Friday, 5 June 2009


By Joanna Codd

He worked hard for most of his life and spent six years fighting for his country in World War Two. Only now, aged 96, has Charles Coutts asked for anything in return.

The Burma campaign veteran needs a life-saving heart operation, and although doctors in London say he is a perfect candidate for a new procedure to replace a faulty valve, NHS Bournemouth and Poole has refused to foot the £30,000 bill.

“I’m not a moaner or whiner or a grabber. I’ve always been active, I’ve never had a major illness or operation, and I’m in generally good health apart from this valve,” said Mr Coutts, of Queens Park, Bournemouth.

“For the last six months I’ve been existing on tenterhooks thinking I’m going to have the operation, then being told I’m not because they’re not paying the money.

“I have deteriorated. I have no strength. I have to struggle to get off the chair and I have falls. It’s depressing not to be able to do anything unless somebody helps you. I don’t want to continue my life like this.”

Widower Mr Coutts was diagnosed as having a narrowing of his aortic valve after suffering an angina attack in Spain last year. When he returned home, he was referred to St Thomas’ Hospital in London.

After several days of scans and tests, he was assessed as ideal for transcatheter aortic valve implantation. The procedure involves inserting a replacement valve through a tube instead of undergoing open heart surgery.

Mr Coutts’ son Douglas pointed out that the procedure had been successfully carried out on people of 99 and 100. “It’s not a question of age. If my father lived in London or Kent, there’s a blanket go-ahead.”

And friend Jane Arnold said: “It’s a death sentence if he doesn’t have this done.”

Mr Coutts was born in the slums of the East End of London, the tenth surviving child in his family. After joining the Hampshire Regiment, he was commissioned into the Somerset Light Infantry, rising to the rank of Major. He spent most of his working life in the drapery trade, ending up as a director of the House of Fraser. He still lives independently.

A spokesperson for NHS Bournemouth and Poole said: “This is a highly specialised, complex and evolving procedure that is not currently routinely available in Bournemouth and Poole and is only considered for those too ill or frail to undergo open heart surgery.

“National guidance makes clear that although there is some evidence of short-term efficacy, there is little evidence about long-term outcomes.

“There is the potential for serious complications, which include the need for emergency cardiac surgery.

“Individuals may request specific funding through demonstrating to the primary care trust that they have good clinical reasons for being treated as an exceptional case. The PCT has not supported any such applications.”


NHS trusts have a legal obligation to provide treatments that have been approved by the National Institute for Health and Clinical Excellence.

But the one recommended for Mr Coutts is classed as an “interventional procedure”.

NICE makes no ruling on whether or not these should be funded.

This is an apparent loophole in attempts to end the so-called “postcode lottery” of access to new drugs or treatment varying according to where you live. A Department of Health spokesperson explained: “In the absence of NICE guidance, primary care trusts have to make decisions locally on the basis of the available evidence. The fact that there is no NICE guidance is not an excuse to refuse funding for a drug or treatment.

“For the first time, the NHS Constitution gives patients an explicit right to expect, where NICE guidance is not available, local decisions on the funding of treatments for individual patients to be made rationally, following a proper consideration of the evidence.

“If the local PCT decides not to fund, then it should explain that decision. To underpin this right, we have issued directions that require NHS organisations to put in place clear and transparent arrangements for local decision-making on exceptional funding requests. The directions came into force on April 1.”

Source: Daily Echo
Articles here about the NHS £1.8bn cash surplus