Jailed former deputy prime minister Anwar Ibrahim's lawyer today confirmed the Kuala Lumpur Hospital (HKL) will send Anwar back to the Sungai Buloh prison if he does not sign a letter of consent permitting the hospital's surgeons to operate on his slipped disc.

Anwar's lawyer Sankara Nair said this was stated in a letter dated April 25 which was signed by HKL director Dr Abdul Razak Syed Kechik.

"The letter stated that should Anwar refuse to sign the letter, he will be returned to the prison and conservative treatment will be continued there," said Sankara.

"It also said that Anwar will be liable for all risks if the operation is not performed and even if the operation is performed, Anwar will still be liable for arising risks," he added.

He explained that the letter of consent is to enable HKL to use the microsurgery on Anwar instead of endoscopic disectomy which the patient had requested for.

Sankara said no deadline was given for Anwar to sign the letter but the indication is that during the period he is deciding, they might conclude to send him back to prison.

"They have allowed a time period, not stated, for Anwar to think about it as my client has said that he would like to discuss it with his family," said Sankara.

Nerve injuries

Among the risks listed in the letter if Anwar decides not to undergo the operation are kidney pains, leg pains, temporary or permanent loss of leg nerves, loss of use of the legs and other functions.

Sankara said the letter also listed the risks of which Anwar would be liable for after the operation, should he agree.

"The risks include spinal and nerve injuries," said Sankara.

Anwar, who is serving a 15-year jail sentence for corruption and sodomy, has been hospitalised at the KLH for his spinal problem since November last year. He had requested for German spine specialist, Dr Thomas Hoogland, to perform his surgery.

However, Hoogland has recently ruled out operating on Anwar at HKL, citing unwarranted interference of the government and mistrust by the HKL director.

The government has allowed Hoogland to operate on Anwar with several conditions imposed.

In his medical report after examining Anwar, Hoogland had stated that Anwar should undergo endoscopic spinal surgery by the end of this month, at the very latest.

The procedure, however, would have the lowest risks and best prognosis if performed at his Alpha-Klinik in Munich, said Hoogland, adding he met with a panel of local medical experts before he came to the conclusion.