Meeting of the Parliament 12 November 2014
Like other members, I congratulate Dave Stewart on securing time for the debate to mark world diabetes day. I recognise the expertise in the area that he brings to the chamber, being the co-chair, along with Nanette Milne, of the cross-party group on diabetes in the Scottish Parliament. He has also undertaken work at an international level with the parliamentarians for diabetes global network in Melbourne. I confess that the idea of a stroll in the Melbourne sunshine is very appealing at this time of the year.
The debate gives us an opportunity both to underline the serious challenge that diabetes presents in Scotland and to outline the work that we have done to improve the lives of those who live with diabetes.
As members have mentioned, the International Diabetes Federation has estimated that one in 10 of the world’s population will be living with diabetes by 2035. As Nanette Milne highlighted, the Scottish figures for 2013 saw the number of people with diabetes increase to more than 268,000, which is 5 per cent—one in 20—of our population. Those figures, along with the figures that Dave Stewart and others cited, are sobering, and they demonstrate the significant challenge that we face.
In Scotland, we are particularly well placed to answer that challenge. Earlier this year, we hosted our diabetes in Scotland conference, which saw more than 300 members of the Scottish and international diabetes community come together to discuss how we can improve services and make life better for people with diabetes and to share good practice. The conference also highlighted how fortunate we are in Scotland to have strong clinical leadership engaged in our diabetes teams and an active patient voice. I pay tribute to the lead clinicians who have chaired the Scottish diabetes group over the past decade—Professor John McKnight, Professor Donald Pearson and Professor Andrew Morris—and who made the event such a success. I note their work to ensure that the diabetes services in Scotland are second to none.
Our national diabetes programme has helped to co-ordinate safe, effective and person-centred diabetes care across Scotland for over a decade. Many members will be familiar with our diabetes action plan—indeed, some members have already referred to it. Over the past few years, the plan has been absolutely key to driving forward improvements in a number of important areas of diabetes care, including the delivery of state-of-the-art e-health solutions to monitor progress; improvements in foot care services; increased access to insulin pump therapy; and enhanced knowledge and skills among our staff.
It is important that we build on that work and strive to continually improve our diabetes services year on year. That is why, earlier today, I agreed to the publication of our new diabetes improvement plan, which will be published by the end of the month.
Our improvement plan aims to build on the existing work of the diabetes action plan by focusing on key priority areas, and it challenges the Scottish diabetes community to deliver continuous improvement in the quality of the care that is available to people with diabetes. A key part of that will be to build on the work that has been identified, particularly for those who are at higher risk in our ethnic minority communities, in order to see continued improvements.
Although I do not have sufficient time to go into great depth on all our diabetes programme’s successes or to set out all the areas that our new improvement plan will cover, I will take the opportunity to set out some of our work to date.
A key measure of diabetes care is our Scottish diabetes survey, which is perhaps the most comprehensive national record of its kind in the world. A major success to highlight from the most recent survey is that the percentage of people with both type 1 and type 2 diabetes who have had their foot risk recorded has more than doubled between 2008 and 2013 to about 80 per cent. That will have a major impact in reducing foot ulcers and lower-limb loss. That is evidence that our world-leading foot risk triage system, which was developed by our diabetes foot action group, is working to ensure that people with diabetes who are at most risk of developing foot complications are receiving the care that they need and that a preventative approach is taken.
A second area to highlight are the very substantial improvements that we have made to insulin pump access, which several members mentioned. I am very pleased to note that we have made significant progress in this area. Making that progress across all health boards has not always been easy, as Dave Stewart and others will recognise. However, we have seen a significant increase in the number of insulin pumps being made available to adults and children.
We have met our overall aim of ensuring that 25 per cent of people under 18 have access to insulin pumps. To put that into context, we have gone from 8.4 per cent of our under-18s with diabetes having access to an insulin pump in 2011 to 27.5 per cent across the country being on an insulin pump. However, I reassure those in the chamber that we are not complacent; indeed, we want to ensure that, by March 2015, the target is met consistently across all health boards.
Improving services for people who have diabetes is not enough. We need to address the underlying risk factors that lead to the development of type 2 diabetes and identify diabetes among young people earlier if we are to safeguard the future health of Scotland.
Earlier this year, the World Health Assembly announced its global target to halt the rise in diabetes and obesity by 2025. That is an ambitious aim, but rightly so. It very much complements our focus on preventing type 2 diabetes and our progress in working on the marked factors that can influence the risk factors in someone developing type 2 diabetes.
We are working to encourage people to make lifestyle changes, such as—Rhoda Grant correctly highlighted these as key components—adopting a healthier diet, managing their weight and increasing their physical activity. We have committed £7.5 million in the current spending period to healthy eating projects to support people in making healthier eating choices. In addition, we have provided improvement funding to several stakeholders over the past year, including Diabetes Scotland, to support projects that encourage healthier eating and lifestyle choices.
We are also committed to continuing our positive engagement with the food industry about our proposals to improve dietary health. Last month, I met Diabetes Scotland and Dave Stewart, along with the Food Standards Agency, to explore that matter further in relation to public procurement. We will continue that dialogue to see whether there are further measures that we can take.
It is essential not only to support people in making healthy living choices to avoid diabetes but to identify people with diabetes earlier. Type 1 diabetes tends to present more acutely than type 2 does, but a key part of the work that we will be doing is to ensure that we continue to make progress on earlier identification. Our paediatric and adolescent group is developing a range of materials for general practitioner surgeries and admitting departments that are designed to support healthcare professionals to recognise the symptoms of diabetes in young people much more quickly to ensure that an earlier diagnosis is made. We will look to roll out those materials over the coming months.
In addition, I have set in motion work that will involve our public health sector playing a much more proactive role in the prevention of conditions such as diabetes. Last week in Aviemore, I announced that there will be a review of public health services in Scotland, the initial findings from which will arrive with ministers in 2015, with a view to continuing to improve public health provision. The preventative agenda is at the centre of that.
It is clear that the NHS in Scotland has delivered real improvements in the care of people with diabetes in the past few years. Now more than ever, we need to ensure that we move forward by making a stronger collaborative effort that involves all stakeholders and agencies to create a health-promoting and diabetes-aware culture in Scotland. I assure members that our new improvement plan will look to build on that progress in the coming years.
Meeting closed at 17:46.