Parliamentary Debates

Eating Disorders Awareness Week 2015

Dennis Robertson (Aberdeenshire West) (SNP):  I thank all the members who supported the motion in order for me to secure the debate. I welcome to the gallery members of Diabetics with Eating Disorders who will participate in an event in committee room 4 after the debate.

Prior to the debate, I asked myself why—why am I doing this? The answer is really quite simple. We need to continue raising awareness within the medical profession of people with eating disorders. It was once said to me that things only change death by death. I am hoping to take a much more positive view of this. I am hoping that things will change by raising awareness—awareness by awareness.

This is the third time that I have come to the chamber to raise awareness. I believe that, as I have done so, we have made significant changes. For instance, last year we had the first ever eating disorders conference held in the Parliament. It was well attended. We brought together clinicians, families and patients, people from the media, colleges, universities and the fashion industry. They all had one aim in mind, which was to look at how best we serve those with eating disorders—how best we can make changes in their lives and how best we can resolve some of the problems that those with eating disorders face.

In the past, I have focused on anorexia, for very personal reasons. Perhaps I can come back to that later. However, I want to look at the whole spectrum—well, maybe not the whole spectrum, but there is a wide spectrum of eating disorders. Those with bulimia nervosa have huge problems in coming to terms with their eating disorder. Quite often, it goes undetected and people cope secretly with their condition. Thankfully, many more seek medical attention, but often much harm has been done to their bodies before they do that. The condition affects their fertility system, it can weaken their heart, it can damage their kidneys and it erodes the enamel from their teeth. It is a dreadful eating disorder.

There are also non-specific eating disorders, one of which is perhaps that related to those with diabetes. I had no idea when I first came into the Parliament, or when I first became aware of eating disorders, that mortality is five times more prevalent among those with diabetes and eating disorders than it is among those with anorexia nervosa. That is a shocking statistic to me.

It would appear that those with diabetes and eating disorders still do not have a recognised diagnosis. There is no medical name attached to this condition, as far as I am aware. I hope that, in raising awareness by bringing the subject to the chamber for debate, having an event here, listening to the clinicians and having the minister attend, we will make some strides forward in listening to those people’s stories.

The Parliament is well aware of my story, and it is with sadness that I recall the fact that Caroline died four years ago—four years ago tomorrow, in fact. When this anniversary comes around, I ask myself why, and I think I know the answer. It happened because it happened. It is as simple as that. It was not because there was no intervention. It was because there was perhaps the wrong intervention. It happened because, maybe, we were ill informed as parents, as Caroline’s main carers. This is still too often the problem—communication between the clinicians and the parents and carers is still not at a level at which we can have confidence that young people and others with eating disorders are getting the care and treatment that they need.

NHS Grampian has had bad press recently, but let me give the Parliament a good story from NHS Grampian. It has, probably, an exemplary service for eating disorders at the moment—exemplary, but with a condition. It has a fantastic transition from the young person’s eating disorder unit to adult services. Why? Because it learned a lesson. It learned a difficult and tragic lesson, but in saying that, I note that it did learn a lesson. That lesson needs to be replicated in other health boards throughout Scotland.

There is good practice. The management of really sick patients with anorexia nervosa—MARSIPAN—code of practice should be picked up and implemented throughout all eating disorder services. Young people who are going to medical services are not being appropriately cared for. They are not getting the appropriate treatment when they go to hospital. Why? Because the people who give that treatment are not aware of the full implications of the eating disorder. Help is available. That just needs to be recognised.

We have got better. The general practitioner referral rate is better and I believe that psychiatric services are coming to terms with eating disorders, although resources are few. Let us look, however, at the economic implication of eating disorders. It is estimated that, in the United Kingdom, somewhere between £7 billion and £8 billion is lost due to eating disorders. That is the cost to the NHS, the cost of people who lack employment or those who require care. I do not think that those with eating disorders are asking for too much.

I said that the NHS Grampian service would be an exemplar. It would, if it had the community services to support the hospital service. I say to the minister that, with the integration of health and social care, let us look at the intensive therapy treatments that people with eating disorders require in the community. Let us take that step. Let us resource that necessary requirement not just for patients or carers, but for clinicians to provide the treatment that those with eating disorders deserve and need.


Click here for full debate.