Her agonizing chronic pain means she cannot work, is unable to sleep properly, and is depressed. But Elizabeth Smyth still doesn’t meet the threshold for spinal surgery.
An overwhelmed public health system means the criteria to access spinal surgery is narrow, leaving thousands of chronic pain sufferers hooked on opioids, a neurosurgery expert says.
Smyth, who cannot afford to pay for the surgery privately, is so desperate to reduce her pain that she has set up a Givelittle page – a move she describes as humiliating.
“Givelittle pages are full of ordinary Kiwis desperately needing health care. We are like beggars competing with each other. It is like the Victorian ages.”
CHRIS SKELTON
Elizabeth Smyth needs surgery for the debilitating pain she suffers, but cannot get it through the public health system.
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The 61-year-old Cantabrian damaged her spine in a car crash when she was 20. Since then, she has had three lumbar spinal surgeries and had to learn to live with the chronic pain.
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But in 2015 Smyth injured her neck, intensifying the pain in her arm and neck. ACC initially covered the costs of her treatment, and she improved after a steroid injection.
In early 2020, her arm and neck pain deteriorated again, but ACC declined cover because there was arthritis, Smyth said. She described the pain as “a toothache all over my body with electric shocks”.
CHRIS SKELTON
Smyth cannot afford the cost of having private surgery for her chronic pain.
Her doctor referred her to Christchurch Hospital for an assessment in February 2020, but this was declined. Dismayed, Smyth borrowed money to see a private surgeon. In October the same year, a neurosurgeon said cervical spinal surgery would solve her problem.
But Smyth, who has not been able to work consistently through her life due to her disability, cannot afford the $26,000 price tag for the surgery.
She wrote to the Canterbury District Health Board (CDHB) to ask why her treatment could not be covered publicly.
In November 2020, the board wrote back telling Smyth she did not qualify to see a neurosurgeon because she did not face paralysis – which was the criteria to access the service.
“The neurosurgery service is not funded at a level or staffed at a level or provided with resources at a level that this kind of service can be provided in any region in New Zealand,” the letter said.
CDHB clinical director of neurosurgery Suzanne Jackson said the criteria for elective spinal and peripheral nerve surgeries was tightened in 2010, to focus on patients with degenerative spinal conditions or spondylosis.
“Pain is a symptom and not in itself an indication for surgery,” she said.
The majority of neurosurgeries are acute and non-deferrable, Jackson said. This leaves only 25 per cent theater capacity for elective neurosurgery, which is mainly made up of spinal, peripheral nerve and functional surgery, she said.
University of Otago professor of neurosurgery Dirk De Ridder said New Zealand was miles behind the likes of Australia, the US and Europe when it came to treating chronic pain.
A lack of resourcing and an inefficient public system led to difficulty accessing surgery to treat chronic pain, leaving sufferers to resort to opioids, he said.
CHRIS SKELTON
Smyth has had spinal issues since a car crash when she was 20.
“The waiting times are unacceptably long – and sometimes you are not even given the option of waiting.”
De Ridder said about 20 per cent of the population have chronic pain, which is the biggest cause of suffering worldwide and can cause disability, anxiety, depression and sleep problems – creating huge costs to society.
Hooked on high doses of painkillers and desperate for help, Smyth wrote to Government ministers and local MPs last year—to no avail.
“Because of my lifetime of disability I am seen as a loser. I have no money, no hope. What a loser. Best just to die really,” Smyth wrote.
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