simon Stevens predicted that an extra £30 billion would need to go into its budget by 2020 just to ensure the standards of care did not slip . In the face of such financial pressure , many trusts have begun rationing procedures which aren ’ t deemed urgent to save money . But this investigation by GP magazine reveals the extent to which managers are refusing patients treatment due to their lifestyles . Freedom of Information responses from 145 of the 211 Clinical Commissioning Groups , ( CCGS ) , – local NHS bodies – showed that 38 per cent restricted some procedures for obese patients . A further 63 per cent refused to allow patients to have certain treatment if they smoked . Dr Richard Vautrey , deputy chair of the British Medical Association ’ s GP committee , who is based in Leeds , said managers were using ‘ spurious clinical reasons ’ to discriminate some patients . He added : ‘ It ’ s blatant rationing . CCGs should be open and honest . ‘ If we ’ re going to ration a service we should ration it for all people , not just those in particular groups and pretend it ’ s for clinical reasons . These include hip and knee surgery , IVF , joint replacements and in the case of one organisation , all routine operations . Senior doctors have described the policies as ‘ blatant rationing ’ and say they are ‘ immoral ’ ‘ If it ’ s purely down to cost saving , it ’ s not ethical . ‘ There are clearly cases where certain people ’ s body size may make it difficult to safely do a certain procedure , but they ’ re exceptional . ‘ I think what ’ s happening here is overt rationing to save money. ’ Katherine Murphy , Chief Executive of the Patients Association , said : ‘ We are aware that hospital trusts are under considerable financial pressures , but we hope that the need to save money won ’ t affect patient safety . ‘ Each case must be individually assessed and each decision must be ethical and in the best interests of the patient . ‘ We recognise that patients do have a responsibility to look after their own health and to be aware of the outcomes of unhealthy lifestyles . ‘ However , patients should not take the brunt for years of wasteful spending in the NHS . ‘ It is easy to target vulnerable patients , and we must be very careful not to unfairly discriminate against people who aren ’ t always able to speak out. ’ Herts Valleys CCG in Hertfordshire refuses to offer any routine surgery to patients whose Body Mass Index ( BMI ) is above 35 . This is a measurement of obesity and above 25 is classified as overweight , over 30 obese and more than 35 , morbidly obese . And a total of 30 CCGs refused to pay for IVF for women with a BMI of over 30 . The figures reveal that Herts Valleys CCG in Hertfordshire refuses to offer any routine surgery to patients whose Body Mass Index ( BMI ) is above 35 . This is equivalent to a 5ft 6 woman ( 170 m ) weighing just under 13 and a half stone ( 84 kg ) . Dr David Haslam , GP in Watton-in-Stone , Hertfordshire , who is also chair of the National Obesity Forum said : ‘ What we hate as GPs is blanket bans and you can ’ t just take BMI ( a measure of obesity ) as a reason to operate or not operate . ‘ Some restrictions could have a sound clinical basis , he said , but it is wrong to turn away patients based on weight and do nothing to help change their circumstances . ‘ Weight loss interventions must be offered , otherwise it ’ s immoral and unethical , ’ he said . Several of the CCGs said that IVF and joint replacements , for example , weren ’ t always successful for the obese patients and therefore not ‘ cost effective. ’ Last year managers at Northern , Eastern and Western Devon CCG threatened to ban all treatments for anyone with a BMI above 35 to help cut a £14.5 million shortfall in its budget . They subsequently dropped the proposals following an outcry from patient groups and health professionals , including the Royal College of Surgeons .
Ops rationed include hip and knee replacement , surgery , and joint replacements . One hospital has restricted all routine procedures for obese patients . NHS boards of trusts also deny some procedures for those who smoke . Senior doctors have blasted the ' immoral ' policies as ' blatant rationing ' But managers said limited budgets mean they ' ve had to cancel some ops .