Expert blasts NHS on vein surgery

http://news.bbc.co.uk/go/rss/-/1/hi/health/7650549.stm

Version 0 of 1.

NHS rationing of varicose vein surgery is leading to serious problems for patients, a leading surgeon has said.

John Scurr, a former NHS surgeon who now practises privately, said most NHS patients were denied surgery.

This caused numbers of complications such as ulcers to increase. The problem was that varicose veins were seen as a "cosmetic problem", he said.

Other top surgeons disputed the claims, but admitted the rules for varicose vein surgery varied around the country.

You can only get NHS treatment if you have an ulcer or severe skin changes, but for the majority of people, or those in the initial stages of the problem, there is no NHS treatment any more John Scurrconsultant vascular surgeon

Mr Scurr said that patients were often left untreated with severe symptoms, such as aching, swelling and pain.

"When I was a surgeon at University College Hospital we were treating thousands of patients in the early stages of the condition but the NHS then decided they weren't going to treat patients with varicose veins, purely to save money and cut waiting lists.

"Now patients are 're-presenting' when their symptoms are far worse, so instead of needing an outpatient appointment, they need several nights in hospital, at far greater cost."

"You can only get NHS treatment if you have an ulcer or severe skin changes, but for the majority of people, or those in the initial stages of the problem, there is no NHS treatment any more."

'No evidence

However, Professor Bruce Campbell, a consultant vascular surgeon at the Royal Devon and Exeter Hospital, disagreed.

His survey, carried out two years ago, suggested that while over a third of hospitals would not treat varicose veins if they were only a cosmetic problem, rather than causing pain or discomfort, only 12% were denying treatment to those with symptoms.

He said: "It may well be that some people will present later with ulcers, but there is no real evidence to support this.

To say that there is no NHS treatment except for those with ulcers or severe symptoms is simply not true Professor Bruce Campbellconsultant vascular surgeon "To say that there is no NHS treatment except for those with ulcers or severe symptoms is simply not true."

The secretary of the Vascular Society, Jonathan Earnshaw, himself a consultant vascular surgeon, said that the rules for treatment did vary from area to area, and that treatment for "uncomplicated" varicose veins had been restricted in many areas.

However, he said: "For the majority of people with varicose veins, they will never go on to develop more serious problems such as ulcers, so it is not right to say that denying someone an operation for uncomplicated varicose veins means they will definitely develop them."

He added that treating ulcers did not necessarily require the long stay in hospital described by Mr Scurr, with most also treated on an outpatient basis in a nurse-led clinic.

Official NHS statistics reveal that there were 58,000 varicose vein operations in England in 2006/07.

Guidelines across the UK recommend treatment being offered to people with "significant symptoms".

A spokesman for the Department of Health said it was up to local PCTs to set clinical priorities, adding: "Any patient requiring varicose vein treatment for clinical reasons should expect to get treatment in their local area."