Meeting of the Parliament 16 November 2022
I am pleased to speak in this much-needed debate on chronic pain, and I hope that it will benefit patients who are dealing with that terrible life-diminishing condition.
As a co-convener of the cross-party group on chronic pain for the past six years, I am aware of the daily struggles that are faced by people who are coping with the condition. I have heard many harrowing stories of personal difficulties, frustration and physical pain, often leading to mental pain and suicide attempts.
Today, we will hear that there are long-standing issues surrounding the pathways for chronic pain treatment. I say that they are long standing because they go back a long way—in fact, right back to the inception of this Parliament. One person who knows that all too well is the cross-party group’s secretary, Dorothy-Grace Elder. For 20 years, she has selflessly devoted her time and, often, her money to helping patients in the group. She is more than an administrator; she is a friend and a passionate supporter of many people in the group. The work that she and her ever-supportive husband, George, do is simply beyond compare, so I thank and applaud them both on behalf of the co-conveners and, I am sure, the entire group.
There is no doubt that, over the years, there have been historical problems with inclusivity and communication between the national health service and the Government. That has not been easy to bear for patients who are already struggling with their conditions. There has also been a postcode lottery of health boards in terms of access to chronic pain treatment. However, we must now look forward and work together for the benefit of the many patients throughout Scotland. It is estimated that, in Scotland, 800,000 people—that is one in five people—suffer from chronic pain. I say that that figure is the tip of the iceberg, because data collection has been sadly lacking.
As the minister outlined, in its 2020-21 programme for government the Scottish Government made a commitment to develop a new framework for pain management services. That plan was published in July 2022 and set out the actions that are planned to improve care and services for people with chronic pain across Scotland. It set out new governance arrangements that are intended to improve co-ordination, engagement and the pace of action to improve care and services for people with chronic pain. That includes a network of third sector organisations that support people who are living with chronic pain being represented on the pain management task force, which is an approach to engagement that ensures that a range of lived experience informs how actions are delivered.
Lived experience is crucial to an on-going framework for pain management, and there has been criticism from the CPG about there being exclusion rather than inclusion. However, as we have heard, the Government has consulted the wider pain community throughout Scotland through the pain management panel, which is designed to support people with chronic pain to discuss and feed back on issues, make proposals and ask questions to inform implementation and delivery of the framework. That panel was commissioned via an independent organisation, The Lines Between, and includes people with chronic pain who have not previously had the opportunity to be involved in the Scottish Government’s work. An initial report on the outputs of the panel will be published shortly.
However, it is important to highlight key patient requests from our cross-party group, which is always extremely well attended. Before Covid, people travelled the length and breadth of the country—often in extreme pain—to attend the CPG. First and foremost, a key request is for protection of specialist chronic pain services, which include infusions and injections—in the correct timescale—for those who need them.
One of the issues that patients have flagged up is the delay in getting follow-up treatment. As we have heard from previous speakers, that is absolutely crucial to a pain patient. The nature of chronic pain means that one appointment will not be enough. One patient and member of the group, who requires an annual injection, has been waiting years in the past and has spoken publicly about their experience. That is why data on return-patient waiting times is vital and has, until now, been sadly lacking. There is no limit on the return-patient waiting time, unlike new patients, who have a statutory 18-week waiting time limit. We heard the minister say that 80 per cent of people who are referred as new patients were seen within that time.
Unacceptable waiting times existed long before Covid, but the pandemic has exacerbated the problem, as it has in many other areas of the NHS. Specialist staffing is a huge problem, and I hope that more emphasis is put on that area of medicine during the training of medical students, as they consider their career pathways. I am pleased to hear the minister set out plans for that.
I also hope that we can consider alternative ways of treating chronic pain patients, possibly with vaccination centres that would be similar to the ones that were set up for Covid and flu jags. We have got to the stage at which alternative thinking is necessary in order that we address the historical problems with which patients have been dealing. With a renewed focus on the framework, feasible ideas in all areas should be proposed.
In conclusion, I say that no number of words will ease the pain for the many people who live with the condition. We need action and co-operative working with patients with lived experience to help us to deliver what they need, when they need it. That is the very least that they deserve.
15:42