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Debate: Chronic Pain

November 16, 2022

Thank you, Presiding Officer.

Musculoskeletal conditions and chronic pain are one of the most common long-standing illnesses in Scotland. Over 29% of the population, 1.5 million people, have one – I myself, included. So, before I say anything else, I want to put on record, my sincere thanks to all the incredible NHS staff for the support they have given me throughout my life and which they provide me now: Doctors, Rheumatologists, Nurses, Podiatrists, Physios and more, many of whom I see weekly, all of you know who you are.

I also want to thank the third sector organisations, and the CPGs on Arthritis and MSK Conditions and on Chronic Pain for their work to raise awareness of these conditions, and for representing the views of people living with them.

Living with chronic pain is constant, pervasive, tiring, distracting, and sometimes depressing. It often means a strong cocktail of pain killers, some self-care (for those of us who listen to our own advice), and often, medical care and interventions. All of these are essential, miss out on one when you need it, and it can all get too much. Living in pain is like having a whole other job with many moving parts. You must plan for it, anticipate it, take time off for it, and often work with and around it. This can all get overwhelming.

I am not exaggerating when I say there are days when I can’t see through the pain. Keeping going, especially in this job, is sometimes the only option. But that comes at a cost.

I make choices everyday about how to manage my pain and my time, it can be so tiring.

These decisions take up time, and energy. But like the millions of others in pain, I make them and move on. When pain is managed, the need for these considerations is reduced and that gives us space to think about the job we’re doing, the things we want to do, and the people we want to spend time with.

Addressing chronic pain is not just necessary to end suffering, it is necessary to help free up the brains and minds of those of us living with it, so that we can contribute to society and lead an ordinary life.

That is why I am not just disappointed that services to help people living with chronic pain are on their knees, I am angry. By letting this crisis continue for as long as it has – with no signs that its ending, this government has let the staff and patients down, and the crisis has gone on far, far too long.

Last June, 3,853 patients were waiting for their first appointment at a chronic pain clinic. That is a 20.9% increase since March this year, and a 46.9% increase since June 2021.

People in chronic pain in Scotland are being left in agony for years, missing out on essential interventions. Many who need regular injections haven’t had them and others don’t know what will work because they’re stuck in a cycle of gatekeeping and barriers that sees them nowhere near finding the solutions that work for them.

Some people lose their jobs, some can no longer go out as much as they used to and so they lose friends, relationships change and so do habits and hobbies.

As someone who believes that people know their own body, I believe self-management is important, and we on these benches welcome the new framework, but I say to the Government that this cannot come at the expense of other interventions. People cannot move on without vital support. But instead of being seen, they’re being asked to follow programmes of self-management, that are often inappropriate for their needs. Help for their pain is seen as elective, like people have a choice, so waiting is fine, they are de-prioritised, sent to an endless waiting list with a check list of things they can do to help themselves.

And they’re left like this for years.

Presiding Officer, when waiting times are into years not months, can this government really argue that other interventions are actually available. A right to healthcare that never comes is effectively no right at all.

The experience of one of my Glasgow constituents lays all of this bare. Despite explaining that his pain is now so debilitating that he is having to give up some work, is becoming increasingly disabled, has had to give up things he used to enjoy and had to cancel trips out with friends, he has waited over two years for essential pain treatment.

He’s been on and off waiting lists, passed from department to department, told he was not a priority, and even that the wait wasn’t as long as he’d thought because trickery with the numbers meant his repeat appointments weren’t recorded, instead only his first appointment was.

I raised this with the Cabinet Secretary and asked that targets and reporting be changed so that they reflected real life experiences, not clever counting, hiding years of pain. I’d appreciate a commitment to addressing this in his closing remarks today.

My constituent eventually got a cancellation and was asked to attend at short notice. When he got there, he was met with worn out and stressed staff. He was told by one exhausted nurse that the clinic had been cancelled several times because of staff shortages and pressures.

The system is working for no one, patients and staff alike. To add insult to injury, he was told that he would need to schedule his own appointments, via a phone number that was never answered. So, I ask the Cabinet Secretary, is he to conclude anything other than the process itself is designed to gatekeep?

Let me reiterate presiding officer, living with chronic pain is a full-time job. The last thing patients need is to have to do an admin job on the side. This really is self-management taken to extremes.

My constituent is in agony. He misses the activity he used to do. He’s frustrated because he’s waiting for answers. And, like many people living in degenerative and chronic pain, he must constantly readjust, mentally and physically, to a new normal or worry about what the next new normal will look like.

The Government claim the experience of people like my constituent is because of Covid. But this situation is not new, this is the result of an understaffed and under-resourced NHS that went into the pandemic fighting for its life, while being tasked with fighting for ours.

The resilience of my constituent is remarkable; as is often the case with people living in chronic pain; however, his life as many people’s, is unrecognisable. He, has lost work and missed opportunities as a result of spending days on end, fighting for the help he needs. And he is not alone. Every one of us in this chamber has cases like his.

The SNP must step up and take action now.

They must work with patients to sort this and improve treatment and wellbeing. They must protect specialist chronic pain services; and give them the support they need to do their job. They must provide greater transparency around waiting times for return patients. And it must end the needless system of passing the admin burden on to patients.

The Government can’t take the pain away, but they can certainly take action to stop adding to it.

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