Chamber and committees

We know people living in poverty have poorer health outcomes and this is why we are committed to addressing the underlying causes of health inequalities and increasing healthy life expectancy. There is a stark social gradient to alcohol harms and outcomes linked to poor diet with those in the most deprived areas being the most affected

Population-wide measures to transform the food environment are more likely to be effective in reducing health inequalities than measures aimed only at encouraging individuals to change their behaviours. That is why we will introduce a Bill in this Parliament that includes powers to restrict promotions of foods high in fat, sugar or salt and introduced Minimum Unit Pricing for alcohol. The Scottish Government’s Alcohol Framework 2018 sets out our priorities for preventing alcohol-related harm, including our world-leading minimum unit pricing policy.

A recent study by Scottish Health Action on Alcohol Problems has highlighted the effectiveness of alcohol nurses in Deep End practices in Glasgow, in supporting people with alcohol problems who have complex needs. The Scottish Government will carefully consider the findings of the report which highlight the need for more research into the effectiveness of these services.

Progress on implementing the summary case reform pilot has been impacted by the Coronavirus pandemic and it is intended that the package of reforms will now be taken forward on a pilot basis recommencing in September 2022. The impact of the reforms will be closely monitored and reported on with a view to informing future rollout of the agreed reform arrangements.

The Scottish Government has supported businesses with more than £4.7bn since the start of the pandemic. All Covid-19 business support funds have closed. No funds remain to be allocated from either the Business Ventilation Fund or other Covid 19 related funds.

In 2020, the latest year for which data are available, there were 912 chronic liver disease deaths in Scotland. Of these, 759 were alcohol-related liver disease deaths. Data are not available for obesity related liver disease deaths.

Liver diseases are generally avoidable or treatable if diagnosed at an early stage and stigma often prevents people from accessing treatment; 75% of people are currently being diagnosed at a stage when it is too late for lifestyle changes or intervention.

We take a whole population approach to reducing alcohol consumption and the risk of alcohol-related harms across the population and that’s why we’ve taken a range of actions to reduce the availability, attractiveness and affordability of alcohol.

We are also taking action to reduce the impact of poor diet on people’s health which is also a significant and growing contributor to liver disease. We are taking wide-ranging action to support healthier choices, as set out in our 2018 Diet and Healthy Weight Delivery Plan , and have set a challenging aim to halve childhood obesity by 2030 and significantly reduce diet related health inequalities.

The Scottish Government is committed to tackling stigma.

In December 2021 a national campaign was launched to tackle the stigma people with problematic alcohol and drug use face. This campaign sought to communicate that drug or alcohol problems are health conditions; people should receive help and support, not judgement.

We are working with Scottish Health Action on Alcohol Problems to develop an action plan in relation to alcohol and stigma. This will include advice from those with lived experience, third sector organisations and academics.

We are supporting the development of the forthcoming UK-wide clinical guidelines for alcohol treatment, led by the Office for Health Improvement and Disparities. The guidance will look to introduce new approaches to treatment, including non-stigmatising service delivery.

On 20 June 2022, Public Health Scotland launched the Challenging Weight Stigma Learning Hub. The learning hub aims to raise awareness of the impact weight stigma can have on people living with overweight and obesity and what health professionals can do to mitigate this. It is interactive and has been developed alongside academics, health professionals and those with lived experience of stigma.

NHS Boards do not currently collate numbers of bronchiectasis diagnoses over and above the usual coding of patients that happens as standard at local level. We do recognise the importance of data in understanding and improving respiratory care in Scotland, and improving access to respiratory data is a key commitment in our Respiratory Care Action Plan. One of the three priority areas for year 1 of the Plan’s implementation is data and a sub-group has recently been established to progress this commitment. The first task for this group will be to determine what data should be collected in order to improve respiratory care. This will include consideration of which individual conditions would benefit from additional data collection.

The Scottish Government intends to publish the summary report on the responses to the public consultation alongside the Implementation Plan for the Framework for Pain Management Service Delivery later this summer.

The information requested is not held centrally.

There are currently no plans to undertake a public awareness campaign regarding migraine.

I held a positive meeting with the Migraine Trust in November 2021 to discuss current priorities regarding migraine care in Scotland and potential areas for future collaboration.

The Centre for Sustainable Delivery (CfSD) has a speciality group for neurology which includes representation from key professional groups for each NHS Board. I understand that the group is undertaking work on clinical pathways for migraine in Scotland and is linking with both the Scottish Intercollegiate Guidelines Network (SIGN) and the Migraine Trust regarding this. As part of this work the CfSD are also collaborating with Health Boards to develop GP facts sheets on managing migraine.

I am delighted that we have recently awarded £78,535 to the Migraine Trust, in partnership with NHS Grampian and Pharmacy Medicines Directorate, towards an innovative project working with community, primary and secondary care pharmacists to help people with migraine manage their symptoms and treatments more effectively.

We will support the Migraine Trust and partners to develop plans of how they intend to widely share the project’s outcomes across health and social care.

Living with overweight or obesity is linked with an increased risk of developing a range of health conditions, including non-alcohol-related fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). According to the 2019 Scottish Health Survey , two-thirds of adults in Scotland were overweight or obese. Obesity prevalence in Scotland has remained relatively stable since 2008.

The Scottish Government has not carried out a specific assessment of the impact of rising levels of obesity on NAFLD or NASH.

We want everyone in Scotland to eat well and have a healthy weight. We continue to implement our 2018 Diet and Healthy Weight Delivery Plan . We also continue to support NHS boards to improve weight management services in line with our Type 2 Diabetes Prevention, Early Detection and Intervention Framework and Public Health Scotland’s national standards .

Further information on NAFLD and NASH is available to the public and clinicians on NHS Inform and other professional groups such as British Society of Gastroenterology , and charitable organisations such as British Liver Trust .