Chamber
Plenary, 03 Sep 2009
03 Sep 2009 · S3 · Plenary
Item of business
Insulin Pump Therapy
I, too, congratulate David Stewart on securing the debate. It is appropriate that we discuss insulin pump therapy again, given the commitment that the Cabinet Secretary for Health and Wellbeing made in the debate 15 months ago:
"I will ensure that I and the Scottish diabetes group continue to monitor closely insulin pump programme availability throughout Scotland".—[Official Report, 21 May 2008; c 8840.]
Despite that monitoring, we still have pitifully low numbers of people on the therapy in Scotland—only 1.6 per cent of those with type 1 diabetes have access to insulin pump therapy.
There are many benefits to using the treatment, which has been with us since the 1970s. The large uptake of pumps in Europe and the USA is testament to the progress that has been made. The benefits of the therapy have been stated, so I will not repeat them. My colleague Nanette Milne made a good point in the previous debate when she described it as
"a spend-to-save provision that concurrently leads to improved quality of life for successful users of the technology."—[Official Report, 21 May 2008; c 8833.]
The National Institute for Clinical Excellence's technology appraisal 151 also fully endorses the value-for-money argument.
It is recognised that not everybody is suitable for an insulin pump. As the motion states, only 4 to 15 per cent of people with type 1 diabetes meet the current criteria for the therapy. It also needs a commitment from the patient, backed up with support from the health care team. However, the benefits are evident.
As Karen Whitefield said, only 57 children in Scotland currently use pump therapy, but according to NICE's estimates, it should be at least three times that. In the Highlands, as David Stewart mentioned, the figure is embarrassing—a word that Kenneth Gibson used—to say the least and probably pitifully low. I understand that no patients under the age of 18 use insulin pump therapy in the Highlands, despite its being available in many other health board areas in Scotland.
The other health board that I will mention is the one that is covered by my colleague John Lamont, who would have liked to attend the debate but has another commitment. He has been contacted by a constituent whose 11-year-old son needs, and is appropriate for, an insulin pump, but has been told by NHS Borders that there is no money for it. I know from parliamentary answers that one person under 15 in the Borders is on the therapy. As other members have done, I ask the minister to comment on what appears to be a rationing policy, if not postcode prescribing. Given the fact that all health boards should have an insulin strategy that covers the full range of insulin use, I also ask the minister to look into the situation in NHS Highland.
I have also been made aware of patients in the west of Scotland who have been described as being "neurotic" for urging consultants to consider the insulin pump therapy option. As David Stewart said, a treatment that can end daily injections and the embarrassment that they can bring, and which can reduce worry, allow more flexible eating and improve care quality and sleep patterns for patients must be encouraged.
In my opinion, the main benefit must be the long-term improvements to health. Diabetes increases the incidence of many life-threatening conditions, but I am told that insulin pump therapy can protect the vital vascular system from that future deterioration.
"I will ensure that I and the Scottish diabetes group continue to monitor closely insulin pump programme availability throughout Scotland".—[Official Report, 21 May 2008; c 8840.]
Despite that monitoring, we still have pitifully low numbers of people on the therapy in Scotland—only 1.6 per cent of those with type 1 diabetes have access to insulin pump therapy.
There are many benefits to using the treatment, which has been with us since the 1970s. The large uptake of pumps in Europe and the USA is testament to the progress that has been made. The benefits of the therapy have been stated, so I will not repeat them. My colleague Nanette Milne made a good point in the previous debate when she described it as
"a spend-to-save provision that concurrently leads to improved quality of life for successful users of the technology."—[Official Report, 21 May 2008; c 8833.]
The National Institute for Clinical Excellence's technology appraisal 151 also fully endorses the value-for-money argument.
It is recognised that not everybody is suitable for an insulin pump. As the motion states, only 4 to 15 per cent of people with type 1 diabetes meet the current criteria for the therapy. It also needs a commitment from the patient, backed up with support from the health care team. However, the benefits are evident.
As Karen Whitefield said, only 57 children in Scotland currently use pump therapy, but according to NICE's estimates, it should be at least three times that. In the Highlands, as David Stewart mentioned, the figure is embarrassing—a word that Kenneth Gibson used—to say the least and probably pitifully low. I understand that no patients under the age of 18 use insulin pump therapy in the Highlands, despite its being available in many other health board areas in Scotland.
