Minister for Health James Reilly has rejected calls by a leading obesity expert for a resumption of life-saving gastric bypass operations on dangerously obese public patients.
Endocrinologist Prof Donal O’Shea has been campaigning for a resumption of the operations at St Vincent’s Hospital in Dublin, which were suspended earlier this month after he performed the 20 procedures provided for in this year’s budget. Prof O’Shea argues that the operations save lives, improve quality of life and are cost-saving within a short timeframe. His waiting list is set to exceed 200 next week.
However, Dr Reilly said allowing more bariatric surgery would mean a cut in other health services. He accused “some clinicians” of failing to engage about the cost of health services and argued that “prevention is better than cure” in relation to obesity.
The Minister said the issue went to the core of budgeting in the health service. He said there was a budget of 20 bariatric surgery procedures at Loughlinstown Hospital before the service was moved to St Vincent's Hospital.
St Vincent’s chose “in their wisdom” to do all 20 procedures in the first five months of the year, even though it was in trouble generally with its budget.
“We will always have this situation; do we allow more bariatric surgery and cancel inguinal hernias? Do we reduce cancer services? This is the core point. There is only one envelope of money, so if you start spending a load of it over here, you’re going to reduce the ability to spend it over there. No part of the health service is independent of the rest of it.”
Dr Reilly said it was “the same with drugs”, some of which were enormously expensive.“Some clinicians don’t engage in the process of how we decide what drugs we’re going to prescribe and what we’re going to pay for them.
He called on clinicians, policymakers, pharmaceutical companies and patients to “come together and face the reality. There is but one pot of money, one envelope. We have to price drugs so as to reward innovation but not to the point where it can break the health service.”
Dr Reilly, who was at last week's launch of the Healthy Ireland Council, said a new drug for hepatitis C would break the entire EU budget for health at its pricing level. There had to be a greater "meeting of minds in a realistic fashion" in relation to how drugs were priced. "That goes for procedures as well. There will always be huge demand for these things."
Prevention, he said, was better than cure: “Why allow people to get to the point of morbid obesity? Have they been attending their GPs? Have they been in a protocol around weight control? Have we got preventive measures in place?”
Dr O’Shea said yesterday that morbidly obese people were subject to “the last remaining acceptable discrimination”. Services for treating obesity were historically underfunded; if Ireland were to match its European neighbours, it would be carrying out 4,000 procedures a year, not the 90 currently performed.
