Cost Cutting Treatments

Another example of health care in Britain being dictated by costs rather than medical opinion.

Thousands of patients could undergo unnecessary spinal operations because of new NHS guidelines on treatments for lower back pain, warn experts.

NICE, the group which spent £4.5 million on PR and only £3.4 million on actually assessing new medicines (their actual role), has told doctors not to recommend therapies which have little evidence to support them- MRI scans, X-rays, ultrasound and steroid injections. So if there is some underlying problem with your back, you may not discover what it is because doctors are being told not to send you for expensive scans. A relative of mine, for example, suffered from some terrible back pain and it was only after some months of agony that doctors discovered a tumour in her back. Under these new guidelines, a diagnosis like that may not be made until it's too late.

Now, many patients who fail to respond to initial treatment could miss out this intermediate stage and proceed straight to risky spinal fusion operations.

NICE estimates the NHS will make annual savings of £33million on back injections and £11million on MRI scans.

Costs which will be eaten up by NICE's approved replacement treatments- which include "acupuncture, manual therapy such as physiotherapy, or exercise."

NICE estimates the NHS will make annual savings of £33million on back injections and £11million on MRI scans.

However, it will spend £24million extra on acupuncture and £16million extra on manual therapy, making the cost-cutting aspect negligible.

A £4 million saving- but at what cost to the patient told to go for acupuncture rather than an MRI to discover the root cause of their pain?

A pain specialist and a member of the Interventional Pain Medicine Group of the British Pain Society is not impressed by the new plans-

Dr Ron Cooper, past chairman of the group and a consultant pain specialist in Northern Ireland, said: ‘I have never known so many pain medicine specialists to be so furious. More patients will end up having more expensive surgery, which is unnecessary, risky and has worse results.

‘NICE made it difficult for us to submit evidence to a committee on which there was not one experienced pain physician.

‘The guidelines will make us the laughing stock of Europe, Australia and the U.S. where pain specialists will continue to have full access to a wide range of treatments.’

In short, in an effort to control costs, intermediate treatments (including important investigative tools) are being denied to patients and some people who may not need it will be told to have surgery.