MANY have been the stories both locally and nationally where those nasty people at NICE (the National Institute for Health and Clinical Excellence) have been slammed for spurning a stricken patient’s call for pioneering treatment on the grounds of cost.
On occasions I force myself to take a harder line than some in certain cases because we have to face up to the fact that there has to be someone in the NHS chain of command who recognises that there isn’t a bottomless pit of money (in any economic situation, let alone this one) and that someone has to take the grim responsibility to say “sorry, we just can’t afford it.”
Sympathies vary according to the individual drugs, costs and plights and I can only imagine how devastating and frustrating it must be to be told there is treatment that could save your life but you cannot have it.
But NICE has now gone and undermined its bedrock argument of viability and best value by suggesting that women should be given the option to have Caesarean births through choice rather than surgical or medical necessity.
It signals a big reversal in policy, given the stigma attached to those deemed to have ops simply because they are “too posh to push.”
And it has attracted a flurry of opposition from many parts of the medical establishment.
The NICE argument is that a mother-to-be should take into account all the long-term pluses and minuses of natural versus surgical delivery which can include medical problems that the former can sometimes cause.
But neither way carries with it a 100 per cent guarantee and when doctors estimate it costs the NHS £800 more to bring a child into the world in the operating theatre than in a bed, it seems a particularly strange move by NICE when cash is in such short supply.
My wife and I have had experience of both ways. Our first child came by Caesarean (due to the potentially dangerous pregnancy condition pre-eclampsia) after which my wife spent several days in hospital and then several weeks hobbling about in severe discomfort and unable to drive.
Our second child came naturally (which is quite unusual after a Caesarean) and while he proved much more of a handful to rear, the time spent in hospital by his mother and indeed her recovery time was a fraction of that for Baby One’s.
It seems senseless to be steering more people towards unnecessary surgical procedures (and cutting through abdominal tissues makes it a major operation) when natural birth is cheaper and, by and large safer.
Caesareans are themselves much safer than they used to be, but given that the population of the world passed the seven billion mark this week, the vast majority of us born the old-fashioned way, there doesn’t seem to be any real need to change that trend now.