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, which is the third debate on diabetes in the Parliament. As Nanette Milne said, we received a helpful briefing on the subject at a breakfast meeting. From that, I thought that it was now beyond dispute that patients' lives can be turned round and transformed by pumps, and that no one should need to be convinced of that.
As Kenny Gibson and Ross Finnie said, it is inappropriate to see pumps as being only for people whose treatment fails. They are for people who have particular problems that need to be treated. There is a catch-22 situation that needs to be considered.
I want to ask a series of questions rather than make a speech. I assure the minister that I do not expect all those questions to be answered today, but perhaps they could be answered in due course.
Sixteen months on, why is the usage figure at only 1.63 per cent? Why has only one health board met the lower level of the NICE target, which is 4 per cent? Does the minister accept the guideline figure of up to 14 per cent, or is there another Scottish benchmark? In her accountability reviews, has she raised with any boards their poor performance on this? It is 14 months since we first debated the matter. Cathy Jamieson was then promised that there would be contact with all health boards that were performing poorly. Has that been done? What was their response? Perhaps the minister could place a detailed response to that question in the Scottish Parliament information centre.
The situation in Ayrshire and Arran is appalling. For the health board there to say to David Stewart that it plans to reach 1 per cent usage in three years indicates that we are not really getting a grip of the matter. If a board thinks that it can get away with a level of 1 per cent three years on, it must be asked serious questions.
The other two areas in which there is pump usage of 1 per cent or less are Highland and Greater Glasgow and Clyde, which has not been mentioned in particular. The usage there is 1 per cent. That is one of the biggest areas. There is mass deprivation in it and serious diabetes complications. What on earth is NHS Greater Glasgow and Clyde doing?
How many and which boards have committed specific spending to pumps? How many have now produced business plans? Perhaps information on that could be placed in SPICe. How much of the change and innovation funds, which are now called health improvement funds, has the Government allocated to redressing the balance and dealing with what is becoming a national scandal? What steps will the minister take to ensure rapid progress to the minimum target?
We have found it difficult to interrogate boards on waiting times—that is also clear from answers that David Stewart has obtained. The outliers appear to be Grampian and Orkney at six months. Is there a common data set and common collection? If not, why not? Will that be part of the 18-week referral-to-treatment guarantee?
I appreciate that there are many pressures on the ministers, not least as a result of swine flu over the summer and upcoming legislation on tobacco and alcohol, and that it is not their job to micromanage the service. However, the second most important fact in considering the issue is that rapid implementation will bear fruit in efficiency savings, as members have said. Will the minister indicate a model for efficiency savings that can be placed in the boards' efficiency savings targets? That alone will encourage them to spend money in order to save.
The most important fact is that patients have a better quality of life on insulin pumps when they are suitable for pumps. The issue needs to be dealt with before it becomes the subject of a main debate for one of the parties, which will require a decision to be made.
As Kenny Gibson and Ross Finnie said, it is inappropriate to see pumps as being only for people whose treatment fails. They are for people who have particular problems that need to be treated. There is a catch-22 situation that needs to be considered.
I want to ask a series of questions rather than make a speech. I assure the minister that I do not expect all those questions to be answered today, but perhaps they could be answered in due course.
Sixteen months on, why is the usage figure at only 1.63 per cent? Why has only one health board met the lower level of the NICE target, which is 4 per cent? Does the minister accept the guideline figure of up to 14 per cent, or is there another Scottish benchmark? In her accountability reviews, has she raised with any boards their poor performance on this? It is 14 months since we first debated the matter. Cathy Jamieson was then promised that there would be contact with all health boards that were performing poorly. Has that been done? What was their response? Perhaps the minister could place a detailed response to that question in the Scottish Parliament information centre.
The situation in Ayrshire and Arran is appalling. For the health board there to say to David Stewart that it plans to reach 1 per cent usage in three years indicates that we are not really getting a grip of the matter. If a board thinks that it can get away with a level of 1 per cent three years on, it must be asked serious questions.
The other two areas in which there is pump usage of 1 per cent or less are Highland and Greater Glasgow and Clyde, which has not been mentioned in particular. The usage there is 1 per cent. That is one of the biggest areas. There is mass deprivation in it and serious diabetes complications. What on earth is NHS Greater Glasgow and Clyde doing?
How many and which boards have committed specific spending to pumps? How many have now produced business plans? Perhaps information on that could be placed in SPICe. How much of the change and innovation funds, which are now called health improvement funds, has the Government allocated to redressing the balance and dealing with what is becoming a national scandal? What steps will the minister take to ensure rapid progress to the minimum target?
We have found it difficult to interrogate boards on waiting times—that is also clear from answers that David Stewart has obtained. The outliers appear to be Grampian and Orkney at six months. Is there a common data set and common collection? If not, why not? Will that be part of the 18-week referral-to-treatment guarantee?
I appreciate that there are many pressures on the ministers, not least as a result of swine flu over the summer and upcoming legislation on tobacco and alcohol, and that it is not their job to micromanage the service. However, the second most important fact in considering the issue is that rapid implementation will bear fruit in efficiency savings, as members have said. Will the minister indicate a model for efficiency savings that can be placed in the boards' efficiency savings targets? That alone will encourage them to spend money in order to save.
The most important fact is that patients have a better quality of life on insulin pumps when they are suitable for pumps. The issue needs to be dealt with before it becomes the subject of a main debate for one of the parties, which will require a decision to be made.
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.