Tinnitus
The final item of business this morning is a members' business debate on motion S1M-1218, in the name of Margaret Jamieson, on tinnitus. The debate will end after 30 minutes, without any question being put.
Motion debated,
That the Parliament notes that tinnitus affects around one in ten of the population, including an even higher proportion of older people; further notes that following advances in various therapies to counter its effects a pharmacological solution is now a real possibility, and urges the Scottish Executive to encourage appropriate research to this end by all means at its disposal.
Tinnitus is a debilitating illness that affects some 500,000 Scots throughout every constituency in Scotland. It is so intrusive that it affects everything a sufferer does and makes it almost impossible for some sufferers to pursue a normal life. The impact of that was brought home to me by my constituent, Mr Tom Smith, of Holmlea Place in Kilmarnock. He drew my attention, and that of my Westminster colleague Des Browne, to an early-day motion on this subject that was tabled at Westminster.
Mr Smith has suffered from tinnitus for some time and has tried alternative therapies to relieve his suffering. He has also attempted to set up a self-help group at Crosshouse hospital in Kilmarnock—unsuccessfully, so far. I hope that the exposure of this issue today will publicise his work further and enable a self-help group to be formed in Kilmarnock and Loudoun.
There have been several developments since the issue was first raised at Westminster, and I am indebted to Mr Jack Shapiro, chairman of the British Tinnitus Association, for keeping me up to date with them. Following a delegation to the minister at Westminster, which was led by Lord Ashley—the association president and a tireless campaigner on hearing issues—the Medical Research Council was asked to evaluate the association's proposals for a tinnitus research unit to develop a number of therapies for tinnitus sufferers.
A key to those therapies will be a pharmacological solution—what the association calls "a pill 4 tinnitus"—which needs to be developed. That requires substantial funding. I hope that the Medical Research Council will look favourably on the project, but it is notoriously tight with its money and it might need some encouragement from the two Parliaments to respond positively to the BTA's proposal.
Tinnitus is a real problem for the national health service, health trusts, hospitals and general practitioners. There seems to be no one way of relieving sufferers, some of whom might need only effective counselling to help them manage the condition. One of the foremost researchers in the field, Dr Ewart Davis, has called tinnitus the
"last great frontier of chronic disability for people"
in Scotland and has been supporting the BTA proposal to the MRC from his research base at Birmingham University.
The lack of understanding and support has spawned a series of self-help groups across the country, including one in the House of Commons. It might be interesting to discover how many MSPs and Holyrood staff are tinnitus sufferers. I am sure that the BTA would give the Scottish Parliament every assistance in setting up such a self-help group at the Mound.
In Scotland, the profile of tinnitus was enhanced by the first Scottish tinnitus conference, which took place in Aberdeen on 3 November. The conference brought together people with tinnitus and people who have contact with tinnitus sufferers, to form friendships, to exchange experiences and perceptions and to help and encourage further support. I understand that more than 140 delegates attended the conference, which was a resounding success.
Scotland is sadly lacking in clinical support. There is only one audiological physician—Dr Irwin at Ninewells hospital in Dundee—and he has a waiting list of more than six months. I know that an urgent review of audiological services in Scotland has been requested of the Scottish Executive; perhaps we will soon hear something about that. The lack of provision is a disservice to Scotland's many sufferers. That, of course, is the key issue.
There is a real need to make the general public and opinion formers in both Parliaments and elsewhere aware of the real suffering of tinnitus sufferers. Only then will tinnitus research be given the priority it deserves to attract the funding that is necessary to make possible the "pill 4 tinnitus" and the development of other therapies.
I pay tribute to the 34 colleagues of all parties who have shown their interest in the issue by signing the motion; that figure was 35 until Mr Chisholm's elevation to the position of minister. Furthermore, I thank the Parliamentary Bureau for allowing the issue to be discussed and pay tribute to the more than 300 Westminster colleagues who signed the early-day motion or indicated their support if they could not sign because of their position in the Government.
This is an issue for us all, as parliamentarians and as caring members of our society, and I look forward to the Parliament's support to assist this often forgotten group of fellow citizens.
