Chamber
Plenary, 01 Oct 2008
01 Oct 2008 · S3 · Plenary
Item of business
Action on Thrombosis
I congratulate Trish Godman on initiating this important members' debate, and I join her in extending my condolences to Katie McPherson's family. We need to do our best to see what lessons can be learned from that tragedy.
The term "thrombosis" means a blood clot, and it covers a wide range of conditions. Cerebral thrombosis in the head leads to a stroke, and coronary thrombosis leads to a heart attack. However, it is obvious that we are talking about deep venous thrombosis, or the blood clot that occurs in the deep veins of the leg. In itself, that does not kill, but when the clot moves on to the lungs, it causes a pulmonary embolism, blocks off the breathing and causes either severe illness or death.
I agree with the motion's call
"to increase awareness of thrombosis among the public and health professionals".
The National Institute for Health and Clinical Excellence already has guidelines for elective surgery, and the Scottish intercollegiate guidelines network has guidelines for thrombosis. I agree that there are times when either those guidelines are not followed or clinical staff are not alert to the possibility of DVT, so it is important that we take all opportunities to correct that situation.
I am not sure, however, that I go along with the idea that population screening is the answer. We know that approximately 2.5 per cent of the population has the factor V Leiden mutation that predisposes them to the development of thrombosis. However, there are strict criteria for population screening, the most important of which is that help is available for those who are found to be at risk. That is not currently the case with thrombosis. There is evidence that the long-term use of anticoagulants to thin the blood and make clots less likely to occur might do more harm than good because of the side effects. On the other hand, selective screening might have a place. For example, young women who have a family history of thrombosis and who want to take hormonal contraception could benefit from selective screening.
The term "thrombosis" means a blood clot, and it covers a wide range of conditions. Cerebral thrombosis in the head leads to a stroke, and coronary thrombosis leads to a heart attack. However, it is obvious that we are talking about deep venous thrombosis, or the blood clot that occurs in the deep veins of the leg. In itself, that does not kill, but when the clot moves on to the lungs, it causes a pulmonary embolism, blocks off the breathing and causes either severe illness or death.
I agree with the motion's call
"to increase awareness of thrombosis among the public and health professionals".
The National Institute for Health and Clinical Excellence already has guidelines for elective surgery, and the Scottish intercollegiate guidelines network has guidelines for thrombosis. I agree that there are times when either those guidelines are not followed or clinical staff are not alert to the possibility of DVT, so it is important that we take all opportunities to correct that situation.
I am not sure, however, that I go along with the idea that population screening is the answer. We know that approximately 2.5 per cent of the population has the factor V Leiden mutation that predisposes them to the development of thrombosis. However, there are strict criteria for population screening, the most important of which is that help is available for those who are found to be at risk. That is not currently the case with thrombosis. There is evidence that the long-term use of anticoagulants to thin the blood and make clots less likely to occur might do more harm than good because of the side effects. On the other hand, selective screening might have a place. For example, young women who have a family history of thrombosis and who want to take hormonal contraception could benefit from selective screening.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan):
SNP
The final item of business today is a members' business debate on motion S3M-2482, in the name of Trish Godman, on action on thrombosis. The debate will be c...
Motion debated,
That the Parliament notes with concern that, according to provisional figures from the Scottish Government, the total number of deaths from thrombosis in 200...
Trish Godman (West Renfrewshire) (Lab):
Lab
Katie was 23 years old when she died of deep vein thrombosis. She had tried three times to get treatment, in two hospitals and from her general practitioner....
Ian McKee (Lothians) (SNP):
SNP
I congratulate Trish Godman on initiating this important members' debate, and I join her in extending my condolences to Katie McPherson's family. We need to ...
Trish Godman:
Lab
I hear what the member is saying, but because there are so many questions about DVT—he is asking them himself—we need money so that we can research whether t...
Ian McKee:
SNP
I agree that research should be done, and that not enough has been done into the causes of DVT and its treatment. However, I still hold that it is wrong to e...
Jackson Carlaw (West of Scotland) (Con):
Con
Once again, Trish Godman has brought to members' business an important and substantial issue. Seven months ago, the issue was the human rights of wheelchair ...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I add my congratulations to those of other members on Trish Godman securing this debate and on the way in which she graphically illustrated the tragic early ...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I, too, thank Trish Godman for securing tonight's debate. As others have acknowledged, she has made a significant contribution to raising awareness of thromb...
The Minister for Public Health (Shona Robison):
SNP
I add my thanks to Trish Godman for securing a debate on this important but complex issue. Her motion mentions the death of Katie McPherson, and the first th...
Ian McKee:
SNP
Does the minister not agree that cigarette smoking is also a lifestyle choice that leads to an increased risk of DVT?
Shona Robison:
SNP
Yes, of course. I will say a bit more about that.The other risks for DVT include pregnancy, age, underlying cancer, being on the pill or hormone replacement ...
Trish Godman:
Lab
You are saying that screening would be done in some circumstances. It seems to me that Katie McPherson's family should have some support and screening, but t...
Shona Robison:
SNP
I am just about to deal with that issue. We agree that high-risk groups should be tested, and we are clear that the adult relatives of someone with factor V ...
Meeting closed at 17:35.