Chamber and committees

We have the evidence from service providers and stakeholders about the services that they provide, but I want to be able to cross-check that with the real experience of the recipients of those services. That is the area that I was exploring. I am happy for Mr Stewart to come back on that.

That is grand. We would be happy to get those figures.

Yes.

Just about.

Thank you very much for that detailed response, Nicky.

Louise, would you like to come back in?

Good morning, and welcome, everyone. The Public Bodies (Joint Working) (Scotland) Act 2014 aimed to better integrate the health and social care systems in Scotland through integration authorities. How does integration work in your local area currently? What are some of the advantages and disadvantages of the model that is adopted in your area? I am aware that there are two different models. Everybody will probably need to provide an answer. I ask Ross McGuffie to start.

Thank you for that, Ross.

Before I bring in the other panellists, I will ask the next part of my question. How much money do your individual areas spend on children’s services, and how has that funding changed over the past decade? Can you give me a comparison with any changes that there might have been in outcomes for young people? In short, I am asking about the money that has been spent and the impact on the outcomes.

Louise, could you respond first?

Do you have any figures for how much is being spent on children’s services and how that funding relates to outcomes?

I welcome the debate, which marks another step forward in the delivery of health and care services that understand and support people with chronic pain. I have listened carefully to the very informative contributions from members, especially Christine Grahame.

Chronic pain is defined as pain that persists beyond normal injury healing time and that recurs for longer than three months. It is a separate condition in its own right and frequently presents alongside other long-term health conditions.

It is often said that living with chronic pain is hard, but dealing with people who do not care or understand can be even harder. Older people represent a significant proportion of people with chronic pain and their lived experience tells us that their pain is sometimes responded to with an uncharacteristic lack of empathy from healthcare professionals, which leads to poor investigation and to little or no therapeutic intervention.

We know that chronic pain is complex and unique to every individual. We hear reports that, as people age and present with chronic pain, their experience of accessing local healthcare services is less than compassionate and lacks empathy. An older person who approaches their GP for advice, guidance and treatment options can find the response—unusually for the caring professions—to be based on assumptions and a sense of inevitability, with old age itself blamed rather than there being a focus on which aspects of the ageing process might be causing chronic pain and on how best to treat and alleviate the patient’s experience of that pain.

Moreover,

“there is evidence to indicate that there are links between adverse experiences and the incidence and impact of pain.”

When an elderly person goes to see their GP for advice and support but they meet with a response that does not acknowledge or engage with their experience, the impact of their pain can potentially be intensified. Indeed, a key finding of the framework that we are debating today is that people with chronic pain feel that

“the lack of recognition of its impact on their everyday life, including from healthcare professionals”

increases the challenges that they face.

The debilitating effect of unmanaged chronic pain reduces the quality of life and the wellbeing of older people, as it does for the rest of the population. The action plan notes

“an approach to care that prioritises empathy and kindness in order for it to be effective”.

I really like the fact that those words are explicitly included in the action plan. Everyone living with chronic pain has a right to expect such an approach when they approach the NHS for care. I hope that, when the plan talks about drawing

“on the expertise of people with lived experience of chronic pain”,

it will include older people, whose voices need to be included in the development of training for health professionals.

An increasing body of scientific research and practical evidence confirms the huge potential of therapeutic touch in reducing the impact of pain. I hope that the toolkit for healthcare professionals can reflect treatment options that are appropriate for older people, including physiotherapy, massage and other bodywork therapies.

It is almost impossible to overestimate the importance of health and care workers—including GPs and their team members—having an understanding of the challenges of living with persistent pain. That is vital in ensuring that they provide informed and compassionate care and it enables them to signpost older patients to appropriate, accessible treatments.

I welcome the fact that the first aim of the implementation plan, which is referred to in the motion, is person-centred care. I also welcome the fact that the actions that are identified to deliver that aim include developing a knowledge hub and a pain-informed care toolkit for healthcare professionals to promote in all care settings. Identifying existing best practice and establishing how the principles of trauma-informed practice can be incorporated as part of pain management care and support services is also a valuable element of the way forward.

I welcome today’s debate and the commitments made in the action plan. To foster an approach that is based on compassion, empathy and respect is the right thing to do. I hope that the work that follows will lead to a significant improvement in the experience of accessing NHS services for all those living with chronic pain, including our valued elderly population.

I am the constituency MSP for Glasgow Kelvin, where the unfortunate tragedies, which the commission referred to as “avoidable”, took place, and I was able to attend the launch of the final report at the Merchants house. Will the Scottish Government join me in pursuing recommendation 6, which calls on asylum accommodation support and care providers to immediately ring fence a fund of £5 million per annum for

“asylum seeker wellbeing and mental and emotional health support”

and treatment of trauma? Does the cabinet secretary agree that there should be no profiteering from pain?