Official Report 1010KB pdf
The final item of business is a members’ business debate on motion S6M-18369, in the name of Kenneth Gibson, on recognising the impact of chronic kidney disease. The debate will be concluded without any question being put. I encourage members who wish to participate to press their request-to-speak buttons, and I invite Kenneth Gibson to open the debate.
Motion debated,
That the Parliament recognises the impact of chronic kidney disease (CKD) on individuals and the NHS, with, it understands, thousands of people reliant on dialysis or living with a kidney transplant, and many more at risk of progression; understands that CKD is one of the most common and resource-intensive long-term conditions but considers that it lacks a specific policy focus; welcomes the Scottish Government’s work on a long-term conditions strategy and notes the belief that the Scottish Government should include CKD as a dedicated strand, with actions on prevention, early diagnosis, equitable access to transplantation, and a home-first approach to dialysis care; notes the view that increasing support for home dialysis and improving organ donation rates would improve outcomes and reduce system pressures, and further notes the belief that the Scottish Government should work with people across Scotland, including in the Cunninghame North constituency, who are living with kidney disease, as well as clinicians, third sector organisations and industry, to deliver meaningful change.
17:33
I thank each member who signed my motion, and I thank Kidney Care UK, the National Kidney Federation and Kidney Research UK for their briefings to members for the debate. I warmly welcome their representatives to the public gallery, along with representatives of the Scottish Kidney Federation.
Our kidneys are our bodies’ silent workhorses. They filter our blood to remove waste, excess fluids and toxins while regulating blood pressure, balancing electrolytes, producing hormones for red blood cell formation and activating vitamin D to strengthen our bones. However, our kidneys seldom receive the recognition that other organs do. That is despite the fact that chronic kidney disease is set to become the fifth biggest cause of premature deaths globally by 2040.
Modelling by Kidney Research UK suggests that, in Scotland, more than 600,000 people—11 per cent of our population—may be living with some degree of kidney disease, much of it undiagnosed. According to data from the Scottish renal registry, 5,732 people in Scotland were receiving kidney replacement therapy as at the end of 2023. Of those, 3,491 had functioning kidney transplants and 2,241 were receiving dialysis. Behind each of those numbers is a story about human suffering.
One CKD patient said:
“Kidney disease is insidious. It creeps into every aspect of your life. Not only that it slowly robs you of your life.”
Another said:
“The condition plays a huge part in your daily living. Need to work, can’t work, depression, worry, anxiety, relationship issues. Life in general can be hard.”
Employment rates for people on dialysis are just 26 per cent. Between 2022 and 2032, people with CKD are projected to lose 81.6 million work days across the United Kingdom, with 11.9 million work days missed by their carers. The number of people who are on dialysis in Scotland is likely to increase significantly over the next decade, while current pre-emptive transplant and peritoneal UK dialysis rates remain below pre-pandemic levels. The direct cost of kidney disease to NHS Scotland last year was £566 million—the sum is expected to reach £1 billion by 2033 without Government intervention.
Improving kidney care is, therefore, not just clinically necessary but financially prudent. A focus on prevention, earlier diagnosis and greater use of home dialysis and transplantation can reduce the reliance on hospital-based care, with all its associated costs. Home haemodialysis is clinically and consistently safe and effective at lower cost than in-centre dialysis, while offering patients and their families greater independence and quality of life.
However, in Scotland, only 12.2 per cent of dialysis patients receive home dialysis. That is the lowest percentage across the four nations, and significantly lower than the UK average of 16.9 per cent. While NHS Grampian recently expanded access to home haemodialysis across Aberdeenshire, Aberdeen and Moray, uptake elsewhere in Scotland remains low. In Glasgow, home therapy uptake is only 7.2 per cent.
A more consistent and ambitious approach is needed to expand equitable access to home dialysis. That is especially important in rural and island Scotland, where transport remains a critical issue for patients who are required to travel for in-centre dialysis three times a week to receive life-saving treatment. Unlike in other parts of the UK, there is no national framework in Scotland to ensure a consistent service for transporting people to dialysis centres. That must change.
Six Scottish health boards told Kidney Care UK that access to all the modes of in-centre dialysis transport that they provide is needs-assessed, while six others told the organisation that their transport is open to everyone travelling to and from in-centre dialysis. Worryingly, almost two thirds of kidney healthcare professionals who were surveyed had concerns about the transport arrangements that their facility had in place for patients travelling to and from in-centre dialysis. I know that patients, their families and those who work with them would greatly appreciate a commitment from the Minister for Public Health and Women’s Health to provide guidance and support to health boards to enable them to assist patients with vital transport needs.
