Official Report 847KB pdf
The final item of business is a members’ business debate on motion S6M-19950, in the name of Bill Kidd, on the mental health impact of cell therapies. The debate will be concluded without any question being put.
I invite members who wish to speak in the debate to press their request-to-speak buttons, and I call Bill Kidd to open the debate.
Motion debated,
That the Parliament recognises the significant mental health impact that cell therapies such as stem cell transplant and CAR-T can have on patients and their families, not only in Glasgow Anniesland but across Scotland; notes the recommendations in the June 2025 report by the charity, Anthony Nolan, How we can improve the mental health and wellbeing of cell therapy patients, and further notes the view that all those involved in the delivery of cell therapies should commit to working together towards these recommendations to ensure that every patient and family receive the support they deserve.
18:31
I thank parliamentary colleagues from across the chamber for their overwhelming support in signing the motion.
Cell therapies, including stem cell transplantation and chimeric antigen receptor T-cell—CAR-T—therapy, represent one of the most significant breakthroughs in modern medicine. Stem cell transplantation involves replacing damaged or diseased bone marrow with healthy stem cells, often following intensive chemotherapy or radiotherapy. CAR-T therapy involves collecting a patient’s immune cells, re-engineering them in a laboratory to recognise and attack cancer cells and then reinfusing them into the patient. These treatments are often complex, lengthy and physically demanding. They can involve prolonged hospital stays, isolation from loved ones and a lengthy recovery period that extends far beyond discharge from hospital. While they offer hope and, in many cases, a cure, they can also bring immense psychological strain for patients and their families.
I thank the Anthony Nolan charity, and all its staff and volunteers, for their invaluable work in supporting patients, families and donors. The organisation was founded in 1974 by Shirley Nolan to find a stem cell donor for her son, Anthony, and it has grown into a world-leading charity that has transformed transplant services and donor registries. For decades, the charity has been at the forefront of research, patient advocacy and clinical support, and Scotland’s transplant community owes a great deal to its dedication.
The charity’s June 2025 report, “How we can improve the mental health and wellbeing of cell therapy patients”, presents compelling evidence that mental health must be treated as an integral part of the overall care experience. The report highlights that almost half of all patients experience anxiety prior to transplant; more than a third experience depression during treatment; and a fifth develop post-traumatic stress disorder. Those figures remind us that survival alone cannot be the only measure of success.
The emotional toll extends well beyond the patient to families, carers and others, who often face exhaustion, anxiety and significant financial pressures, with families losing on average around £30,000 in income during treatment and recovery.
One patient described how
“Mental health support, particularly during and following treatment, would be a very welcome addition to patient care”,
as
“the ongoing risk of return affects mental health and family relationships going forward.”
Another added:
“Mental health is sadly overlooked; patients aren’t given the support urgently required when given a blood cancer diagnosis.”
Those voices must guide our response.
The evidence clearly shows that mental health support remains inconsistent across Scotland. Currently, only NHS Greater Glasgow and Clyde has access to a specialist bone marrow transplant psychologist, despite transplant centres also operating in Aberdeen, Dundee and Edinburgh. As new CAR-T centres open and patient numbers increase, specialist psychological provision has not, unfortunately, expanded at the same pace.
In several national health service boards, there is as yet no specialist oncology psychology support at all, which means that patients leaving hospital are often left to navigate general mental health services, which may not fully understand a patient’s complex clinical experience.
Certain groups are particularly vulnerable. Patients who are undergoing treatment for non-malignant conditions, such as sickle cell disease and thalassaemia, frequently fall outside oncology pathways, despite facing identical treatment burdens. Families, carers and siblings, who often experience their own trauma and distress, rarely receive structured psychosocial support.
The recommendations that Anthony Nolan has set out are both practical and achievable. The charity calls for every cell therapy patient to have access to a specialist transplant psychologist throughout their treatment journey. It emphasises the importance of training all patient-facing staff so that mental wellbeing is recognised and supported at every stage of care. Crucially, it highlights the need to extend psychological support to families and siblings, recognising that serious illness affects entire households, not only individuals.
