Health: Back pain? Don't take it lying down: 'They gave my life back to me'

ON MY first visit to the Wolfson Centre, at the Atkinson Morley Hospital's rehabilitation unit in Wimbledon, south-west London, I arrived lying in the back of my sister's car, with a corset on, while she drove at 10mph. Following a back injury, and various failed treatments, I had spent two years as an invalid, first in a series of hospitals and then at home.

Returning for my three- monthly follow-up, I walked to the Underground, changed trains, and climbed the hill to the unit. I did have to lie on a bench to rest at one stage, and I did go home by taxi. But these days I get around, and that's the point. I have a life again - and you never get over the thrill of that.

It took the Wolfson unit a month to get me back on my feet. Since its establishment in 1967, the unit has helped thousands of patients suffering from head or spinal injuries. Until the new market-style NHS took effect, people came from all over Britain for treatment. Now, admittance for those living near the centre is frequently blocked, waiting lists have been frozen and a third of the beds are empty.

The unit was founded to 'enable patients to fulfil their maximum potential for recovery'. A team of doctors, physiotherapists, occupational therapists and nurses puts patients through hours of daily hydrotherapy, gym and controlled exercises, with time off only for lunch. The team believes that people with serious disabilities need intensive therapy to regain full function.

Since the NHS reforms, some health authorities have paid a lump sum at the beginning of each financial year in block contracts to cover an agreed amount of treatment for the patients they send to the Wolfson. But authorities near the hospital, including Croydon, Kingston and Esher, Wandsworth, North West Surrey, East Surrey and West Lambeth, have exhausted their budgets for the current financial year and cannot afford to refer any more patients for treatment to be undertaken before the new financial year begins in April.

The Wolfson has closed its waiting list to these authorities and is concentrating instead on smaller numbers of more lucrative patients who are referred individually from distant health authorities. As a result, many severely disabled patients are being denied treatment at the Wolfson and are not being offered an alternative, even as their conditions become increasingly difficult to treat.

Dr David Jenkins, the director of the centre and a consultant in rheumatology and rehabilitation, is dismayed. 'I consider it totally absurd that I cannot assess patients in their due turn, regardless of where they are referred from,' he says.

But Tom Cumberland, deputy chief executive of St George's Group, south London, to which the Wolfson belongs, argues that the days of long waiting lists are over. 'This last year, the Wolfson has overperformed on its contracts by about 29 per cent. We should have treated 174 patients, and we've treated 224. So we've been extraordinarily efficient. But, of course, that doesn't get us any more money. Therefore, we're having to manage selectively whom we admit.

'Under the old health system, it was a kind of badge of honour to have a long waiting list, but these days that's a great disincentive for people to place contracts with you. Health authorities don't want their patients to have to wait six to nine months to get in.'

Dr Jenkins says: 'The whole thing is being run on a financial basis, and not being directed to patient needs at all. Illness is just not accountable in that way.'

(Photograph omitted)