We must also recognise the psychosocial toll on people with kidney disease and their families. Sadly, too many people with CKD feel that they are left to get on with it alone. Kidney Care UK’s recent survey of adults living with kidney disease revealed that 73 per cent of patients who need psychosocial support from their NHS kidney team do not receive it, and 69 per cent said that such needs had never been formally assessed. There is a real and pressing urgency to ensure that specialist support is available to all who require it, regardless of where they live.
Improving access to kidney transplantation is also critical. Transplantation offers the best outcome for many patients, yet the transplant waiting list is at its highest level ever and transplant rates remain below pre-pandemic levels. In 2023, 265 patients received a kidney transplant, but more than 480 adults remained on the waiting list as of March 2024. That is deeply concerning. Every missed opportunity for a transplant is a chance lost for someone to live a fuller, healthier life. The transplant pathway needs to be strengthened, including with better support for living donation.
CKD is one of the most prevalent and serious long-term conditions in Scotland, yet it arguably remains largely absent from national health planning. The Scottish Government’s own consultation paper on its forthcoming long-term conditions framework acknowledged that kidney disease is one of the few major conditions with no national strategy. The kidney charities that are represented in the public gallery today, and others, are calling for the introduction of a national CKD framework. Such a framework would cover prevention and early detection; patient involvement in care; support for children and young people; effective management of chronic and acute kidney conditions; and better end-of-life care.
The organisations also want CKD prevention and treatment to be a clinical priority, with annual testing for those who are most at risk, access to appropriate medications and lifestyle support to delay progression. I trust that the minister will address those asks in responding to the debate.
Before I conclude, I highlight the bloody amazing kidneys campaign by Kidney Care UK. Since the campaign’s launch in October 2024, around 200,000 people have completed the online kidney health checker, with around half identified as being at increased risk of CKD.
The campaign has reached national health service networks, public health clinics and even the European Renal Society congress. It is a helpful, albeit scary, reminder that you can lose up to 90 per cent of your kidney function without realising it. Symptoms are often vague, or are mistaken for other conditions. I encourage everyone to find out whether they are at a lower risk or an increased risk of developing kidney disease.
I pointed out earlier that other areas of health concern steal the spotlight, so to speak, while kidney health struggles in the shadows to receive the attention that patients deserve. That is changing. In May, the World Health Organization passed its first-ever resolution on kidney health, recognising it as a global priority. The time for the Scottish Government to place a national and strategic focus on kidney health, and to ensure that every person with CKD has access to the care, support and treatment that they need, is now.
I am pleased that colleagues will talk of the life experiences of constituents with CKD, and I look forward to hearing those stories.
We move to the open debate.
17:41
I thank my colleague Kenny Gibson for bringing the debate to the chamber. I also thank the organisations with which I have engaged fairly regularly—I met Kidney Care UK today, in fact, and I have met Kidney Research UK. NHS Ayrshire and Arran has been very helpful, as have the British Heart Foundation and Obesity Action Scotland.
The statistics for chronic kidney disease are stark. More than 600,000 people in Scotland are living with CKD, which is more than 10 per cent of the population. Much of that—as Kenny Gibson stated—is underdiagnosed. It will not surprise members to hear that poverty and health inequalities disproportionately affect people with CKD; we hear the same across many conditions. I heard today from Kidney Care UK’s advocacy and support teams about those who come to the organisation for advice and grants. In 2023, 45 per cent of those people were sitting at stages 3 to 5, with kidney function of less than 60 per cent.
We can talk about prevention, as I often do in the chamber. CKD currently costs Scotland’s economy more than £0.5 billion per year, and Kidney Research UK suggests that, without significant Government intervention, that could rise to more than £1 billion by 2033. The total annual economic impact of kidney disease in the UK is £7 billion, costing the NHS £6.4 billion, which is about 3.2 per cent of the overall NHS budget.
Employment rates among people on dialysis are low, sitting at 26 per cent. It is projected that between 2022 and 2032, CKD in the UK will result in something like 8.1 million missed work days in people diagnosed with CKD, and 11.9 million work days missed by carers of people with CKD. Both the prevalence of CKD and its cost to the NHS are expected to increase significantly in the next decade.
