From 2007 he was diagnosed with malignant mesothelioma, and due to his illness, his participation in Parliament became fleeting, although he remained as an MP until his death in August the following year.

[9] He was mentioned as a potential candidate for the Central Fife constituency in the Scottish Parliament when Henry McLeish announced his retirement;[10] however the selection went to his successor as council leader, Christine May.

He had had major surgery and a lung removed after being diagnosed with Mesothelioma, which transpired after his death came from the shipyards, but his doctor expected him to return to full health after he took part in the MARS Trial.

MacDougall was not recorded as having participated in any Parliamentary votes from early December 2007, and by June 2008 it was clear that his health problems were serious and there was a rumour that he would have to resign.

[17] MacDougall attended the House of Commons on 11 June 2008 to support the government on a knife-edge vote on pre-charge detention periods, giving an interview in which he admitted to having had an operation for pleural mesothelioma; he declared his intention to stand for re-election.