This is a leg ulcer, this is the dreaded complication of varicose veins and reflux. Once they develop this is quite a severe one once they develop, they are very difficult to heal, they are very difficult to eradicate. Even when you do get them healed,they heal with a lot of scar tissue. The area is quite vulnerable and it's never quite normal,so it's always a little bit more vulnerable to knocks and injuries. So leg ulcers, once they're established, do tend to recur, even with the best available treatment, because of the vulnerability and the scar tissue. So avoid leg ulcers if you can. I'm sure nobody wants a leg ulcer, but if you've got varicose eczema and you've got any complications from your veins, we know that early treatment will give better results and will reduce the risks of complications. So as I mentioned, many people go and see their doctor, they say "I've got vein problems"but the NHS doesn't treat them. Why is this? Well, the NHS doesn't see veins as a priority and the majority of people, even with quite severe vein problems, don't get a major complication. The NHS is strapped for money, I think we have to accept that, and there are other,more pressing requirements.
There's no national target for veins, there's no two-week wait for veins, and there's no targets as there are, as you'd expect, for an ambulance arriving. We all expect, if we're injured, that an ambulance will arrive within a certain time, we all expect that it will take us to a well-equipped hospital with an operating the atre if we need urgent surgery, and we all expect that if we suffer a heart attack, we're taken to coronary care and that we're looked after. This all costs money, and obviously the NHS has limited resources. I don't want to get too political, but you can imagine that if the majority of people don't get a major problem from their veins, the NHS can't treat everybody, it has to ration treatment.
The National Institute for Care and Health Excellence (NICE) last year 2012, or no 2013,earlier this year, only in the summer of this year, made several recommendations about the treatment of veins and it said specifically that anyone who's got symptoms from their veins should be referred to a vascular surgeon. However, we know and I know that currently people, even with varicose eczema, are finding it difficult to get NHS treatment. So although nice believes that people should have advice, the reality here in this area is that people are finding it difficult to get access to treatment.
Other reasons thread veins are often regarded as cosmetic, when we now know that the majority of people, even with thread veins, have reflux. Varicose veins are not a priority, as I've mentioned. There are other, more pressing problems for the limited resources of the NHS. I was going to say it's rationed by strict criteria, they seem to be getting stricter and stricter and access seems to be getting poorer and poorer as time goes by, and I see people who have had bad phlebitis or who have had varicose eczema who can't get treatment very difficult. And, obviously, your doctor needs to keep up-to-date with all sorts of new developments in diabetes and blood pressure and child care and dementia. He finds it very difficult to keep up-to-date with all the latest treatments on veins. Not surprisingly,your GP may not be able to refer you to the local hospital for veins so, at the end ofa busy surgery, he's hardly going to spend hours reading up on the latest developments on veins.
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