There are a lot of comorbidities associated with CKD. One issue that I discussed with the organisations earlier today was the impact that a diagnosis of CKD will have on someone’s mental health. One in three people with CKD experience depression, which worsens health outcomes and adds to the pressures on the mental health system. Kidney Care UK, through its free counselling service, hears daily from people who are undergoing those challenges, but there is very limited support available to patients on the NHS.
Obesity is linked to a higher risk of CKD. As we well know, obesity levels in Scotland are at a record high and are rising, and that needs to be tackled. As every member in the chamber will know, having heard me speak about this before, we should be looking at how we prevent conditions such as obesity in the first place, rather than having to treat them once they occur. Prevention, detection and lifestyle advice are all really important. CKD is also a major risk factor in developing cardiovascular disease, and it can be made worse by CVD.
We recognise the importance of the integrated approach to comorbid chronic disease. However, there is significant concern that a single long-term condition framework risks oversimplifying the complexities of long-term conditions, which often have significantly different clinical pathways, with different specialisms and different impacts on patients’ lives. As Kenny Gibson alluded to, kidney disease in particular remains largely absent from national planning in Scotland, despite being identified in the long-term conditions framework consultation as a major gap.
In conclusion—having got about halfway through what I wanted to say—I thank Kenny Gibson again, and I thank Kidney Care UK for its briefing. We need to consider how we prevent the disease in the first instance, because the cost to the national health service and the cost to the individual is high.
17:45
I thank the many organisations concerned for their briefings, and I thank my colleague for securing the debate and raising the profile of kidney disease.
Members’ business debates allow parliamentarians to bring to public awareness issues that go unnoticed, and kidney disease is one of those. They also educate politicians like me. The disease does not grab the headlines, yet it is my understanding that more people die in Scotland from kidney or kidney-related disease than from cancer. It is a long-term condition that does not usually have visible symptoms until the advanced stage, and it is incurable.
Chronic kidney disease should be a significant public health concern in Scotland. I understand that it affects 600,000 people, according to data contained in a recent petition to the Scottish Parliament. There is a slow-growing understanding of the issue, and there have been calls to improve early diagnosis and treatment. Key challenges include improving access to care, supporting vulnerable patients and preventing progression to end-stage kidney disease.
Without wishing to frighten anyone, I note that people are more at risk if they have high blood pressure, diabetes or a history of the disease in their family. Although there is currently no cure, unfortunately, treatment can slow or halt the disease’s progression. Apart from the physical symptoms, there is a possible need for treatment such as dialysis or a transplant. Here I give notice, in passing, that I am sponsoring an organ donation exhibition in the Parliament later this month because, despite there being an opt-out system, organ transplants are on the decline.
“Chronic Kidney Disease: An Action Plan for Scotland” estimates that
“More than one in ten people in Scotland are estimated to have CKD. Of those, 45% ... are already in the more severe, later stages”.
Is it not therefore time to make tackling the disease a priority? On that data alone, CKD requires to be much higher up the health agenda.
Statistics are one thing but, to bring home the impact of the disease, I shall recount Craig’s story. Craig was diagnosed with immunoglobulin A nephropathy, or IgA nephropathy, a form of chronic kidney disease, in his 20s. He is now 54. He managed his condition without intervention until the summer of 2018, when he started to feel very unwell. Tests revealed that his kidney function had dropped to a critical level, and he was immediately put on to the transplant list. Fortunately, his mother, two sisters, brother and partner all put themselves forward to be a potential donor and, after initial tests, his eldest sister was found to be a perfect match. He was lucky.
In the interim, Craig had to go on dialysis. He opted for peritoneal dialysis, which he could do from home, and which would mean less disruption in his daily life. He had to have surgery to get a tube inserted into his abdomen, which he could then hook up to a peritoneal dialysis machine at the side of his bed at home. From then, for a period of eight months, he hooked himself up every night, and the machine used his peritoneal cavity to cleanse and filter his blood inside his body, performing the function that his kidneys no longer could. The family grew used to the whirring, gurgling and beeping noises that the machine made throughout the night, and they affectionately nicknamed it “George” after an inspirational transplant patient they had met. In a grim situation, a bit of humour helps.
