Why Isnt the US Mens National Team Better at Soccer

Monday marks the 2014 World Cup debut for the United States men’s national team, and with it begins the Americans’ 10th attempt to capture soccer’s most prestigious trophy. Since 1930, when the team placed third in the inaugural World Cup, the U.S. has never come closer to victory than the quarterfinals in 2002. The United States has the world’s biggest economy, the world’s third-largest population, and spends an exceptional amount of money on sports, but it can’t field a world-class men’s soccer team.Clearly, the U.S. women’s national team can say better. Since the advent of the Women’s World Cup, the United States has boasted the most successful women’s team on the planet, including two World Cup wins to go with one second-place and three third-place finishes. But global women’s soccer is quite young, relatively speaking,1The first Women’s World Cup was staged in 1991; before that, the major international women’s scene consisted of prototype events and assorted unofficial tournaments. and one of the challenges for the men’s national team is that the rest of the world had a sizable head start on the men’s side.Economists love to frame the U.S. men’s team’s problems by searching for correlations between other countries’ socioeconomic status and their athletic performance in international competitions. In a broad-based event like the Olympics, this approach works surprisingly well.2The correlation coefficient between the linked medal-count predictions and the actual totals from the 2012 Olympics was 0.987! But in a more specific sport like soccer, there isn’t as much of a link between a country’s vital statistics and its prospects of winning.If you tried to find a relationship between national populations and the Soccer Power Index (SPI), you’d have very little to show for your effort. For every Brazil, which ranks fifth in population and first in soccer talent, there’s a China or an India — hugely populous countries that aren’t especially good at the world’s favorite sport. Likewise, the link between a country’s economic performance — as measured by per-capita gross domestic product — and its SPI is similarly weak. Rich countries like Norway and Qatar aren’t soccer powerhouses, while a disproportionate number of the world’s best national soccer teams belong to poor South American and African countries.Total GDP, which combines population and per-head productivity, explains a somewhat larger proportion of a country’s SPI rating,3The correlation coefficient was .233. but still doesn’t scratch the surface when it comes to clarifying why a country like the United States isn’t better at soccer despite its overwhelming wealth and large number of inhabitants. Money alone doesn’t seem to be able to buy success in international soccer (a fact that, as Max Ehrenfreund of The Washington Post notes, stands in sharp contrast to the widespread perception of soccer’s top club leagues).There are other explanations for Americans’ soccer futility: Recent research suggests that the U.S. has been held back by historical inexperience playing at the highest level, and — traditionally speaking — its absence from the game’s most important competitive regions.More successful models looking to explain countries’ soccer superiority include factors beyond GDP. At the far end of the spectrum, these studies add a dizzying array of supplementary variables, such as a country’s type of government, its level of political freedom, its colonial history and even its amount of oil production.4I tend to be wary of such kitchen-sink models because of the risk of overfitting. But a simpler and more widely known model was developed by the economist Stefan Szymanski for his book (co-authored with journalist Simon Kuper) “Soccernomics.” Szymanski’s only additional variable was the number of matches a country’s senior national team had played, the effect of which dwarfed both population and GDP.This “experience” factor measures how long a country has been playing soccer, and serves as a useful proxy for how much exposure it’s had to the international game. It begins to explain why the U.S. hasn’t yet caught up to the powerful national programs of Europe and South America, despite America’s built-in advantages. Counts vary depending on how matches are classified, but according to the database maintained by the Rec.Sport.Soccer Statistics Foundation,5That link has data only up to 2001, but I augmented it with data through 2011. the U.S. Men’s National Team has played 618 international matches in its history. Almost all teams ranked ahead of the U.S. in SPI have played more frequently than that,6Excluding former