Hansard

I will also start by paying tribute to the work that members of the cross-party group on chronic pain have done over the past 23 years and, in particular, by remembering those who are no longer with us. I know that she will hate the amount of praise that she has received today, but Dorothy-Grace Elder really must be commended for everything that she has done to support patients, sometimes in the most difficult circumstances that anyone could imagine.

I also want to thank and pay tribute to my fellow co-conveners of the cross-party group, Monica Lennon and Rona Mackay, because, over the past six years, we have desperately tried to make some progress for patients. It is not unfair to say that the situation with access to chronic pain services in Scotland has been totally unacceptable for too long. We need to see reform, and we need a new approach, so I genuinely hope that today is the start of a process to deliver change for chronic pain patients across Scotland. The Versus Arthritis briefing for today’s debate states that chronic pain is a public health crisis. I agree.

Jackie Baillie said that politicians are quick to talk about listening to people and to lived experience and about delivering patient-centred care. However, one group of patients for whom that has clearly not been the case is chronic pain patients across the country.

I can honestly say that listening to the stories of patients who have attended the cross-party group has involved some of the most challenging and harrowing conversations that I have had in my six years as an MSP. When someone who is living in such pain feels that contemplating suicide is the only option available to them, that should act as a major wake-up call to us all, but especially to politicians who have direct responsibility for our NHS. Sadly—I am sure that my fellow conveners would back this up—that seems to be the experience of so many of our fellow Scots who live in pain every waking hour of every day.

That is why I desperately hope that the debate is an opportunity for the Government to listen to those concerns and, fundamentally, to start work on fixing services that people rely on.

We have heard a lot of statistics today on the number of people who are waiting for services, but I want to highlight my concern about the movement towards self-management as the service that people will be offered. That is not acceptable and it is not something that we should look to do. As part of some of the service reductions, we have seen the introduction of new pathways that offer patients alternatives to being seen at a consultant-led outpatient clinic. However, if patients take up that offer, they are removed from waiting lists. That creates more hidden waiting lists in our health service.

The suggestion that I have proposed for some time is included in our amendment—namely, to call on NHS Scotland to develop access to specific regional clinics, so that we can drive forward action on waiting times. Patients could access injections and infusions in such clinics, which would help to reduce waiting times and improve follow-up appointments.

A model similar to what we have seen during the pandemic for vaccinations would deliver for our constituents.

Many issues have been touched on, which I hope that the minister has taken on board. During the pandemic, we saw reports that one in 10 Scots were being prescribed powerful opioids purely to deal with the chronic pain that they were living with. I know from conversations that I have had with constituents that they feel that they are now addicted to those opioids—and, indeed, that self-prescribing has become the norm or the only option available to them, with people resorting to purchasing drugs online to manage their pain. That is a hidden part of the crisis that I do not think that we have discussed, but which we must recognise.

The Scottish Government’s framework for pain management services can and must present an opportunity to resolve all those issues and improve access to services. That will take leadership from the minister and the cabinet secretary, and from every local health board. Challenges around staffing remain a significant part of this. We need to see a workforce plan for chronic pain services. Self-management is important, but it can never be an excuse for withdrawing pain services.

The debate has been helpful in relation to two areas. Christine Grahame made a point very well about the work that can be done to provide peer support. A couple of weeks ago, I led a debate on the Cancer Card model, which provides online support and brings all cancer services together. It is about time that we saw such a model for chronic pain patients. It will be useful to see how the hub will develop that. Bob Doris made a number of good points about that. I hope that the approach will be developed organically, by patients, so that they are at the heart of it.

As the minister said, in every single case, it is about the experiences of individuals who are living with chronic pain. The importance of that cannot be underestimated. Access to mental health support has not been looked at enough either. For many people, the pain that presents initially leaves them in a situation where their mental wellbeing becomes poor very quickly, and deteriorates while they wait for access to services.

Today must be the start of a process. I hope that the minister and cabinet secretary will take personal responsibility for how the framework for pain management service delivery will be implemented. It is clear that we need the implementation plan to be explained to patients. How will they access services? What specific detail will be provided on staffing, investment and—ultimately and as always—patient involvement? As Alex Cole-Hamilton said, chronic pain patients across Scotland are watching today, and must see the Scottish Government deliver the change that we need.