There is not yet a cure, but I hope to sound a positive note. Craig had his kidney transplant from his sister six and a half years ago, and he is still going strong. He will be on immunosuppressants and a cocktail of other drugs for the rest of his life, but that allows him to lead a relatively normal life. He is forever grateful to his sister and to the doctors, the nurses and the surgeon who took care of him throughout the process.
I hope that the debate progresses diagnosis and early treatment. I repeat my thanks to Kenny Gibson, to Craig, for letting me tell his story, and to those attending. I look forward to hearing the Government’s response.
17:50
I congratulate Kenny Gibson on securing this important debate and thank him for the substance of his contribution.
We almost certainly all know somebody with kidney disease, because it affects one in 10 Scots. However, we might not be able to identify those people, because many of them are undiagnosed. According to Kidney Research UK estimates, for every two people who are diagnosed with chronic kidney disease, there is a third who is struggling on, not knowing and not diagnosed. For many people who do get a diagnosis, it often comes too late to prevent kidney failure.
Behind those figures are countless tragedies and lives cut short, not to mention the misery that is experienced by hundreds of thousands of Scots every day—fatigue, swollen joints, nausea, breathlessness—and the many people not knowing or guessing the cause of their symptoms.
Kidney charities are clear that the key to tackling kidney disease is not in the accident and emergency department, when it might already be too late, but in the community. It is about prevention and early intervention rather than crisis management. We need annual testing for those who are at risk, such as those with diabetes or high blood pressure. We need conversations about lifestyle changes that can prevent and delay the disease, medication that will help to ease the symptoms, and technology that allows patients to receive dialysis at home rather than having to trek to distant hospitals. As Kenny Gibson rightly said, only 12.2 per cent of current dialysis patients in Scotland are on home therapies—the lowest percentage across the UK.
I have heard from patients in rural areas. One woman from the Western Isles is forced to travel hundreds of miles for dialysis when it could be delivered at home. These life-changing interventions can be delivered by general practitioners, who combine the detective work of diagnosis with a deep understanding of the local community. However, the Scottish Government has woefully underfunded primary care.
According to the BMA in Scotland, GPs’ share of the NHS budget has fallen from 11 per cent to 6.2 per cent since 2008. In real terms, because of inflation, that feels like a cut of 22.8 per cent. Targets for the number of new GPs that are set by the Government are increasing, and that is welcome, but we know from Audit Scotland that those targets will not be met.
Kidney Care UK is calling for a national chronic kidney disease framework that will set standards for good-quality care. I urge the Scottish Government to embrace that and agree to it, but it starts with ensuring that someone who is experiencing symptoms such as weight loss or muscle cramps can actually get an appointment with a GP and that, in turn, GPs are properly resourced to take the lead on the patient’s care. If we are to make a difference, the Scottish Government must listen to kidney disease patients and campaigners and invest in primary care. That will not only improve the lives of countless Scots with kidney disease but save our NHS millions of pounds in costly hospital interventions. If we tackle chronic kidney disease, everyone benefits.
I urge the Scottish Government to accept the terms of Kenny Gibson’s motion. Let us have a national strategy, let us make a difference and let us focus on tackling kidney disease.
17:54
I thank Kenneth Gibson for lodging the motion, which gives us all an opportunity to highlight the profound impact of chronic kidney disease on individuals, families and our national health service. I, too, welcome the visitors in the gallery, as I do the briefings that we have received.
In many ways, chronic kidney disease is a silent epidemic. As has been mentioned, it affects more people in Scotland than cancer—its prevalence is about 3 to 4 per cent. It can have a huge impact on people’s ability to deal with their daily living, and on families. It can hugely affect people’s ability to go about their day-to-day lives, including work. Kenny Gibson has highlighted that well, and I will not rehearse it further.
The outlook and prognosis for those living with chronic kidney disease have improved immeasurably over the years. Many conditions are now treatable and manageable in the long term, and the advances in transplant technology and its availability over the years are incredible.
I am a registered nurse, and I worked in California, albeit a long time ago. I had the privilege to be part of the liver transplant team and, on many occasions, took part in kidney and pancreas transplants. I put on record my thanks to everyone in the transplant and dialysis teams and all the support services for all that they do to improve the lives of their patients. The teams offer hope to many who might previously have had no options.
In NHS Dumfries and Galloway, in my region, over recent years, there has been an expansion in dialysis services. As well as the site at Mountainhall treatment centre—the previous Dumfries and Galloway Royal infirmary site—there are dialysis sites in Stranraer and Kirkcudbright. That saves those who need dialysis as part of their chronic kidney disease treatment from travelling long distances to Dumfries three times a week. I imagine that that would have been quite cumbersome for people before the Stranraer and Kirkcudbright sites opened.