It is, however, important to acknowledge the progress that is already being made in Scotland. The Scottish Government’s “Mental Health Strategy: 2017-2027” sets out an ambitious national framework, and the “Cancer Strategy for Scotland 2023-2033” recognises that psychological care must be a fundamental part of cancer treatment. Those strategies are very welcome, and I believe that they demonstrate the Scottish Government’s commitment to holistic healthcare. I also welcome the continuing engagement and support from the Cabinet Secretary for Health and Social Care and from ministers, who have shown genuine interest in addressing the mental health challenges that are associated with advanced therapies.
Alongside thanking Anthony Nolan for the work that it does, I thank the NHS-Macmillan psychological support project for its valuable mapping work, and Blood Cancer UK. I also thank Myeloma UK for its innovative support projects, such as its peer buddy service, which matches people with a trained peer buddy for one‑to‑one support from someone who has experience of high‑dose therapy and autologous stem cell transplant—HDT-SCT—and its myeloma support groups, which provide the opportunity to meet other patients, carers and family members to share experiences and information in an informal and supportive setting. I am encouraged by those and other initiatives, and by the collaborative approach that is emerging across the sector.
On that particular note, I am very pleased to be hosting a round-table event alongside the Anthony Nolan charity next Thursday lunchtime, on 12 February, on the issues that we are discussing today, bringing together the Scottish Government, clinicians, charities and patient representatives. The meeting will represent an important opportunity to build consensus and accelerate progress, and I hope that many members will consider joining us on the day.
Scotland has rightly earned a reputation for excellence in clinical innovation and compassionate healthcare. As cell therapies continue to evolve and save more lives, we must ensure that mental health care evolves alongside them. Patients who undergo those treatments demonstrate extraordinary courage and resilience, and they, and their families, deserve the support that reflects the full reality of their experience.
I urge all those who are involved in delivering cell therapies—Government, NHS boards, clinicians, charities and Parliament—to commit to working together to implement the Anthony Nolan report’s recommendations. By doing so, we can ensure that every patient in Scotland receives not only cutting-edge medical treatment but the psychological support and the dignity that they deserve.
We move to the open debate.
18:38
I am pleased to speak today about the mental health and wellbeing of people in Scotland who undergo cell therapies, including stem cell transplants and CAR-T treatment. I put on record my thanks to Bill Kidd for bringing the debate to the chamber, and I note, as he did, the significant cross-party support that the motion has received.
The cell therapies to which the motion refers represent some of the most advanced care that is delivered anywhere in the world. For people in Scotland who are living with blood cancers or rare blood disorders, the therapies can offer life-saving treatment and renewed hope. Our specialist centres, clinicians, researchers and nursing staff provide that care with expertise and dedication, often under significant pressure, and their contribution to Scotland’s health service is considerable. However, alongside those medical advances, there is an essential part of care that requires greater focus: the psychological experience of patients and their families through the cell therapy pathway. Bill Kidd outlined that very well.
The Anthony Nolan report provides clear evidence of the emotional impact of those treatments and offers insights that are directly relevant to Scotland. Cell therapy can involve lengthy hospital stays, intensive treatment regimes and extended periods of isolation. For many patients, that means time spent far from home, particularly for those living in rural and island communities who must travel to specialist centres. Separation from family, disruption to work and caring responsibilities, and uncertainty about outcomes place a significant emotional burden on patients. Many people experience anxiety, low mood and trauma-related symptoms during treatment and recovery, and adjusting to life after treatment can bring further challenges, including on-going health concerns and changes to identity and independence. Those experiences shape recovery and quality of life long after hospital discharge.
Families, carers and donors are deeply affected, too. Partners might take on caring roles while balancing employment; parents might support children through treatment far from home; and donors might carry an emotional weight that is connected to outcomes that they cannot control. Their wellbeing influences the patient journey and deserves recognition in our healthcare system.
