Verruca and wart patients forced out of GP surgeries

The Scottish Government has been criticised for stopping GPs from using liquid nitrogen for the treatment of warts and verrucas.

Critics to the withdrawal of the therapy point to Heston Blumenthals use of liquid nitrogen on TV

Cryotherapy, using liquid nitrogen, has been dropped from the General Medical Scotland contract meaning that practices are no longer obliged to provide minor surgery.

It is understood that new health and safety rules governing the transportation and storage of liquid nitrogen had increased the costs of offering the treatment at general medical practices.

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But doctors believe the cost-cutting move means patients will suffer and it will place an unnecessary burden on hospital dermatology departments.

Retired West Lothian GP Dr Donald Macaulay said: “This is purely a cost cutting move. When I was complaining about this they came out with all these health and safety reasons, but it was all rubbish. I could not find evidence of a single incident where anybody had come to any harm.

“I mean, Heston Blumenthal uses liquid nitrogen to make ice cream on the TV. You think ‘This is nonsense’. It is just madness.”

GPs had traditionally used liquid nitrogen’s sub zero -196°C temperatures to freeze off warts and verrucas, which are caused by the human papillomavirus infection.

Cryotherapy was used to treat other conditions including actinic keratosis, Bowen’s disease and other skin lesions.

Dr Macaulay, who practiced at Ashgrove Medical Centre, in Blackburn, West Lothian, added: “People’s lives are not at risk but things like warts or verrucas are unpleasant and if you can help remove them as a GP and save the patient a long journey, that’s a service.

“The dermatologists still have access to liquid nitrogen so it’s not as if they’ve said there is no use for cryotherapy and nobody needs that treatment any more.

“What this decision means is that it will take forever for a patient to receive cryotherapy treatment whereas before GPs could do it straight away. The burden is now placed on dermatology departments that already had long waiting times.”

NHS Lothian stopped supplying practices with liquid nitrogen in 2012 – and NHS Scotland has just implemented the move across all 14 of the country’s NHS Trusts.

Practices in Scotland’s biggest NHS Trust Greater Glasgow and Clyde have recently been issuing letters to patients attending their practice informing them cryotherapy is no longer available.

It is understood that health and safety rules mean flasks of liquid nitrogen can no longer be delivered by car to avoid any risk of spillage that could mean a driver suffering asphyxia, damage to lungs or cold burns.

It was also ruled that storage facilities at health centres no longer complied with ventilation requirements and did not have appropriate alarm systems.

Some GPs are paying for private contractors to continue cryotherapy services – but it is no longer being supplied to surgeries by NHS Scotland.

Scottish Labour’s Health spokesperson Monica Lennon MSP said: “If this is a cost-cutting exercise it is a further sign of the challenges facing our NHS under the SNP and it needs to be fixed.”

A Scottish Government spokesperson said: “The latest evidence indicates that a separate service for minor surgery for warts and verruca is no longer clinically recommended.”