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Meeting of the Parliament 17 March 2011

17 Mar 2011 · S3 · Meeting of the Parliament

Item of business

Chronic Pain Services

Milne, Nanette Con North East Scotland Watch on SPTV

I apologise to you, Presiding Officer, and to colleagues for not being able to stay for the whole debate. I have commitments elsewhere in the building.

Mary Scanlon has brought a very important issue to the chamber, and I congratulate her on securing the debate. I realise that a number of people in my age group and above suffer significant aches and pains from wear and tear and that arthritis of various kinds affects many people of all ages in Scotland. Before I started on my preparations for the debate, I confess that I was unaware of just how many people’s lives are adversely affected by chronic pain and how many are severely disabled by it. Any condition that affects nearly 20 per cent of the population must be taken seriously. It came as something of a surprise that, even today, chronic pain remains poorly recognized and often poorly managed and that progress is only now beginning to be made in developing chronic pain services in Scotland.

The recognition of chronic pain as a long-term condition in its own right and not just a symptom of other problems has been a major step forward. The development of a national policy to cope with it puts us ahead of England, but it is clear that the policy is not yet implemented consistently across Scotland. Chronic pain is yet another condition where adequacy of care is a postcode lottery.

There are, however, encouraging developments and there is a growing momentum to recognise chronic pain as worthy of clinical and academic investment. The acceptance by the Royal College of General Practitioners that it has a major role to play and its decision to make chronic pain one of its clinical priorities for the next two years is very encouraging. The appointment of the first lead clinician in chronic pain will, I hope, add to the momentum to develop good practice across the country.

I was heartened to read the aspirations of the RCGP, notably to develop enhanced chronic pain education and training for professional staff and to work with the third sector on developing public awareness of the condition, tapping into the rich pool of patient information and resources that is already in existence.

The drive to achieve an audit of the pain services that are currently available in the United Kingdom, to review existing models of good practice and assess existing evidence-based data, plus the intention to press for a National Institute for Health and Clinical Excellence guideline on a quality standard for treating chronic pain, are important developments that should bring together the important work that is already being done in a piecemeal fashion by many organisations, mostly in the voluntary and charitable sectors.

It makes sense that every health board should have a pain group or managed clinical network to develop specialist pain services, but that is not yet the case. It also makes sense to increase GPs’ understanding of pain and its management. Surely it does not make sense to spend more than £600,000 in two years to send patients with chronic pain to the south of England to access pain management programmes, yet that is happening to patients in more than half of Scotland’s health board areas. Surely proper investment in local services would be far more cost effective.

Progress is undoubtedly being made, but it is evident that much more needs to be done. The cross-party group is to be congratulated on putting chronic pain on the political agenda, as is Mary Scanlon for highlighting the issue today. I hope that, next time such a debate takes place in the chamber, we will hear that good practice in the management of chronic pain has been replicated across Scotland and that sufferers have access to appropriate services regardless of where they live. Now that the will is there, I hope that more rapid progress towards that goal will be made.

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