S5M-08218 Incontinence

The Deputy Presiding Officer (Linda Fabiani): The next item of business is a members’ business debate on motion S5M-08218, in the name of Alex Cole-Hamilton, on incontinence in Scotland. The debate will be concluded without any question being put.

Motion debated,

That the Parliament understands that incontinence has the potential to affect everyone at some point and that the condition can arise as a symptom of a range of varied medical conditions, such as obesity, traumatic childbirth and muscle weakness; believes that 20% of women between 17 and 30 will experience so-called giggle incontinence, which has the potential to lead to greater complications in later life, in particular the need for surgical interventions, including transvaginal mesh implants; understands that the only country to have calculated the costs associated with this is Australia, which estimates these to be around $43 billion (£25 billion) per year as they go beyond the provision of sanitary wear, medication and surgery, and include the cost of dealing with the depression and anxiety that can arise; recognises what it sees as the importance of physiotherapy in alleviating the symptoms, and notes that, when provided early, this has reportedly proved effective in 80% of cases; understands that there is no formal training around basic incontinence prevention in Scotland for the midwifery, health visitor or physiotherapist workforce; acknowledges the taboo around the subject, which, it believes, suppresses an open discussion about it and often prevents people experiencing the condition from seeking help, and notes the view that the case for a national incontinence strategy is compelling, as it would be important to improving the life quality of hundreds of thousands of people in Edinburgh and across the country and would be of benefit to the public purse.

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13:12

Stewart Stevenson (Banffshire and Buchan Coast) (SNP):

In essence, this debate is about the competition and tension between social embarrassment about talking about the functions of our bowels and bladders and the underlying medical urgency that might be associated with dysfunction in that regard. If social embarrassment wins, there is a risk that we delay engagement with the medical assistance and advice that might well be necessary to protect us from the severe impacts of underlying conditions that need urgent attention.

I often learn things in members’ business debates that I had not previously been aware of. It had never occurred to me that the issue that we are considering had a gender aspect to it. Members might forgive me, given my age, for being a little fixated on the future operation of the older gentleman’s prostate and for neglecting to understand issues that are associated with pregnancy and incontinence in females. We have heard that the problem is bigger for the female than it is for the male. I have learned something.

I am grateful to Alex Cole-Hamilton for securing this debate, which I hope will, more broadly, enable people to feel a little more comfortable about talking about issues that are rarely discussed at the dinner table.

The issue is important. Glasgow Caledonian University reports that 30 to 40 per cent of people over 65 who live in their own homes and 70 per cent of frail older people who live in care homes struggle with incontinence—so it is not a trivial matter.

Despite what Alison Johnstone said—I will look out some of the references that she cited—I had not previously thought that incontinence was a matter of humour. However, if humour can be used as a vehicle that allows us to talk about and recognise the condition, that is very much to be welcomed.

A lot is expected of healthcare professionals. I hope that practice nurses, who will often be the ones to be consulted on the condition rather than general practitioners, have the appropriate training and the sensitivity to raise with patients something that may be of considerable embarrassment to them. Patients often go to their primary health provider for a reason other than incontinence, and the condition may emerge as a secondary issue, or it may simply be that questions about general health reveal an incontinence problem that is part of their deterioration in health.

I hope that midwives, health visitors, physiotherapists, practice nurses and GPs are, in future, better equipped for, and more comfortable with, raising difficult issues about incontinence. As the Australian numbers illustrate, the key point is that if we tackle incontinence early, there is an economic saving in addition to the benefit to the quality of life of sufferers. Sustained and regular exercise is important and helpful, with the caveats that I have just heard about from Alison Johnstone.

We have the potential to alleviate unnecessary pain, anxiety and aggravation, and to improve the quality of mental health of incontinence sufferers. The topic has been neglected for too long. This debate is a contribution, but not the end of the story in improving matters for incontinence sufferers.

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