EARLIER this week, it was varicose veins and bunions. Today, we reveal the list of conditions you may no longer be able to get treated on the NHS has grown shockingly longer.

In future, you will have to be virtually housebound before you can get your hip replaced, one leading GP has warned. And you may not be considered for a cataract operation until your sight is so bad you are in danger of losing your driving licence, he claims. In a bid to reduce the number of patients being treated and so drive down costs, health bosses across North Yorkshire are introducing a tough new system for prioritising operations.

It is not only patients with hip problems or debilitating cataracts who may suffer. Except in exceptional cases, you will no longer even be able to get a vasectomy on the NHS.

This is madness. We are no longer talking about painful but minor conditions. An arthritis-ravaged hip can be excruciating. Cash constraints should not dictate whether your pain or disability is bad enough to merit an operation. And as for vasectomies.... are we really prepared for the unwanted pregnancies that will result?

It is time to start getting seriously angry. Yes, we all know about the cash problems caused by increasing demand and the cost of new treatments. And yes, we all know that simply throwing money at the problem is no answer - especially in an organisation as large, leaky and inefficient as the health service.

But someone needs to sort out the sick man that is the NHS soon, because it is falling apart before our eyes. Someone must find the political courage either to make us pay more for our care, or to really get to grips with bureaucracy and waste. Putting sticking plasters on the wounds isn't good enough any more.

Updated: 11:53 Friday, May 19, 2006