SCOTTISH EXECUTIVE
Health and Wellbeing
Maternity Services (Greater Glasgow and Clyde Health Board)
To ask the Scottish Executive what the catchment area is for maternity services at the Southern general hospital and whether it considers that there is sufficient capacity in Greater Glasgow and Clyde NHS Board. (S3O-9484)
The catchment area for maternity services is determined by postcode analysis. I am more than happy to forward to the member the analysis that NHS Greater Glasgow and Clyde has provided. The board assures me that, based on its detailed forward planning projects, there is sufficient capacity in NHS Greater Glasgow and Clyde.
The minister might be aware that the Queen Mother herself suggested the name of the Queen Mother's hospital—the maternity service in my constituency—in 1963. She might also be aware that Andrew Calder has led calls to retain that name for the new maternity service at the Southern general hospital. He said that it would be a shame if the memory of the facility was lost and that the Queen Mum's is the "cradle of ultrasound scanning" and of Ian Donald's world-renowned work on that. Given that the cabinet secretary acknowledged in a recent letter to me the strength of feeling on the Queen Mum's, does she agree that NHS Greater Glasgow and Clyde should retain the name for the reason that I have given? Will the cabinet secretary support the idea of retaining the name?
As I said in my letter to Pauline McNeill, I understand the strength of feeling on the issue and the reasons for the view that the name of the Queen Mother's hospital should be retained. As I said in the letter, NHS Greater Glasgow and Clyde is still considering the name of the new maternity unit and it will make a decision on that in due course. I expect the board to take account of the representations on the matter that have been made to it by Pauline McNeill, Sandra White and others before taking a decision.
I am sure that the minister will want to join me in acknowledging the great work and dedication of staff in the maternity units throughout Glasgow. She will be aware that Glasgow's Princess Royal maternity hospital had a United Nations Children's Fund seal of approval for promoting breastfeeding, but has recently lost that seal. What steps is the Scottish Government taking to promote breastfeeding?
The Government is absolutely committed to the objective of promoting breastfeeding. The health benefits to children later in life from breastfeeding are well known and we will continue to work with NHS boards, which have the principal responsibility on the ground, to do everything possible to promote breastfeeding. I know that all members support the calls to encourage women to breastfeed their children where it is right for them. I certainly welcome the support of any MSP in that endeavour.
Does the cabinet secretary accept that the future of midwife-led services at Inverclyde Royal hospital and throughout Greater Glasgow and Clyde NHS Board depends on accurate workforce planning? Does she share my concern that newly qualified midwives are being forced to leave the country to find their first position? Is she disappointed that health boards are turning their backs on the Scottish Government's job guarantee scheme and that, to date, only nine newly qualified midwives throughout Scotland benefit from the scheme?
I agree with Duncan McNeil on the value of midwife-led maternity services and that it is important that we have robust workforce planning in place, not just for maternity services, but for all services in the NHS. As all members will be aware, workforce planning is not an exact science and it takes considerable work by boards to ensure that they make the best estimates. The methodology that is used in workforce planning continues to improve.
New Pyjamas Campaign
To ask the Scottish Government what reports it has received from NHS Lothian regarding the new pyjamas campaign organised by the Sick Kids Friends Foundation. (S3O-9535)
I am aware of recent media reports regarding the new pyjamas campaign organised by the Sick Kids Friends Foundation. NHS Lothian has confirmed that it recently met representatives from the Sick Kids Friends Foundation and will work with them to ensure a successful fundraising campaign, with the appropriate governance structure. I have asked NHS Lothian to keep me fully up to date with the situation.
I welcome the investigations that the Office of the Scottish Charity Regulator and NHS Lothian are carrying out into the matter. Does the cabinet secretary agree that although it is important that the investigations are completed as soon as possible and that any action that is necessary is taken, we should never lose sight of the fantastic work that has been undertaken in the past by the Sick Kids Friends Foundation? She will be aware that my family had cause to spend time at the royal hospital for sick children recently. We saw at first hand how the results of fundraising efforts have made a difference to patients and families. Will she join me in encouraging people in Edinburgh and further afield to continue to support the worthy fundraising work for facilities at the new hospital at Little France?
I am sure that Shirley-Anne Somerville and other members agree that it is vital that the allegations that have been made are properly investigated. That is not a matter for me or the Government; it is a matter for OSCR. The Sick Kids Friends Foundation has made it clear that it will co-operate fully with OSCR, and everyone will welcome that.