Members' business is becoming an opportunity to raise awareness of conditions that affect thousands of people and somehow get lost in the grand scheme of things. I am very grateful that Margaret Jamieson has raised this issue today. I began last week hardly able to pronounce mesothelioma, but by the end of the week I knew more about the condition. Similarly, I must admit that I have only heard of tinnitus; however, through this debate, we can raise awareness of the condition and find out more about it.
If I were to say to colleagues in the tea room at the back of the chamber that I had ringing, whistling, buzzing, hissing, whirring or humming noises in my ear, it is unlikely that I would attract much sympathy or serious medical concern. In fact, it is more likely that I would attract a humorous comment. That made me think that there are probably sufferers who do not even want to talk about their condition, because they feel that that is what is likely to happen.
At its worst, tinnitus can cause ceaseless loud bangs, whistles and metal-clashing noises inside the head. That is bad enough, but it also leads to anxiety, insomnia and depression. Bringing more attention to this chronic, neglected medical problem will help to bring greater understanding of its effects on people and will, I hope, encourage sufferers to join organisations, such as Tinnitus Action, that can offer free information and advice. Even just giving an explanation and offering reassurance to sufferers that they are not the only people in the world with the problem can do much to help understanding of the condition, to alleviate suffering and to help people to live with the problem.
We must raise awareness of the long-term effects of exposure to loud noises in younger people, which is probably the leading cause of tinnitus. Loud music has an obvious effect, but there are also issues to do with health and safety in the workplace. Employees should be fully informed of the potential long-term effects of exposure to loud noise. It should also be incumbent on employers to offer and insist on the use of measures to protect hearing.
I understand that certain drugs are used to treat tinnitus, the major one being Triptafen, which is usually prescribed for depression. That illustrates the depth of the problem and people's inability to speak about it.
I thank Margaret Jamieson for raising the issue. It has helped us to understand the problem and to bring awareness of the problem to a wider audience.
It is my pleasure to speak in support of Margaret Jamieson's motion. Many conditions seem to be neglected, largely because they are not life threatening and therefore given a lesser priority. Many chronic conditions, such as tinnitus, are not uppermost in the minds of the medical profession. There is ignorance among the medical profession of the problems associated with tinnitus. It is perhaps not only among members that awareness must be raised, but among those who have to deal with the problem professionally.
Margaret Jamieson encouraged us to support the production of a pill. There is not necessarily a pill for everything. A pharmacological solution may be possible, but we should not bank on that as the only means of offering relief. Margaret Jamieson noted that there is only one audiological physician in Scotland, but there are audiologists in the health service—though not many. I had the privilege of representing them for a short time on the NHS Whitley council. I am aware that there is a significant shortage of scientists trained in such work in the UK, particularly in Scotland. I hope that the minister will bear in mind the possibility of a scientific as well as a medical solution in any review of staffing.
I do not have much more to add other than to express my general support for the motion. I point out to Mary Scanlon that a number of drugs are used for a variety of purposes and that the fact that the principal indication for a drug is depression does not mean that it will not have beneficial effects in other areas.
For example, Amatriptyline, which is widely prescribed for depression, is also good as a muscle relaxant. The fact that a drug has antidepressant qualities need not be the reason why it has been prescribed. I would hate to think that those who have been prescribed Triptafen for tinnitus are really being given the drug to combat their depression—and I suspect that that is not the case.
Margaret Jamieson is to be congratulated on drawing Parliament's attention to the plight of tinnitus sufferers. The motion has received all-party support both in the Scottish Parliament and at Westminster. The issue is of interest and concern across the political spectrum, including in the Executive as was recently demonstrated by the contribution that we made to the funding of the recent Scottish tinnitus conference that Margaret Jamieson referred to.
I am told that there are seven continuing and 14 recently completed research projects investigating different aspects of tinnitus. They are funded on a UK basis. Margaret Jamieson talked about the approach to the MRC with a specific proposal for tinnitus research. The MRC is independent of both the Scottish Parliament and Westminster and makes its own funding decisions. Having said that, it would be appropriate for us to draw its attention to the widespread support for today's motion. I will certainly do that.
