Hansard

I thank Kenneth Gibson for lodging the motion, which gives us all an opportunity to highlight the profound impact of chronic kidney disease on individuals, families and our national health service. I, too, welcome the visitors in the gallery, as I do the briefings that we have received.

In many ways, chronic kidney disease is a silent epidemic. As has been mentioned, it affects more people in Scotland than cancer—its prevalence is about 3 to 4 per cent. It can have a huge impact on people’s ability to deal with their daily living, and on families. It can hugely affect people’s ability to go about their day-to-day lives, including work. Kenny Gibson has highlighted that well, and I will not rehearse it further.

The outlook and prognosis for those living with chronic kidney disease have improved immeasurably over the years. Many conditions are now treatable and manageable in the long term, and the advances in transplant technology and its availability over the years are incredible.

I am a registered nurse, and I worked in California, albeit a long time ago. I had the privilege to be part of the liver transplant team and, on many occasions, took part in kidney and pancreas transplants. I put on record my thanks to everyone in the transplant and dialysis teams and all the support services for all that they do to improve the lives of their patients. The teams offer hope to many who might previously have had no options.

In NHS Dumfries and Galloway, in my region, over recent years, there has been an expansion in dialysis services. As well as the site at Mountainhall treatment centre—the previous Dumfries and Galloway Royal infirmary site—there are dialysis sites in Stranraer and Kirkcudbright. That saves those who need dialysis as part of their chronic kidney disease treatment from travelling long distances to Dumfries three times a week. I imagine that that would have been quite cumbersome for people before the Stranraer and Kirkcudbright sites opened.

Home-first dialysis also offers the potential for a better quality of life for those who receive treatment—in particular, those living in rural areas, who face the biggest practical barriers, as I have just described, to accessing that life-saving support. It will not be suitable for everyone, but we should strive to make it the default position for those for whom it is suitable, as it will support patients and reduce the pressure on secondary care facilities in our NHS. That embedding of treatment for kidney diseases in our communities is hugely welcome and is evidence of how our health service is developing in the right direction as resources allow and as the medical technology that is available for treatment improves all the time.

Embedding also has to include primary care at the GP or community health level. We need to ensure that those professionals who are usually the first to see patients presenting with symptoms have the necessary tools and training to make that diagnosis and get the earliest possible intervention put in place, whether that be a referral to secondary care or simply the identification and management of issues at the local level.

Early intervention is key. As with many other conditions, the longer that problems are left untreated, the greater is the potential for long-term complications and more serious medical intervention. Given the way in which CKD interacts with other health conditions—for example, the risk of its association with high cholesterol and high blood pressure—identifying it at an early stage offers the potential for interventions targeted at those conditions, thereby boosting the health outcomes not just in renal health but across the board.

I do not have time today to delve into the detail of the implications of CKD at stage 1 through to stage 4. That would take a whole lecture. However, I welcome the Government’s on-going work on the long-term conditions strategy. The consultation on that has closed recently. I am sure that the Government is working to determine the process for moving forward, so I look forward to hearing the minister’s response.

Again, I thank all our dedicated professionals across our NHS, and campaign groups such as Kidney Research UK, for their support towards improving the prognosis for everybody who is affected.