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Women’s healthcare in Britain ‘worse than in China and Saudi Arabia’

Women’s healthcare in the UK is worse than that of China and Saudi Arabia, according to a global tracker. 

Poor efforts at prevention, diagnosis and treatment of health problems left the UK ranked lower than several countries with a troubling record on women’s rights.

The research, which compared a wealth of data, found Britain fared worse than most comparable Western countries, including the United States, Australia, New Zealand, France and Germany.

The UK was placed 30th out of 122 countries, in the 2021 Hologic Global Women’s Health Index published on Tuesday.

The score – three points lower than when a similar exercise was carried out last year – places it on a par with Kazakhstan, Slovenia, Kosovo and Poland for women’s healthcare provision.

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Source: The Telegraph, 24 January 2023

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‘Risk averse’ NHS 111 algorithm sends too many patients to A&E

NHS 111 sends too many people to accident and emergency departments because its computer algorithm is “too risk averse”, the country’s top emergency doctor has warned.

Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), said that December was the “worst ever” in A&E with 9 in 10 emergency care leaders reporting to the RCEM that patients were waiting more than 24 hours in their departments.

Asked what measures could help improve pressures in emergency care, Dr Boyle said more clinical input was needed in NHS 111 calls.

“In terms of how we manage people who could be looked after elsewhere, the key thing to do is to improve NHS 111,” Dr Boyle told MPs.

“There is a lack of clinical validation and a lack of clinical access within NHS 111 - 50 per cent of calls have some form of clinical input, there’s an awful lot which are just people following an algorithm.”

Dr Boyle added where clinical input is lacking “it necessarily becomes risk averse and sends too many people to their GP, ambulance or emergency department”.

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Source: The Telegraph, 24 January 2023

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Hospital patient discharges putting strain on Devon's care sector

Devon care homes say they are being asked to accept patients with Covid-19, flu and other infectious diseases to ease the pressure on local hospitals.

One owner said it felt like the start of the pandemic again, as the safety of care homes was being "compromised".

Devon has some of the longest waits for emergency care in the country, according to NHS figures.

Simon Spiller, owner of The Croft Residential Care Home in Newton Abbot, said since the start of winter the home was being asked to shortcut its assessment process to help ease the blockages in Devon's hospitals.

He said other local care homes have told him they were facing the same pressure.

Mr Spiller said: "We're being encouraged, or really asked, to shortcut our assessment process. Normally, one of our team would go to the hospital to assess people, to really understand their care needs, to ensure they're an appropriate fit for our care home, which specialises in dementia.

"Increasingly, because of the speed they're trying to achieve a discharge, we're being asked to accept people at kind of face value, as presented by the NHS."

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Source: BBC News, 26 January 2023

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Coroner says student might be alive if GP had seen him

A law student who died after four remote GP consultations might have lived had he been given a face-to-face appointment, a coroner ruled.

David Nash, 26, died in November 2020 from a bone infection behind his ear that caused an abscess on the brain.

Over a 19-day period leading up to his death, he had four phone consultations with his GP.

The coroner, Abigail Combes, said the failure to see him meant he underwent surgery ten hours later than it could have been.

Andrew and Anne Nash fought for more than two years to find out whether their son would have lived if he had been seen in person by clinical staff at Burley Park Medical Centre in Leeds.

Yesterday they said they were “both saddened and vindicated by the findings that the simple and obvious, necessary step of seeing him in person would have saved his life” and wanted to make sure “others don’t die as David did”.

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Source: The Times, 21 January 2023

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Annual breast cancer checks could save 1,000 lives a year, says women’s health tsar

Offering women annual breast cancer checks could save 1,000 lives a year, the Government’s women’s health tsar has said.

Dame Lesley Regan said that the current system of screening women aged 50 to 70 once every three years was “not based on scientific evidence”.

The UK’s breast screening programme has the longest gap between screens in the world. In the US, it is every one or two years, and in Europe, it is every two years.

