Polypropylene Mesh Medical Devices
To ask the Scottish Government how many women in the last year have been treated with mesh, or tape, products to treat pelvic prolapse or stress urinary incontinence. (S4O-03991)
In 2013-14—that is, to the end of March 2014—1,360 women had a mesh implant procedure for stress urinary incontinence, pelvic organ prolapse or both. Those mesh implants include biological and polypropylene mesh.
The answer that the cabinet secretary gave was not about the last year, but I understand why.
On 17 June last year, Alex Neil told the Parliament’s Public Petitions Committee and mesh survivors that he was suspending the use of mesh for the treatment of those conditions. However, on 16 July, the deputy chief medical officer, Frances Elliot, wrote to health boards encouraging them to continue to recruit women on to clinical trials in which mesh would be fitted inside their bodies.
Why do the mesh survivors who have campaigned relentlessly on the issue feel that the former Cabinet Secretary for Health and Wellbeing completely misled them?
I will meet some of the women who are affected on 23 February. I am very concerned that women have suffered complications following surgery, which is why we set up the independent review that the previous cabinet secretary announced on 17 June. All health boards that carry out such procedures have considered the request and almost all have suspended the procedures.
The review is analysing the number of people who have undergone the procedures in Scotland and the number of complications. From that information, we will be able to consider the level of underreporting. I will be able to give Neil Findlay figures beyond March 2014—I will write to him on that.
On clinical trials, the clinical community fully endorses medical research in the field as the most credible way to answer legitimate clinical research questions and improve the care of patients. Of course, women agree to participate in a clinical trial only when they are fully aware of the facts and associated risks. No one goes into clinical trials without the full information.
The acting CMO wrote to all health boards on 20 June requesting that they consider suspending mesh implant procedures, as Neil Findlay knows. That request to health boards was framed in the strongest possible terms, but it must be balanced against the wishes of women who, having fully considered the risks, prefer to continue with the procedure. Consultants are providing additional counselling and using the new patient information and consent leaflet that the expert group developed to ensure that any woman who wants to go forward understands the risks.
Those are difficult issues to balance. I hope that Neil Findlay understands that the letter to health boards was framed in the strongest terms but individual patient choice still remains.
The cabinet secretary will be aware of the growing number and size of successful compensation claims regarding mesh implants in America. As well as being concerned about the pain and suffering that the implants cause, is she concerned that, notwithstanding Alex Neil’s instruction to health boards to stop the treatments, some health boards are still using mesh implants, which might leave Scottish health boards and, ultimately, the Scottish Government open to compensation claims?
As I laid out in my previous answer, health boards have been given a very strong letter from the acting CMO about the suspension of the procedures, but individual patients, in discussion with their consultants and in full knowledge of the risks, can decide that they want to go ahead.
In relation to looking at the issue more fully, the regulation of medical devices, including implants, is within the remit of the Medicines and Healthcare Products Regulatory Agency, which is the United Kingdom body that is responsible for regulating all medical devices. It works with the European Commission on those issues and has responsibility for the regulatory framework. We follow the guidance in exactly the same way that other UK countries do.
Evidence is required before suspension is mandatory, and the current European Commission has not proposed a change to that. To an extent, that covers that issue. Should the situation change, the situation in Scotland would change, too. We would follow the advice that was given. Scotland has written to the European Commission to seek assurances that the results of the research that it is carrying out will be acted on swiftly.
As I said, I will meet some of the women affected on 23 February and will listen to their concerns. Obviously, if there is anything more that we can do, we will do it. I hope that that reassures the member.
2020 Heat from Renewables Target
To ask the Scottish Government what progress it is making towards meeting the target of 11 per cent of demand for heat being met by renewables by 2020. (S4O-03992)
The most recent United Kingdom data, upon which progress towards our renewable heat target is based, shows that in 2012 renewable heat generation equated to 3 per cent of Scotland’s non-electrical heat demand, which is up from 1 per cent in 2009.
I would like to focus on district heating. Colleagues on the Economy, Energy and Tourism Committee received evidence—which it highlighted in its report on the draft budget in January—that Scottish Renewables and others were concerned that Scotland was still “very far off” meeting its target for district heating. The committee wished to relay a plea for a step change in investment in renewable heat. I invite the minister to give his response to that plea and to say how many of the recommendations that the expert commission on district heating made in its report of November 2012 are being actioned.
I acknowledge Claudia Beamish’s interest in the matter. I will look at the evidence that was given to the Economy, Energy and Tourism Committee. We accepted all but one of the expert commission’s recommendations and we are working to make progress with all of them. I chaired a meeting of the expert commission on 11 November.
We have a target of 40,000 homes being supplied with affordable low-carbon heat, and we are working very closely with local authorities, housing associations and the national health service to deliver district heating schemes. Retrofitting district heating to existing buildings is expensive, complex and logistically challenging, but we are making progress in Glasgow, Aberdeen and Wick. Like Claudia Beamish, I want to see a step change, so that in Scotland, as in Denmark, district heating forms part and parcel of the way in which we provide heating for people’s homes.
