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Chamber

Meeting of the Parliament 04 December 2018

04 Dec 2018 · S5 · Meeting of the Parliament
Item of business
Thyroid and Adrenal Testing, Diagnosis and Treatment
Stewart, David Lab Highlands and Islands Watch on SPTV

This has been an excellent and well-informed debate. I thank the Public Petitions Committee for its hard work. I particularly acknowledge the contribution of Elaine Smith; she has been a fantastic campaigner and has made a huge difference in the campaign. I warmly thank the campaigners in the gallery for their courage, patience and dedication. They should be applauded for the hard work that they have done over many years. [Applause.]

I was pleased to be the convener of the Public Petitions Committee when the petition was first received. I notice that there are a couple of survivors from those days here, in the shape of Angus MacDonald and David Torrance, who were involved in the evidence sessions. Some people might feel that the subject is very technical—undoubtedly, it is—but the key issue is crucial, particularly for women’s health. As Jackie Baillie said, 95 per cent of the people who are affected are women. As Elaine Smith said, given that at least 2 per cent of the population suffer from thyroid disease, it is clear that many parliamentary colleagues and their neighbours, friends and constituents will be in that patient cohort.

It is obvious from the evidence and the report that thyroid diagnosis and treatment have lagged behind other areas of endocrinology, for example diabetes. Specialists cover conditions including metabolic disorders, some cancers and excessive or insufficient production of hormones. As other members have found, it is interesting to quote the British Thyroid Association, which has expressed concern about patients being taken off T3 due to cost rather than clinical need. I will quote the association’s words in its guidelines of December 2016:

“The BTA Executive Committee have been made aware of recent difficulties encountered by patients in obtaining Liothyronine (L-T3). In some instances, patients who have long been established on L-T3 have had their treatment abruptly withdrawn and some clinicians have received requests from local health authorities to switch patients from L-T3 to levothyroxine (L-T4). We are concerned that these actions are driven by cost considerations rather than clinical need and that the BTA position statement on the management of hypothyroidism is being inappropriately cited to support these requests.”

In its response to the committee, the Scottish Government has made it clear that T3 prescribing must continue. It said:

“The Scottish Government’s position is that the treatment should be consistent with the BTA guidance in relation to Liothyronine (T3)”.

However, as Jackie Baillie suggested, when the minister winds up, could he make it very clear that, where appropriate, there should be no postcode lottery and that patients wherever should be able to get necessary medications. That is vital.

When I was convener of the Public Petitions Committee during consideration of the petition, a dossier of more than 50 patients with different stories was issued to us. I do not have time to do them all justice, but I will quote one—Lee-Anne—who said:

“Prior to my diagnosis, I was slipping into such a black hole, reacting very badly to antidepressants, which caused panic attacks, full-body spasms, insomnia, clenching jaw, suicidal thoughts and the list goes on. When I reported this reaction to my GP, her answer was to double the dose.”

In summary, I acknowledge the fantastic work of the Public Petitions Committee, which shows the innovative role that it can play in Parliament. I thank the committee and the campaigners for their sterling work. As a member of the Health and Sport Committee—I cannot speak for the rest of the members—I support a full inquiry by the Health and Sport Committee. My colleagues on the committee and in the chamber might wish to support me in that.

