Hansard

As Johann Lamont said, this particular petition has exercised the Public Petitions Committee for some time. I would like to thank the petitioner, Sandra Whyte, for lodging the petition and to mention the work that Elaine Smith has done over the period of the consideration of this petition and in keeping the committee in line.

In discussions about the disparity in healthcare provision, we regularly hear the term “postcode lottery”. What became clear during the committee’s investigation is that when it comes to the diagnosis and, in particular, the treatment of thyroid conditions, it is often not a question of postcode but of individual medical practitioners. While I recognise that the conventional T4-only treatment is successful in the majority of cases of hypothyroidism, I am concerned that when the conventional treatment is not effective, the options that are available to patients seem to be driven more by the individual opinions of treating physicians than by any clear guidance.

Both inside and outside the committee’s investigation, I have had the opportunity to speak with a number of thyroid patients about their experiences. What struck me most was the vast range of experiences that they had, from those who received faultless treatment to some who are now having to pay for their own T3. To me, that level of inconsistency in treatment is a real cause for concern.

To give you an idea, I will read out a description that one hypothyroid patient gave me of their path through diagnosis and treatment. In their own words:

“T3 changed my life. It’s as simple as that. At least, it should be as simple as that. But before T3 could change my life, I had to get it, and that was more difficult than I believe it should be.

Luck played an enormous role in my experience. Hypothyroidism is less common in men, so when I went to see my GP suffering from depression, low energy and other symptoms, hypothyroidism was never really considered. That’s why it was years of different ineffective medications, some with fairly unpleasant side effects, before I received a diagnosis. Even then, it was pure luck—a consultant looking into an unrelated issue ran a blood test that diagnosed me.

When I was put on T4, and ever-higher doses were having little or no effect, it was luck that my GP at the time suggested I ask my consultant about taking T3 as well. Then it was even more luck that my consultant was willing to try using T3. It was only later that I discovered he was the only consultant in that health board who would have prescribed it.

I understand that the medical profession has mixed views on the use of T3, but when there are so many people like me, who rely on it to function, it’s unfair that so much is left to chance. T3 works for me. Most people with hypothyroidism may not need it, but that’s not an argument to say it shouldn’t be available to those who do.

When I was diagnosed with depression, I went through various different combinations of medications. When the most commonly effective combination didn’t work, my GP knew they had other options and they tried them. When it comes to T3, the options are there, but it’s up to the doctor to decide whether they’re worth trying or not. That’s simply wrong. The effectiveness of a treatment may always have an element of luck. Whether or not someone can get a prescription for a treatment shouldn’t.

T3 changed everything for me. Without it, I don’t believe I’d have the job, the friends or the life that I have now. Without it, I really don’t know where I’d be. I hope Parliament can do more to ensure that it can change the lives of others.”

That is by no means an isolated case in the evidence that we took. Although it is not our remit in this place to make any kind of medical recommendations, the pervasive inconsistency and lack of clarity shown by the healthcare profession on this issue cannot be allowed.

Because healthcare is not an exact science, there will always be differing opinions on treatment options. Our healthcare professionals are trained to make those decisions and, in the vast majority of cases, I assume that that is in line with what we would all expect. However, when the medical profession is so split on a treatment, especially for a condition that can have such a devastating effect on a person’s quality of life, I think that it is incumbent on the Scottish Government and specifically the cabinet secretary to call for strong guidance to be given to healthcare professionals on the treatment of hypothyroidism, especially on when the prescription of T3 may be appropriate.

We cannot allow a situation where patients are left to order their own medicines—medicines that they know are making a difference and are making a significant contribution to their quality of life—to continue. We need a clear direction from the Scottish Government to the medical profession that guidance needs to be given to the front line where appropriate.