Soviet satellites. and in many cases, it’s not close. France, Italy and the Netherlands have the U.S. beat by more than 100 historical games; Uruguay and Germany are ahead by more than 200; and England, Brazil and Argentina are up by more than 300. The U.S. comes out ahead of Colombia (509), Portugal (547) and Ecuador (464) on experience, but those are the outliers.At first blush, the apparent importance of historical experience in international soccer seems to be a chicken-or-egg dilemma along the lines of Malcolm Gladwell’s famed 10,000-hour rule: Is a country good at soccer because it has a long history of playing the sport, or does it have a long history of playing soccer because it’s good?Szymanski and Kuper sidestep this quandary in favor of a far more interesting discussion about what the experience factor means for the spread of information through interconnected knowledge networks. As they tell it, being isolated from the forefront of tactical innovation is one of the biggest handicaps a national soccer team can suffer. A lack of wealth and a small player pool matter, of course, but only to a point. For more developed countries — those that aren’t subject to malnutrition and extreme poverty — the things holding soccer back might be inadequate training and a sense of detachment from global soccer, whose networks allow innovation to spread.The United States is a good example. Between 1950 and 1990, the U.S. didn’t qualify for a single World Cup, and played in fewer than half as many international matches as Brazil, Argentina, England, Italy, France or West Germany. Even Spain (held up by Kuper and Szymanski as an example of soccer isolationism under the dictatorship of Francisco Franco from 1939 to 1975), played nearly three times as many international games as the U.S. did during the 1940s, 1950s and 1960s. Cut off from the rest of the soccer world, the U.S. missed decades of innovation, and is still playing catch-up. For years, the men’s national team was defined as unsophisticated — a tough, hustling team that ran a lot and relied on counterattacks, while the rest of the world played tactically advanced, attacking soccer.There’s nothing the U.S. can do about those lost decades. But as Kuper and Szymanski note, there is a “shortcut” for new-world teams that lack experience: They can import it, bringing in coaches who can teach players the art of soccer as found in continental Europe, the central node in Kuper and Szymanski’s global soccer knowledge network.7Where does South America fit into that network? After all, Brazil and Argentina have combined to win five of the last 11 World Cups. But even those countries’ biggest individual stars tend to play club football in Western Europe. That’s effectively what the U.S. did when it hired the former Germany and Bayern Munich manager Jürgen Klinsmann as head coach in 2011. Klinsmann’s plan has often been described as one of de-Americanizing the men’s national team, bringing a European sensibility to it. The U.S. is hoping his personal experience in soccer’s most important information network can make up for an entire country’s lack thereof.Visions of such a utopian future have come in fits and starts. The best American players are still nowhere near the level of the best in the world, and the demand for their services in the club leagues of Western Europe remains limited. In the run-up to the World Cup, Klinsmann repeatedly warned the media that expecting the U.S. to win this year’s tournament was “unrealistic.” Thanks in large part to a brutal draw, American soccer will likely take a step backward before it can move forward.8Going into Monday, the U.S. had just a 32.9 percent chance of advancing out of the group stage, according to the FiveThirtyEight World Cup model.At the same time, inroads are being made. Klinsmann has stressed the importance of American players securing loans in Europe, to place themselves in the center of the game’s most fiercely competitive, innovative battleground. And he’s also taken steps to rid the U.S. of its traditional playing style, adopting tactics more emulative of the possession-based scheme that correlates best with winning. The Klinsmann experiment is not a slight adjustment to American soccer — it’s a total overhaul.Viewed this way, perhaps the United States isn’t underachieving at all, even after taking into account its economic resources. American soccer is making its way down an evolutionary path that other countries traversed decades earlier. The early growing pains of the U.S. men’s program under Klinsmann are part of a long process, one that someday may produce a team capable of legitimately competing for a World Cup. read more

