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Meeting of the Parliament 29 May 2013

29 May 2013 · S4 · Meeting of the Parliament

Item of business

Chronic Pain Services

Baxter, Jayne Lab Mid Scotland and Fife Watch on SPTV

As we know, chronic pain has been the subject of parliamentary discussion for more than 10 years. The number of reports that have been produced on chronic pain is startling—the cross-party group on chronic pain has highlighted that there were five reports before devolution and there have been four in the years since. Despite that, chronic pain appears to be one of the ignored issues in the debate about Scotland’s health services, so it is welcome that it has finally been given the debate time and attention that it deserves.

As recently as 2012, the then Cabinet Secretary for Health, Wellbeing and Cities Strategy answered a parliamentary question by stating that there was

“insufficient evidence for an economic case to support the development of a Residential Pain Management Programme.”—[Official Report, Written Answers, 7 February 2012; S4W-05186.]

Although a commitment was made to a review by the chronic pain steering group in the summer of last year, that was just the latest of the varying responses to the recommendations that have been made over the years for pain services in Scotland.

I was surprised to learn of the Scottish Government’s response that there is a lack of evidence for an economic case and I hope that that attitude is shifting, because the Chartered Society of Physiotherapy Scotland has highlighted the fact that the direct healthcare cost of chronic pain in Scotland is about £160 million. That figure pales in comparison with the associated costs of chronic pain to the economy. For example, when we consider the number of working days or workers lost to the economy in the United Kingdom due to chronic pain, the figure leaps to £1.7 billion. Despite the huge opportunity and economic costs associated with a condition that can be long term, the level of care available throughout Scotland is extremely patchy.

Unfortunately, adults are not the only ones who suffer. It has been estimated that up to 80,000 children in Scotland have chronic pain. It is worrying that, in many places, those children face the same difficulties in accessing appropriate treatment and support. Healthcare Improvement Scotland’s “Update Report on Scottish Pain Management Services” noted:

“The development of children’s pain services in Scotland is at a relatively early stage”.

Given the numbers of children who are affected, that is a disappointing statement.

Equally disappointing is the postcode lottery of multidisciplinary care, which varies as much throughout the country for children’s pain services as it does for adult services. Few health boards offer primary care provision of multidisciplinary pain management for children or adults.

NHS Fife is one of those few. The Fife integrated pain management service for patients with chronic pain has a single referral system, clear referral criteria and a triage process. Through that approach, the health board can refer one patient in 10 with chronic pain to a pain management programme. That might not seem like a high figure, but it compares well with the shocking experiences of patients in some other health board areas who, as we have heard, have been referred to a pain management programme hundreds of miles away in Bath.

The combination of primary and secondary care that NHS Fife uses is based on self-management and physiotherapy and uses community venues. It was developed from work done in west Fife. When the initiative was established some years ago as the Rivers pain service, the aim of the physiotherapists and pharmacists involved was to provide services for people who were coping with chronic pain in local settings, such as community and leisure centres.

I am grateful to the Chartered Society of Physiotherapy for highlighting the service to me before the debate. I share its view that such community-based treatments are essential to providing pain care programmes that enable those who suffer chronic pain to gain greater control of their condition.

I encourage the Scottish Government to look into the Fife example when it begins to implement the Scottish service model for chronic pain. Sadly, not all examples are as positive as the one that I just outlined.

One of my constituents, Linda Penn, who is a patient under another health board in the Mid Scotland and Fife region, has raised with me her experiences of the long waiting times that she has endured to see a specialist and the difficulties that she has encountered in accessing treatment. Having waited 12 weeks for an initial appointment with the pain specialist, she waited a further seven weeks for a 10-minute acupuncture session. As she is a resident of Alloa and unable to drive, she had to undertake a one hour and 20 minute bus journey each way to the pain clinic at Falkirk. Strangely enough, any benefits of the 10-minute treatment at the pain clinic are undone by the round trip of nearly three hours. After the debate, I will raise the detail of my constituent’s case with the cabinet secretary and the health board.

Unfortunately, I am sure that Linda Penn’s experiences are not unique. They serve to highlight the need for a chronic pain residential treatment centre like the one in Wales that has been mentioned. Scottish Labour’s amendment, on the need to establish such a centre as a matter of urgency, is to be welcomed. I hope that improvements take place across the board for patients with chronic pain in Scotland as soon as possible.

15:24

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Meeting of the Parliament 29 May 2013

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