NHS: Pain Management Services

Baroness Masham of Ilton Excerpts

Wednesday 7th July 2010 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I thank my noble friend Lord Luce for this important short debate on chronic pain and congratulate him on his ongoing campaign to make conditions better for people with continuing chronic pain. Some years ago, when I was sitting next to my noble friend at lunch, he had such excruciating pain in his back that he had to go out and lie on a bench, and an ambulance was called. I have always had the greatest admiration for his tenacity in holding down an important position while enduring such chronic pain. It is good to see him still bringing this matter up. Who knows better what pain means? He is an expert and I hope that the Government will listen.

I know excruciating pain. I broke my back and fractured many ribs in an accident many years ago. When I arrived at the spinal unit at Stoke Mandeville Hospital I was not given any painkillers for fear of addiction. In those days, that was the policy because we were turned only three-hourly to prevent pressure sores. Cramp used to set in and I understand the expression “blood, sweat and tears”.

When a doctor told me that the pain should ease off in three weeks, that was the light at the end of a very dark tunnel. It is important that the psychological implications of chronic pain are understood—for example, how it can cause depression, break up partnerships or loss of jobs. Pain can eat into people’s lives. In 2008, there was hope in the Chief Medical Officer’s annual report, which wanted,

“to widen access to high-quality pain services”.

What action has been taken in the past two years by the National Quality Board on clinical priorities for the NHS? What are the Government’s views on this subject?

The public need education in what to expect from analgesics and in how they can help themselves to cope with chronic pain. Postgraduate training is needed for the safe and appropriate prescribing of analgesics and the use of other therapies. Often, GPs prescribe pain-killing drugs to patients who are not reviewed and end up becoming dependent and addicted. About 8 million people of all ages suffer from chronic pain. Only about 14 per cent of them have access to any pain specialists. Long-term pain can have a devastating effect on the lives of sufferers and families. Forty nine per cent suffer from depression; 25 per cent lose their jobs; and 16 per cent feel suicidal.

Pain can be very complex. I am president of the Spinal Injuries Association. Some of our members have root pain or phantom pain, which is not well understood. Some people turn to alcohol, which may help but can damage their kidneys. Something has to be done to improve the situation. There is much need for research into pain and for multidisciplinary pain management services across the NHS which encompass doctors, physios, nurses, occupational therapists, psychologists and expert patients who are all trained in pain care. There needs to be co-operation and co-ordination, and not fragmentation. I wait in anticipation for the Minister’s reply.