Committee
Public Petitions Committee 09 February 2016
09 Feb 2016 · S4 · Public Petitions Committee
Item of business
Continued Petitions
Thyroid and Adrenal Testing and Treatment (PE1463)
Will you also comment on the range? The committee has been looking into it. It is different in different countries. We have heard evidence that, far too often, general practitioners rely just on the blood tests and do not look at the patient’s symptoms. There are a lot of patients who are on many other medications for various symptoms but, if their thyroid was treated correctly, they would not have to be on all those other medications, which include drugs for depression, drugs for fibromyalgia, painkillers and so on. If there was better treatment for thyroid patients—treatment that was more centred on them, in the same way as with diabetic patients—there could be moves forward for patients and for the NHS. There is scope for the NHS to save money. Why is care for people with diabetes, which is a fellow endocrine neighbour of hypothyroidism, provided on a person-centred basis, whereas those with underactive thyroid are simply put on levothyroxine? There is one medicine for them.
In the same item of business
The Convener
Lab
Our second item of business is consideration of PE1463, on effective thyroid and adrenal testing, diagnosis and treatment. We will take evidence from the Min...
The Minister for Public Health (Maureen Watt)
SNP
Good morning and thank you for inviting me to give evidence. At the outset, I make it clear that I have not only an on-going interest in the petition as Mini...
The Convener
Lab
Thank you—that was a comprehensive overview of the situation from your perspective. As you said, the petition has been running for a substantial time. Commit...
David Torrance (Kirkcaldy) (SNP)
SNP
The Thyroid UK survey report shows that 42 per cent of respondents considered that their clinician was not open to discussion about treatment options and tha...
Maureen Watt
SNP
As I said, the survey was UK wide, so we cannot extrapolate the Scottish situation from it. It did not involve a randomised sample, as one would normally exp...
Professor Graham Leese (NHS Tayside and Chief Medical Officer Specialty Adviser)
I am not directly involved with that, but we have been involved with the British Thyroid Association. As the minister mentioned, the British Thyroid Foundati...
The Convener
Lab
Elaine Smith has a question—is it a supplementary on this specific point?
Elaine Smith (Coatbridge and Chryston) (Lab)
Lab
My question is relevant to the point. I might have asked it later, but it is perhaps better if I ask it now, if you do not mind.
The Convener
Lab
We will take your question now, then I will come back to David Torrance.
Elaine Smith
Lab
The petitioner has told me that the British Thyroid Foundation changed its advice online as recently as this week. My question is directly for Professor Lees...
Professor Leese
I cannot comment on the British Thyroid Foundation document that you refer to, as I am not sure that I have seen it. However, it probably refers to the Briti...
Elaine Smith
Lab
Will you also comment on the range? The committee has been looking into it. It is different in different countries. We have heard evidence that, far too ofte...
Professor Leese
The evidence suggests that patients who are on thyroxine are treated very much at an individual level. The guidelines, and most GPs, try to adapt the levels ...
Maureen Watt
SNP
I say, perhaps for people who are not so involved in the issue, that anybody who is on levothyroxine gets tested. They get a thyroid-stimulating hormone—TSH—...
Professor Leese
It is worth noting that there is a wide range of what is deemed to be acceptable TSH, so there is scope for moving doses, perhaps to small amounts, to mainta...
David Torrance
SNP
The minister said that new guidelines for GPs would be published later in the year. Will you expand a bit on what is in the guidelines and how quickly SIGN w...
Professor Leese
There needs to be increased general awareness of the guidelines. That comes down to educating GPs and advertising the guidelines. Each year, every GP must do...
Maureen Watt
SNP
The condition is something that most GPs will come across in their practice. Just as Diabetes UK’s website includes information on tests for people with dia...
Hanzala Malik (Glasgow) (Lab)
Lab
I accept what the minister said about the figures in the survey report being UK based, which means that the true picture in Scotland is not clear. Perhaps sh...
Professor Leese
The guidelines, which have been available since May, are not a one-off. As with any advertising campaign, it comes down to continuing to promote them—to incr...
Hanzala Malik
Lab
You are stepping around the issue and you are still not giving me a clear guide on how you are focusing on it. How will we assess the success of the advertis...
Maureen Watt
SNP
There are already SIGN guidelines for GPs. We are talking about whether there will perhaps be revised SIGN guidelines. One of the petitioners has been invol...
The Convener
Lab
I ask for order in the public gallery, please. I ask the minister to stop for a moment while the matter is dealt with. Interruption. I am sorry for the distu...
Maureen Watt
SNP
As I said, my understanding is that the petitioner was involved in discussions about SIGN guidelines—I do not know whether anyone else wants to come in on th...
Hanzala Malik
Lab
I accept what you say and I am sure that you will try to ensure that the guidelines are fit for purpose, but I have been pressing you on the matter—I will st...
Maureen Watt
SNP
As I said in my opening statement, the timing is not up to the Scottish Government. It is up to the SIGN council—we cannot really determine its timeframe.
Professor Leese
The guidelines are being distributed at the moment. You talked about measuring their success, Mr Malik, and I would welcome your thoughts as to how we do that.
Hanzala Malik
Lab
Shall I respond to that, convener?
The Convener
Lab
If you are being asked a question, you can respond if you have an answer.
Hanzala Malik
Lab
I am happy to do that in a bid to help. I have already indicated that we do not have Scottish figures.