The report highlights variation in access to psychological support across cell therapy services. Specialist mental health input is available in some settings and limited in others, as Bill Kidd has outlined, and routine screening for psychological distress is not consistently embedded in care pathways, which creates unequal experiences for patients across different parts of Scotland. That is an issue that I will take up directly with NHS Lanarkshire following the debate. The fact is that mental health care strengthens clinical care. Psychological support helps patients engage with complex treatments, manage uncertainty and navigate recovery, and early identification of distress allows for timely intervention and contributes better to long-term wellbeing.
The report offers practical recommendations that align well with Scotland’s commitment to person-centred care. First, specialist clinical psychologists should be integrated into all transplant and cell therapy teams within NHS Scotland. Their presence supports patients throughout treatment and recovery and enhances multidisciplinary working.
Secondly, staff across all disciplines should receive training to recognise and respond to psychological distress. That will build confidence, encourage compassionate conversations and support continuity of care.
Thirdly, peer support should be developed and supported across Scotland. Patients consistently value opportunities to connect with others who share similar experiences, and peer support can be particularly meaningful for those returning to communities where specialist services are less visible.
Fourthly and finally, families and donors should have access to appropriate psychological and practical support. That should also provide for guidance concerning the end-of-life period and bereavement.
Scotland has made clear commitments through its mental health strategies and with its approach to personalised care. Cell therapy pathways provide an opportunity to translate those commitments into action in one of the most intensive areas of modern medicine. By embedding psychological care alongside advanced treatments, NHS Scotland can improve patient experience, support families across urban, rural and island communities and promote recovery that addresses both physical and emotional wellbeing. Such an approach reflects the values of a health service that recognises the whole person and which supports people through every stage of treatment and beyond.
Cell therapies save lives, and with integrated mental health support, they can also help people across Scotland live well during treatment and in the years that follow. I encourage the Parliament in this session and, indeed, the next one to support the continued development of psychological care as a component of cell therapy services in Scotland. I look forward to the minister’s response to the points that have been raised this evening, and I again thank Bill Kidd for bringing the motion to the chamber.
I call Sandesh Gulhane, who joins us remotely.
18:43
I declare an interest as a practising NHS general practitioner.
As a doctor for over 20 years, I have seen that physical illness and mental health are inseparable. Across NHS Scotland, we recognise that patients undergoing major surgery or systemic chemotherapy, or living with chronic and life-limiting conditions, commonly experience anxiety, depression and trauma-related distress. That is well evidenced in our national code of guidance, and it is reflected in routine primary care practice.
However, cell therapies such as stem cell transplant and CAR-T present a particularly profound mental health challenge, and one that our current systems are not yet consistently designed to meet. Cell therapy is not a single event; it is an extended, high-intensity treatment pathway, and patients often endure prolonged uncertainty before treatment, followed by aggressive conditioning, significant physical toxicity and long periods of in-patient isolation within specialist centres. In Scotland, it frequently means travelling far from home, disrupting family life, employment and social support networks.
From a clinical perspective, cell therapies carry a unique physiological burden. Parents face high-stakes uncertainty. The treatment may offer a cure but it also carries a real risk of severe complications or mortality. Neurocognitive effects, delirium, mood disturbance and post-treatment psychological sequelae are well recognised as both reactions to illness and a direct consequence of treatment-related inflammation and medication.
Families, too, experience sustained emotional strain. They are often excluded from day-to-day care during prolonged admissions, yet are expected to provide complex support once patients return home. As a GP, I frequently see carers in distress, struggling with anxiety, exhaustion and a lack of clear post-treatment guidance.
Crucially, the mental health impact does not end at hospital discharge. Survivorship following cell therapy can involve long-term cognitive impairment, fatigue, fear of relapse and difficulties in reintegrating into work and family life.
