THREE decades ago, when I was aged 40 and a GP in the NHS, I sustained a prolapsed (‘slipped’) lumbar disc, the level of which was correctly identified as being at L4/5 (i.e. between the 4th and 5th lumbar vertebrae).

My GP referred me to an orthopaedic surgeon, who in turn referred me to a neurosurgeon at provincial teaching hospital A.

The latter recorded in his notes that he had operated successfully by performing a laminectomy at L4/5 (and had also checked L3/4). However, I was no better.

A year or so later, I sustained a prolapse at a different lumbar level. This was successfully treated by an orthopaedic surgeon at provincial hospital B, but by a technique which was well out of date and involved me in unnecessarily major surgery.

Still suffering from the original slipped disc, I was recommended by my GP to London teaching hospital C, where the orthopaedic surgeon recorded in the hospital notes that he (also) had operated successfully at L4/5. Again I was no better.

In desperation, I took my X-rays (which I still have) to my local hospital and showed them to the radiologist, who affirmed that there was no evidence of a laminectomy ever having been performed at L4/5.

Finally, I wrote to the Professor of Orthopaedics at Oxford (where I trained as an undergraduate), and told him the story. By this time, five years after the initial injury, I was obliged to walk with crutches.

The professor recommended a local surgeon, who treated me successfully in Oxford, using microsurgery.

So much for “patient choice”, which to my mind, is a convenient cop-out by the powers-that-be, for failing to introduce proper standards of professional quality control into the health service, whereby a patient may be reasonably sure of having competent treatment at his or her local hospital.

(Dr) ANDREW NORMAN, Poole