The other health board that I will mention is the one that is covered by my colleague John Lamont, who would have liked to attend the debate but has another commitment. He has been contacted by a constituent whose 11-year-old son needs, and is appropriate for, an insulin pump, but has been told by NHS Borders that there is no money for it. I know from parliamentary answers that one person under 15 in the Borders is on the therapy. As other members have done, I ask the minister to comment on what appears to be a rationing policy, if not postcode prescribing. Given the fact that all health boards should have an insulin strategy that covers the full range of insulin use, I also ask the minister to look into the situation in NHS Highland.
I have also been made aware of patients in the west of Scotland who have been described as being "neurotic" for urging consultants to consider the insulin pump therapy option. As David Stewart said, a treatment that can end daily injections and the embarrassment that they can bring, and which can reduce worry, allow more flexible eating and improve care quality and sleep patterns for patients must be encouraged.
In my opinion, the main benefit must be the long-term improvements to health. Diabetes increases the incidence of many life-threatening conditions, but I am told that insulin pump therapy can protect the vital vascular system from that future deterioration.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan):
SNP
The final item of business is a members' business debate on motion S3M-4723, in the name of David Stewart, on insulin pump therapy. The debate will be conclu...
Motion debated,
That the Parliament acknowledges the benefits that insulin pumps have for people with type 1 diabetes in assisting with the condition; notes that between 4% ...
David Stewart (Highlands and Islands) (Lab):
Lab
I welcome the opportunity to debate access to insulin pumps and thank members throughout the chamber who signed the motion and who have deferred travelling t...
The Deputy Presiding Officer:
SNP
We come to the open debate. As a substantial number wish to speak, I ask members to limit their contributions to four minutes.
Kenneth Gibson (Cunninghame North) (SNP):
SNP
I congratulate David Stewart on securing this debate on an issue of great importance for many families throughout Scotland. As we have heard, type 1 diabetes...
The Minister for Public Health and Sport (Shona Robison):
SNP
I have information on Ayrshire and Arran, which the member might find useful. As I understand it, a redesign of the dietetic resource is going on, to support...
Kenneth Gibson:
SNP
I am delighted to hear that. I was contacted by constituents about the issue only this week. If that redesign is taking place, I hope that people whose child...
The Deputy Presiding Officer:
SNP
The member should conclude.
Kenneth Gibson:
SNP
I will finish on that point, then.
The Deputy Presiding Officer:
SNP
I am obliged.
Karen Whitefield (Airdrie and Shotts) (Lab):
Lab
I welcome the opportunity to speak in the debate on insulin pump provision, which is an important issue, and I congratulate Dave Stewart on securing the deba...
The Deputy Presiding Officer:
SNP
That is a good point on which to conclude.
Mary Scanlon (Highlands and Islands) (Con):
Con
I, too, congratulate David Stewart on securing the debate. It is appropriate that we discuss insulin pump therapy again, given the commitment that the Cabine...
The Deputy Presiding Officer:
SNP
The member must conclude.
Mary Scanlon:
Con
I will leave it there.
Cathie Craigie (Cumbernauld and Kilsyth) (Lab):
Lab
As has been said, Parliament had the opportunity to discuss this important matter in May 2008. I thank Dave Stewart for securing this evening's debate and fo...
Ross Finnie (West of Scotland) (LD):
LD
I, too, congratulate David Stewart on securing the debate and on his continued interest in the matter.I must make a declaration of interest, Presiding Office...
Hugh Henry (Paisley South) (Lab):
Lab
I congratulate David Stewart on continuing to bring to our attention an issue that is of great significance to far too many people throughout Scotland.Let me...
The Deputy Presiding Officer:
SNP
At this stage, I would be prepared to accept a motion without notice to extend the debate by up to 10 minutes.
Motion moved,
That, under Rule 8.14.3, the debate be extended by up to 10 minutes.—David Stewart.
Motion agreed to.
Nanette Milne (North East Scotland) (Con):
Con
I, too, am pleased that David Stewart has secured the debate and thank him for his efforts in doing so. My comments will be fairly brief but, given that I ch...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I, too, congratulate David Stewart on securing the debate, which is the third debate on diabetes in the Parliament. As Nanette Milne said, we received a help...
The Minister for Public Health and Sport (Shona Robison):
SNP
I acknowledge David Stewart's long-standing commitment to the issue in the Parliament. As members have said, the Cabinet Secretary for Health and Wellbeing n...
Karen Whitefield:
Lab
The Government is currently undertaking work to review the Scottish diabetes framework. I do not expect the minister to tell us what will be in the revised d...
Shona Robison:
SNP
I will come on to the framework in a minute.Some of the credit for the progress that has been made—albeit that there is still more to do—must be given to the...
Meeting closed at 17:53.