35YearOld Justin Gatlin Not Ready to Relinquish Crown to

QUOTABLE“It’s unfortunate, because for sure every time I come out to the track and compete, I want to put on a show. This time, I have to be smart. I want to wear the USA uniform and bring home a medal [in London]. That’s what it’s really about,” two-time Olympic triple jump gold medalist Christian Taylor, who was required by rules to compete at nationals even though he has a wildcard spot to worlds. He fouled on his first attempt and then called it a day. He flew in from Amsterdam the night before.CONFIDENCE BOOSTTeenager Candace Hill dominated the 100 to win the junior national championship and earn a trip to Pan American junior championships in Peru. She’s hoping the confidence carries over to Saturday, when she steps up to the senior level for the 200. A trip to London will be on the line.“This reminds me of what my potential is,” said the 18-year-old Hill, who signed a 10-year sponsorship deal with ASICS in December 2015.FACTS & FIGURESVashti Cunningham won the high jump. She’s the daughter of longtime NFL quarterback Randall Cunningham. … Paul Chelimo set a meet record in winning the 5,000. … Will Claye won the triple jump. … Shelby Houlihan held off Shannon Rowbury for the victory in the women’s 5,000.ON DECKWorld record-holder Keni Harrison goes for the title in the 100-meter hurdles Saturday. She’s already qualified for worlds, courtesy of her Diamond League title. She hasn’t raced much since breaking her hand at a meet in early May. Gatlin edges Coleman pic.twitter.com/xhgpR8ffSE— Joe Fleming (@ByJoeFleming) June 24, 2017SACRAMENTO, Calif. (AP) — Justin Gatlin showed the youngsters that age is just a number. As in, get down the track quick and post a good one.A changing of the guard? Not on his watch.The 35-year-old Gatlin surged past up-and-comer Christian Coleman to win the 100 meters on Friday night at the U.S. Track and Field Championships. To celebrate, Gatlin sidestepped back down the track.At 21 and coming off an NCAA title, Coleman was the sprinter all set to usher in a new era. It will have to wait.Gatlin finished in 9.95 seconds to edge Coleman by 0.03 seconds. Both are products of the University of Tennessee and both are now Nike-sponsored runners, with Coleman just signing a three-year deal. Christopher Belcher finished third.“These guys are just starting their career off,” said Gatlin, who’s been dealing with nagging quad/groin injuries. “I have to make sure I stay hungry.’”Awaiting the trio in August, Jamaican Usain Bolt at the World Championships in London.“The sweet thing about it is there are two hungry guys who have no nervousness about [Bolt] and are hungry to make a name for themselves,” Gatlin said.Gatlin proved he still has plenty left, too.“He never lost it. He’s a good competitor,” Coleman said. “It was a good race. Looking forward to many more.”In the women’s 100 final, Olympic silver medalist Tori Bowie got off to a blazing start and never looked back. She finished in 10.94 seconds to beat Deajah Stevens. Ariana Washington was third, while Allyson Felix finished last.The highlights of Day 2 from nationals:DID YOU SEE THAT?Paralympian Patrick “Blake” Leeper, running on carbon-fiber prosthetics, ran 45.25 seconds in the semifinals of the 400 meters to break the T43 world record held by Oscar Pistorius of South Africa. Leeper wound up seventh in his heat and didn’t qualify for the final.“Pretty cool to say I broke it. I’m in the world record books,” said Leeper, who was born without legs due to a congenital birth defect. read more

Sabermetrics Helped Put Tim Raines In The Hall Of Fame

After a combative voting season, the Baseball Hall of Fame announced the induction of three players Wednesday evening: Ivan Rodriguez, Jeff Bagwell and Tim Raines. Of the three, two came as no surprise: Rodriguez made it on his first try, and Bagwell came incredibly close in 2016, so this year’s less-crowded ballot helped him get over the top. But the real story is the Hall’s embrace, at long last, of Tim Raines. In his tenth and final year on the ballot, the former Montreal Expos speedster showed that a concerted campaign based on advanced metrics can help elect a player who might previously have been overlooked.Raines was never a contender for the Hall if you looked solely at his traditional numbers. His 170 home runs spoke more to longevity than prodigious power, and he fell short of such old-school benchmarks as 3,000 hits or 1,500 RBI. Making matters more difficult, Raines was perpetually overshadowed by fellow Hall of Famer Rickey Henderson, who played in the same era with a similar set of skills, but racked up much more value. (According to Baseball-Reference.com, Henderson had 110.8 career wins above replacement, compared with 69.1 for Raines). As a result, Raines failed to acquire much “black ink” in his career: He rarely led the league in any particular category; Henderson always seemed just a little bit better.But Raines still found ways to excel: He got on base in about 38.5 percent of his plate appearances, and he racked up more than a hundred runs of value above average in his career as a baserunner. Although 69.1 WAR may not be in Henderson’s league, it still made Raines worthy of serious Hall of Fame consideration.Despite the misfortune of playing alongside Henderson, Raines also developed a passionate fanbase. His underrated statistical merits, combined with his lack of traditional accomplishments, spurred the nascent sabermetrics movement to lobby for him. Noted analytics website Baseball Prospectus consistently advocated for Raines’s election from the moment he retired, with former BP staffer (and, later, FiveThirtyEight contributor) Jonah Keri spearheading the campaign.Partially because of sabermetrics and a changing electorate, Raines’s vote totals climbed almost every year he was on the ballot. After news broke of Raines’s induction, Keri told me that “a handful” of voters had reached out to him over the years to credit his work with changing their mind on Raines. This year, Raines finished with 86 percent of the vote, a long way from the low of 22.6 percent he received in his second year.Raines’s election should give hope to all the underappreciated players whose advanced metrics exceeded their traditional accomplishments. As the electorate gets smarter and more informed, even hitters like Raines — without gaudy home run or RBI totals — can hope to make their way to Cooperstown eventually. read more

