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4 February 2004

Through a Glass Darkly

Some debates in Parliament get close and personal. That might be a way to describe fundamental disagreements between politicians. Or, as in this case, it might describe cross-party agreement on a matter affecting individuals.

The debate on macular degeneration this week was a clear example of the latter.
Members of all parties spoke out on behalf of the 650 people in Scotland who start to lose their eyesight from the “wet” form of this condition.

Our Parliamentary debate focussed on this. And I quote from my contribution;

“It is difficult to engage with the subject at a technical level. For example, the description of the condition that one of my constituents has is:

“’classic with no occult subfoveal choroidal neovascularisation’.

“It is not especially useful to go into such technical complexities in the debate. The issue is really—and inevitably—about people and the effect that the condition has on them.

“I have known the constituent of mine who suffers from the condition for many years. He is a lively 80-year-old, but I can see a change in him. He has the misfortune—in one sense—to live in the NHS Grampian area, which has not had the discretionary funds to make treatment available to him. That has been particularly difficult for him because he has seen people come from south-west Scotland with NHS funding to one of the only treatment centres in Scotland, which happens to be in Aberdeen.

“Of course, he could have bought treatment from the NHS and an offer was made. I understand the difficulties that are involved in deciding a fair and equitable policy for providing treatment in the early stages. However, let us consider the 650 people and the costs that are involved. I do not think that the cost of providing the treatment in question exceeds £1 million. I do not have such money in my back pocket and it is not a trivial amount, but we must make the important contrast between it and the several millions of pounds that those 650 people would end up costing the public purse if they were not rescued from having a lack of sight. The difficulty is that different budgets are involved.

“Fortunately, I managed to get my constituent in contact with a specialist in Edinburgh and we managed to get him on a programme. However, he suffered from the wet form of the condition, which is a matter of extreme urgency. There was a delay of some six or seven weeks before he was treated on the NHS, which, with the wet form of the condition, is enough time for a person to lose around 50 per cent of the remaining sight that is provided by the macula, or the centre of the eye, which is the part of the eye that enables a person to recognise people, watch television and read books. One can be left with orbital sight, which enables one to navigate and move around, but the condition is serious. For people such as my constituent who are well stricken in years, such things can be difficult to cope with.

“I hope that the minister will tell us that moneys will be available in the future to treat people with the condition and that there will be a relatively consistent policy throughout Scotland. I also hope that he will tell us that the two and a half years that it has taken before treatment for some forms of the disease is approved is not the kind of period that might be experienced with diseases that need treatment similarly urgently in future.”

The 1961 film directed by Ingmar Bergman, “Through a Glass Darkly”, was shot in black and white. It contains the highly relevant dialogue from Karen, “It's so horrible to see your own confusion and understand it.”

And for sufferers of a rapidly developing condition where their eyesight can deteriorate over a matter of weeks, it strikes me that Karen was right.

So it is important that our NHS responds rapidly with help for sufferers.

Holyrood

The evidence about mismanagement of the Holyrood building project is stacking ever higher. The Fraser enquiry has been set up to get to the bottom of why we are paying more than £400 million when we expected a building for Parliament for much less.

The revelation that Liberal David Steel presided over a cover-up is sheer dynamite. Previously it looked like the now deceased Scottish Secretary, Donald Dewar, and the late architect, Enric Miralles would carry the can alone.

But with the damaging admission that Steel allowed only “edited” minutes of meetings about the building project to be seen by MSPs, we now know that the truth there to be told – and it was concealed.

Watch this space.

Stewart Stevenson
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