Scottish health minister admits 'influence' on chronic pain research

The Herald Scotland

27-04-2025

Minto says there was no intention to 'minimise or undermine' patient experiences. But The Herald has uncovered a Government official dictating in advance to researchers the levels Government sought of pain causing little and even no impact on activities. Campaigners now want all health research checked for interference.
For over two years, there's been secrecy over this Pain Management report, while NHS clinics dealing with serious pain are being discussed in private by the same officials in a Government 'Task Force'.
Read more: Hundreds of Scottish pain patients dying in agony in NHS queues (add link)
Health Secretary Neil Gray and John Paul Marks, head of Scotland's civil service wouldn't even reply to letters from MSPs Miles Briggs and Monica Lennon. Minto herself acknowledged complaints but excluded answers on the report until now. Secrecy meant Freedom of Information had to be used to discover officials had replaced authenticated volunteers with people paid £200 each, commercially recruited.
But what amounts to shambolic and ignorant Government interference in health research is now shown in a letter by Minto to Labour's Rhoda Grant MSP who persisted, like the SNP's Fergus Ewing, Conservative Miles Briggs and Holyrood's Cross Party Group on Chronic Pain, in pushing for truth.
Now, the public health minister:
Admits the term 'no impact' for three patients was 'Proposed by the Scottish Government – participant patients did not use the term no impact themselves'.
Admits that 16 people 'were not asked if they were diagnosed by a health professional' But this was not revealed.
Admits Govt included three of the self-diagnosed who also self-medicated from the internet.
Admits the Scottish Government sought people who 'self-reported chronic pain but did not experience any impact on their activities'.
Ministers and officials in charge of Scotland's health clearly did not know that three learned bodies state that 'no impact is not a recognised category with chronic pain'
'Chronic pain does not exist without having any impact. - sufferers have to make life choices, changes, compromises." states the Faculty of Pain Medicine of the Royal College of Anaesthetists.
An email shows private researchers, The Lines Between, had told Clinical Priorities they couldn't find any with no impact'. But an official insisted the researchers persist, saying 'We are still very keen to recruit from this group', urging the Lines Between to try their recruitment firm again (which uses social media)Three were later classed no impact, ludicrously in the case of an Inverness woman, quoted in the report stating she was on pain relief from her GP and 'had severe migraines and sciatica and could hardly walk'. She was marked 'no impact'. Two others, also from Inverness, were also marked 'no impact' without explanation.
Ms Minto now admits that no impact meant only at time of being asked on the patient panel. Minto added: 'It did not mean that they had never experienced any impact from their chronic pain'. But the report doesn't say that. This is an extraordinary statement from anyone in charge of health and lives. We don't know if patients were aware how impact was classed on the day. Although not officially diagnosed, they do describe real suffering especially those at high level.
The small numbers suffering at high level produced under Clinical Priorities officials contrast with many other reports.
Public Health Scotland surveyed 92 chronic pain patients in 2022, finding 82% reported high suffering, 16% a little. They found 'only one person in 92 said their chronic pain does not limit their activities'
That contrasts with three out of 16 claimed to have no impact, seven little and only six out of 16 in serious pain, in the Government officials' handling.
Minto now says, over two years later, it was a mistake to use no impact without explanation, adding: 'The wording no impact that we chose has clearly created the unintended impression that experiences shared by some participants were being undermined or minimised'.
But suffering levels were dictated and minimised ahead of the report. An FOI-released email to the Parliament's cross party group showed a senior official at the Clinical Priorities Unit dictated patient numbers and suffering levels to researchers in August 2022, long before November publication. The report is still circulating in connection with a new pain 'Framework' where the same Unit's officials are also recommending on patients' future services.
Suffering 'a lot' was to be in the minority compared with a combination of little and no impact. A name-redacted Clinical Priorities official wrote to private researchers in advance asking them to 'adjust the quotas/targets on impact' on numbers suffering to:
'A lot' – 7
'A little' – 11 – 12
- 'Not at all' – 2 – 3 (also called no impact)
The finished Government report showed only six high impact, seven little impact and three no impact.
Former health secretary Alex Neil said he was appalled and called for an independent probe into health work, saying of Govt interference: 'This is shocking. You don't do this to research in advance. It's totally dishonest. Anyone from Government suggesting such sharp practices should be disciplined. There should be a complete clear out and new people brought in who can be trusted.'
When he was health secretary, he 'would have sent back anything if it was manipulated like that'.