Dame Lesley, who is also a professor of obstetrics and gynaecology at Imperial College London, claimed that the decision to give women mammograms once every three years had been based on the budgets available in the Eighties, when checks were introduced. 

However, she said that more recent studies showed annual mammograms could save significant numbers of lives. 

On Tuesday, she told the launch of the Hologic Global Women’s Health Index in London: “If [someone] has a mammogram which is reported as normal today and she developed, for example, a precancerous lesion next month, she will then be waiting [until her next check], when it may well have become invasive, in the belief that she’s fine.

“If you have yearly mammography – and I appreciate that’s an expensive resource – there are very good studies demonstrating how many lives you save.”

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Source: The Telegraph, 25 January 2023

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One in three Black and minority ethnic staff face discrimination or bullying

A third of Black and ethnic minority health staff have suffered racism or bullying as the NHS fails to address “systemic” levels of discrimination, The Independent can reveal.

Levels of bullying and harassment of minority workers have not improved in the past five years with almost 30% saying they have been targeted in the past year, compared to 20%of white staff.

Despite being one-quarter of the workforce, minority ethnic staff make up just 10% of the most senior positions, the NHS’s flagship report is set to reveal.

One nurse told The Independent she was forced to leave her job following a campaign of bullying, while another, who has left for the private sector, said her mental health was hugely impacted by the discrimination she experienced.

Another nurse said she was left “traumatised” by bullying and harassment and she was “gaslighted” by her employer.

“This incident is going to affect me for the rest of my life … when I first joined [the NHS trust] I thought I was going to retire there but ... my career [has been cut] short and it’s not fair,” she said.

Equality for Black Nurses, a membership organisation founded by Neomi Bennett in 2020, has launched 200 cases of alleged racism against a number of NHS trusts since it was set up.

“Racism is driving nurses out of the NHS,” Ms Bennett, told The Independent, warning that this issue had reached “pandemic levels”.

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Source: The Independent, 24 January 2023

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Wynter Andrews: Trust faces fine in baby death prosecution

A hospital trust is facing a fine in a criminal prosecution over the death of a baby.

The Care Quality Commission (CQC) is prosecuting Nottingham University Hospitals (NUH) NHS Trust over the death of Wynter Andrews.

Wynter died 23 minutes after she was born by Caesarean section in September 2019 at the Queen's Medical Centre. 

The prosecution is one of only two the CQC has brought against an NHS maternity unit.

The trust is due to face sentencing at Nottingham Magistrates' Court later.

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Source: BBC News, 25 January 2023

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Dreaded Covid-flu twindemic cost NHS this winter

Simultaneous big waves of Covid and flu - the 'twindemic' experts warned of as people returned to 'normal' pre-pandemic mixing - cost the NHS this winter, say NHS bosses.

NHS England chief strategy officer Chris Hopson said hospital pressures in England peaked on 29 December.

The workload involved gave hospitals a "significant problem" at the turn of the year, he said. 

It was at this point that record-long waits at A&E were seen. Since then the pressures have begun to ease a little.

Speaking to MPs on the House of Commons' health committee, Mr Hopson said: "The issue was always going to be this winter was the degree to which we saw prevalence of both Covid and flu and the degree to which they combined.

"Now we're obviously not through winter yet but the really important point - that I don't think has come out enough - is both Covid and flu peaked so far on 29 December."

At the turn of the year one in eight beds were occupied by patients with either Covid or flu.

And Mr Hopson added this combined with the 12,000 beds occupied by patients medically fit to leave but unable to be discharged because of the lack of support in the community meant more than a quarter of beds were lost.

"It gives a significant problem in terms of patient flow, which then means you get the back up right the way through the system."

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Source: BBC News, 24 January 2023

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Manchester to open two homes for vulnerable children stuck in hospital

Manchester city council is setting up two special children’s homes to house the increasing number of vulnerable young people who end up stuck in hospital because no residential providers will take them.

