Tees Valley Spinal Unit

Phil Wilson Excerpts

Wednesday 18th January 2012 Commons Chamber

[Phil Wilson (Sedgefield) (Lab)]

I want to highlight the work of the spinal unit at the University Hospital of North Tees and the charitable support group established in 1999 by patients who have used the spinal unit for surgery to relieve chronic back pain, allowing some patients to walk again and many others to get on with their lives pain-free. I speak with first-hand knowledge of the unit and its support group because of the major spine surgery performed on me in November 2008, after years of pain.

At a time of controversial change to the NHS, I want to put on record my belief that the spinal unit at the University Hospital of North Tees and the volunteer network that supports patients before and after treatment is a shining illustration of all that is good about the NHS, and should be an example of how other acute care and chronic pain services should operate elsewhere. Recent advances have made spine surgery safer and more effective and now there are safe and effective surgical options to treat back pain. It is no longer accurate to tell patients that nothing can be done and they just have to live with it. The North Tees spinal unit specialises in the holistic treatment of spinal pain—from physio to surgery, with surgery being the last option.

The spinal unit at the University Hospital of North Tees is in the constituency of my hon. Friend the Member for Stockton North (Alex Cunningham), who is a good friend of the hospital. It serves the Tees Valley and South Durham area, including my constituency, but its reputation has now reached far and wide, with patients travelling from all parts of the country for treatment. The spinal unit was set up in 1997 by consultant spinal surgeon Manoj Krishna, who operated on me. The unit was originally staffed by two spinal surgeons but is now staffed by three dedicated consultant spinal surgeons supported by associate specialists and middle-grade doctors, nurses, allied health professionals and other support services such as radiology. The unit offers a number of leading therapeutic, non-surgical and surgical procedures. My understanding of the procedures used is only surpassed by my complete inability to pronounce many of them, but they include lumbar disc replacement, neck surgery and other surgery on the spine.

The spinal assessment team’s specialist nurses carefully examine patients’ medical history to establish the best course of treatment for each case. Patients who require non-operative treatment are then channelled to the appropriate department and patients requiring surgery are referred for treatment in the spinal surgical unit. The unit’s consultants see about 2,000 new patients a year, usually from the musculoskeletal service but sometimes directly from GPs both in and out of the area. Patients come from as far as London and the south-west to have their surgery at North Tees. Fifteen major spinal operations are carried out in the unit each week. The average length of stay in the unit is two and a half days. The unit is a training centre for specialist registrar and spinal fellowship programmes. It is active in research and development, represented on the national and international stage.

I suffered from back pain for years. Initially, the periods between incidents of pain were long, lasting several months. Then the pain became constant. The by-election that I fought in 2007 was not pain-free, but was something that had to be coped with of necessity. One does learn coping techniques—for instance, exercise and physiotherapy are essential—but the more the pain intensified, the stronger the painkillers became. Heat wraps and ice packs were bought in abundance as a short-term remedy.

Coping mechanisms included wearing slip-on shoes because it was too painful to bend over to fasten shoelaces. Books, television remote controls and clothes would be left on the backs of chairs or on shelves at a particular height so it was not necessary to bend or stretch. Working in the office meant standing at the filing cabinet, using it as a desk, or walking around the room reading papers or documents. Sitting for any length of time could be torture. Standing in the Chamber attempting to catch the Speaker’s eye would be a welcome relief for a few seconds, and speaking would be a relief in more ways than one. The pain would be in the legs rather than the back, because the damaged disc was catching the sciatic nerve.

My back was continuing to deteriorate. I was referred to Manoj Krishna, who treated me for about a year with physiotherapy regimes and epidurals that bathed the base of my spine with anaesthetic. All the treatments worked for a time, but the underlying problems caused by discs that were disintegrating meant that I needed surgery. The surgery meant removing the two offending discs and fusing the three vertebrae. Years ago that technique meant recuperating in hospital for many weeks, but in November 2008, when I had the operation, I hobbled into the hospital on a Wednesday morning and walked out on Thursday afternoon, less than 48 hours later. I have not looked back since. Nevertheless, surgery is not a silver bullet. People must continue to exercise, and must not take for granted the new lease of life that the operation has given them. Mr Krishna told me that I had an 80% chance of being 80% better, and I am, I think, more than 80% better. I experience the odd twinge, but the pain that I had before is gone.