Clinical Priorities officials already recommend policy on nine major issues – long covid, stroke, diabetes, respiratory conditions, heart disease, endometriosis, out of hospital cardiac arrest, neurological conditions, chronic pain.
Read more: The sorry tale of Scotland's chronic pain crisis
Professor Lindsay Paterson of Edinburgh University's School of Social and Political Science thought the situation 'very disturbing'. He is not involved with chronic pain, 'but all this is similar to what has been noted in other connections, such as sex and gender' – a reference to pressure from government-paid groups in the trans controversy. Prof Paterson declared the need for urgent investigation on wider influence, stating:
"There is a real problem in Scottish policy research that the people who commission it are sometimes unhealthily close to the researchers who do it. This can compromise the independence of researchers and the objectivity of research reports. To assess the extent of the problem, and point to ways forward, the Scottish Parliament should commission a report from a distinguished researcher based outside Scotland who has not recently had any research funding from the Scottish Government."
Professor Lindsay Paterson of Edinburgh University's School of Social and Political Science called the situation 'very disturbing' (Image: Edinburgh University) Although a private firm was used on pain, Prof Paterson also wanted universities to be more protected. 'If a researcher is under pressure from their university or other employer to take the money, even with the possibility of Government interference, then the researcher should say that in public, so there is wider public debate on what is happening.'
On The Herald expose, he remarked: 'This confirms the importance of researchers refusing to give in to pressure from the Scottish Government. That must mean they should insist on this in the contract.'
Some treatment cuts have already happened under a Nicola Sturgeon policy, still pursued. Sturgeon wrote in Sept 2020 she wanted to 'reduce reliance' on NHS specialist pain clinics for out patients and increase self-management. Patients protested this was false economy, claiming that withdrawing key treatments would increase costs and GP and emergency work.
Conflict of interest
But Jenni Minto is now set to let the Clinical Priorities Unit, now renamed the Long Term Conditions Policy Unit, tackle an even bigger project, increasing their influence on health.
Chronic pain has around 800,00 Scottish sufferers, all long term conditions are estimated at over a million to 1.5 million in Scotland. There's to be yet another Consultation, so far with the same unit. Although renamed, they have the same Unit head, Will Wood and mostly the same staff. Wood wrote last year to the voluntary cross party group refusing to answer questions on the report. He is also deputy chair of the Pain Management Task Force recommending to ministers on patients' future treatments.
Using the same Unit to commission and supervise research and also recommend on patients' future treatments is a major patient concern, which the pain group calls 'direct conflict of interest and surely against Human Rights protections on disability'.
Minto was informed by patients at a March 12 meeting, that they did not want this Unit involved again in any capacity. Ian Semmons, the disabled founder of Action on Pain, a leading UK Charity, says the way pain suffering is treated by the Scottish Government is the worst he's encountered in the UK and Europe.
Read more: Revealed: Hidden scandal of chronic pain wait times
He wants an urgent investigation into health handling at the top.
'In over 30 years of chairing our charity, my journey has taken me across these islands and well beyond. Our charity's experience and knowledge have been valued and helped shape some services in the world. The Scottish Government stands in shocking contrast to all I've dealt with in the way it ignores patients. The behaviour of its official team beggars belief.' He volunteered for a previous SG advisory group he called 'another sham'.
'The constant barriers of delay, deceit, intimidation and bullying mixed with sheer arrogance left me angered and in despair.
I've no axe to grind I wanted to help patients, but patients are treated like outcasts by this Government. People must be held to account, as they've all clearly demonstrated why they should no longer be in their roles.'
The Government's £19 billion health and care budget has given no extra money to NHS hospital pain clinics.
Government officials didn't inform voluntary patients with known conditions that they sought a 'patient panel'. Commercial recruiters were told to exclude 'patient advocates' and those with prior knowledge of Government groups, claiming only 'little heard' people were sought. Such a diktat deprives patients of anyone with knowledge on their side.
The report was signed off by former public health minister Maree Todd, now minister for social care, mental health and sport. But her successor Jenni Minto has long defended the report. Todd's original welcome of the report is now removed online.
A new Consultation on almost all long-term conditions was proposed in October 2024, but no clear information since. Jenni Minto has so far relied on the same officials patients want changed urgently.
Patients have had no details and fear yet another consultation will mean no action on shortages until 2026 election time or after.