If the condition was not life-threatening I would be more inclined to ask the patient to tolerate the pain

Neurosurgeon responding to Newsnight survey

It also reveals that the majority of consultants are changing the way they practise medicine because of the threat of being sued.

Patients over the age of 65 who have a brain condition are the most likely to lose out from this form of "defensive medicine".

Neurosurgeons operate on the brain and spine - they are responsible for some of the most delicate and high-risk procedures available.

The stakes are high, not only for the patients, but for the surgeons with the ever-present threat that if it all goes wrong, settlements for permanent disability can reach millions of pounds.

The survey was sent to all 190 members of the Society of British Neurological Surgeons. 70% replied.

Seven out of 10 said the growth of litigation had led them to change the way that they practise medicine.

And of those 52% said they would be less willing to offer major surgery to a high-risk patient than they were five years ago.

Ciaran Bolger says there is an atmosphere of blame

Ciaran Bolger, a consultant neurosurgeon at Bristol's Frenchay Hospital, said: "When you are dealing with a patient your primary concern is to do the best you can for that particular patient - they are your responsibility now.

"However, the atmosphere of looking for someone to blame if things don't work out quite right does make people stop and think, and it does make people more reluctant to take on the more difficult kind of surgery."

Among comments from other neurosurgeons who completed the survey were:

• "If the patient might sue if they were not left 100% normal I would be less likely to offer surgery"
• "If the condition was not life threatening I would be more inclined to ask the patient to tolerate the pain".