In NHS Scotland, much of that on-going care falls to primary care, often without formal psychological follow-up or clear shared-care pathways. That is not to suggest that only cell therapy patients need mental health support; major illnesses and subsequent treatment in hospital are seriously traumatic for people and can often significantly change patients’ lives. However, cell therapies are distinctive in their intensity, duration and complexity, and therefore require a more proactive, embedded and co-ordinated physiological approach.
Recognising the mental health impact of cell therapies is about not exceptionalism but the delivery of holistic, realistic and compassionate care. If all who are involved across NHS Scotland commit to working together towards the report’s recommendations, we can ensure that patients and families in the greater Glasgow region—and, indeed, across the country—receive not only cutting-edge treatment but the psychological support that allows recovery to be truly meaningful.
18:46
I start by thanking Bill Kidd for bringing this important debate to the chamber. I am always pleased to join in his debates, which are often on subjects that the Parliament does not have time to really shine a light on. Whether they are international issues, with a focus on peace, or issues such as today’s, with a focus on the care and delivery of services to our constituents, they are always important.
As others have said, it is important that we consider and describe the therapies that are mentioned in the motion—Dr Gulhane described them very much more eloquently than I can do—together with the intensity of the treatments. Stem cell transplant and similar cell therapies are often the only curative options for patients with blood cancers and other blood disorders. Patients can receive their own cells or cells from a donor such as a sibling or an unrelated volunteer.
From my research for the debate, it is clear that the toll on people’s health must be enormous. We can think of how the physical presentation of cancer might affect us in that way. We can see the physical presentation of disease and, in some therapies, the treatment is very present. We can all imagine how even the journeys back and forward for diagnosis and treatment might affect us physically. However, this important report lays out the reasons that a patient who receives a stem cell transplant and similar treatments must receive the mental health support that Bill Kidd and others have mentioned and which is also mentioned in the motion.
Although those therapies are potentially life saving, they are intensive, have a lot of steps to go through and, ultimately, have those life-long consequences that involve thinking about what is happening to the body. Typically, patients have made journeys for diagnosis, and, as we all know, it can then be very difficult to move on to a specialist service. A patient may have built up a link with services and then move to a specialist service before finally getting treatment. That treatment is intensive, with multiple visits, often in isolation, to receive chemotherapy or radiotherapy before the actual infusion. The report has highlighted how emotional that journey is for both the patient and the family.
I want to raise the voices of my many constituents who live in very rural areas. It is often the case that such treatments cannot be carried out at local hospitals. Patients and their families accept that and understand the importance of having specialist services in centres of excellence. However, we must understand the additional strain that that puts on the family unit, who might not be able to provide support as frequently or immediately because of transport issues or other commitments far from those services.
I know that we in the chamber value the incredible specialist services and the work that they do. However, as parliamentarians and representatives of our constituents, we must think about how we can ensure that those families and individuals get the mental health support that they need. We know that the resources of the NHS are under considerable strain and that staff work incredibly hard every day to provide care and treatment—that is their job. However, it is our job to think about how we can maximise the impact of the points that were raised in the report. Others have mentioned specific things that I am sure that the Government is working on.
I look forward to the response from the minister on what we all agree is an important issue. I thank members for their contributions and, of course, I thank Bill Kidd for bringing the motion to the chamber.
18:51
I thank my colleague Bill Kidd for bringing the motion to the chamber. I pay tribute to him for his years of tireless support, advocacy and work on behalf of Anthony Nolan, which I know has been recognised. He is a tremendous ambassador for the charity and an example to us all of how to champion a cause. I certainly draw inspiration from Bill’s work, and I am sure that many in the chamber do, too.
I also thank Fulton MacGregor, Sandesh Gulhane and Carol Mochan for their important contributions to the debate.
Cancer remains a priority for the Scottish Government, and our ambition is clear: to prevent more cancers, reduce the impact of diagnosis and deliver compassionate, consistent services that improve outcomes and survival rates. Our cancer strategy for Scotland in 2023-33, supported by our initial cancer action plan for 2023 to 2026, will help us to get there. The latest statistics show that the risk of dying from cancer in Scotland is at a record low. However, we know that we must do more, at a greater pace, to improve survival rates and support for those who are affected by cancer.