The homes, believed to be the first of their kind, aim to undercut private operators which sometimes demand tens of thousands of pounds each week to look after children with the most complex needs. 

Five Manchester children with complex emotional needs spent many weeks in hospital in 2022 because no children’s homes would take them because of their challenging behaviour, according to the city council’s director of children’s services.

Manchester council has developed what it calls the Take a Breath model. Two houses are being renovated to house up to four children in total, with the first hopefully moving in by March. The idea is that when children first turn up at hospital – often at accident and emergency after a suicide attempt or self-harming incidents – once their injuries have been treated they can be discharged straight into the new homes rather than occupying a paediatric bed they do not need.

Jointly commissioned by the council and the NHS, the two homes will cost £1.4m a year. Of that, MCC expects to spend £5,500 a week for each child.

It represents a huge cost saving compared with some external placements. Last year the council was charged £16,550 a week by one private provider to look after a young profoundly autistic person with learning difficulties deemed a danger to themselves and to others.

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Source: The Guardian, 22 January 2023

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Women in low-income households are less likely to receive the health care they need

A study of 10,650 females in the UK found those with a combined household income of up to £25,000 per annum are less health literate and are less likely to attend health screenings or vaccination invitations.

In fact, 1 in 10 have never had health issues such as blood pressure or cervical cancer checked, compared to just 5% of those in a household earning more than £40,000 per annum.

15% of lower earners said they didn’t take up offers of preventative healthcare because they felt it was not needed.

They are also the least able to talk to and understand healthcare professionals (72% compared to 81% of high-income households) and least likely to know where to access health information (79% compared to 89% of high-income households).

Although 75% feel informed about what is needed to be healthy, this rises to 88% of those in high-income households.

It also emerged 30% of low earners who experience daily pain, such as joint pain, backaches or headaches, have stopped work completely as a result, compared to just 10% of high-income households.

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Source: The Independent, 24 January 2023

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ICS cancels four urgent treatment centre contracts after performance concerns

An integrated care system has terminated a private provider’s contract to run four urgent treatment centres following performance concerns.

Two local acute trusts were expected to take over from provider Greenbrook Healthcare this week, following the decision by North West London ICS.

The impacted sites include Hillingdon UTC, which is co-located with the Hillingdon Hospitals Foundation Trust, as well as the Ealing, Central Middlesex and Northwick Park sites that are near to the respective hospitals run by London North West University Healthcare Trust.

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Source: HSJ, 24 January 2023

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Smear tests: GP waiting times putting women off cervical screening

"I got my cervical screening letter in November and I've been putting it off because I don't want to do it - I don't think any girl really wants it done to them."

Elena Coley Perez is 26 and due to have her first cervical screening - or smear test - that examines the opening to your womb from your vagina.

NHS records show 4.6 million women - or 30% of those who are eligible - have never been screened for cervical cancer or are not up to date with their tests.

Women are sometimes too embarrassed to come forward or put it off because they are anxious, surveys have found.

Struggling to book their tests due to GP backlogs will not help the situation, say charities.

Elena has told the BBC she was already worried about having a smear test, and the difficulty she experienced in booking one put her off even more.

"I got another letter in December so I went to book online because with my local GP you have to go through this long-winded form," she said.

"I typed in cervical screening and nothing was coming up, so I ended up waiting 35 minutes on the phone to be told they had no appointments for the rest of the year and to phone back in the new year."

Elena then tried again in January and was told there was no availability.

"At this point I was like, 'what's the point?' - you're trying to do something that can hopefully prevent you from getting cancer and you get to the doctor's surgery and you just get a 'no' - it's really off-putting," she says.

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Source: BBC News, 25 January 2023

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New A&E target branded ‘extremely unambitious’

The new national target to see 76% of A&E patients within four hours by March 2024 has been described as ‘extremely unambitious’ by senior emergency clinicians.

