“TYPE 1 DIABETES DOES NOT CHANGE ONCE YOU CROSS THE BORDER, WHY SHOULD TYPE 1s IN SCOTLAND MISS OUT AND RECEIVE WORSE CARE BASED ON WHERE THEY LIVE?”
Scottish Labour MSP for Lothian Region, Foysol Choudhury, led the Scottish Parliament’s first Member’s Business of 2025 on one of Scotland’s most pressing healthcare technology issues – access to medical technology for diabetic patients.
This debate comes after much campaigning from both in and outside of parliament, including groups like iPAG (Insulin Pump Awareness Group), Diabetes Scotland, and MSPs like Mr. Choudhury, fellow Lothian MSP Sarah Boyack and Labour’s health spokesperson, Jackie Baillie.
Access to diabetes technology is crucial for people with Type 1 diabetes (T1D), an incurable autoimmune condition that requires lifelong insulin therapy and constant management, including making up to 180 more daily decisions about their health to balance blood glucose levels.
Access to diabetes technologies is essential to reducing the physical and mental burden of type 1 diabetes and preventing serious complications like seizures, heart disease, blindness, kidney failure, and death.
The physical and mental toll of T1D is immense, often causing symptoms like lethargy, nausea, and anxiety, as well as diabetes distress, but tailored treatments and access to current technologies are critical to easing this burden and improving quality of life.
This push for access to technology comes not only from campaign groups and politicians but also from those suffering long wait times to access HCL systems, with Scottish Labour figures showing about 3,000 patients waiting across Scottish health boards. Nearly 1,000 are waiting in Lothian alone, with some in Scotland waiting over five years for an insulin pump.
In June 2024, the Scottish Government announced “up to” £8.8 million to improve access to diabetes technology, including pumps and continuous glucose monitors. Yet health boards are still facing significant pressures to fund diabetes technology with the ongoing cost of managing and replacing these devices.
Some have stated that patients outside the identified priority groups will not have access to this technology for the foreseeable future. As of November, NHS Lothian has stated that there has been no additional funding for dieticians, diabetes nursing, and administrative costs from the Scottish Government.
As a result, these constraints are driving a shift toward less suitable options, such as systems that prevent carers from monitoring glucose levels remotely. Families report being offered Freestyle Libre 2+ or Freestyle Libre 3 as standard, with little consideration for individual needs.
This approach poses significant safety risks, particularly for young children and individuals unable to manage their own systems. This goes against SIGN 170, a toolkit published by NHS Health Improvement Scotland and the Scottish Intercollegiate Guidelines Network.
During the debate, MSP Choudhury emphasised: “Type 1 diabetes does not change once you cross the border, why should type 1s in Scotland miss out and receive worse care based on where they live?
“Diabetes technology is genuinely preventative care which will save the NHS money in the long term.”
Mr. Choudhury concluded: ““I want to finish by asking members to place themselves in the shoes of a type 1. Knowing the technology to change your life is available, but there is no political will to ensure you get it soon. Imagine the frustration you would feel day by day. We cannot just tell people to wait.”
Online activist and T1 diabetic, Lesley Ross, contributed online: “We shouldn’t have to fight for the best possible care when we are struggling to manage our condition.”
Chair of iPAG Scotland, Mary Moody contributed online: “We know that diabetes teams across Scotland want to do the best for their patients but are restricted by administrative and budgetary constraints.
A toolkit to assist decision-making is published by NHS Health Improvement Scotland and the Scottish Intercollegiate Guidelines Network,
(SIGN 170 – https://www.sign.ac.uk/our-guidelines/optimising-glycaemic-controlin-people-with-type-1-diabetes/)
but may be disregarded with people being given equipment that does not meet their exact needs and may put them at risk. This has got to improve. Patient safety has to come first.”
Following the debate, MSP Choudhury concluded: ““I want to thank the campaigners and type 1s who have been advocating and contributing to this discussion and thank them for their hard work.”
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