I associate myself with the comments of the cabinet secretary and Shirley-Anne Somerville. What a fantastic job the Sick Kids Friends Foundation has done over the years. The foundation is based in my constituency and I have had quite a lot of contact with it.
I thank Mike Pringle for his words of support for the Sick Kids Friends Foundation's work. I am sure that he agrees that it is important that the foundation works with NHS Lothian to secure the future of fundraising and—this is crucial—to ensure that the governance arrangements around fundraising are absolutely robust, whatever they look like. I encourage NHS Lothian and the Sick Kids Friends Foundation to continue their dialogue, to ensure that the work of the foundation in general continues, notwithstanding what might or might not have happened in relation to the new pyjamas campaign. As Shirley-Anne Somerville said, the foundation's work brings great value to the lives of sick children.
NHS Fife (Meetings)
To ask the Scottish Executive what will be discussed at its next meeting with representatives of NHS Fife. (S3O-9457)
Forthcoming meetings with representatives of NHS Fife will cover a wide range of matters of current interest to the NHS in Scotland in general and to NHS Fife in particular.
Does the cabinet secretary share my concern that Levenmouth in Fife has a population of almost 40,000, a high density of older people, families with young children and households with no access to a car, and no local pharmacy that is available on a Sunday—a day when there are poor public transport links to Kirkcaldy and Glenrothes? Does she agree that that leaves many in the Levenmouth area vulnerable? Will she support my request for a pilot for increased provision and raise it with NHS Fife?
I certainly appreciate Claire Baker's interest in raising the issue. It is important that, in all areas, there is access to a range of good-quality health care services. Obviously, what is available in every local community depends on a range of factors but, if Claire Baker wants to pursue the matter with NHS Fife, I would be happy to draw it to the health board's attention and I encourage her to enter into discussions with the board.
The cabinet secretary may recall that, last September, I asked her about dispensing general practitioners in Balmullo and Leuchars in the NHS Fife area. Was she made aware in her meetings with NHS Fife that permission was granted to open a pharmacy in Leuchars, very much against the wishes of locals, who supported their dispensing GPs? Is she also aware that the situation is complicated by a further application to open a pharmacy in neighbouring Balmullo, this time with the support of local residents? What discussions and progress have there been in the review on which pharmacies might be added to the pharmaceutical list? Are Scottish patients to have a greater say in how new pharmacies are established?
I acknowledge Ted Brocklebank's interest in the issue. I have twice met those from Leuchars who have campaigned on the issue: first when I opened the St Andrews community hospital, and secondly at the NHS Fife annual review.
During her discussions with representatives of NHS Fife, will the cabinet secretary take the opportunity to raise with them the support that their director of public health has given to the introduction of a form of minimum pricing for alcohol in Scotland, a position that is now supported by all directors of public health in Scotland? Will she also raise the fact that the NHS Fife director of public health is now joined by four of the most eminent experts in public health in the world in calling for the introduction of minimum pricing in Scotland?
I thank Michael Matheson for his question. As members will be aware, it is not only in Fife that the director of public health has supported minimum pricing: all directors of public health in Scotland have done so. They join the four United Kingdom chief medical officers, doctors, nurses, the police and sections of the licensed trade in recognising that we have a major problem with alcohol misuse in Scotland and that, although minimum pricing is not the whole answer to that—the Government has never pretended that it is—it can play a big part in rebalancing the relationship and reducing some of the social, economic and health harms of alcohol misuse.
“Scotland's Sporting Chance: a Manifesto for Sport in Scotland”
To ask the Scottish Government what its position is on the commitments made in "Scotland's Sporting Chance: a Manifesto for Sport in Scotland", recently launched by the Scottish sports alliance. (S3O-9478)
The Scottish Government welcomes the contribution that the Scottish sports alliance offers in helping us to achieve our ambition of creating an active nation. I have and will continue to have regular discussions with the alliance to determine how best we can deliver our shared sporting outcomes for the people of Scotland. I was pleased to attend the SSA's reception in the Parliament on Tuesday night.
I welcome the launch of the alliance's manifesto. Along with other parliamentary colleagues, I attended both the event to launch the document and the reception this week.
I remind Frank McAveety that the target was set in 2004—perhaps when he was the minister with responsibility for sport. By 2007—three years later—5 per cent of primary schools and 7 per cent of secondary schools had achieved the target. From there, we have managed to raise the levels significantly to 33 per cent of primary schools and 16 per cent of secondary schools.
