Rationing of NHS treatments is becoming more widespread, a survey of GPs and hospital doctors suggests.

Doctor magazine asked readers about rationing. Of 653 answering questions on consequences, 107 - 16% - said patients had died early as a result.

More than half - 349 - said patients had suffered as a result. This compared with one in five in a similar survey conducted nine years ago.

The government said decisions had to be made on which treatments to provide.

The magazine asked 12,000 of its readers a variety of questions with between 473 and 857 replying to each one.

Doctors said more debate was urgently needed over what should and should not be rationed.

They reported not being allowed to prescribe drug treatments including smoking cessation drugs and anti-obesity treatment.

They also reported that local NHS trusts had been placing restrictions on fertility treatments, obesity surgery and a host of minor operations, including those for varicose veins.

The magazine said the findings of the latest poll showed rationing was becoming more widespread.

A similar survey nine years ago showed that a much smaller proportion - one in five, compared to half - were aware of patients who had suffered due to rationing.

Rationing has become a sensitive subject in the NHS.

Independent advisory body, the National Institute for Health and Clinical Excellence, makes recommendations on new, expensive treatments.

But with limited budgets, local trusts are often forced to cut back on other treatments to keep pace with the recommendations.

'Honesty'

Many experts fear the situation will get worse with increasing demands on the health service made by the ageing population and expected advances in medicines.

Richard Vautrey, deputy chairman of the British Medical Association's GPs committee, said: "There is not much honesty and openness about this.

"The NHS could spend whatever you gave it, but it obviously works with a limited budget so we urgently need to have a debate about what can be provided.

"Trusts are already being forced into this but the political parties are not talking about it."

And Dr Michael Dixon, chairman of the NHS Alliance, which represents NHS trusts, added: "Rationing is the great unspoken reality.

"The only people who refuse to mention the 'r-word' are the media and the politicians, who continue to want to promise everything for everyone in order to win elections."

A Department of Health spokesman said it was not trying to avoid the issue.

"The NHS has received an unprecedented funding boost in recent years but finance is not endless and hard decisions will always have to be made about which treatments to provide."

But he added: "Doctors and nurses make these clinical decisions with patients - not managers or politicians."