Hansard

It is a pleasure to speak in the debate. I acknowledge the fundamental challenges in the provision of chronic pain services; there seems to be agreement across the parties on that. However, there are also opportunities. I have read the new “Framework for pain management service delivery—implementation plan”, which the Scottish Government has produced, and I think that it is considered, strategic, co-ordinated and potentially—the word “potentially” is doing a lot of heavy lifting here—innovative. However, it also has to be implemented, and much of the debate has been about that.

I welcome the first action in the delivery plan, which is to

“Establish a national expert working group to oversee coordination and development of chronic pain information and resources”.

Crucially, those with lived experience of chronic pain will be directly involved in that. I acknowledge that there has been discussion this afternoon about how we capture that direct lived experience in a meaningful way, and other members have put on record their concerns about that.

We need to be open about pressures and resources across the public sector, and we absolutely need to map out and identify local and regional variations in resources and service delivery in relation to chronic pain. We then need to address those variations. I would welcome more details from the minister about how we set about tackling that—for instance, will the learning from that work be connected to action 6 of the delivery plan, which is to establish

“a national expert working group to identify and scale-up improved pain service planning and delivery”?

A connection between implementing a strategy document and identifiable delivery and change on the ground is obviously important. Between 30 and 50 per cent of people are estimated to suffer from some form of chronic pain, and 5 per cent of people in Scotland report severe and disabling chronic pain that adversely affects all aspects of their lives, so such variation needs to be addressed.

I mentioned resources. The most important resources are the patients, who know their pain best, and our healthcare professionals, who do their level best to offer support. I welcome the action to

“Establish a Chronic Pain knowledge hub for healthcare professionals to promote understanding and learning on chronic pain”.

Healthcare professionals who offer support locally do not always have all the answers, but their colleagues elsewhere across Scotland might. We need to share the expertise, and I commend the knowledge hub. However, it must be easy for healthcare professionals to access, and they need to have time to refer to and use it. I ask the minister whether the hub will allow healthcare professionals to interact directly with each other, so that they can offer peer advice and support, rather than it just being an online portal.

I was pleased to see in the delivery plan a clear appreciation of the greater strain on pain management that is caused by the substantial waiting list for various NHS procedures, including orthopaedics, which gets a specific mention.

I know that NHS waiting lists have been a key subject for debate in this Parliament and that the matter has been politically sensitive. In many ways, those in the NHS in Scotland are outperforming colleagues in the NHS in England and Wales, but I acknowledge that we still have a heck of a lot to do—we must do better here in Scotland, too. I welcome the health secretary’s focus and drive in seeking to do so.

However, that does not wash away the reality of individual patients’ experiences of chronic and persistent pain as they face extended waits for surgery. It is important to see in the delivery plan that the Scottish Government is considering how pain management support can be integrated as part of the pre and post-operative care pathways.

The other day, I met a constituent who has waited about a year for an orthopaedic procedure. Unfortunately, that wait is likely to go on for a fair bit yet. Understandably, their on-going pain impacts on their quality of life and on their employment. They need their surgery, but they also need support for chronic pain, which is being exacerbated by their lengthy wait.

Given that reducing surgical waiting times is an on-going challenge—across the UK—it is important to embed support for chronic pain management and support into services that are offered to patients who face long waits. My understanding is that the delivery plan seeks to do that, and I would welcome further details on how it will achieve that.

In the case of my constituent, their GP has tried to be supportive on pain management, and I hope that their referral for physiotherapy has been helpful to a degree. However, it is clear that that person needs their surgery—that is the reality.

The delivery plan talks a lot about specialist services. I draw Parliament’s attention to action 8, which is to

“Establish the NHS pain service managers network to improve coordination and planning of specialist pain services”.

Who could disagree with that? We must do that. Where possible, we must also promote pain self-management. It should not be one or t’other; it should be a commitment to both. What a specialist service looks like might change over time. That must be evidence based, and it must take patients and the chronic pain community with it.

At the start of my speech, I mentioned that the delivery plan is considered, strategic, co-ordinated, integrated and—potentially—innovative. However, it must also be monitored for delivery on the ground. I would welcome more details on how that will be achieved. The plan is hugely ambitious and I am hugely supportive of it.