NHS trust accused of privatisation over surgery shopping list

NHS trust is accused of ‘disgraceful privatisation’ for charging £18,000 for hip replacements on shopping list of operations for people not sick enough for free treatment

  • The Warrington and Halton Hospitals NHS Trust has faced harsh criticism
  • Cataract surgery prices start at £1,624 and knee replacements from £7,179
  • The hospital trust said NHS commissioners had made some ops unavailable
  • It claims its prices are ‘affordable’ and the ‘majority’ of NHS hospitals are doing it 

An NHS hospital trust has been accused of ‘disgraceful’ privatisation for trying to charge patients more than £18,000 for a hip replacement.

Rationing means the thresholds for some operations have grown higher and people may be expected to live with severe pain before qualifying to get the ops for free.

But Warrington and Halton Hospitals NHS Foundation Trust, near Liverpool, has posted a price list on its website offering various operations to paying customers.

A photo of a poster about ‘self-funded procedures’ has also been posted online and people have railed against the hospitals charging for once-free treatment.

The hospital trust itself said its treatments are ‘affordable’, they don’t affect waiting times and the ‘majority’ of other NHS hospitals do the same thing.

It also admitted nobody has used the paid-for service since it began last year. 

The NHS trust runs Warrington Hospital in Cheshire (pictured). It said it doesn’t make the decisions about which operations are offered for free by the NHS

This list of procedures published by The Mirror shows an upper limit of more than £18,000 for joint replacement operations

‘It really is a total disgrace,’ Labour’s Shadow Health Secretary, Jonathan Ashworth, told The Mirror.

A list of 45 paid-for procedures is available on the website of the trust, which runs Warrington Hospital and Halton General Hospital in Cheshire.

Among them are a knee replacement from £7,179; cataract surgery costing upwards of £1,624; and hip replacement revision surgery for more than £8,447.

A separate list published by The Mirror shows upper prices of £18,143 for knee or hip replacement operations and £7,777 for bunion removal.

People even protested in Halton earlier this week when they found out their hospital is charging for what are now considered procedures of ‘low clinical priority’.

Chair of campaign group Keep Our NHS Public, Tony Sullivan, said: ‘There are many ways the tentacles of private interests envelop our health service.

‘But this rationing of access to health care on the NHS is one of the most blatant ploys. It’s simply disgraceful.’

He called the My Choice service ‘privatisation from within’. 

The procedures are listed alongside the NHS logo and beneath a slogan which reads: ‘My Health, My Well-Being, My Choice’.

On a poster published on Twitter, the trust tells patients they ‘have the option to self-fund some procedures’.

A photo of a poster seen on Twitter shows the hospital trust advertising patients’ ‘option to self-fund some procedures’ – the trust’s CEO insists the money is reinvested in NHS services

The trust also runs Halton General Hospital (pictured). Campaigners said the My Choice service suggested the hospitals were in the grip of ‘tentacles of private interests’

Among the list of procedures offered on the trust’s own website are breast reduction with prices starting at £3,720, hip resurfacing (£7,060) and bunion removal (£1,904)

People can also pay for tonsil removal (£2,292), haemorrhoid removal (£1,319) and circumcision (£2,000) at the trust

The Warrington and Halton trust says ‘the majority’ of NHS hospitals do the same thing because NHS commissioners have changed which operations are free.

It also claims the paid-for treatment offers ‘affordable, convenient access’ for patients and the money is reinvested in the NHS.


Three quarters of hospital trusts have started denying hip and knee replacement operations to patients who ‘aren’t in enough pain’, it was revealed last year.  

Under rules introduced to cut costs sufferers are turned away unless they are judged to be in distress for most of the day, unable to sleep or taking painkillers non-stop.

Some trusts insist patients must be ‘largely incapacitated’ – in need of a walking stick, a frame or a wheelchair. 

In other cases the pain must be so intense it is a struggle to carry out basic activities such as washing or dressing.

An average hip replacement costs £9,000 while a knee replacement is slightly cheaper at about £6,500. 

The rationing policies came to light following freedom of information requests by the Daily Mail to England’s 207 health trusts, which are now known as clinical commissioning groups.

Of the 184 CCGs that responded, 73 per cent admitted imposing strict pain thresholds. 

Cambridgeshire and Peterborough said the pain must be so bad the patient would struggle to stand for half an hour. Wiltshire stipulated the use of a walking stick, frame or wheelchair. 

Ian Eardley, senior vice-president of the Royal College of Surgeons, said: ‘Restricting surgery simply delays the inevitable, simultaneously adding to the overall cost, often prolonging the use of pain relief, severely impacting patients’ quality of life and, particularly among the elderly, increasing the need for social care.’

Other procedures on offer include tonsil removal (£2,292), haemorrhoid removal (£1,319), circumcision (£2,000), breast reduction (£3,720) and the removal of silicone breast implants (£2,164).

Mr Ashworth MP added: ‘This tells you everything you need to know about the Tory NHS.

‘Squeeze funding, impose cutbacks, force greater rationing of treatments, grow waiting lists and then tell patients in agony they can pay if they have deep pockets.’

The Warrington and Halton Hospitals NHS Trust said it introduced the service in September 2018 in response to choices by more senior NHS figures to stop offering certain procedures.

Mel Pickup, its chief executive, said in a statement: ‘The Trust does not charge NHS patients for NHS funded procedures.

‘Not all healthcare services are funded by the NHS. These services are referred to as Criteria Based Clinical Treatments (previously called Procedures of Low Clinical Priority).

‘It is not the role of hospitals to determine which services are funded and which are not. This is the role of NHS commissioners.

‘Therefore where a patient wishes to have a procedure that is not funded by the NHS they can approach the private sector.

‘Therefore, the Trust, like the majority of hospitals is now offering self-funding procedures to their patients.’

Ms Pickup added: ‘Procedures such as hip and knee replacements and cataract removal operations remain available on the NHS in the usual way if the criteria are met.

‘We are now also able to offer these procedures via our My Choice service to make them more accessible for patients who otherwise would not qualify for them under commissioner guidelines.’

The CEO said patients would not jump a waiting list if they had paid for their operation, but would simply be added to an existing scheduled list.

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