Home-first dialysis also offers the potential for a better quality of life for those who receive treatment—in particular, those living in rural areas, who face the biggest practical barriers, as I have just described, to accessing that life-saving support. It will not be suitable for everyone, but we should strive to make it the default position for those for whom it is suitable, as it will support patients and reduce the pressure on secondary care facilities in our NHS. That embedding of treatment for kidney diseases in our communities is hugely welcome and is evidence of how our health service is developing in the right direction as resources allow and as the medical technology that is available for treatment improves all the time.
Embedding also has to include primary care at the GP or community health level. We need to ensure that those professionals who are usually the first to see patients presenting with symptoms have the necessary tools and training to make that diagnosis and get the earliest possible intervention put in place, whether that be a referral to secondary care or simply the identification and management of issues at the local level.
Early intervention is key. As with many other conditions, the longer that problems are left untreated, the greater is the potential for long-term complications and more serious medical intervention. Given the way in which CKD interacts with other health conditions—for example, the risk of its association with high cholesterol and high blood pressure—identifying it at an early stage offers the potential for interventions targeted at those conditions, thereby boosting the health outcomes not just in renal health but across the board.
I do not have time today to delve into the detail of the implications of CKD at stage 1 through to stage 4. That would take a whole lecture. However, I welcome the Government’s on-going work on the long-term conditions strategy. The consultation on that has closed recently. I am sure that the Government is working to determine the process for moving forward, so I look forward to hearing the minister’s response.
Again, I thank all our dedicated professionals across our NHS, and campaign groups such as Kidney Research UK, for their support towards improving the prognosis for everybody who is affected.
17:59
I congratulate Kenneth Gibson on bringing an important issue to the chamber. I have previously considered it as a member of the Citizen Participation and Public Petitions Committee, which is when I first researched chronic kidney disease. I was surprised to find that 10 per cent of Scotland’s population are living with the condition—that would be more than 90,000 people in the NHS Lothian area. Despite that prevalence, it is not an issue that has drawn much attention. A third of people with CKD are not even diagnosed, according to Kidney Research UK.
Chronic kidney disease refers to a range of conditions that affect the functioning of the kidneys. It overlaps with many other conditions, such as obesity, diabetes and heart disease, and it can be treated through lifestyle changes such as exercise. It is therefore right that we should look to raise awareness.
I welcome the progress that has been made on CKD in recent years, including reimbursing people for the electricity costs of at-home dialysis. Many people who are in the later stages of CKD spend hours in hospital—sometimes three days a week—undergoing treatment. Members will appreciate how that could upend people’s lives and take them away from work, their families and the things that they enjoy.
At-home dialysis can lessen the burden and give people back control over their conditions. It can also free up NHS staff time and lessen the burden on health services. However, only about 12.5 per cent of patients are currently treated at home. Given the benefit, I struggle to believe that that is a true reflection of demand. Other countries, such as Sweden and Finland, are looking to increase self-care to 50 per cent and 40 per cent respectively. We should have a similar ambition, so that everyone who wants at-home care can access it.
However, as with most conditions, our focus should be on prevention and ensuring that as few people as possible get to the point at which they require dialysis. That involves raising awareness of chronic kidney disease through education, and informing those with conditions that put them more at risk about how to manage their conditions. It also involves supporting primary care to reach out to the communities and groups that are most affected, especially ethnic minorities, who are seven times more likely to face kidney failure in their lives.
Kidney Research UK’s action plan for Scotland says that the current approach is “haphazard”, with huge variation from practice to practice. The argument for a specific policy focus is a reasonable one.
Chronic kidney disease does not have to be something that is caught when it is too late or something that takes over a person’s life. The upcoming long-term conditions strategy is an opportunity to ensure that that is the case.
18:03
I, like others, thank Kenny Gibson for lodging the motion. I welcome people to the public gallery tonight.
The motion rightly recognises the immense impact that chronic kidney disease has on individuals, families and our NHS. I declare a slight interest, Deputy Presiding Officer. When I was a teenager, I was going to go through some surgery and had a body scan. Through the body scan, we could not find any kidneys. However, as Kenny Gibson pointed out, the kidney is a secret worker, so I presume that because I am standing here tonight, something is happening in my body.
