Maybe it was playing hockey for far too long on those old unforgiving Astro pitches, but the result is a GP appointment to plead for an orthopaedic referral. New knees are inevitable if I’m ever to walk free of pain.
Like thousands of Scots hoping for a new hip, knee or ankle, it could be at least two years before I’ll go under the knife in a Scottish hospital without paying at least £15,000 to go private. Maybe with one of the many long-term re-payment plans I could just about manage it, but not everyone is in that position.
Yet that’s what 2,755 Scots waiting for a hip replacement chose to do last year ─ half the total going private ─ compared to 654 in 2019. It’s a vast opt-out from the NHS, and the acceleration of a two-tier system in which paying to beat elective surgery queues is not an exception.
Some patients technically treated by NHS Scotland are actually being sent elsewhere at huge expense, like a family friend in the Borders who will have an NHS-funded operation, including return taxis, at the private Spire hospital near Sunderland.
For all orthopaedic surgery, some 42,000 people are on the list ─ just over 12,000 of them already waiting over a year ─ an 80 per cent increase on 2019’s average, as fewer operations are carried out in NHS hospitals compared to pre-pandemic levels.
Yet the facilities and surgeons are there. The Royal Infirmary of Edinburgh has six orthopaedic operating theatres which could be used virtually round the clock to cut backlogs. But surgery is limited to a normal working day and only emergencies at weekends, and some surgeons are only operating one day a week but would willingly increase their theatre hours if conditions allowed.
The problem is the lack of skilled theatre nurses, which tracks back to the reduction of training places in 2011 under then health minister Nicola Sturgeon, and alarm bells were being sounded long before the pandemic. In the past year, NHS Scotland nursing and midwifery vacancies shot up 24 per cent, with 6,010 full-time posts available in June compared to 4,845 last year, and now even training courses have vacancies.
In the blizzard of data all pointing in the same direction, the one which matters most to patients is how long they must wait for treatment to restore their quality of life. And for far too many that basic information simply isn’t available, or if it is, it’s unreliable.
The targets only measure the time from the first consultant meeting to the operation, so the wait can be far longer than even rough estimates, and now concerns about the reliability of new NHS Inform statistics have been raised with the Office for Statistics Regulation and Audit Scotland.
Accurate information is essential for cutting the queues, and significant reductions make economic as well as clinical sense; the longer the wait, the more disease spreads. The more the condition deteriorates, the more complex the surgery becomes, and the longer the rehab. It all adds up to needless cost.
In May Health secretary Humza Yousaf promised new waiting time data by late summer, but it should surprise no-one that, like thousands of NHS patients, we are still waiting.