Brain Cancer Survival Rates
To ask the Scottish Government what action it is taking to improve survival rates from brain cancers. (S4O-03993)
The Scottish Government is committed to ensuring that people with brain cancer receive the best possible care. Early detection and appropriate, timely referral are key to improving survival rates. Through our £30 million detect cancer early programme and the refresh of our “Scottish Referral Guidelines for Suspected Cancer”, we are working to increase the number of brain cancers that are detected at the earliest possible stage.
The cabinet secretary will know that survival rates from brain cancers are depressingly low—only 15 per cent of people with brain cancer survive. It is the biggest cancer killer in Scotland of those under 40 years of age.
Will the cabinet secretary join me in congratulating my colleague Cameron Buchanan, who is a brain cancer survivor, on the success of the recent gala dinner that he organised for the Brain Tumour Charity, which raised just short of £20,000, all of which will go to research? Perhaps the Cabinet Secretary for Finance, Constitution and Economy will double that before the day is out.
Will the cabinet secretary agree to contact health departments elsewhere in the United Kingdom with a view to jointly promoting and encouraging internationally further research into what, sadly, is regarded by the pharmaceutical companies as an orphan condition in research terms? That would allow us to look forward to genuine progress, through research, into improving survival rates for brain cancers and other cruel conditions such as motor neurone disease.
I join Jackson Carlaw in congratulating Cameron Buchanan on the very important work that he has done on the issue.
Jackson Carlaw highlights the importance of research, and I would be happy to write to the other health departments in the UK about a co-ordinated approach. The chief scientist office recently announced funding of £225,000 for a research project led by Professor Anthony Chalmers at the University of Glasgow. The purpose of that project, which is due to start shortly, is to evaluate the clinical potential of a novel treatment strategy for one of the most common and lethal adult brain tumours.
I am sure that Jackson Carlaw will know that most cancer research in Scotland is not funded by the CSO but by Cancer Research UK, which does a huge amount of crucial work in the area. The CSO provides funding of around £440,000 a year to the Scottish cancer research network. Some good work is happening in the area but obviously more can be done. I am happy to write to the other health departments to see whether we can co-ordinate further action.
Freight Transport
To ask the Scottish Government what steps it is taking to encourage industry to move from road haulage to rail freight. (S4O-03994)
The Scottish Government is committed to encouraging the transfer of freight from road to more sustainable modes, including rail. That is why, in the current rail funding settlement to 2019, a £30 million Scottish strategic rail freight investment fund has been made available over and above the funding for the rail network as a whole and the separate freight mode shift grant schemes that continue to operate.
Taken together, that substantial package of investment and funding will help encourage growth in rail freight and support our vision for a greener and more efficient transport network.
The far north line carries nuclear fuel, unfortunately, but it is no longer able to cope with existing, or indeed potential, traffic. Oil tanks travel to Lairg only 75 per cent full due to restrictions on one of the viaducts, and lower-platform wagons to take higher containers have been banned due to track conditions. What is required is dynamic loop, faster points and improved signalling. Will the minister agree to press Network Rail to significantly improve line speed and capacity on the far north line?
Yes, I will. I will look into the specifics of the case. There are rail improvement works that, working with Network Rail, we will proceed with on the line. However, if further pressure is required, I will certainly apply it.
National Accommodation Strategy for Sex Offenders
To ask the Scottish Government whether it will order a review of the national accommodation strategy for sex offenders. (S4O-03995)
The Care Inspectorate and HM inspectorate of constabulary in Scotland are carrying out a review of how well the public are protected by the current multi-agency public protection arrangements for assessing and managing the risk posed by registered sex offenders in our communities.
The review will include an assessment of how effective the responsible authorities are in the discharge of their statutory duties, including adherence to national guidance such as the national accommodation strategy for sex offenders. When the review is completed later this year, a report along with appropriate recommendations will be published
Since the murder of Mark Cummings over 10 years ago, the word “review” has been used on a number of occasions, and on a number of occasions, as a result of a number of reviews that have taken place, it has been recognised that sex offenders are disproportionately allocated housing in deprived areas, particularly in Glasgow. Is that still the case today?
I appreciate and understand the member’s long-term concerns about the matter. Housing registered sex offenders in the community is an important aspect of the risk assessment process. The location and type of accommodation will always be determined by the circumstances of the individual offender and the risk that they may present to the community.
Current MAPPA guidance indicates that registered social landlords do not have to assess and manage the risks but must co-operate with those who do. Does the minister believe that current guidance is adequate in relation to social landlords?
