Health and Wellbeing
Good afternoon. The first item of business this afternoon is portfolio question time. In order to get in as many members as possible, it would be helpful if questions and answers could be short and succinct.
Postnatal Depression (Support)
To ask the Scottish Government how it identifies and supports women who have postnatal depression. (S4O-02687)
It is important that women who are at risk of postnatal depression are identified quickly and that appropriate and timely care, treatment and support are put in place to respond to individual needs.
The Scottish intercollegiate guidelines network published in March 2012 evidence-based guidance and recommendations on the management of perinatal mood disorders. That includes not only guidance on predicting and reducing risk, but guidance on detection, including routine inquiries about depressive symptoms, and use of the Edinburgh postnatal depression scale and the Whooley questions as tools to aid identification and clinical monitoring of those who are at risk of antenatal and postnatal depression.
Most women will be treated in the community in primary or community mental health services, with access to the full range of services and support that NHS Scotland and its partners provide.
Mental health issues affect about one woman in 10 during or after pregnancy. If postnatal depression is untreated, it can have a devastating impact on families. It sometimes leads to suicidal feelings and it often affects the mother’s ability to bond properly with her baby.
In view of that and the minister’s response, does he believe that it is acceptable for women to wait 21 weeks for an appointment? One of my constituents who was suffering from postnatal depression had to wait for that time to secure an appointment to see an NHS Lanarkshire counsellor. Has the Scottish Government considered introducing a scheme that is similar to the one in England to train specialist mental health midwives?
A wait of 21 weeks is unacceptable. That is why we have taken forward the health improvement, efficiency and governance, access and treatment—HEAT—standard to drive forward improvements in access to psychological therapies, which will come into force in December 2014. The data that we have received from national health service boards show that it takes on average about 10 weeks for patients to access psychological therapies, but we want to ensure that all boards are making sufficient progress, which is why the target was introduced. I expect NHS Lanarkshire to continue to take forward measures to ensure that it complies with the target that has been set.
Another important part of the work that has been set out by the SIGN guidelines is to ensure that those who are directly involved in clinical care of women, including midwives and other nursing staff, are properly trained and are able to provide the right support and assistance to individuals who may be at risk of developing postnatal depression. I expect all boards to continue to make sure that they take forward a range of measures to help to support their staff to adequately identify and, as necessary, refer on patients to get access to appropriate treatment and care.
Royal College of Nursing Scotland (Meetings)
To ask the Scottish Government when it last met the Royal College of Nursing Scotland and what issues were discussed. (S4O-02688)
The Minister for Children and Young People met representatives of the RCN on 28 November 2013 to discuss the Children and Young People (Scotland) Bill.
A survey that the RCN published last week shows that more than half our nurses work more than their contracted hours. Some 58 per cent said that they are under too much pressure, which led to 55 per cent saying that they are unable to deliver the level of care that they would like to deliver. That is against a backdrop of a 21 per cent decrease in student nurse numbers since 2009. Although the increase of 100 places for the forthcoming year is welcome, it still represents a decrease of almost 17 per cent.
What steps will the cabinet secretary take to monitor workforce planning at board level and ensure that it is a Government priority to have a sufficient supply of nurses in the future in order to alleviate the pressures that nurses are working under?
We have 1,000 more whole-time equivalent nurses working in the health service in Scotland today than we inherited in 2007. We have also introduced and made mandatory the workforce planning tool, which will allow every health board to ensure that we have the right number of nurses with the right skills mix in the right place at the right time.
We will obviously study the RCN survey and discuss with the RCN any points arising from it. I am satisfied that we are as skilled up as we can be, with plans to improve further the numbers and skilling of nurses to cater for the complex demands of the comorbidity and long-term conditions from which so many people suffer today.
Does the cabinet secretary agree with the RCN that, in order to accommodate the Scottish Government’s estimate of the number of health-visiting hours that would be required to fulfil one of the aims of Children and Young People (Scotland) Bill, as well as the family nurse partnership nurses and health visitors who are currently employed in primary care, an additional 450 health visitors need to be recruited and trained?
As Nanette Milne knows, we are bringing back the traditional health visitor and school nurses, and we are looking at the demands on their services—in particular we are considering the intensive need to roll out the very labour-intensive family nurse partnerships throughout Scotland. I believe that that will produce substantive gains for the people who are involved and for society as a whole. We already have a workforce planning tool for nursing and we will be guided by that when deciding on the exact number of nurses and the skills mix that we require in any particular function or location at any particular time.
Aberdeen Maternity Hospital (Cleanliness)
To ask the Scottish Government whether it will provide an update on the state of cleanliness at Aberdeen maternity hospital. (S4O-02689)
The standards at Aberdeen maternity hospital that were first exposed by the Healthcare Environment Inspectorate report, which was published on 29 October, were unacceptable. However, I welcome the latest report that has been published by the inspectorate on 4 December, which notes a series of positive quality improvements that will help to enhance patient care at Aberdeen maternity hospital.