My story is not unique; far from it. The cost to the individual, the family and the nation of chronic back pain is massive. Back pain is common in the UK. In any given year, about 30% of the population suffers from it, and 20% of the population—12 million patients—visit their GP with it. Between 3% and 4% of the population are chronically disabled by back pain, and 52 million work days a year are lost because of it. The chance of someone’s returning to work after being off work with it for two years is less than 5%. Research shows that, for the individual, sudden severe and then chronic back pain is debilitating and can result in low mood, loss of libido, disturbed sleep, poor appetite or weight loss, fatigue, feeling worthless, problems with concentration, and even thoughts of suicide.

Back pain can also threaten the stability of the sufferer’s family, possibly leading to marital and family breakdown. Because it often strikes during a person’s maximum earning period, it can threaten the economic survival of the family unit. A person’s back pain and associated side effects can become very draining for the family, as an inability to remain in one position for any length of time threatens normal daily activity as well as leisure. The extent to which the whole family is affected when one of its members has back pain cannot be underestimated. The economic consequences to the nation are also apparent. The individuals concerned are often at the peak of their earning capacity, and months and years of not being able to work and to contribute to society add to their feelings of worthlessness.

For those reasons, I want to pay a special tribute not only to the work of the spinal unit at University Hospital of North Tees but, more specifically, to the voluntary workers of the Tees Valley spinal support group. In 1999 Victoria Fenny, a patient waiting for back surgery, approached Mr Krishna and asked what support there was for patients with this debilitating condition. She wanted to talk to someone who had been through the experience, but no support group existed, and as a result the Tees Valley spinal support group was formed. The group, which now attracts at least 100 people to its quarterly meetings at the hospital’s teaching centre, includes former patients and those awaiting surgery, and provides an invaluable source of learning and support for the hundreds of people who have back and neck surgery each year.

The feedback from the group is used to improve the service further. Health professionals attending the support group say they learn as much from the patients as they teach them about how quickly they can get back to normal after surgery. North Tees and Hartlepool NHS Foundation Trust supports the work of the charity by providing a counselling room for patients where they can meet volunteers and talk about their concerns, and rooms at the teaching centre where the quarterly support groups are held.

The Tees Valley spinal support group is a registered charity and it raises funds to support the work of the spinal unit. I have visited the support group on a couple of occasions and it is good to speak to people who have suffered from the same symptoms—people who coped by wearing slip-ons, used the filing cabinet as a desk and left the TV remote on the back of the chair. I would like to place on record my recognition of the voluntary work undertaken by Victoria, and also Linda Botterill, Claire Poulton, Peter Evans, Peter Allan and Gordon Marron.

In 2011 the support group held its first fun-walk to raise funds for educational equipment for the unit. I met former patients who had spent years in wheelchairs but can now walk. I agree with Mr Manoj Krishna when he says that it is no longer accurate to tell patients nothing can be done for their back pain and they have to live with it. The skills are there. The support is there too. What can the Government do to ensure the excellent example of the spinal unit and its support group can be replicated around the country so that the millions of our citizens who suffer from back pain can receive the treatment they need instead of being told they just have to cope with it?

Is the Minister aware that Britain has 18 spinal surgeons per 100,000 head of population, whereas the Netherlands has 30 and the USA has 76? Back surgery rates in the UK are 30 per 100,000 head of population, as against 52 in Sweden, 115 in the Netherlands and 158 in the USA. What more can be done to improve Britain’s position, because we obviously have the talent, skills and expertise to be world leaders in this area?

What will the Government’s proposed reorganisation of the NHS do to ensure that patients who need the treatment will get the treatment, especially as spinal surgery techniques are rapidly improving and becoming ever more sophisticated? Finally, will the Minister join me in congratulating the management and the surgical and nursing staff at the hospital on the work they are doing to ensure chronic back pain is being treated with such professionalism? In particular, will he join me in congratulating the volunteers who run the support group, and who ensure that the service provided is holistic in its approach and helps secure the good will of patients to help other patients, in order to give them hope and address their fears? All specialties in all hospitals would do well to have their own support groups. I know from personal experience how important they are.