CKD is one of the most common and resource-intensive long-term conditions in Scotland, yet, as others have pointed out, it remains one of the few areas that does not have a dedicated policy with a real focus. We have heard tonight that that must change, because we know about the scale of the challenge. Thousands of people across Scotland rely on dialysis every single week, while others live with a kidney transplant and many remain at risk of disease progression. That demands action, because dialysis is not a treatment that one can simply fit in around ordinary life—it becomes life itself.
The NHS does extraordinary work, and, like others, I thank the extraordinary doctors and nurses who do that, but the system is under pressure and those with long-term conditions are often the first to feel the strain. For those living with chronic illness, equity means access to the right treatment, at the right time and in the right place, whether they live in the centre of Edinburgh or on a remote island in the Highlands, but we are falling short of that right now.
Rural patients face long and exhausting journeys to access treatment and people in our most deprived communities are 60 per cent more likely to develop chronic illness, including kidney disease, and face a life expectancy that is up to 25 years shorter than that of those in our wealthiest areas. As we have heard from other speakers, ethnic minority patients encounter language and cultural barriers, and disabled people face hurdles with transport, accessibility and advocacy.
The challenges are not abstract; they are lived day in, day out. That is why it is so important that the Scottish Government makes CKD a specific strand in its long-term conditions strategy. I would be interested to hear whether the minister can, in her closing speech, confirm that the Scottish Government is heading towards that and tell us when we are likely to get there.
These are not luxuries; they are necessities. We know what works. Expanding home dialysis brings greater independence, improves quality of life and reduces pressure on hospital services. Increasing organ donation rates saves lives and eases demand. As Brian Whittle said, prevention through early screening in high-risk communities has the power to slow progression and reduce the long-term burdens on patients and the NHS alike.
International examples show us what can be achieved and what we should be aiming for. For example, in Australia’s Northern Territory, mobile dialysis units have transformed care for remote communities, proving that geography need not dictate outcomes. Scotland can, and should, be as bold, but that cannot be done by Government alone. It requires action from doctors, third sector organisations, industry and from patients themselves, whose voices must shape the services that they rely on.
Chronic disease is not only a medical condition; it dictates how you shape your life day in, day out. We need action and I look forward to hearing from the minister.
I call Jenni Minto to respond to the debate.
18:07
I, too, thank Kenneth Gibson for his motion and thank members from across the chamber for their helpful contributions.
The Scottish Government is committed to ensuring that all people in Scotland who live with long-term conditions, including chronic kidney disease—CKD—are able to access the best possible care and support and can benefit from healthcare services that are safe and effective and that put people at the centre of their own care. I thank all the organisations that are here tonight and the individuals who help and support those with CKD.
I will first respond to the points made by Mr Gibson and others about the long-term conditions framework. That framework recognises that, although every condition is different, there are universal standards that everyone should expect, no matter which condition they have. I thank Kidney Care UK, Kidney Research UK and the chronic kidney disease working group of Kidney Research UK in Scotland for contributing to the consultation on the framework, as well as thanking everyone else who contributed to our public consultation. We received 371 validated responses to that consultation and an analysis report will be published in October.
We will soon announce the governance arrangements, including the role of the third sector and those with lived experience in the development of the framework’s action plans. The Scottish Government and I place a huge importance on hearing from organisations representing people with long-term conditions and hearing directly from people with lived experience. That will be an important aspect of how we develop the framework and the on-going action plans to improve services for people with long-term conditions, including CKD, especially in highlighting inequalities.
I note the important role that the third sector has played over the years in driving improvements in condition-specific strategies. We want to ensure that kidney organisations can play that role, too. Importantly, this will be an opportunity for kidney organisations, as well as organisations representing other conditions, to come together and work collaboratively with the Scottish Government on improving care for people with long-term conditions. I very much look forward to meeting Kidney Care UK soon to discuss the framework and to attending Kidney Research UK’s summit in the next few weeks.
I also want to note where our wider Government policies deliver the asks of the motion regarding prevention, early diagnosis, equitable access to transplantation, a home-first approach to dialysis care and improving donation rates. That is important, as I agree with the points that Brian Whittle and others made about the impact that those issues can have on people and on Scotland’s economy.
