A patient weighing 140kg (22 stone) who was refused weight-loss surgery on the NHS challenged his primary care trust before the Court of Appeal yesterday in a landmark case.
Thomas Condliff, 62, is seeking a ruling from the court on whether his personal circumstances should have been taken into account by the NHS when it decided whether to fund treatment.
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Mr Condliff has Type 2 diabetes and a body mass index of 43, against a healthy ideal for men of 20-25. He has lost the sight in one eye, has kidney problems, cannot stand or walk for more than a few minutes and relies on his wife to help him to wash and dress.
NHS North Staffordshire, his local trust, told him he did not qualify for stomach shrinking surgery because his BMI was below its minimum requirement of 50.
Mr Condliff says even an extremely calorie-restricted diet has failed to help him lose weight. "I've been given about a year to live by one of the specialists," he said. "I feel more and more poorly each day, my diabetes is way out of control."
In common with many other primary care trusts, North Staffordshire does not take personal circumstances in to account. A patient has to show he would have a greater than average medical benefit from any treatment.
The case revolves around Article 8 of the Human Rights Act which sets out the broad right to a family life, and could open the way to other challenges. If Mr Condliff wins his case the PCT would have to look again at his situation but could reach the same conclusion.