The future of pain services in the NHS. Is there one?
Since our last editiorial on this subject our mailbag has been
heavy with views from people affected by pain and healthcare professionals working
in NHS pain services. Generally it makes for unhappy reading with stories of
difficulty getting treatment on one hand whilst services are either being closed
down or under threat on the other. The information we receive comes from all
over the UK highlighting the plight that dedicated NHS pain services generally
find themselves. Despite close investigation it has proved impossible to find
one solitary example where some of the vast amounts of money poured into the
NHS has found its way to enhance pain services. In stark contrast it is very
easy to find clear examples where money has been and continues to be wasted
by the NHS. What is particularly frustrating is that all too often the NHS managers
responsible for the wastage and huge debts just move from NHS Trust to NHS Trust
or worse end up at the Strategic Health Authority. What chance does you the
patient have?
The impact of this financial mismanagement is plain to see with redundancies
being announced across the NHS as the debts mount up. We are led to believe
that this will have "no impact" on patient care which begs the question"
well if not,why has that post been created in the first place?" Let us
be under no illusion-patient care will suffer which includes pain services with
evidence of two more services under threat within the last couple of months.
Yet the issues around effective pain management will not go away. We have an
ageing population which will have an major impact on demand for pain services
in the future. The logic behind creating effective pain services now in preparation
for what is to come cannot be faulted. Yet it is hard to find any evidence that
pain features on the government "radar". It does not feature in the
GP contract which leaves little incentive for a GP to prioritise treatment for
pain. We see new medication which has proved effective for people with pain
being denied to patients on cost grounds. Costs that are based purely on prescribing
rather than the more obvious and logical broader picture. NHS managers and prescribing
advisors have proved themselves to be particularly inept in being able to grasp
the wider issues around supporting people affected by pain content to adopt
a "silo" mentality. Harsh words perhaps-but when you are on the receiving
end the implications can be totally and utterly demoralising.
Whatever your political views it cannot be denied that the NHS is in a mess
and this government appears to have little idea on how to resolve matters. The
Health Secretary, Patricia Hewitt, has been very quiet over the past few months
appearing to lack the insight to be able to take the drastic action that is
needed.
In summary the future for dedicated pain services within the NHS remains deeply
uncertain. Such a postion is untenable for people affected by pain and the dedicated
healthcare professionals that work in NHS pain services. It is surely time that
the government faced up to its reponsibilities by developing an effective and
achievable pain service across the UK. After all chronic pain only affects 1
in 7 of the UK population!