In the “NHS Scotland Operational Improvement Plan” document, which was published on 31 March, the cabinet secretary set out that we will work to ensure that people receive the right care in the right place. Home dialysis can offer many benefits to NHS boards and patients, as many members have said.
Last year, we implemented a Scotland-wide policy of reimbursing home dialysis patients for the extra electricity costs incurred in their treatment, as Foysol Choudhury noted. That removes the financial disincentive to choose home dialysis over in-centre treatments, allowing personal choice in where and how to receive treatment, whether people are in a rural, urban or island community. I note the targets that the Nordic countries are aiming for, which Mr Choudhury mentioned, and I will take them into further consideration.
I will quickly respond to Kenneth Gibson’s points about transport and, in doing so, thank Kidney Care UK for its in-centre dialysis transport report, “Left to get on with it”. In October 2024, we published the “Transport to Health Delivery Plan” document, which sets out 20 commitments across the Scottish Government and partners. We look forward to hearing from a short-life working group that was created by the chief executives of NHS boards to address the issue of transport and renal dialysis access. Once we get the outputs from that, we will consider them closely.
Our cardiovascular disease risk factors programme is undertaking work in that area, with the aim of reducing avoidable CVD death by 20 per cent in 20 years by improving the identification and management of high blood pressure, high cholesterol, raised blood sugars, obesity and smoking. As part of that programme, we have committed to supporting 100,000 patients with enhanced-service GP appointments by March 2026 for those key risk factors, with a particular focus on supporting people living in areas of deprivation.
The Scottish Government is also committed to improving outcomes for people living with diabetes. Through sustained investment, innovation and strategic policy, we are transforming diabetes care to reduce complications and support long-term health. Notably, more than £42 million has been invested in the type 2 diabetes prevention framework, supporting early intervention and remission strategies such as the Counterweight plus programme.
Through the actions that are set out in the “Donation and Transplantation Plan for Scotland: 2021-2026” document, the Scottish Government is committed to increasing organ donation numbers and access to life-changing and life-saving transplantation. I thank Christine Grahame for hosting, in September, a parliamentary event focused on organ donation, as we need to work to increase the number of organ donations that are made. Key to that is ensuring that as many people as possible have registered their decision on the organ donor register. Scotland has a good record on that in comparison with other parts of the UK, with 57.9 per cent of the population now having recorded their decision.
Do we have any idea why the rate of organ donation has fallen? The legislation that we introduced was supposed to make organ donation easier and much more accessible. Do we have any idea why that is not the case?
We need to recognise that, although one big launch does a lot, we need to continue to get that information out there, which is why I am pleased that we will be conducting a Scottish Government-led publicity campaign.
As Christine Grahame says, we have done well, but we must do more. That is why, during this year’s organ and tissue donation week, in September, we will be encouraging as many more people as possible to register. That is the best way to ensure that people’s wishes in respect of donation are respected.
The Government is committed to supporting everyone to live longer, healthier and more fulfilling lives. We know that improvements to the health of our population have stalled and that inequalities have widened in recent years, which experts attribute to the combined impacts of UK Government austerity policies, Brexit, the Covid pandemic and the cost of living crisis, and that incidence of non-communicable disease is forecast to rise if action is not taken to prevent those illnesses.
Brian Whittle regularly—perhaps in every speech that he makes regarding health—talks about prevention, and I hope that he has read and supports our recently published population health framework, which was co-authored with the Convention of Scottish Local Authorities and sets out our 10-year strategy to improve the wider determinants of Scotland’s health through a whole-system, cross-Government and cross-sector approach that is focused on prevention. As Jackie Baillie said, that work has to be anchored within our communities.
A key priority of the framework is to improve levels of healthy weight, including by ensuring that a healthy diet is accessible and affordable to all. By shifting the focus from treating illness to preventing it, addressing the root cause of poor health and targeting our efforts where they are needed most, we can ensure lasting improvements for this generation and the next.
One of the most life-affirming experiences that I have had was witnessing a live kidney organ transplant and meeting families who have benefited from that amazing surgery. I was struck by their humbling appreciation and their wish to give back to society by encouraging people to register and raising awareness by sharing their stories.
Like Emma Harper, I pay tribute to the fantastic teams of nurses, clinicians and scientists from our NHS who support and care for those living with chronic kidney disease and, of course, the third sector organisations, many of whom are represented here. I thank Kenneth Gibson for bringing this important motion to the chamber.
Meeting closed at 18:17.Previous
Decision Time