Here We Go Again The Cavaliers And Warriors Part IV

Welcome to The Lab, FiveThirtyEight’s basketball podcast. On Tuesday’s show (May 29, 2018), Neil, Kyle and Chris discuss the end of the conference finals and preview a familiar NBA Finals. They cover the similarities between the collapses by Boston and Houston, discuss what to make of Houston’s season now that it’s over and ask whether the Cavaliers have any chance against the Warriors.The Lab will be back with another episode later this week. In the meantime, keep an eye on FiveThirtyEight’s NBA predictions, which are updated after every game. By Neil Paine, Chris Herring and Kyle Wagner Embed Code More: Apple Podcasts | ESPN App | RSS | Embed read more

As US Tennis Power Fell Spanish Men And Czech Women Were Rising

Patrick McEnroe announced his resignation Wednesday as general manager of player development for the U.S. Tennis Association, the nonprofit group that organizes the U.S. Open.This year’s Open shows how little top U.S. talent has emerged during McEnroe’s tenure. He took the job in April 2008. No American male player who was under 20 at that time won a men’s singles match at this year’s U.S. Open. Young American women have done better, but Nicole Gibbs was the only one who was younger than 20 when McEnroe took over who reached the third round in singles.But as I wrote Monday, the decline of U.S. tennis had begun long before McEnroe (who is a tennis analyst for ESPN, which owns FiveThirtyEight) got the job of developing players. American women’s global power in the sport — by share of total WTA Tour ranking points — bottomed out in 2011 and has rebounded since. American men’s share of global ATP World Tour ranking points has kept falling since 2008, but much more slowly than the rapid decline between 1990 and 1998, from about a quarter of world power to one-tenth.At the end of this post are four charts that fill in the details about when the U.S. lost its dominant position in the sport and which countries have taken over. Spain has led the U.S. in men’s ranking points each year since 2001. France overtook the U.S. in 2007. Sweden, though, has seen the most precipitous dropoff, from second in the world in 1990 to 39th today.With their recent comeback, American women retook the top spot from Russia, thanks in large part to world No. 1 Serena Williams. The Czech Republic has risen to challenge the two leaders, which remain well ahead of a declining France.Trends in share of ranked players are similar, though less dramatic, because a player who falls from No. 1 to No. 100 counts the same by this measure. There are still plenty of Swedish ranked men and French ranked women, but their influence has waned.My colleague Paul Schreiber helped me gather the data from the ATP and WTA ranking archives on their respective websites. The WTA data for the years 2000 to 2002 omits 100 ranked players for each year; the data is missing from the website and a WTA spokesman wasn’t able to immediately provide the numbers. None of the missing players was ranked in the Top 400, so their omission will have little influence on global ranking-points share, though slightly more on share of the world’s ranked players. My colleague Andrew Flowers helped compile the annual ranking data — from the first day of the U.S. Open each year — using the statistical programming language R. read more

Associate coach Greg Schiano involved in vehicular crash with cyclist

Then-Tampa Bay Buccaneers head coach Greg Schiano crouches on the field during a time out on Sept.15, 2013, in Tampa, Florida | Courtesy of TNSEarly Thursday on the Ohio State campus, OSU football associate head coach Greg Schiano struck a bicyclist with his vehicle. The Columbus Dispatch was the first to report the incident, and it was confirmed to The Lantern by an OSU spokesman.Chris Davey said in an email that the accident occurred at the intersection of West Lane Avenue and Fred Taylor Drive which resulted in the injury on the bicyclist. According to the report by The Dispatch, the victim was a 26-year-old male who was taken in stable condition to the Wexner Medical Center. Sgt. Brooke Wilson of the Police Division’s Accident Investigation Unit told The Dispatch that the victim suffered a head injury, but is expected to survive.University Police, the Columbus Division of Police and the Columbus Division of Fire arrived at the scene of the crash. The incident remains under investigation.“Our concern is with the young man who was injured and doing everything was can to support him,” Davey said.Schiano is in his first season as a coach with the Buckeyes. He oversees the defense with co-defensive coordinator Luke Fickell.OSU is on a bye week. The team’s next opponent is on homecoming week against Rutgers on Oct. 1 at noon at Ohio Stadium.The Lantern will continue to follow this story. read more

