Hansard

I congratulate Annabel Goldie on obtaining today's debate, which will help to raise the profile of endometriosis in Scotland. The timing of the debate is appropriate, as an awareness day for endometriosis takes place next week, on 4 July.

As a man, I will never suffer directly from the condition, but I have read about the symptoms and can imagine how debilitating and distressing it must be. Perhaps the most distressing thing is the fact that endometriosis can cause fertility problems. It is estimated that between 3 and 10 per cent of women between 15 and 45 have endometriosis. Endometriosis accounts for 25 to 30 per cent of women who have fertility problems. As Elaine Smith reminded us, endometriosis is the second most common gynaecological condition in this country.

Various members made important points about the need for the greater awareness to which the motion refers. Greater awareness of the condition is needed among the general public and I hope that today's debate has helped. I will certainly consider Elaine Smith's suggestions about an information campaign. We are developing an information strategy for patients in the health service, which I am sure will take on board the points that have been made today.

Awareness among general practitioners is also required, which Annabel Goldie referred to when she suggested that guidelines be provided. I am pleased that the Royal College of Obstetricians and Gynaecologists has produced UK-wide guidelines on the investigation and management of endometriosis. The guidelines have brought together the latest knowledge and best practice and are based on clinical evidence and treatment of endometriosis. The guidelines also examine the options for treatment in the light of symptoms and associated infertility. The guidelines will, if necessary, be reviewed and updated in 2004.

The guidelines have been distributed to all the fellows and members of the Royal College of Obstetricians and Gynaecologists and been made available to the Royal College of General Practitioners. I hope that the guidelines will lead to earlier and better diagnosis of endometriosis, although, having spoken to GPs, I know that they do not always receive the guidelines that are sent to them. One GP suggested that local health care co-operatives should look at the endometriosis guidelines—and, indeed, other protocols that they receive—as part of clinical governance. We will certainly try to take that work forward as well.

The NHS in Scotland provides treatment that can help reduce or eliminate the symptoms, such as hormone treatment, which has been referred to, and laparoscopic or conventional surgery. Hysterectomy is a last resort.

The Scottish Executive is aware that service provision could be improved. All members referred to problems with infertility treatment, which we recognise has, in the past, been variable. Last year, the report of the expert advisory group on infertility services in Scotland was published. It set out how the management of delivery of infertility services could provide equity of access to services and treatment and so end the postcode lottery for treatment across Scotland. NHS boards and trusts are now working on how best to implement the report's recommendations. Officials in the health department have recently written to boards and trusts to ask for information on what progress has been made to date.

The need for further research has also been mentioned. Two endometriosis research projects in Scotland are currently being funded through research funds that have been made available through the chief scientist office. The projects, at Aberdeen University, are looking at a particular form of treatment for the conditions and the most suitable form of anaesthesia for that treatment.

The motion also refers to the need for greater co-operation. Because of its unfortunate tendency to recur, endometriosis might be said to come into the category of chronic enduring conditions. In "Our National Health: A plan for action, a plan for change", the Executive promised that we and the NHS would work closely with patient support groups to ensure that the needs of those with chronic enduring conditions are met. As the plan states:

"These groups possess a powerful and valuable insight into the spectrum of needs of people suffering from enduring health problems. We want to ensure that these support groups are closely involved in service design and delivery at both a local and national level."

One of those groups is clearly the National Endometriosis Society. I pay tribute to the work of that society. It is based in England but it could, of course, apply to the Scottish Executive health department for funding for its work here in Scotland.

I hope that we have learned more about endometriosis today. I commend Annabel Goldie for drawing this little-understood condition to our attention. As she said—and this is a fitting way to end our debate—it is a tribute to the accessibility, accountability and responsiveness of the Scottish Parliament that this debate has been held here today.

However, we will not rest content with having discussed the issue. I undertake to work in the ways that I have indicated. I thank all members who have contributed today and helped to draw more attention to this very serious condition. It certainly needs our attention.