I recognise the significant physical and mental impacts that cell therapies can have on individuals. As we have heard, the immunocompromising nature of the treatment means that patients must isolate, unable to work or socialise, while managing not only the physical side effects but the anxiety of waiting to find out whether the treatment has been successful.
Advanced therapies are transforming treatment pathways, particularly for rare conditions and cancers. Their introduction requires co-ordinated planning across clinical services, data, logistics and workforce. CAR-T is, as we have heard, one of those advanced therapies. The treatment is personalised for individual patients, meaning that their immune system is no longer compromised in the same way as it is with traditional cell therapies, offering patients a more targeted and potentially less burdensome treatment.
Such treatments for cancer are often provided in tandem with other chemotherapy services. Access to those medicines is vital for patients with cancer. The Scottish Government remains firmly committed to ensuring access to medicines that the people of Scotland need. Through the Scottish Medicines Consortium, we have a robust and independent process for assessing the clinical effectiveness and cost effectiveness of new medicines, which ensures value for patients and the NHS. We have committed to additional funding for chemotherapy services, reaching up to £10.5 million a year by 2027, with £3 million released in 2023-24, £4.6 million released in 2024-25 and £6.6 million in 2025-26. That funding will support increased regional working and workforce recruitment and will maximise capacity across the existing workforce through initiatives such as non-medical prescribing and treatment closer to home.
Of course, as we have heard, cancer care is not just about treatment. Facing an unknown journey is daunting, and people need emotional, practical and sometimes financial support. That is why we have invested in the £27 million partnership with Macmillan Cancer Support to roll out the improving the cancer journey service nationally. As part of that programme, each patient will receive a holistic needs assessment to generate a care plan to meet the needs that are identified.
In addition, our single point of contact pilots are improving access to care and timely reporting of results, and are supporting people to navigate complex cancer pathways, as well as placing individuals firmly at the centre of decisions and actions that affect them. The pilots have had more than 30,000 patient interactions, freeing up more than 3,900 hours of clinical nurse specialist time and, crucially, improving experiences. We are actively considering how to best scale up that approach to benefit all patients with cancer in Scotland.
Just as the Anthony Nolan research focused on patients’ reported experience, the Scottish Government is committed to supporting the development and use of patient-reported outcome measures in Scotland. Capturing PROMs in routine cancer care can help to monitor the impact of treatment on quality of life, improve discussion with patients, inform treatment decisions and transform care pathways that impact the value and sustainability of cancer care. Further, the Scottish Government’s communities mental health and wellbeing fund for adults has provided funding to a range of initiatives, including cancer-specific projects delivered by the Beatson Cancer Charity in Glasgow, Team Jak in West Lothian and Western Isles Cancer Care.
As well as supporting programmes of work that specifically focus on psychological support for people affected by cancer, the Scottish Government published the mental health and wellbeing strategy and accompanying delivery plan and workforce action plan. The strategy commits to improving mental health outcomes for all, including people with long-term physical conditions, and prioritises reducing inequalities. Since 2020, we have invested £164 million in community-based supports for adults and children. That support will continue, with a baseline of £15 million going to local authorities every year and £15 million in funding for projects for adults in 2026-27 as part of the fairer funding pilot. Both funds provide much-needed focus on early intervention and prevention, delivering tailored support to keep people mentally healthy.
Finally, I give my sincere thanks to organisations such as Anthony Nolan that provide valuable information, help and support to anyone who is undergoing cell therapy as part of their cancer treatment. We will continue to work closely with the third sector, including Anthony Nolan and community and social care partners, to deliver the right care at the right time for the people of Scotland.
I reiterate my sincere thanks to Bill Kidd for his tireless work in this area and for bringing this important motion to the chamber.
Meeting closed at 18:58.
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