15:19  

In the same item of business

The Presiding Officer (Ken Macintosh) NPA
The next item of business is a debate on motion S5M-14984, in the name of Johann Lamont, on the “Report on petition PE1463: Effective thyroid and adrenal tes...
Johann Lamont (Glasgow) (Lab) Lab
The Public Petitions Committee has been considering PE1463 since 2012. I only recently became the convener of the committee, but it is my privilege to speak ...
Elaine Smith (Central Scotland) (Lab) Lab
Does the convener acknowledge that even patients who are on the standard T4 treatment can have symptoms that they do not know are associated with the thyroid...
Johann Lamont Lab
The evidence suggests—as do constituents who have spoken to me—that there is, across the board, a fundamental lack of understanding of the impact of the cond...
The Minister for Public Health, Sport and Wellbeing (Joe FitzPatrick) SNP
I thank the Public Petitions Committee for securing the debate, and the convener, Johann Lamont, for moving the motion. I offer my personal thanks to the pe...
Elaine Smith Lab
I will come to this issue again in my own speech. Would the minister expect health boards to get in line with that approach and not stop people getting T3 or...
Joe FitzPatrick SNP
What people are experiencing on the ground is really important. The guidelines make it clear that, if T4 is not working for an individual, the endocrinologis...
Brian Whittle (South Scotland) (Con) Con
As Johann Lamont said, this particular petition has exercised the Public Petitions Committee for some time. I would like to thank the petitioner, Sandra Whyt...
Elaine Smith (Central Scotland) (Lab) Lab
I have made many speeches in this chamber over 20 years but this is one of the most important. It is quite literally a matter of life and death, including my...
The Presiding Officer NPA
Thank you. We turn now to the open debate. 15:00
David Torrance (Kirkcaldy) (SNP) SNP
I am extremely pleased to have the opportunity to speak today, because I was on the Public Petitions Committee when the petition was lodged in 2012. Since th...
The Deputy Presiding Officer (Christine Grahame) SNP
I remind people in the gallery that we do not permit applause in the public area. Thank you very much. 15:06
Rachael Hamilton (Ettrick, Roxburgh and Berwickshire) (Con) Con
I thank Sandra Whyte for highlighting the importance of thyroid-related conditions and for working so hard to get us to this point. I also thank Elaine Smith...
Jackie Baillie (Dumbarton) (Lab) Lab
It has been more than a year since we last debated access to T3 for people who suffer from thyroid conditions. That begs the question: what has changed? I fe...
David Stewart (Highlands and Islands) (Lab) Lab
This has been an excellent and well-informed debate. I thank the Public Petitions Committee for its hard work. I particularly acknowledge the contribution of...
Miles Briggs (Lothian) (Con) Con
I, too, think that it is important that we pay tribute to the petitioners and thank the Public Petitions Committee for giving Parliament the opportunity to a...
Elaine Smith Lab
Will the member take an intervention?
The Deputy Presiding Officer SNP
The member is in his last minute. If he does not mind losing a little time, he can give way.
Miles Briggs Con
Okay.
Elaine Smith Lab
Unfortunately, although two other companies produce the drug, the price is not coming down.
Miles Briggs Con
I note that point. Given that I have 30 seconds left, we will perhaps discuss that outside the chamber. I support Elaine Smith’s important ask that the Heal...
Joe FitzPatrick SNP
I am very grateful to members who have shared their experiences this afternoon, and I appreciate the work that members have put into advancing the issue on b...
Miles Briggs Con
In the debate, the useful point has been made that there is a postcode lottery across Scotland. As Jackie Baillie suggested, will the minister commit to writ...
Joe FitzPatrick SNP
I will come to that point. I re-emphasise that the Scottish Government’s position is that T3 can be prescribed by an endocrinologist if it is considered to ...
Jackie Baillie Lab
I very much welcome the minister’s confirmation, but will he monitor whether boards pay attention to him?
Joe FitzPatrick SNP
I suspect that, if boards are not paying attention to me, many members will ensure that I am aware of that. If people cannot access the treatment that we all...
The Deputy Presiding Officer SNP
I call Angus MacDonald to close the debate on behalf of the committee. You have a tight seven minutes, Mr MacDonald. 15:29
Angus MacDonald (Falkirk East) (SNP) SNP
When the Parliament last debated this issue, and the petition, in Elaine Smith’s members’ business debate, I gave her an assurance that the Public Petitions ...
Elaine Smith Lab
On a point of order, Presiding Officer. I think that the deputy convener might have misheard me, because I said earlier that the price does not seem to have ...
The Deputy Presiding Officer SNP
As a former Deputy Presiding Officer, Elaine Smith knows that that is not a point of order, but I will let it pass—I am in a good mood.