Adrian Boyle, president of the Royal College of Emergency Medicine, also told the Commons Health and Social Care Committee that the objective – included in NHS England planning guidance for 2023-24 and agreed with government  – could also drive “perverse incentives” for some emergency department managers.

The new target to admit, transfer or discharge 76% of patients by the end of 2023-24 is the first time a specific bar has been set against the four-hour standard for several years. In December, just three acute trusts were hitting the new 76% objective.

But Dr Boyle told MPs: “The aspiration from NHS England is that we return to a four-hour target performance of 76%. We think that is too unambitious, and we think that is going to create all sorts of perverse incentives, because it’s going to encourage managers and senior clinicians just to focus on people who can be discharged from hospital, without dealing with our problem, which is exit block [people who cannot be admitted as wards are full].

“We think the 76 per cent is an extremely unambitious target. It was 95% – I know that’s going to be a long way to go back to and we haven’t achieved it since 2015, but we would say we need to have a trajectory to a higher target.”

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Source: HSJ, 24 January 2023

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Paramedics say people are getting ill because their homes are so cold

Ambulance crews say they are treating a growing number of patients who are falling ill because they are unable to afford to heat their homes.

The soaring cost of gas and electricity has forced many people to switch off their heating in the winter months.

Scottish Ambulance Service crews say they are seeing people who are unwell because their homes are so cold or they cannot afford to eat properly.

Charities have warned many people are dealing with a "toxic cocktail" of increasing energy bills, growing inflation and higher interest rates this winter.

Glasgow ambulance workers Tanya Hoffman and Will Green say that most weeks they see patients who are facing the stark choice between eating and heating.

They have been in homes which feel ice cold, where the patients are clearly struggling to cope.

"It is sad to see people are living like that," said Tanya.

"There's been quite a few patients I have been out to who can't afford to buy food. They have to choose one or other, heating or food.

"So they'll sit quietly at home and it's usually a relative or a friend who will phone for them as they don't want to bother anybody.

"They're sitting there [and] you can't get a temperature off them because they're so cold.

"So you take them into hospital because they are not managing. You know if you leave that person at home they are probably going to die through the fact they are so cold."

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Source: BBC News, 24 January 2023

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NHS: More cancer specialists needed in A&E, doctors say

Being placed on immunotherapy to treat Stage 4 cancer was a life-saver for Imogen Llewellyn.

Three years on, the 34-year-old is currently cancer-free, but said if it was not for specialist doctors, the side effects could have killed her.

The Royal College of Physicians (RCP) claims Wales needs more oncology experts in A&E to recognise and treat emergencies.

The Welsh government said all acute hospitals were expected to have an acute oncology service.

The RCP report wants investment in emergency cancer care because of the sheer volume of patients who need urgent care during their treatment.

With about a fifth of acute hospital beds occupied by people who have a cancer-related problems, they add that about a third of admissions could be avoided if same-day care were more widely available in Wales - which in turn would relieve pressure on hospitals.

Dr Hilary Williams, consultant oncologist and Wales Cancer Network lead for acute oncology, said: "Wherever a patient lives in Wales, they should be able to access excellent acute oncology services.

"When people think about cancer treatment, they might think about undergoing surgery or receiving chemotherapy, radiotherapy or immunotherapy in an organised way, perhaps during weekday hours in a specialist centre. But what happens when an emergency arises?"

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Source: BBC News, 24 January 2023

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Harlow hospital suspends gas and air over nitrous oxide levels

A hospital has stopped using gas and air in its maternity unit to "protect our midwifery and medical team".

The Princess Alexandra Hospital in Harlow, Essex, said the decision followed tests on nitrous oxide levels.

It said it would temporarily suspend the use of Entonox while additional safety equipment was installed.

Giuseppe Labriola, director of midwifery, said: "There is no risk to mothers, birthing people, their partners and babies."

