[rosedee]

Hi again Alastair,

NICE is about guidelines and recommendations - just because a procedure is not recommended by NICE, it does NOT mean that it can not be obtained in the UK - both on the NHS and privately. I think this shows why it is so important to have knowledge of treatments/procedures that are not routinely done in the UK - particularly for people with complicated histories and conditions, it may well be that the less common procedures are exactly what are necessary. Only knowing the usual options in the UK narrows people's choices. NICE's remit is as much to do with cost-effectiveness as clinical effectiveness. This is very different from best choice for clinical effectiveness in individual cases.

You obviously know only too well that ADR is neither a widely-used procedure in the UK, nor are there a great many surgeons with a lot of experience and expertise (which is not to ignore the excellent ones that there are). That is why you, and others from the UK, have gone to Germany to have your surgeries done. Given the problems with our health system in the UK, more and more people go abroad for treatment (So called "health tourists"); I certainly want to know what is the best treatment for my spinal problems - nor merely the best treatment I can get in the UK.

The above is not to take away from the need for information about UK-specific isses. What I've written shows how important it is to be fully aware of them. Obviously most of us in the UK have little interest in USA insurance companies per se, but everything else is certainly of interest to me. So as I see it the UK board is an additional resource, not a replacement for this site.