Intensity of Ohio StateMichigan rivalry not lost on womens volleyball team

When Ohio State women’s volleyball coach Geoff Carlston first arrived on campus in 2008, he had no idea how colossal the OSU-Michigan rivalry truly was. During his first matchup with the team up north, he got a crude welcome to the battle. “The first time we played them, we weren’t as strong as we are now,” Carlston said. “We got pretty much taken to town by Michigan both times. We just got demolished and it was hard.” Carlston said the program has come a long way since then, and he’s optimistic about his team’s chances Friday, when it will battle Michigan at 7 p.m. at St. John Arena. “You really felt the weight of that rivalry. You want to win, but we just weren’t there (my first year), so it’s fun to be in a place now where you got the rivalry and to be in a position where we can be competitive,” he said. Carlston wasn’t the only one who had to learn about the momentous game. His seniors were on the same journey as he was back when they first stepped on campus. Coming from Texas, senior outside hitter Emily Danks had no idea the rivalry existed. “I have to be honest, when I came here I had no knowledge of Michigan,” Danks said. “So I had to be taught that we’re not supposed to like Michigan.” Senior outside hitter Mari Hole, who came from Norway to California to Ohio, said she learned that the word “rivalry” had a whole new meaning here at OSU. “I thought I knew what rivalry was before I played Michigan last year just because of the experience of UCLA against USC, but I could not be far more off,” Hole said. Hole didn’t fully grasp the gravity of the competition until a stop at a restaurant in the northern state. “I remember we walked into a restaurant in Michigan, and the whole restaurant started booing on us because we were wearing Ohio State gear,” Hole said. “I just remember we stopped in the middle and I had to start laughing because I thought it was the funniest thing ever. Although I haven’t been a Buckeye for as long as some of the other girls on the team, that definitely started a rivalry right there for me.” The seniors are fully aware of the rivalry now and embrace every aspect of it – even parts that aren’t so politically correct. “I think my favorite part about Michigan week is people getting all their T-shirts and the funny little phrases,” Danks said. “I love going to the T-shirt stands and getting the inappropriate ones that I might not be able to wear, but just to have.” Even though most people think of football when talking about the competitive matchup, Carlston said that it goes beyond that one sport. “I mean, even though it’s a football thing, I think it does spill over to all the other sports,” Carlston said. “So anytime we’re playing Michigan, we want to beat them.” The matchup against Michigan will also serve as senior night. “It’s an exclamation point,” said senior middle blocker Mariah Booth said. “It’s my last home game of the season of my four years. My college career is just all end of the road, my family will be here, it’s Michigan week and it’s just an exclamation point.” Danks said as big as this game is in terms of rivalry, what really makes it memorable is the fact that her whole family will be at her game. “It means the world to me,” Danks said. “They have always been my biggest supporters. My family doesn’t get to be together, except for maybe like three months out of a year. We’re usually all in five different states, so the fact that we can all come together and they’re here to support me, I’m really excited to play.” Booth said that her family will be at the game as well, and the thought that her dad plans to come to see her play on her senior night makes her smile. “My whole family is coming down, and my dad is coming down, and he’s always too busy with work,” Booth said. “For basketball he scouts the colleges like Ohio State and the Midwest region, so I don’t get to see him often this time of year. My mom, sisters and brothers are coming down, so it will be one of those rare occasions where I have my whole family with me together.” Living thousands of miles away from home, Hole is ecstatic to have her sister at her game. “She has never seen me play in the states,” Hole said. “She has seen me play at home, but it’s different. She has never seen games in this kind of environment. I want her to have a great time, and like any sister, I want to make an impression on her too.” Hole said she will miss her time as a Buckeye and playing with her teammates who have become her sisters. “It’s been an adventure, it’s been a great experience,” Hole said. “You never know what’s coming up next and that’s probably why we love this too. Every day is a battle in the gym, as well as every game. My experiences have been truly adventurous and has taught me how to battle and how to make some great friends.” read more