Other hospitals have previously temporarily suspended the use of gas and air in recent months including Basildon and Ipswich.

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Source: BBC News, 22 January 2023

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Trust spends £3m on B&B rooms for patients stuck in hospital

A mental health trust has spent millions this year on places in “bed and breakfast” accommodation in order to discharge inpatients, HSJ has learned.

South London and Maudsley Foundation Trust, which serves four London boroughs, confirmed to HSJ it had spent £3.1m since April for a range of basic bed and breakfast places, and spaces with a specialist housing association, to ease its bed shortage pressures.

The trust told HSJ clinicians were often reluctant to discharge patients to street homelessness, and that people with mental health problems can be more challenging to find accommodation for.

The trust’s chief executive officer David Bradley told HSJ system leaders had been asked to think “innovatively” about how to mitigate discharge problems. B&Bs are generally a cheaper and more appropriate alternative to a £500 a night mental health hospital bed for people who don’t need acute treatment and have no housing, he said.

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Source: HSJ, 24 January 2023

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WHO urges action after cough syrups linked to more than 300 child deaths

The World Health Organization (WHO) has called for “immediate and concerted action” to protect children from contaminated medicines after a spate of child deaths linked to cough syrups last year.

In 2022, more than 300 children - mainly aged under 5 - in the Gambia, Indonesia and Uzbekistan died of acute kidney injury, in deaths that were associated with contaminated medicines, the WHO said in a statement on Monday.

The medicines, over-the-counter cough syrups, had high levels of diethylene glycol and ethylene glycol.

“These contaminants are toxic chemicals used as industrial solvents and antifreeze agents that can be fatal even taken in small amounts, and should never be found in medicines,” the WHO said.

As well as the countries above, the WHO told Reuters on Monday that the Philippines, Timor Leste, Senegal and Cambodia may be affected because they may have the medicines on sale. It called for action across its 194 member states to prevent more deaths.

“Since these are not isolated incidents, WHO calls on various key stakeholders engaged in the medical supply chain to take immediate and coordinated action,” WHO said.

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Source: The Guardian, 24 January 2023

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Shrewsbury maternity scandal: Pay out over boy's brain injury

The health trust behind the worst maternity scandal in NHS history has accepted responsibility for a boy's brain injury.

Adam Cheshire, 11, contracted a Group B Strep (GBS) infection following his birth at the Royal Shrewsbury Hospital in 2011.

A High Court judge approved a pay out from Shrewsbury and Telford Hospitals NHS Trust (SaTH) to provide special care for the rest of his life.

His case was examined as part of senior midwife Donna Ockendon's investigation into SaTH which found catastrophic failures might have led to the deaths and life-changing injuries of hundreds of babies, as well as the deaths of nine mothers.

Adam, from Newport, Shropshire, was born nearly 35 hours after his mother's waters broke in the afternoon of 24 March 2011. 

In the hours that followed, he began to show signs of early onset GBS including struggling to feed, crying and grunting. After weeks in intensive care, he was finally diagnosed with the infection and meningitis.

Adam is living with multiple conditions including hearing and visual impairments, autism, severe learning difficulties and behavioural problems so he relies on others to care for him.

His mum, the Reverend Charlotte Cheshire, said she had expressed concerns about bright green discharge at one of her last antenatal appointments but no action was taken.

"From that point I just had a mother's instinct something wasn't right but I was reassured by the midwives so many times that everything was OK," the 45-year-old said.

Mrs Cheshire added: "While Adam is adorable and I am so thankful to have him in my life, it's difficult not to think how things could have turned out differently for him if he'd received the care he should have.

"Adam will never live an independent life and will need lifelong care. While I'm devoted to him, I'm now raising a severely disabled son, which is extremely challenging and has changed the path of both our lives forever".

