Chamber
Plenary, 03 Sep 2009
03 Sep 2009 · S3 · Plenary
Item of business
Insulin Pump Therapy
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 measures that we and the Scottish diabetes group have put in place. Chief among those is the regular reporting of the position on a board-by-board basis. Pump availability is a standing item on the agenda of the regular meetings that our lead clinician for diabetes has with the clinical leads of the diabetes managed clinical networks.
The measures also include events such as the very successful insulin pump study day, which the Scottish diabetes group organised in May. The event brought together more than 60 health care professionals to learn more about insulin pumps from patients, specialists and suppliers. I welcome the fact that other such events are likely to be held in future years. It is at such events that we can perhaps address some of the points that Hugh Henry raised about the differing views among clinicians.
We acknowledge the need to do more, though, and there are a number of opportunities to do so. The Scottish intercollegiate guidelines network is reviewing its guideline on the management of diabetes. I do not want to pre-empt SIGN's work, but the indications are that its advice is likely to be much in line with the NICE technology appraisal. The revised guideline will be accompanied by a resource impact appraisal. That should clearly establish for NHS boards the costs and benefits of further investment in insulin pump therapy over and above other insulin therapies, and encourage them to develop their insulin pump provision appropriately.
The Scottish diabetes group's short-life working group on type 1 diabetes is developing a template for insulin strategies that will help to promote consistency of approach at board level. The availability of insulin pumps within each board will be recorded in the Scottish diabetes survey from this year onwards. That will help to formalise the collection of information on insulin pump usage across Scotland, allow boards to compare their progress with progress in other boards and enable the Government to carefully monitor that progress.
That approach will be supplemented by Diabetes UK Scotland's plans for its pump up the volume campaign, through which it will ask NHS boards to ensure that those who would benefit from a pump are not denied access. The campaign will ask boards to indicate the level of resources that they will allocate to pump provision over the next five years.
The Scottish diabetes group is aware of the need to develop a standard approach to calculating the waiting times for access to insulin pump therapy, which is one of the other issues that is covered by the motion. It needs to be made clear, at the very least, whether the waiting time includes waiting for the essential education and training that are required before someone is able to manage a pump.
Insulin pump therapy and structured education are two of the key issues that are discussed in the consultation document on the revision of the 2006 diabetes action plan, which I launched in May this year. That revision gives us the chance to pull together all this work. The consultation specifically asked for thoughts on how the appropriate availability of pumps should be increased, and what support structures need to be in place to ensure that insulin pump therapy is fully effective. The word "appropriate" was included deliberately, because we need to be a little bit cautious in this area. Insulin pump therapy requires determination and commitment on the part of the person with diabetes. It does not inevitably lead to better control of blood glucose levels. Children, in particular, need continuing care, especially during the transition through adolescence and into adulthood. The choice of insulin regime should be reached by agreement between the person with type 1 diabetes and the team supporting their care—I think that that was one of the points that Ross Finnie made.
In framing the section of the revised action plan that deals with insulin pump therapy, I can give a guarantee that we will take account of those responses, as well as the points that have been made in the debate. I am happy to come back to Parliament to give members that information. Richard Simpson asked a number of questions, and I will ensure that he gets answers to them. I will make those answers available to others, too, if they would find that helpful.
Some of the credit for the progress that has been made—albeit that there is still more to do—must be given to the measures that we and the Scottish diabetes group have put in place. Chief among those is the regular reporting of the position on a board-by-board basis. Pump availability is a standing item on the agenda of the regular meetings that our lead clinician for diabetes has with the clinical leads of the diabetes managed clinical networks.
The measures also include events such as the very successful insulin pump study day, which the Scottish diabetes group organised in May. The event brought together more than 60 health care professionals to learn more about insulin pumps from patients, specialists and suppliers. I welcome the fact that other such events are likely to be held in future years. It is at such events that we can perhaps address some of the points that Hugh Henry raised about the differing views among clinicians.
We acknowledge the need to do more, though, and there are a number of opportunities to do so. The Scottish intercollegiate guidelines network is reviewing its guideline on the management of diabetes. I do not want to pre-empt SIGN's work, but the indications are that its advice is likely to be much in line with the NICE technology appraisal. The revised guideline will be accompanied by a resource impact appraisal. That should clearly establish for NHS boards the costs and benefits of further investment in insulin pump therapy over and above other insulin therapies, and encourage them to develop their insulin pump provision appropriately.
The Scottish diabetes group's short-life working group on type 1 diabetes is developing a template for insulin strategies that will help to promote consistency of approach at board level. The availability of insulin pumps within each board will be recorded in the Scottish diabetes survey from this year onwards. That will help to formalise the collection of information on insulin pump usage across Scotland, allow boards to compare their progress with progress in other boards and enable the Government to carefully monitor that progress.
That approach will be supplemented by Diabetes UK Scotland's plans for its pump up the volume campaign, through which it will ask NHS boards to ensure that those who would benefit from a pump are not denied access. The campaign will ask boards to indicate the level of resources that they will allocate to pump provision over the next five years.
The Scottish diabetes group is aware of the need to develop a standard approach to calculating the waiting times for access to insulin pump therapy, which is one of the other issues that is covered by the motion. It needs to be made clear, at the very least, whether the waiting time includes waiting for the essential education and training that are required before someone is able to manage a pump.
Insulin pump therapy and structured education are two of the key issues that are discussed in the consultation document on the revision of the 2006 diabetes action plan, which I launched in May this year. That revision gives us the chance to pull together all this work. The consultation specifically asked for thoughts on how the appropriate availability of pumps should be increased, and what support structures need to be in place to ensure that insulin pump therapy is fully effective. The word "appropriate" was included deliberately, because we need to be a little bit cautious in this area. Insulin pump therapy requires determination and commitment on the part of the person with diabetes. It does not inevitably lead to better control of blood glucose levels. Children, in particular, need continuing care, especially during the transition through adolescence and into adulthood. The choice of insulin regime should be reached by agreement between the person with type 1 diabetes and the team supporting their care—I think that that was one of the points that Ross Finnie made.
In framing the section of the revised action plan that deals with insulin pump therapy, I can give a guarantee that we will take account of those responses, as well as the points that have been made in the debate. I am happy to come back to Parliament to give members that information. Richard Simpson asked a number of questions, and I will ensure that he gets answers to them. I will make those answers available to others, too, if they would find that helpful.
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.