Hansard

I thank my colleague Kenny Gibson for bringing the debate to the chamber. I also thank the organisations with which I have engaged fairly regularly—I met Kidney Care UK today, in fact, and I have met Kidney Research UK. NHS Ayrshire and Arran has been very helpful, as have the British Heart Foundation and Obesity Action Scotland.

The statistics for chronic kidney disease are stark. More than 600,000 people in Scotland are living with CKD, which is more than 10 per cent of the population. Much of that—as Kenny Gibson stated—is underdiagnosed. It will not surprise members to hear that poverty and health inequalities disproportionately affect people with CKD; we hear the same across many conditions. I heard today from Kidney Care UK’s advocacy and support teams about those who come to the organisation for advice and grants. In 2023, 45 per cent of those people were sitting at stages 3 to 5, with kidney function of less than 60 per cent.

We can talk about prevention, as I often do in the chamber. CKD currently costs Scotland’s economy more than £0.5 billion per year, and Kidney Research UK suggests that, without significant Government intervention, that could rise to more than £1 billion by 2033. The total annual economic impact of kidney disease in the UK is £7 billion, costing the NHS £6.4 billion, which is about 3.2 per cent of the overall NHS budget.

Employment rates among people on dialysis are low, sitting at 26 per cent. It is projected that between 2022 and 2032, CKD in the UK will result in something like 8.1 million missed work days in people diagnosed with CKD, and 11.9 million work days missed by carers of people with CKD. Both the prevalence of CKD and its cost to the NHS are expected to increase significantly in the next decade.

There are a lot of comorbidities associated with CKD. One issue that I discussed with the organisations earlier today was the impact that a diagnosis of CKD will have on someone’s mental health. One in three people with CKD experience depression, which worsens health outcomes and adds to the pressures on the mental health system. Kidney Care UK, through its free counselling service, hears daily from people who are undergoing those challenges, but there is very limited support available to patients on the NHS.

Obesity is linked to a higher risk of CKD. As we well know, obesity levels in Scotland are at a record high and are rising, and that needs to be tackled. As every member in the chamber will know, having heard me speak about this before, we should be looking at how we prevent conditions such as obesity in the first place, rather than having to treat them once they occur. Prevention, detection and lifestyle advice are all really important. CKD is also a major risk factor in developing cardiovascular disease, and it can be made worse by CVD.

We recognise the importance of the integrated approach to comorbid chronic disease. However, there is significant concern that a single long-term condition framework risks oversimplifying the complexities of long-term conditions, which often have significantly different clinical pathways, with different specialisms and different impacts on patients’ lives. As Kenny Gibson alluded to, kidney disease in particular remains largely absent from national planning in Scotland, despite being identified in the long-term conditions framework consultation as a major gap.

In conclusion—having got about halfway through what I wanted to say—I thank Kenny Gibson again, and I thank Kidney Care UK for its briefing. We need to consider how we prevent the disease in the first instance, because the cost to the national health service and the cost to the individual is high.