About 20 per cent of people—1 million Scots—will suffer from tinnitus at some point in their lives. All three members who have spoken have mentioned the large number of people who are affected and the serious nature of the condition. We should remember what Mary Scanlon said about the fact that people sometimes wrongly make light of the condition. I hope that no one who is paying attention to the debate will do that again.
Although persistent tinnitus is more common with age, it is a misconception that it is confined to the elderly. Studies show that it can happen at any age, even in quite young children. Tinnitus is caused by damage to the tiny hair cells in the inner ear, which respond to sound waves. A false message is sent by the damaged cells to the brain and the sufferer hears a noise which is not there. There is no doubt that tinnitus is a common, distressing and often debilitating condition. When a specific cause can be identified, sometimes treatment can be curative. For example, avoiding exposure to loud noise, drinks containing caffeine, alcohol and other precipitating factors can be helpful.
If the cause is an ear infection, completing a course of antibiotics will clear up the infection and usually the tinnitus will disappear in a few days and may be no more than a minor irritation to the patient. Unfortunately there is no evidence, yet, that drug treatment for tinnitus is effective. Many preparations have been prescribed over the years, including antihistamines, antidepressants, anxiolytics, massive doses of vitamins, anticonvulsants and local anaesthetics. However, they have met with variable results.
We know that tinnitus is often a feature of Ménière's syndrome. There are a number of medicines licensed for the principal symptoms of that condition but drug treatments aimed at treating tinnitus alone have had little reported success. That said, there are measures available that help tinnitus sufferers. They include maskers, which block out the noises of tinnitus, hearing aids, which suppress tinnitus by amplifying background noise, and relaxation techniques.
Margaret Jamieson has rightly drawn attention to the importance of research. We know that some researchers working in the area believe that the cure for tinnitus lies in drug treatment. For example, there has been interest in giving lidocaine, which is a local anaesthetic, to tinnitus sufferers to damp down the false signal that underlies the condition. However, to be effective, the lidocaine has to be given either intravenously, which carries considerable risk of causing abnormal heart rhythms, or by injecting it directly through the eardrum. Understandably, many patients found the second method too distressing and withdrew from the research project. I agree that it is vital that research efforts in this area should continue.
Against that background, it must be remembered that only a quarter of people who suffer from tinnitus seek medical help. The family doctor knows the patient's medical, occupational and social background. Examination may show a treatable cause, such high blood pressure. If the situation merits and the patient wishes, the general practitioner can refer the patient to a national health service consultant. Traditionally, that consultant has been an ear, nose and throat surgeon. Margaret Jamieson talked about the small number of audiological physicians in Scotland. That may be one reason why referrals are routinely to a surgeon. After the debate, I will examine the matter of the number of audiological physicians.
Will the minister also investigate the number of audiological scientists, who provide many of the front-line clinical services?
I do not have information to hand about that aspect of the matter, but I will certainly examine it.
Sophisticated examination and investigation techniques can sometimes demonstrate a treatable cause for the tinnitus. Surgery is rarely indicated and is limited to very serious problems, such as a tumour on the auditory nerve. Cutting the nerve relieves the tinnitus but has the permanent and unwelcome effect of making the patient permanently deaf in that ear.
The NHS also provides support, counselling and pharmacological treatment for sufferers who become depressed and introspective as a result of the tinnitus.
In Scotland, the chief scientist's office is not directly funding research in this area and would be pleased to receive research applications. At present, Scottish Executive funding for research is awarded through that office. The Scottish Executive health department will continue to keep itself informed of any national developments in the field.
I give an assurance that we will give careful consideration to all the points that have been raised. I hope that we can work together to achieve the aim that we all hold in common, which is to improve the support and services for all who suffer from this distressing and often debilitating condition.
Meeting suspended until 14:30.
On resuming—
Before we begin question time, I want to say that last week's session was unacceptably noisy. I am determined that our question-and-answer sessions should not degenerate into the kind of shouting matches that are held elsewhere. [Members: "Hear, hear."] I remind members that the standing orders specifically require them to
"conduct themselves in an orderly manner".
I will be watching carefully for anyone who barracks other members persistently.