Girl refused risky operation by mean Scottish health jobsworths

Little Leah’s cerebral palsy dilemma Pictures - CBS News

I got tweeted this article by someone who writes a lot on disability issues, and it’s a photo-gallery feature (not mobile-friendly, although I managed to view it on my phone) about a young girl with cerebral palsy whose family have had to raise money for them to have surgery in the USA because “Scotland’s national health insurance program doesn’t want to pay for the surgery — estimated to cost more than $80,000”.

The surgery in question is selective dorsal rhizotomy, and is described at the Scope website thus:

Selective Dorsal Rhizotomy describes a surgical procedure carried out to the lower vertebrae usually between L2 – S2 (lumbar and sacral area). The vertebrae are opened to reveal the spinal cord which contain the neurones of the central nervous system. These neurones (bundles of nerve fibres) channel messages between the brain and different areas of the body.

Electrical stimulation is used to identify and sub-divide sensory and motor nerves. This process continues until the specific nerves and nerve roots affecting the spastic muscles and which may not be “transmitting” properly are identified and cut. Due to the size of the nerves and rootlets, this is a very precise procedure and therefore the surgery can last several hours and requires a general anaesthetic.

The surgery is meant to improve motor function, particularly in those who already are able to walk or crawl, reduce spasticity, and improve motor function and body positioning in more severe CP cases. It does, however, have a lot of unpleasant side effects; 58% experience severe pain, 40% unpleasant skin sensations, 40% increased spasticity and 20% constipation. None of these side effects (they’re cutting through bits of your spinal cord, remember) are mentioned in the CBS News article; it seems to be a case of mean Scottish bean counters refusing surgery to a poor little girl, and the good old US of A coming to the rescue.

The fact is that Scottish healthcare (much like healthcare in the rest of the UK) is paid out of taxation, not insurance (national insurance is used to pay for pensions — it’s effectively a Ponzi scheme, as it’s paid to existing pensioners with a vague promise that today’s workers will get paid out of tomorrow’s contributions, if we can afford it then) and Scottish devolution meant that the government was able to abolish prescription charges to win votes, so if the state pays for everyone’s drugs, something has to give. The idea that doctors refused this surgery because the cost is not worth it given the likely benefits and risks is not mentioned. It looks like the American “death panel” view of British healthcare.

(I know of a family who are seriously considering this procedure for their daughter — they live in England, and it appears that they will be able to get it on the NHS. Her disability is much more severe than that of “little Leah”, and it may be the only way of avoiding other unpleasant surgery. They are not going headlong into it like this family want to.)

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