Access to Migraine Treatment — [David Mundell in the Chair]

Part of the debate – in Westminster Hall at 10:18 am on 20 March 2024.

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Photo of Owen Thompson Owen Thompson SNP Chief Whip 10:18, 20 March 2024

I commend Dehenna Davison on not just bringing this debate, but all the work she has done on raising awareness and campaigning for those who suffer with migraine. Like many, I spent a long time not realising that I was getting migraines. I am very lucky—I do not get migraine very often, and I know I am very fortunate in that, but when I do, I am absolutely floored. I tend to get clusters due to stress, as others have mentioned. I am very fortunate that it does not happen very often, but it took me many years to realise that that was what was happening. I was very lucky that I had a GP who was able to understand what I was saying to them. I now know what my triggers are and what I need to do when it happens. That does not make it any easier to deal with, but at least I know what needs to happen.

It is common for many of us to know what migraine is, but the fact that we have not had a debate about it in this place for so long—even when so many in this Chamber alone are talking about our own personal experiences—says that, even here, it is not something that we want to talk about very often. I give huge thanks to the hon. Member for Bishop Auckland for ensuring that we are, and we definitely need to do so more often.

We have heard from others how prevalent the condition is, but we still fall so far short in addressing its stigmatising nature. We have heard others say, “It’s just a headache”, and that it is easy to look past. I suppose I was very lucky that, in one of my earliest jobs, my boss suffered from migraines, so there was a level of understanding there. But that was just fortunate circumstance, and we need to have much clearer opportunities for anyone suffering from this condition.

There has definitely been improvement, albeit the waiting times for treatment in Scotland, England and Wales are lengthening, according to the figures put out by the Migraine Trust. We all need to be doing better in that sense, but the Scottish Government are certainly supporting a very high standard in migraine care, with 86% of health boards giving access to the CGRP blockers. That is welcome, but we cannot rest until that is 100% everywhere, and we certainly cannot be complacent.

We know that migraine attacks can signify impact on all aspects of a person’s life, as we have heard, and there is so much more that we could do. We have heard about CGRP blockers, which are one medication, but there are others. I have personally done some work looking into the potential for alternatives like psilocybin, about which we have had some debates previously in this place. I think it was last June, or thereabouts, that I met Professor Jo Neill at the University of Manchester, who highlighted some of the challenges that it faces simply in trying to research the potential for psilocybin. It is still classed as a schedule 1 drug, like crack cocaine or heroin, so the blocks to simply researching what is possible are a massive hurdle to moving forward what could be a significant and useful treatment for many people. As we have heard, not all treatments work for all people, and everybody will have the thing that works best for them. A vast body of research exists, but again, so much more could be done. I ask the Government to consider again what more they could do about those blocks in particular to make research slightly more straightforward, so that we can all have a much better understanding of what is possible.

There are glimmers of hope, and the Centre for Sustainable Delivery has published the “National Headache Pathway”, which will help to drive standards further in migraine care across the NHS, certainly in Scotland. The SNP continues to push the UK Government on the right for flexible working. There is a right to request flexible working in legislation; we think that it should be a right, not simply a request. A Migraine Trust report called “Heading in the wrong direction” said that there should be greater awareness of the pathways that exist for managing migraines, and revealed that half of Scottish health boards said that

“they had undertaken work to review their headache and migraine pathways.”

Again, that is encouraging, but a half is only a half—it is still not enough. As I have mentioned, Scotland was found to have the best access to medication, but more still needs to be done. The Migraine Trust report said:

“There are less than 80 GPs with Special Interest…for headache and migraine across the UK”.

That is simply not enough. People are very lucky if they find one with that understanding, but given that we are talking about universal healthcare, 80 GPs across the isles of the UK is nowhere near enough.

Robert Music, the chief executive of the Migraine Trust, said:

“Not only are patients struggling, but poor management of migraine is putting unnecessary additional strain on an already struggling NHS. We are seeing rising A&E admissions for migraine across the UK. There is a shortage of GPs, consultants and nurses specialising in headache to meet the need that we know exists, and a broad lack of understanding of the condition, meaning patients are not being treated in the right place or at the right time, if at all.”

That is simply not good enough for any of us, and we need to be pushing. I hope debates such as this help to raise that awareness, show that this is a very serious condition and that we need to be doing so much more. Dr Brendan Davies, the chairman of the British Association for the Study of Headache and consultant neurologist at Royal Stoke University Hospital, said,

“Migraine is the most common of all the neurological disorders yet is vastly under-recognised. The time has come for a nationally agreed educational framework and quality standard for primary care, as we have with other important long-term conditions.”

As I and my party persistently advocate for enhancing devolved powers, it will be no surprise to anyone present that we would like to see further devolution of employment powers, so that we can address the issues previously mentioned on employment and flexible working options. While not addressing treatment, that would at least help individuals to best manage their condition in a way that works for them. If we could all look to identify the best treatments, it would be beneficial not just to the individuals but to the economy.

Each passing day that the Government neglect to use their reserved powers to address workplace changes underscores the need for us to be able to make these decisions in Scotland. I hope I will hear something positive from the Minister. Everyone in here is coming from the same place; we recognise that while a great deal has been done, significantly more can be done. It is on all of us to embrace and take forward this challenge. I look forward to hearing the Minister’s response on what steps we could take both immediately and in the longer term, and I once again commend the hon. Member for Bishop Auckland on bringing today’s debate.