With Frank McAveety and others, I was present at the alliance's launch. That was an important event for Scotland, so I was surprised by the absence of sportscotland and of any reference to it. I was more surprised when I checked that sportscotland's mission is
Absolutely no direction came from the Scottish ministers for sportscotland not to attend that event. Sportscotland was active at the reception on Tuesday night. It is keen to work with the alliance and has supported the alliance in coming together. Sportscotland and we are the very people who have told members of the sporting community that they should come together with one voice to further the aims of sport. We are pleased that they have listened to that and done that. Sportscotland has supported what the alliance is doing and is in discussions with the alliance, which will continue as we progress important developments that will happen in the coming months and years.
Fuel Poverty
To ask the Scottish Executive what progress has been made in tackling fuel poverty. (S3O-9475)
The Scottish Government is fully committed to meeting its objective to ensure as far as reasonably practicable that people in Scotland are not living in fuel poverty by November 2016. The energy assistance package, which is aimed at households that are in fuel poverty, is contributing to that. By the end of December, that new programme had helped more than 56,000 people in more than 33,000 households.
Does the minister share my concern about how the energy assistance programme is being run? One reason for my concern is the significant underspend—I understand that only £20 million from a budget of £60 million has been spent. Will he, as a matter of urgency, review the way in which stage 4 referrals are being handled? I refer in particular to the figures that were revealed in answer to a parliamentary question on the subject from Duncan McNeil. Those figures showed that, of 599 appeals against the decision to reject an application, 529 were upheld. That stunning figure calls into question the assessment process. Given that many people whose applications were rejected may not feel able or confident to pursue an appeal, how will the minister ensure that people—past, present and future—who are entitled to a central heating system can secure one?
The number of central heating installations to the end of December was 5,500. The number of households that received insulation was 3,594, of which 2,462 were installations that arose from referrals this year.
NHS Fife (Meeting with Chief Executive)
To ask the Scottish Executive when the Cabinet Secretary for Health and Wellbeing last met the chief executive of NHS Fife. (S3O-9551)
I last met the chief executive of NHS Fife, together with other NHS board chief executives, on 20 January 2010. I also met the chief executive when I chaired the NHS Fife annual review in Dunfermline on 18 January 2010.
The cabinet secretary may be aware that Fife has been dubbed the Ritalin capital of the United Kingdom. In September 2008, the National Institute for Clinical Excellence and the national collaborating centre for mental health recommended that drugs such as Ritalin and Concerta should be used as front-line treatments only when severe attention deficit hyperactivity disorder is diagnosed or other options have failed. The latest NHS figures for Scotland show that Fife is prescribing at 247 prescribed items per 1,000 population aged five to 14, which is twice the Scottish average for ADHD drugs. Will the cabinet secretary raise the issue as a matter of concern with the chief executive of NHS Fife and ask for a review of the treatment methods for ADHD in Fife?
We are aware of variations across the country in prescribing patterns for Ritalin. As Iain Smith will acknowledge, it is for clinicians to prescribe; they have to do that based on the judgments that they make. As a Government, we are trying to develop alternatives to drugs such as Ritalin, one example of which is psychological therapies. A lot of work is going on in the area.
Measles, Mumps and Rubella Vaccination
To ask the Scottish Executive what its position is on the MMR vaccination. (S3O-9459)
The Scottish Government's position on the MMR vaccine is that it is an important part of the routine childhood immunisation programme. It is the safest way in which parents can protect their children against measles, mumps and rubella.
The minister will be aware that the General Medical Council ruled in January that Dr Andrew Wakefield, the lead researcher in the discredited study that linked the MMR vaccine to autism, showed callous disregard for children and acted dishonestly when carrying out his research. She will also know that the journal that published the study has accepted that claims of a link are false. Despite the overwhelming body of scientific evidence that the combined MMR vaccine is safe, the minister did much in her years on the Opposition benches to erode public confidence in the vaccine, including supporting the call in motion S1M-1168 for a moratorium on its use. Does she now regret that error of judgment? Will she apologise to Scotland's parents for her scaremongering on the issue?
The issue is far too important for the member to degrade it in those terms. The recent ruling is a matter for the General Medical Council. Our role is to ensure that as many parents as possible protect their children in the safest way by ensuring that their children receive the MMR vaccine.
Question 8 was not lodged.