Urban Meyer Ohio States influence obvious across Big Ten teams

Kaily Cunningham – Multimedia editorCHICAGO — Ohio State football coach Urban Meyer and the undefeated Buckeyes were a topic of conversation from the start of Big Ten Media Days in Chicago.Media Days kicked off at 10 a.m. Wednesday with opening statements and interviews from all 12 Big Ten head coaches.OSU, Meyer and his pending disciplinary actions were nothing short of a hot topic throughout the nearly entire Big Ten as different coaches took the mic.Northwestern head coach Pat Fitzgerald and the Wildcats are scheduled to play against OSU Oct. 5 with home field advantage. Fitzgerald said he “quite frankly hasn’t thought about it yet,” and since that game is Northwestern’s season opener within the Big Ten conference, having an undefeated team coming in is “pretty special.”Darrell Hazell, first-year head coach at Purdue, worked at OSU for seven years under former coach Jim Tressel before moving to Kent State University where he coached from 2011 to 2012.“I learned a lot from Jim Tressel in my seven years at Ohio State,” Hazell said. “Coach Tressel was a big influence on the way I do things.”Wisconsin head coach Gary Anderson talked about his close relationship with Meyer.“He’s very good to me, I respect him very much,” Anderson said. In regards to the teams’ Sept. 28 face-off, which is the conference opener for OSU, Anderson said, “that’s going to be a big game.”Meyer agreed there is plenty of mutual respect between Anderson and himself.“It’s great, Gary and I talk quite often. He was arguably one of the best hires we’ve ever made,”  Meyer said.Meyer did not talk much about ‘The Game,’ whereas Michigan head coach Brady Hoke mentioned the strength of the rivalry that has been there for so long.“This is a great rivalry, the greatest there is, it’s competitive, and it’s passionate,” Hoke said.The Buckeyes travel to Ann Arbor Nov. 30 to finish the regular season for both teams the week before the Big Ten Championship game in Indianapolis.“As far as the back end of the schedule, we’ve got a great schedule,” Hoke said.Meyer’s disciplinary actions were also a topic up for discussion among other coaches, including Iowa coach Kirk Ferentz. When asked how he, as a head coach, sees disciplinary actions, Ferentz compared it to parenting.“Once the parents, families turn their young people over to you, (for) first time they’re living independently, typically, away from home, (there’s) a whole different set of circumstances, choices to make,” he said.Despite the attention focused on Meyer and his players’ performance off the field, he chose to focus on the positives, but established a clear “no nonsense” approach to recent disciplinary issues.“I want to make sure our punishment is as hard or harder than any discipline that’s out there. That’s maybe where I’ve changed over the years.” said Meyer. “Even as a first-time offense from a freshman, I want to make sure we’re setting the tone.”Running back Carlos Hyde was named a “person of interest” in the reported assault of a woman at a Columbus bar Saturday, according to a Columbus Division of Police report. Hyde has since been suspended from all football team activities pending the outcome of the student code of conduct and criminal investigations.Cornerback Bradley Roby was scheduled to attend Media Days, but senior safety Christian Bryant was tacked on as a replacement after it came to light that Roby was arrested Sunday in Bloomington, Ind., and charged with misdemeanor battery. read more

Mens soccer falls to West Virginia in exhibition match 10

The Ohio State men’s soccer team lost its first exhibition game of the season to West Virginia by a score of 1-0.Mountaineer junior forward Andy Bevin recorded the lone goal in the match, scoring on a free kick in the 75th minute that bounced off an OSU defender.OSU junior forward Kenny Cunningham had the best chance of scoring for the Buckeyes, but his shot in the opening minutes of the second half hit off the crossbar.WVU outshot the Buckeyes 14-6 in the contest, led by Bevin’s four. OSU junior goalkeeper Alex Ivanov recorded three saves in the game and was the only Buckeye to play the full 90 minutes.A total of 17 players on OSU’s roster saw action Sunday, including eight freshmen.OSU is scheduled to play another exhibition game against Indiana University-Purdue University Fort Wayne on Aug. 20 at 7 p.m. in Columbus before finishing its preseason schedule Aug. 26 at Notre Dame. read more

