Chamber
Plenary, 03 Sep 2009
03 Sep 2009 · S3 · Plenary
Item of business
Insulin Pump Therapy
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 noted in her reply to the debate last year that the Parliament would want to monitor the issue closely. This afternoon's debate shows that she was correct in that prediction.
I fully understand the concern of the insulin pump awareness group and Diabetes UK Scotland that those who would benefit should have access to insulin pump therapy. We know that enabling people to achieve better control of their diabetes can promote confidence in their ability to manage their condition and that improved control reduces the devastating complications of diabetes, which members have mentioned. I am also aware that we are, in the main, talking about young people with type 1 diabetes, who have to manage their condition along with all the other things that they have to cope with, especially during adolescence. I can well sympathise with the anxieties of their parents, who naturally want to ensure that their children are getting the best possible care.
For all those reasons, it is already our national policy that each NHS board should have an insulin strategy that covers the full range of insulin usage, including insulin pump therapy. Ross Finnie made the important point that an insulin strategy must cover all the issues, including communication with patients. We expect NHS boards, in considering their approach to insulin pump therapy, to be guided by the latest evidence on clinical effectiveness. As members have mentioned, that is set out in technology appraisal guidance 151, which was published in July 2008 by NICE and has been validated for Scotland by NHS QIS. Under that technology appraisal guidance, insulin pump therapy should be considered as an option for adults and for children over 12 when multiple dose insulin therapy has failed. I take the point that some members have made about insulin pumps not being used only in response to the failure of other therapies. I will go back and have discussions on that point. Pumps are recommended as a possible treatment for children under 12 with type 1 diabetes if treatment with multiple daily injections is not practical.
Despite the concerns that have been raised, which I totally understand, access to pumps in Scotland has improved, although at a more gradual rate than many would like to see—I accept that. As members have pointed out, there are unacceptable variations between NHS boards in terms of the availability of pumps. So, although we have seen, I think, a 66 per cent rise in the use of pumps throughout Scotland since 2007, the baseline figure was unacceptably low and a lot of progress still requires to be made. I have asked the Scottish diabetes group to keep me regularly informed of progress, and I will write to NHS boards, reminding them of the need to make progress.
I fully understand the concern of the insulin pump awareness group and Diabetes UK Scotland that those who would benefit should have access to insulin pump therapy. We know that enabling people to achieve better control of their diabetes can promote confidence in their ability to manage their condition and that improved control reduces the devastating complications of diabetes, which members have mentioned. I am also aware that we are, in the main, talking about young people with type 1 diabetes, who have to manage their condition along with all the other things that they have to cope with, especially during adolescence. I can well sympathise with the anxieties of their parents, who naturally want to ensure that their children are getting the best possible care.
For all those reasons, it is already our national policy that each NHS board should have an insulin strategy that covers the full range of insulin usage, including insulin pump therapy. Ross Finnie made the important point that an insulin strategy must cover all the issues, including communication with patients. We expect NHS boards, in considering their approach to insulin pump therapy, to be guided by the latest evidence on clinical effectiveness. As members have mentioned, that is set out in technology appraisal guidance 151, which was published in July 2008 by NICE and has been validated for Scotland by NHS QIS. Under that technology appraisal guidance, insulin pump therapy should be considered as an option for adults and for children over 12 when multiple dose insulin therapy has failed. I take the point that some members have made about insulin pumps not being used only in response to the failure of other therapies. I will go back and have discussions on that point. Pumps are recommended as a possible treatment for children under 12 with type 1 diabetes if treatment with multiple daily injections is not practical.
Despite the concerns that have been raised, which I totally understand, access to pumps in Scotland has improved, although at a more gradual rate than many would like to see—I accept that. As members have pointed out, there are unacceptable variations between NHS boards in terms of the availability of pumps. So, although we have seen, I think, a 66 per cent rise in the use of pumps throughout Scotland since 2007, the baseline figure was unacceptably low and a lot of progress still requires to be made. I have asked the Scottish diabetes group to keep me regularly informed of progress, and I will write to NHS boards, reminding them of the need to make progress.
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.