Health Protection Scotland (Meetings)
To ask the Scottish Executive when ministers last met representatives of Health Protection Scotland. (S3O-9474)
The most recent meeting between representatives of Health Protection Scotland and the Scottish ministers took place on 26 January this year, when I met HPS representatives to discuss hospital-acquired infections.
The cabinet secretary and her colleague may have chosen at that meeting—or may choose at a future meeting—to reflect on their past views on MMR. They supported a campaign for single vaccines and called for investigations and moratoriums. Was it an act of duty or judgment, or simple exploitation of parental fears, when the cabinet secretary chose to muddy the waters substantially during that debate? Is she prepared to do at least one constructive thing in the matter—to organise a catch-up campaign for those who may have missed out on vaccination, a situation which is partly her responsibility?
Andy Kerr should know that vaccination rates in Scotland are very high; that is important, and all MSPs should welcome it. As Shona Robison said, members can and will continue to disagree about very many issues; that is legitimate and is the stuff of political debate. However, I hope that all of us can rise to the occasion and agree not to engage in party-political debate about an issue as important as childhood vaccination. That is what is really important. All responsible MSPs should agree to get together on the issue, instead of trying to sow party-political divisions.
Patient Transport Services
To ask the Scottish Executive what procedures are in place to monitor the effectiveness of patient transport services, especially in relation to visits to accident and emergency departments. (S3O-9504)
The Scottish ambulance patient transport service undertakes nearly 1.6 million journeys every year, the majority of which are for planned appointments at hospitals and clinics. The patient transport service also supports the transfer of patients to and from accident and emergency departments when it is clinically appropriate for it to do so. The Scottish Government and the Scottish Ambulance Service monitor the effectiveness of the patient transport service in a variety of ways, including through the formal NHS annual review process, local delivery plan targets, reporting to the Scottish Ambulance Service board and weekly monitoring by the Scottish Ambulance Service executive team.
What lessons were learned during the periods of extreme weather conditions that we have suffered in the past couple of months? Was patient transport maintained during the periods of severe weather? What measures have been put in place for patients who miss appointments due to the failure of patient transport services to pick them up? How are those appointments rearranged?
I thank John Wilson for raising an important issue. Everyone is aware that the Scottish Ambulance Service was under significant pressure during the recent period of cold weather. Because of that, in certain parts of the country there were times when the patient transport service was disrupted for some patients. The focus was on ensuring that the most vulnerable patients were given the highest priority. However, because staff and, in some cases, vehicles had to be diverted to support the accident and emergency service, disruptions were unavoidable in some cases. That said, the Scottish Ambulance Service coped admirably during the period of cold weather. It was under significant pressure, but the various measures that it put in place to respond to that pressure worked well. Everyone working in the service is to be congratulated on their efforts.
The minister is aware of the problems that are experienced in many parts of the Highlands due to an inadequate patient transport service that lacks both resources and staff. What is she doing to rectify that position so that patients in those areas who miss appointments day and daily do not continue to do so?
As I just said, the Scottish Ambulance Service is putting in a great deal of effort to ensure that the patient transport service is reliable. As with other parts of the health service, the challenges are even greater in some of the remotest and most rural parts of the country. One of the issues that the Scottish Ambulance Service has faced up to—and it is not always easy to face up to this—is in ensuring that its services are used for those who have a clinical need for transport rather than for people who have a need for transport perhaps because of distances or a lack of other transport. The Scottish Ambulance Service is working with territorial NHS boards to help improve provision for the latter.
Will the minister join me in welcoming the provisions in the Public Services Reform (Scotland) Bill to regulate private ambulances, which I have long campaigned for? Does the minister have any idea of the timescale envisaged for its implementation?
Sandra White is correct to say that it is important that we have that regulation, and the bill will give us the opportunity to do so. With her permission, I will happily write to her with the details of the timescale for implementation.
Health Care Associated Infections
To ask the Scottish Executive what discussions it has had with regard to changes in testing for health care associated infections. (S3O-9492)
Discussions take place between Scottish Government officials, Health Protection Scotland, the Scottish microbiology forum and the Scottish national clostridium difficile reference laboratory on an on-going basis to ensure that testing for C diff infection reflects best practice and conforms to European recommendations. The chief nursing officer issued new guidance last month on testing for C diff for implementation by all microbiology labs across Scotland.