As the member indicated, registered social landlords have a duty to co-operate under MAPPA. Their role is to contribute to responsible authorities’ management of risk by allocating housing that has been assessed as manageable for released offenders. The extent to which the duty applies in practice will depend on the nature of the accommodation that any given landlord has available and the extent to which responsible authorities consider that such accommodation would help to manage the risk in any given case.
Question 6, in the name of Lewis Macdonald, has been withdrawn. The member has provided an adequate explanation.
Schools (Pupil Assessment)
To ask the Scottish Government what plans it has for pupil assessment in schools. (S4O-03997)
We are committed to improving outcomes for all children and young people. In order to raise attainment, it is important to be able to demonstrate success and identify challenges so that we understand where improvements need to be made. That is why, in schools, teachers already gather evidence on pupils’ progress across a range of learning and why the Scottish Government and local authorities always look at good practice wherever we find it.
Does the minister agree that there can be no dispute about the significant difference in attainment between children in Scotland’s most deprived areas and those in better-off parts of the country? We all want progress on closing that gap, which has existed for far too long. How does the minister intend to measure any improvements, especially among primary school pupils?
I do not think that there will be any disagreement between the member and me about the importance of closing that attainment gap. One of the central aims of curriculum for excellence, and indeed of the Government, is to ensure that everyone has an opportunity to succeed and to fulfil their potential. Schools are always measuring their progress on closing the gap.
I have been in conversations with Education Scotland on the role of school inspections in this area, and there are many other activities. For instance, insight, the benchmarking tool, allows schools to make meaningful comparisons with one another of what they are doing to ensure that their policies and ours are all centred on closing the attainment gap wherever it exists.
Railway Timetabling (North-east Scotland)
To ask the Scottish Government what discussions it has had with its partners about railway timetabling and capacity in the north-east. (S4O-03998)
We meet regularly with Nestrans, the north-east of Scotland transport partnership, and other partners in the north-east to discuss a full range of railway issues, including timetabling and capacity. The next meeting with Nestrans is currently taking place.
In 2013-14, north-east stations accounted for 3.35 per cent of Scotland’s patronage, compared with 2.44 per cent in 2004-05. There has been significant growth at all eight stations, notably Portlethen, with 350 per cent growth, and Inverurie, with 290 per cent growth.
Can we get a question, please?
In the case of Inverurie, passenger numbers rose from 128,000 in 2004-05 to 500,000 in 2013-14.
Come on, Mr Stewart, get to the question.
Can the minister assure me that such growth will be taken into account when rail investment resources are allocated? Will he commit to looking at increasing station numbers, rolling stock and services in the north-east so that rail patronage can continue to grow?
I can give that assurance. We have accepted that there are demand issues with the current franchise, and that is why work is in place on capacity and crowding issues. We will do more of that with the new franchise. There are commitments on stations, journey times, reliability and new rolling stock. I am sure that that is the answer that the member seeks.
The answer was a lot shorter than the question.
Chronic Migraine Disorder
To ask the Scottish Government whether it plans to introduce new initiatives to help people with chronic migraine disorder. (S4O-03999)
All clinicians in national health service boards in Scotland are expected to be aware of and to adhere to guidelines that are published by the Scottish intercollegiate guidelines network, or SIGN. SIGN guideline 107, on diagnosis and management of headache in adults, which is from November 2008, provides clinical guidelines for the management of headache, including chronic migraine.
Is any new money being put aside for research? Is the Government aware of how widespread the disorder is and how often it leads to prolonged absence from the workplace?
The chief scientist office has responsibility for encouraging and supporting research into health and healthcare needs in Scotland. The CSO responds primarily to requests for funding research proposals that are initiated by the research community in Scotland. We are not currently funding any research project on the cause or treatment of chronic migraine, but we would welcome research proposals in the area, which would of course be subject to the usual peer and committee review.
Out-of-hours General Practitioner Services (NHS Lanarkshire)
To ask the Scottish Government what its position is on the review of out-of-hours GP services in NHS Lanarkshire. (S4O-04000)
The Scottish Government is liaising with NHS Lanarkshire and is being kept abreast of progress on its review of out-of-hours services in its health board population area. We expect the outcomes of the review to be in line with any recommendations that arise out of the Scottish Government’s recently announced national out-of-hours review, which is to be led by Sir Lewis Ritchie.
NHS Lanarkshire intends to make its out-of-hours service more centralised than its accident and emergency service. Is the Scottish Government concerned that that could lead to extra pressure on A and E from patients who present at emergency rooms when they would be better dealt with in a primary care setting?
The consultation is on-going and it is important that the views of the public in Lanarkshire are listened to.
In the context of its review of the local out-of-hours service, we expect NHS Lanarkshire to come into line with any emerging direction of travel, findings and recommendations from the national out-of-hours review to which I referred.
It is important that any steps that NHS Lanarkshire takes on its out-of-hours service do not impact on other parts of the system. We will probe that very carefully indeed.