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Source: BBC News, 23 January 2023

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Trust must pay £200k to whistleblower it subjected to ‘campaign of harassment’

A trust that sacked a whistleblower who had warned them about potential patient harm from a new procedure has been told to pay her more than £200,000.

Jasna Macanovic won her case against Portsmouth Hospitals University Trust last year after the employment tribunal found board members had broken employment rules, including by telling her she would get a good reference if she agreed to quietly resign.

Earlier this month, an employment tribunal judgment to establish the compensation she was owed said the trust had subjected Dr Macanovic to “a campaign of harassment” and rejected Portsmouth’s claim she had contributed to her own dismissal.

The consultant nephrologist, who had been at the trust for 17 years, raised concerns about a technique called “buttonholing” – carried out to make kidney dialysis more convenient and less painful – that she claimed had caused harm to patients.

After the procedures continued, the dispute escalated, culminating with Dr Macanovic being dismissed in March 2018.

The employment tribunal panel said Dr Macanovic had raised her concerns about buttonholing properly, adding: “She was not alone in her concerns. The consultant body were fairly evenly divided.

“She, however, went further than others, and where she believed that risks were being downplayed she did not hesitate to describe this as a cover-up or an act of dishonesty. Most people would not use that language, and it did cause very serious offence, but it had a specific meaning. It was not a general slur.”

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Source: HSJ, 23 January 2023

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Older patients on medley of drugs ‘at higher risk of adverse reactions’

Older women are at higher risk than older men of experiencing adverse reactions to drugs prescribed by their family doctor, and older patients taking more than 10 medicines are at higher risk than those taking fewer, according to a study.

Overall, one in four older people experience adverse drug reactions (ADRs) to pills prescribed by their GP, the research published in the British Journal of General Practice suggests.

It has prompted calls for GPs to consider deprescribing ineffective medications and prioritise patients taking lots of drugs for a regular review of their prescriptions.

The medicines most commonly associated with ADRs included those used to treat high blood pressure and other cardiac conditions, strong painkillers such as tramadol, and antibiotics such as amoxicillin, according to the study.

The study monitored 592 patients aged 70 and older across 15 general practices in the Republic of Ireland over a six-year period. One in four experienced at least one ADR.

Patients prescribed 10 or more medicines had a threefold increased risk of experiencing a reaction, researchers said. Women were at least 50% more likely to have ADRs than men, the study found.

“ADRs can be difficult to identify in medically complex older adults as they often present as non-specific symptoms,” the researchers wrote in the British Journal of General Practice.

“GPs are well placed to detect the occurrence of ADRs from drugs prescribed in primary care as well as in other care settings. Deprescribing of ineffective medications and those no longer clinically indicated is one approach to reducing the risk of ADRs in older patients.”

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Source: The Guardian, 24 January 2023

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Record waits for endoscopy as referrals soar

The waiting list for endoscopies has broken the record set during the height of the covid pandemic, as referrals for suspected colorectal cancer surged, HSJ analysis shows.

In November 2022, 110,00 people were waiting for a colonoscopy (or flexible sigmoidoscopy) and the median wait was 4.2 weeks, double the median wait in November 2019. The pandemic peak waiting list for these tests was 107,000 in September 2020.

Nearly a quarter of those waiting as of November 2022, the most recent figures, were on the list for more than 13 weeks. In November 2019 only 2.9 per cent of the list waited this long.

Health policy manager Matt Sample said: “As with all diagnostic services, endoscopies were hit hard by the pandemic, but the service was under considerable strain even before this as staff numbers and equipment simply weren’t rising to match demand.

“The latest data shows that more than two in 10 people who started treatment for bowel cancer in England waited more than 104 days since their urgent referral – this is unacceptable.

“Without continued efforts to expand diagnostic capacity, and in particular investment in addressing chronic workforce shortages, people affected by cancer will not receive the care they deserve.”

