Hansard

I welcome the opportunity to debate this issue. The cross-party group on chronic pain has been calling for the Scottish Government to hold a debate on chronic pain for some time now, so I will take this opportunity to acknowledge its hard work over the years, with former MSP Dorothy-Grace Elder continuing to champion its cause.

There are difficult issues to discuss, and there is a lack of trust from some patients about the Scottish Government’s intentions and actions. Some people with lived experience have been excluded from those discussions before by the Scottish Government, and we must ensure that that does not happen again. The Scottish Government set up the national advisory committee for chronic pain back in 2017, but seven out of the 10 elected patient representatives quit the committee because they felt that their voices were not being heard and that they were somehow simply part of a tick-box exercise.

The cabinet secretary promised to meet patients, but he has cancelled meetings at least three times. However, he did meet the cross-party group conveners and I am grateful for the work that Monica Lennon, Miles Briggs and Rona Mackay do for those with chronic pain.

I do not want to dwell on those particular incidents, but I would make the observation that successive Governments have made promises about patients’ voices being at the heart of shaping policy—and that is right. That lived experience should not be dismissed, though, if those voices are challenging and do not fit with the Government’s preferred narrative.

Turning to chronic pain services and the “Framework for pain management service delivery—implementation plan”, I think that the broad approach that recognises the context of living with chronic pain is helpful—there is the impact on employment and the impact on family life. However, the pace of change that is suggested in the plan is much too slow. Services are currently patchy and there are not enough staff; we need to move more quickly to support the hard-working staff in this field as well as improving things for patients.

Try as I might, I do not really see the commitment to funding to help to deliver the change that is required, but I am delighted that the minister, in response to an intervention, told members in the chamber about the resources that are attached to the plan. However, I would ask, are those resources new? Are they specifically attached to particular actions in the plan? Will the minister publish the detail of that financial support so that we can have transparency about how change will be delivered as existing staffing and resources are already overstretched?

Let me illustrate the challenge with the latest figures released by Public Health Scotland: 1,835 patients were seen at a consultant-led chronic pain clinic during the last quarter. That is great, but when compared to 2,122 in the previous quarter, it is a decrease of 13.5 per cent. At the same time, just shy of 4,000 patients were waiting for their first appointment at a chronic pain clinic. That figure has increased by 29.9 per cent in just three months in this year, but it is almost 50 per cent higher than the number of patients who were waiting last year. Although first appointments are measured against an 18-week waiting time, there are no such time limits or waiting standards for returning patients and many have waited over a year for that treatment. I believe that the Government acknowledges that further work is required in this area and I hope that the minister can agree to Scottish Labour’s call for greater transparency around waiting times for follow-up treatment.

Let me also address the issue of self-management. If we can give people the tools to help themselves and provide opportunities for self-management, that is a good thing, if it works for patients and is deemed appropriate by their doctors. However, access to specialist services must remain in place not only to help those living with the most serious conditions but to review those who are more able to self-manage. Removing that access is not an option and concerns have been raised that patients have been forced into unsuitable self-management pathways, which has also resulted in increased pressure on primary care services and indeed on many voluntary sector providers.

GPs are already struggling to cope with the increased volume of patients that they are seeing. Stripping away money from the sustainability fund for them and having £65 million stripped away from the primary care improvement fund will simply add to that pressure, so I would appreciate a reassurance from the minister that specialist services will not be reduced as a result of the implementation plan and that the burden will not fall on GPs or indeed on the voluntary sector.

I remember that it used to be the case that patients were sent from Scotland to Bath for some specialist services; I understand that, more recently, patients have had to travel to Doncaster to get pain-relieving treatment. The more that can be provided by the Government in Scotland, the better, and I hope that the minister will address that.

There is undoubtedly similarity here to many other areas of healthcare at the moment. Waiting times are increasing. There are not enough staff, and those we have are under pressure and are underresourced. Patients are getting sicker before they are seen and before they are treated. I have no doubt that the pandemic has exacerbated the situation, but this was a problem before the pandemic began.