Rationing joint replacements

Editor—Rationing hip replacements may save costs for commissioners, but it cannot in this timescale save any costs to providers in the NHS—which means, money is wasted.¹

Delaying operations on “punitive” grounds may increase long term costs. Personal experience shows that delaying joint replacement surgery causes deterioration of functional capacity, which is difficult or impossible to reverse after later operation. What is the evidence that these strict conditions are not in the longer term damaging?

This is rationing by any other name—or choice if your commissioner is not overspent, if your body mass index is not too high, and you do not have a major disability. A curious definition.