NHS: Pain Management Services

Baroness Greengross Excerpts

Wednesday 7th July 2010 Lords Chamber

[Baroness Greengross]

My Lords, I, too, thank the noble Lord, Lord Luce, for introducing this important debate. Pain can last for many years and some people have life-long symptoms. Sometimes it starts after a specific injury, but it is not always clear why people suffer in this way. As we have heard, some people suffer with continuing low back pain, pain related to joint inflammation or pain related to a nerve injury. Pain can follow an operation or an amputation, or even after what seems to be a not- very-serious infection, such as shingles.

We know that the effects of chronic pain can be disastrous and many people will need support in managing their symptoms. While specialist services are available in the community and in hospitals, I am aware that many people spend far too long without appropriate treatment. We are talking about large numbers of people and the accompanying huge costs spent in welfare benefits when people have to leave work and stop being productive in the community. We also know that death by suicide in chronic pain patients is double that of the general population and that severe chronic pain is associated with an increased 10-year mortality.

Much remains to be done with chronic pain management generally. I am particularly concerned about the status of older people in this regard. The recent National Audit Office health inequalities audit stated that much progress remained to be made on the issue, which would not be surprising as older people usually experience discrimination in the form of health inequalities, but also in poorer chronic pain management targets. Given the current austerity programme that the public sector is facing and the even greater importance of value for money, I hope that the Minister can assure the House that this aspect will be considered in terms of where any cuts will fall—bearing in mind that while we have been reassured that the NHS budget is ring-fenced, in fact that promise includes an existing £20 billion cut in expenditure.

In a survey, the BMA found that 43 per cent of those trusts which responded to it stated that there was a freeze on recruiting doctors and nurses and that many treatments, including varicose vein operations and blood tests, were being rationed. Set against this background, it is hard to see how the parlous state of chronic pain management services will be speedily remedied.

Finally, evidence strongly suggests that a human rights approach could have a practical role to play in this new era of austerity, breathing life into the Government’s promise to protect the most vulnerable and enabling us to interpret large sums into consequences for human beings. Public bodies have a duty to protect people who are suffering from inhuman and degrading treatment, and prolonged pain is in fact a category that would come under that heading. In their review of the Human Rights Act, the Government have said that they will keep these obligations intact, so an approach involving human rights could help public sector staff to remain aware of the huge human costs involved in chronic pain management. For example, the Mersey Care Trust has pioneered the use of human rights to give people with mental health problems and learning disabilities a meaningful role in the organisation, and there have been positive results. Service users and carers are involved in staff appointments, and this has led to a greater emphasis on finding staff with empathy and understanding as well as good technical skills. Perhaps such an approach to joined-up chronic pain management could reap enormous dividends.