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Source: HSJ, 24 January 2023

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Ministers order ‘rapid review’ into mental health inpatient care in England

Ministers have ordered an inquiry into the quality of care in mental health inpatient units in England after a series of scandals in which vulnerable patients were abused or neglected.

Maria Caulfield, the mental health minister, announced the establishment of a “rapid review” in a written ministerial statement in the House of Commons on Monday.

The inquiry “is an essential first step in improving safety in mental health inpatient settings”, she said. In recent years, coroners and the Care Quality Commission, the NHS care watchdog, have repeatedly raised concerns about dangerously inadequate care that inpatients have received.

It will examine the evidence of “patient safety risks and failures in care” in units that hold and treat patients who have serious conditions including psychosis and personality disorder. It will look in particular at evidence of failings brought forward by patients and their families and how better use of data can help show that care has fallen below acceptable levels.

The inquiry will be headed by Dr Geraldine Strathdee, a psychiatrist who used to be NHS England’s national clinical director for mental health. She is likely to look at problems including patients being subjected to controversial restraint techniques, left at risk of being able to take their own lives and segregated from fellow inpatients, and the impact of their experiences on their recovery.

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Source: The Guardian, 23 January 2023

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Sexual assault and domestic violence ‘going unchecked’ by regulators, NHS staff warn

Patients and staff are in danger as regulators are accused of poor handling of sexual assault allegations made against doctors and nurses, The Independent has been told.

Campaigners and frontline staff who spoke to The Independent warned that professional regulators are not dealing adequately with allegations of sexual assault, harassment and domestic violence.

A study of rulings by the Nursing and Midwifery Council (NMC) has also revealed that male nurses account for 80% of striking-off orders relating to sexual assault allegations, despite only making up 11% of the register.

The warning comes after horrific details of rape and abuse by police officer David Carrick were uncovered this week.

Dr Rebecca Cox, who helped sparked a major #MeToo movement in medicine and is co-founder of the Surviving in Scrubs campaign group, told The Independent: “There are great similarities, in the recent cases of prolific sexual harassment and assault, between the Met Police and the NHS.

“As an organisation, we have had multiple healthcare professionals contacting us desperate to seek support after facing repeated barriers when trying to report harassment and assault to their employing NHS organisation and regulators such as the GMC.

“Victims find their cases ignored or dropped without good reason, and perpetrators being able to continue working without repercussions. We need a public inquiry into sexism, sexual harassment and sexual assault in healthcare.”

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Source: The Independent, 22 January 2023

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‘It’s not medical tourism, it’s desperation’: rising number of Britons resort to treatment abroad

Cathy Rice had been in all-consuming pain for 18 months when she decided to fly to Lithuania. “I was going up the stairs on my hands and knees. I couldn’t get to the shop. I had no quality of life,” she says.

Rice, 68, who has four grandchildren, had been told she needed a knee replacement for an injury caused by osteoarthritis but – like millions of NHS patients – faced a gruelling wait.

At a clinic in Kaunas, Lithuania’s second largest city, the operation was arranged within weeks and cost €6,800 (£5,967) – around half the cost in the UK. The price included a pre-travel consultation, return flights, airport transfers, two nights in an en suite hospital room, pre-surgery check-ups and post operative physio.

“I thought, ‘Just look at your choices. You can stay here and be in this kind of pain for another couple of years or you can take a decision’,” Rice says.

The former health sector worker, from Glasgow, is one of a growing number of Britons going abroad for routine medical care. She had never gone private before and never had a desire to. But last week, a year after the first surgery, she returned to Lithuania to have the same procedure on her other knee. This time, she says the wait she faced on the NHS was three years.

She explains tearfully that to cover the costs of the surgeries in Lithuania, she sold her house. “People think that if you’re doing this you’ve got a wonderful pension or you’re very well off. But the driver here is that people are in pain,” she says. “This is not medical tourism; it’s medical desperation.”

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Source: The Guardian, 21 January 2023

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