Speech Delivered by Oliver Heald MP, Shadow Health Minister, at the Conservative Party Conference Fringe Meeting, hosted by Action on Pain, on 10 October 2001 Action on Pain I am delighted to be able to speak to this Meeting today and congratulate MORI on the research which they have demonstrated today. The subject of long-term pain relief has often not been given the attention that it should and I know that that will not be the case here today. Over the last few years, Action on Pain has started to focus attention on people currently living in chronic pain. The problem was neatly summarised by an eminent pain specialist, who said, `Everybody, quite rightly, supports relieving pain in patients who have a terminal illness. Nobody pays attention to those patients who have to live with pain for thirty to forty years. It is this group of people whom we must champion'. There is a huge job to be done to raise awareness amongst the general public and health professionals that people are living in pain unnecessarily. There is also a challenge to encourage people to seek better management of their pain. The scale of the problem is substantial. The Pain Relief Foundation undertook research, as has Action On Pain, which shows that at any particular time between 7% and 8% of the population are suffering from chronic pain. We now learn from MORI that the figure is close to 23%, and we have heard today that Arthritis is also a major contributor. The Department of Health statistics show that back pain is clearly the number one cause of disability in Britain, with 40% of adults saying that they have suffered from back pain lasting more than one day in the previous twelve months. More than two and a half million people have continual back pain. The cost to the U.K. has been estimated at six billion pounds a year, and the cost to the NHS alone is high, with almost 900,000 hospital bed days a year being taken up by people with back pain. The performance of the NHS around the country is very patchy. The Clinical Standards Advisory Group report in March 2000 found that chronic pain services were so poorly resourced that many could not meet local need and waiting times were often unacceptable. They found that although 88% of hospitals had set up acute pain teams, some were token and in some cases, there was still no service at all. Doctors leading these services felt excluded from management decisions about contracts and frustrated at a lack of understanding of their potential. Only half the trusts had pain management programmes offering posture training, relaxation techniques, medication review or psychological intervention. It is clear that waiting times vary tremendously too. In London, 42% of pain management patients wait for more than six months to be seen, and nationally the figure is almost a quarter. But that is once the patient is on the waiting list for treatment. The waiting list for first outpatient appointments shows that pain management outpatients wait longer than other specialities, with 17.5% waiting more than twenty six weeks to be seen. These long delays and substantial variations in quality mean that many people who might be helped, are not helped at all and that even those who are helped do not necessarily receive the full range of services which could help them. This is tragic for the individuals concerned. In many cases, if a person is not treated within six months for a chronic pain condition, they never return to work. Apart from the effect on the dignity of the individual and the well-being of his or her family, there is also the dull misery of years and years of chronic pain, which could have been modified or eradicated completely. There is therefore a strong case to be made to Government for improved pain management services across the country. In its NHS Plan, the Government goes some way towards recognizing the need for improvements, although the Plan tends to concentrate on particular forms of pain, such as the need for rapid access chest pain clinics, rather than putting the full authority and resources of the NHS solidly behind pain management in areas such as back pain and arthritis. But apart from the moral case for improved pain management services, there is also a strong financial case. If back pain alone is accounting for 119,000,000 days of certified incapacity, 12,000,000 GP consultations and 900,000 hospital bed days per year, clearly there are savings to be made if proper pain management could reduce the days lost, cut the GP consultations and reduce the days of hospital care. There are also savings which could be made in other departments and my predecessor Philip Hammond said at this Meeting last year that it was his view that the Health Service should take account of possible wider benefits when investigating whether the NHS should provide treatments. He gave the example that a person who was unable to work for many years as a result of chronic pain, would cost the Social Security Department a huge sum and the Treasury would lose out on many years of taxes. He promised that he would raise this issue with the Comptroller and Auditor General, Sir John Bourn. I can report that he kept that promise and that Sir John replied earlier this year. Unfortunately, the reply was rather disappointing. Clearly this is an area where a proper cost benefit analysis is called for and I will continue to press Government to achieve this. It is therefore of great importance that pain management ceases to be a Cinderella service and a proper account is taken of the gains in quality of life which could be achieved, if patients were more aware of the ability of pain management to help them and if the standards across the country could be improved, in terms of quality and waiting times. That is the challenge and the Opposition will press the Government to achieve an improvement.