On 25 November, following the outbreak in Dundee, I asked about the rapid polymerase chain reaction test that was being used in Dundee for pathogenic C difficile. I am pleased that the new algorithm on C difficile testing now includes PCR. Does the cabinet secretary agree that the standard ELISA test that has previously been used as a screening test is no longer fit for purpose? Can she tell me whether the ELISA test is still the initial screening test for the new algorithm, which is a two-stage test? If that is the case, will she publish the detail of how and why the experts are still of the view that two-stage testing is required, rather than PCR testing alone, as is increasingly the case in the United States? Can she assure me that one of the three available PCR tests will very quickly be in use across Scotland?
The ELISA test, as Richard Simpson will know but other members may not, is a biochemical technique used mainly in immunology to detect the presence of an antibody in a sample. As I said, the chief nursing officer issued new guidance last month on the testing for C diff for implementation by all labs. The consensus behind that guidance follows the evaluation report "Clostridium difficile toxin detection assays", which was published in February last year by the NHS Purchasing and Supply Agency. It recognises the shortcomings in current testing methods and recommends a two-step testing algorithm for provisional positives. NHS Scotland has advised the use of testing kits as recommended by the agency in its 2009 report. I am more than happy to enter into more detailed correspondence with Richard Simpson on some of the more technical details of the issue.
Eating Disorder Services (Children and Young People)
To ask the Scottish Executive what progress has been made in developing eating disorder services for children and young people. (S3O-9545)
Caring for people of all ages with mental health problems, including children and young people, is a priority for the Scottish Government. It is vital that all children and young people, including those with an eating disorder, have access to high-quality mental health services when they need them. When that need is urgent, that already happens immediately in most cases. To address delays in planned access to specialist child and adolescent mental health services, we have a new waiting time target that means that, by March 2013, no one will wait longer than 26 weeks from referral to treatment. That timetable is supported by our additional investment of £5.5 million more each year in CAMHS by 2011-12.
Early treatment and counselling can prevent more significant problems from developing, especially in relation to eating disorders. It is important for a person's recovery that they get appropriate support as soon as possible, because behaviours that become ingrained can be hard to alter. Does the minister believe that NHS boards are making sufficient progress in driving down waiting times for access to child and adolescent mental health services? When will she be in a position to announce targets for access to psychological therapies?
On the last point, we are still working around the access target for psychological therapies, and I am happy to keep Alison McInnes posted about that.
To assist children and young people with eating disorders, will the minister tell us how many schools or local authorities in Scotland have introduced annual health and fitness checks to identify health problems at an early stage, to be delivered by
I am sure that Mary Scanlon will welcome the 16 per cent increase in the number of school nurses that has been delivered since 2007. However, as I have also made clear, the evidence suggests that the best support for children in the school environment is multidisciplinary, and although the school nurse has a critical role, other roles are important, such as the mental health support role. I am sure that Mary Scanlon will agree with that. If that is what the evidence tells us, we should listen to the evidence, which is why we are testing a school-based health resource involving a number of disciplines, including mental health, in considering how best we can support the children concerned within the school environment. I am sure that Mary Scanlon will welcome that, and I am happy to keep her updated on progress on the test sites.
Personal and Nursing Care (Adults with Disabilities)
To ask the Scottish Executive, further to the answer to question S3W-27069 by Nicola Sturgeon on 17 September 2009, in light of the almost 75 per cent of consultation responses that raised concerns about applying national standard eligibility criteria and waiting times for personal and nursing care to adults with disabilities, what it means by saying that the criteria "should apply to older people in the first instance". (S3O-9458)
The guidance on national eligibility criteria and waiting times for the personal and nursing care of older people delivers on the recommendation arising from Lord Sutherland's review of free personal and nursing care for older people. It is recognised that some councils might choose to apply the eligibility criteria framework that is set out in that guidance to other community care groups. However, that is a matter solely for individual councils, and it is not tied in any way to the agreement between the Scottish Government and council leaders on free personal and nursing care.
Is the minister not aware that, while we wait for that new guidance to come out, local authorities are viewing the phrase "in the first instance" as a green light to apply the criteria to vulnerable adults with disabilities; that constituents in my area of Edinburgh are deeply worried that that is being used to withdraw support from people who receive day-care services and respite and community support; and that family carers for people with learning disabilities will now be forced to spend longer caring for their relatives at the expense of their own health?
I recognise Sarah Boyack's concerns. Following the highlighting by the consultation process and the subsequent discussions with COSLA of the emergence of a number of issues, it was agreed that the guidance would apply only to free personal care clients, as would the six-week waiting time.