Obese patients and smokers banned from routine surgery  in most severe ever

first_imgThe restrictions echo others made by health bosses in Hertfordshire, the North West and London in the past two years, where blanket referral bans were imposed on patients on the basis of their weight.Last month St Helens CCG in Merseyside said it was considering temporarily suspending all non-essential hospital referrals by GPs because of financial concerns.Reports of rationing have emerged after NHS England admitted in May that its provider sector overspent by £2.45 billion in 2015-16,  more than a threefold increase on the previous year.The figure, which was described as conservative by think-tanks, prompted some hospital chief executives to question the future viability of free universal healthcare.Mr Hopson called for a “realistic national conversation” about how much should be spent on the health service, and said that if procedures had to be restricted, the reduction should be managed on an NHS-wide basis. Want the best of The Telegraph direct to your email and WhatsApp? Sign up to our free twice-daily  Front Page newsletter and new  audio briefings. At this rate we may see brutal service reductions becoming the norm, rather than just being exceptionsClare Marx, president of the Royal College of Surgeons Leaving patients waiting in pain for treatment longer than is clinically necessary cannot be acceptedClare Marx, president of the Royal College of Surgeons A spokesman for NHS England added: “Major surgery poses much higher risks for severely overweight patients who smoke. So local GP-led Clinical Commissioning Groups are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their hip or knee operation. Reducing obesity and cutting smoking not only benefits patients, but saves the NHS and taxpayers millions of pounds. “This does not and cannot mean blanket bans on particular patients such as smokers getting operations, which would be inconsistent with the NHS constitution. “Vale of York CCG is currently under “special measures” legal direction, and NHS England is today asking it to review its proposed approach before it takes effect to ensure it is proportionate, clinically reasonable, and consistent with applicable national clinical guidelines.” A statement from Vale of York CCG said: “The local system is under severe pressure. Hospitals are being warned they will not be paid for surgery if they carry out operations on obese patients who are not exempt from the policy.“This work will help to ensure that we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it.”  However, Clare Marx, president of the Royal College of Surgeons, condemned the decision to bar obese patients and smokers from routine surgery.“This policy from Vale of York is among the most severe the modern NHS has ever seen,” she said. Smokers who refuse to quit will have planned operations postponed for six months, but may be included on surgeons’ waiting lists earlier by proving they have given up for at least eight weeks.The ban will not apply to cancer patients, or those with some conditions that could becoming life-threatening, or if exceptional circumstances can be shown. Surgeonscenter_img Chris Hopson, the head of NHS Providers, which represents acute care, ambulance and community services, said: “I think we are going to see more and more decisions like this.“It’s the only way providers are going to be able to balance their books, and in a way you have to applaud their honesty. You can see why they’re doing this – the service is bursting at the seams.” The announcement is the latest in a series of setbacks for patients who are facing rolling strikes by junior doctors that threaten to cripple the health service as winter approaches.The decision by Vale of York Clinical Commissioning Group (CCG) comes amid increasing limits across the NHS on surgery for cataracts as well as hip and knee operations. Smoking man Smokers are also included in the new measuresCredit:Jonathan Brady /PA  Under the latest restrictions, patients in the catchment area who have a BMI of 30 or more will be barred from routine surgery for non-life-threatening conditions for a year, although they may secure a referral sooner if they shed 10 per cent of their weight.A BMI – weight in kilograms divided by height in metres squared – of 30 is the point at which a person is classed as obese and, on current estimates, more than half the population could be classified as such by 2050. Obese people and smokers will be barred from some operations Obese people will be routinely refused operations across the NHS, health service bosses have warned, after one authority said it would limit procedures on an unprecedented scale.Hospital leaders in North Yorkshire said that patients with a body mass index (BMI) of 30 or above – as well as smokers – will be barred from most surgery for up to a year amid increasingly desperate measures to plug a funding black hole. The restrictions will apply to standard hip and knee operations.The decision, described by the Royal College of Surgeons as the “most severe the modern NHS has ever seen”, led to warnings that other trusts will soon be forced to follow suit and rationing will become the norm if the current funding crisis continues. “Leaving patients waiting in pain for treatment longer than is clinically necessary cannot be accepted. In the last month alone, the Royal College of Surgeons has learnt of at least three clinical commissioning groups that are planning to introduce policies that deny or delay patients’ access to surgery as a means to cut spending.“At this rate we may see brutal service reductions becoming the norm, rather than just being exceptions.”last_img read more