Hansard

I encourage the cabinet secretary to read the rest of our manifesto. If he delivered on all our manifesto commitments, I might have more praise for him.

The cabinet secretary and I share the objective of setting up a residential service, because we often think about people who have to make a return journey of 800 to 1,000 miles to get a service. The distances can be even longer; I understand that one sufferer from Shetland was sent on a marathon return journey of more than 1,600 miles. The number of patients might be small, but the people who are subjected to such gruelling travel are perhaps at the most acute end of suffering. I therefore welcome the cabinet secretary’s promise to create a Scottish in-patient service.

I sound a note of caution. Specialist provision, by its very nature, cannot be scattered across Scotland, especially when there are gaps in the most basic services, as we acknowledge to be the case.

There has been a lack of action on the matter in the past, so I applaud the cabinet secretary’s determination to set up an in-patient service, which is in stark contrast with what went before. In the past few years, more than £1.1 million of Scottish taxpayers’ money has been used to send just 119 patients on long journeys, rather than spent on creating a Scottish in-patient service. Wales has long had an in-patient centre at Powys, and I commend that model to the cabinet secretary. Our amendment is about not bricks and mortar but recreating specialist provision in Scotland, which, because of its nature, I fear needs to be centralised.

Members might know that Susan Archibald brought a petition to the Parliament on behalf of the cross-party group. She asked for residential services to be provided in Scotland, not Bath. She asked for improved and consistent access to pain services for patients throughout Scotland. As a severe pain sufferer, her evidence to the Public Petitions Committee was courageous and profoundly affecting. I do not think that anybody remained unmoved by her story. I am extremely proud of the campaigning by the cross-party group’s volunteers over the years because, despite obstacles, they have persevered to keep their focus on improving services.

I turn to local services. The Scottish service model for chronic pain, to which the health secretary referred, was outlined by the late Dr Peter Mackenzie, our first lead clinician in chronic pain, in 2009. However, so far only six of the 14 health boards have the model in place. I accept that more are in the pipeline but how long do patients have to wait? I share the cabinet secretary’s desire to accelerate the rate of change.

We now hear from the Scottish Government that it will hold health boards accountable for implementing the model. That is welcome, but real improvement cannot be implemented without funding. We know that 10 of the 14 health boards do not record a budget for chronic pain treatment. That is not me saying that; it is the campaigners who the cabinet secretary rightly praised a few moments ago. The previous health secretary declined to give any direct funding to stimulate the provision of chronic pain services beyond initial funding of some £50,000 for a managed clinical network in Glasgow. For the past few years, it appears that the Scottish Government has put chronic pain—which affects some 780,000 people in Scotland—in the slow lane. Now, at least, in complete contrast to his predecessor, we have a health secretary prepared to inject some momentum.

Accelerating the pace of change is essential if we are to see a difference on the ground, but we also need transparency. Information on the true state of chronic pain services has not always been evident. I doubt that even the cabinet secretary has been told about some of the issues that have arisen. For example, was he told that NHS Lanarkshire, which has one of Scotland’s worst chronic pain rates, has only two part-time consultants working with pain? That is one whole-time equivalent for a population of 562,000, with an estimated 26 per cent of the population suffering from chronic pain. We know that Lanarkshire has had some small seed money for an improvement group, but the need is clearly far greater than that. We have consultants who are part time—they are also, in the main, anaesthetists. That also applies to people in multidisciplinary teams—the nurses, physiotherapists and clinical psychologists. In many areas, disciplines such as occupational therapy and physiotherapy are just not represented.

I know that money is tight but the cabinet secretary needs to be aware that more than 50 patients were suddenly removed from NHS Lanarkshire’s waiting list last year, apparently without the knowledge of the doctors or the staff. They were sent to a private hospital for pain treatment but were not seen by a pain specialist. Making a waiting list look better is not confined just to a few areas. That money could have been better spent on securing more time for chronic pain treatment in the NHS.