Hansard

I would be happy to, but what I am calling for is a network of long Covid clinics, because that is how we will get treatment and help to patients who suffer from long Covid. That is what people across Scotland are asking for.

Let us also remember that it can be very difficult for chronic pain sufferers to function in the workplace. In turn, that impacts their family finances. With one in five Scots living with chronic pain, the Scottish economy suffers, too, but let us stay focused on the patient for now. The problem right now for chronic pain sufferers is poor access to treatment to reduce the debilitating impact on their daily lives. Almost 4,000 people are waiting for their first appointment at a chronic pain clinic, and only 26 per cent of patients are seen by a chronic pain specialist within six weeks. In the quarter ending 30 June 2022, 20 per cent of patients waited for ten to 12 weeks.

It is vital that everyone in the Parliament and at home understands that those patients, despite having been seen by their GP and being on significant pain killers such as co-codamol, tramadol or even morphine, are still in intractable pain. It is not the toothache that I described at the start of my speech—it is significant chronic pain. As for patients with musculoskeletal conditions, Versus Arthritis reports that more than 42,000 people are waiting for joint replacement surgery, and that list is anticipated to grow over the coming months.

Scotland has a chronic pain crisis, which is a public health crisis. Although, in July, the Scottish Government published its “Framework for pain management service delivery—implementation plan”, it is underwhelming. It has four laudable aims—person-centred care, access to care, safe and effective support to live well with chronic pain, and improving services—but the plan does little to outline how it will be implemented or explain how patients will access services, and there is no detail on staffing, investment or the involvement of patients. The plan provides little confidence that sufferers of chronic pain will experience any improvements soon.

Does the cabinet secretary expect Scotland’s shrinking GP workforce, with its shrinking budget, to deliver? The Scottish Government said that its thinking on improving care and services is being undertaken in partnership with people who have chronic pain. That would, indeed, be the correct way forward, but the trouble is that we have heard a different story. According to Dorothy-Grace Elder, the voluntary secretary of the Scottish Parliament’s cross-party group on chronic pain, there has been no proper partnership with patient representatives on the Government’s national advisory committee for chronic pain. The committee is closed to the public, stacked with health board officials and civil servants and supervised by the Health and Social Care Alliance Scotland—the ALLIANCE—which is funded by the Scottish Government to the tune of around £6 million a year.

The patient representatives were promised equality and “co-production” with the sharing of facts and documents, but that did not happen and access to documents and facts has been refused. They were barred from seeing the framework document on chronic pain service delivery before it was printed and, six months later, they were sent a printed report that was marked?“draft” without being given an opportunity to comment on it. Ms Elder’s account is disturbing. We have a multimillion pound taxpayer-funded organisation versus sufferers of chronic pain, so whose interests are being represented?

Although appointed for two years, patient representatives were dropped after four months and just two meetings. A freedom of information request revealed that Scottish Government officials and the ALLIANCE discussed, by email, that patient representatives should be told to stop communicating with one another unless they are in meetings that are supervised by the ALLIANCE.

There is an old expression that says, “If it looks like a duck and it quacks like a duck, then it is a duck”. Well, it certainly looks as though the ALLIANCE—supposedly a patient-voice organisation—is taking advice from the Scottish Government on how to control the narrative. A Sunday Post article quoted the ALLIANCE saying that it is not

“subject to instruction from government officials”,

while the Scottish Government said that it did not

“request restrictions on ... members,”

but emails that were sent on 24 and 25 May 2021 suggest otherwise.

Members of the CPG on chronic pain usually pack the gallery during debates that are of interest to the group. The CPG is upset about the timing of today’s debate, because its members feel that the lack of notice cruelly excludes patients with disabilities, who need time to plan and often require to be accompanied.

We call on the Scottish Government to recognise that far too many patients have attempted suicide over extensive delays in physical waiting times. Gross understaffing in pain-related mental health has not been addressed for years. Pain causes job loss, family break-ups, poverty and deep depression.? Pain suicide risk should be fully included in the Scottish Government’s suicide prevention plans.

Patients are worried that the Scottish Government wants to reduce reliance on chronic pain services and certain treatments and increase self-management of pain. The Scottish Conservatives believe that NHS Scotland should develop access to new specialist services, which might include regional one-stop injections and infusions clinics, to help to reduce waiting times and improve follow-up appointments for patients.

Our patients who are suffering with chronic pain are desperate, and we have a duty to come up with solutions—not woolly words. I spoke about one-stop injections, but let me give the minister another solution: where there is spare capacity, with surgeons not in theatre due to lack of beds and delayed discharge, why not use that capacity for trained surgeons to administer pain-relieving injections for people who might otherwise wait for up to 12 months? It is day-case surgery and does not require beds.

I draw members’ attention to my entry in the register of members’ interest, as I am a registered GP.

I move amendment S6M-06779.2, to leave out from “notes the actions” to end and insert:

“notes the concerns from some chronic pain patients regarding the Scottish Government’s lack of meaningful engagement with their representatives, which is causing upset and distrust; supports the focus on delivering person-centred care and improving access to local support for pain; recognises the efforts to increase NHS staff skills and knowledge of chronic pain and its impact, and agrees with the commitment to improve the consistency and quality of pain management services across Scotland; regrets, however, the continued reports of many vulnerable people with chronic pain being forced into unsuitable self-management pathways, with increased pressures on primary care, due to a lack of access to specialist services; recommends that the Scottish Government works in partnership with patient groups to ensure a truly collaborative approach to improving the treatment and wellbeing of chronic pain patients, and calls on Scottish Government ministers to protect specialist chronic pain services, and provide greater transparency around waiting times for return patients.”