NHS Grampian has responded to the serious issues that have been identified, and has made tangible progress through the rigorous action plan that it has put in place. Staff should be commended on their work to date and on promising areas of progress, and I expect NHS Grampian to continue to ensure that quality, safety and cleanliness are key priorities for all its staff.
It is encouraging that significant progress has been made through strong inspection followed by swift action. We will continue to work closely with NHS Grampian to monitor progress on its improvement plan and the standard of care that is provided across the health board area.
I am glad that the cabinet secretary believes that NHS Grampian is in a position to improve and maintain the high standards that people in the north-east expect of Aberdeen maternity hospital. My colleagues in the north-east and I recently met Richard Carey, who is concerned about some equipment that is used in the hospital, especially the beds. Will the cabinet secretary work with the health board to ensure that the beds in the birthing unit are suitable for what they are required to do?
Absolutely. I should note that the HEI’s latest inspection report, which was published on 4 December, highlighted improvement through the work that was carried out to review the function and ease of cleaning of the beds that are in use. I understand that labour-ward beds have mechanical and electrical parts and have to be taken apart to be adequately cleaned. All the labour-ward beds have been dismantled and deep cleaned, and results of trials of alternative beds have confirmed that the beds that are currently in use in Aberdeen maternity hospital are the best that are available in terms of their cleanability.
Independence (Equality)
To ask the Scottish Government how the written constitution outlined in the white paper on independence would protect and promote equality. (S4O-02690)
A written constitution would set out principles and rules that would apply to the institutions of the state, and would underpin the relationship between citizens and the state to protect rights and secure fairness and equality. In addition, the Scottish Government intends that an equality provision would be included in the interim constitution that would be put in place at the time of independence. After independence, a constitutional convention would consider how to protect and promote equality further.
As we all know, equality comes in many forms. I take the opportunity to welcome the commitment in the white paper to end detention and to close Dungavel. Given that it is migrants’ rights week next week, can the minister tell us what provisions will be put in place to make refugees and those who seek sanctuary feel welcome in an independent Scotland, as outlined in “Scotland’s Future”?
As a nation that will play a socially responsible role in the world, an independent Scotland would continue to provide a place of safety for people who seek asylum. The asylum process in an independent Scotland will be robust and humane, with clear adherence to human rights and equality principles and to the rule of law.
As Christina McKelvie mentioned in her question, we would close Dungavel and end the inhumane practice of dawn raids. However, independence would also enable us to address asylum seekers’ access to employment, education and accommodation. As she did, I welcome migrants’ rights week next week. I am sure that it will be an opportunity to highlight many of the issues.
Can the minister tell us why the white paper guarantees us our own Eurovision entry but does not guarantee gender equality in an independent Scotland?
Gender equality is a significant part of the white paper—on page 106, as Kezia Dugdale has been told on a number of occasions. We will consult on a target for female representation on company and public boards and we will, if necessary, legislate as appropriate. I do not understand what Kezia Dugdale’s alternative to that is, because I cannot see it anywhere. The white paper has put gender equality very much on the agenda and will allow us to move forward to becoming the progressive Scotland that we all want.
Royal Alexandra Hospital (Service Transfers to Southern General Hospital)
To ask the Scottish Government what services will transfer from the Royal Alexandra hospital to the new Southern general hospital. (S4O-02691)
The ear, nose and throat in-patient service will move to the new Southern general in 2015 as the single specialist site for in-patients for the whole of the Glasgow and Clyde area. That change, which was approved by the previous Administration in March 2007, affects a relatively small number of patients, with the majority of care continuing to be delivered locally as out-patient or day-case episodes.
Was any consultation done with patients, the council and patients groups before that transfer was done? If any further transfers are to be done, will consultation be carried out? A number of concerns about issues of transport and accessibility have been raised with me.
That decision was taken by my predecessor, Andy Kerr, when he was Minister for Health and Community Care in the previous Administration. I assume that he undertook the necessary consultations. Obviously, he reached the decision that he did and it is now not appropriate to reverse that decision.
The Royal Alexandra, Inverclyde and Vale of Leven hospitals are the three main hospitals that accrued as a result of the merger of NHS Argyll and Clyde and NHS Greater Glasgow. In due course, a solution as imaginative as the Southern general will be required to take the area’s health concerns forward. Will the cabinet secretary undertake to ensure that that decision has the widest possible support across all parties and is not simply imposed, as major health decisions were in the earlier years of this Parliament?
It is my policy always to consult when there is any major redesign of service provision. As the member will know, NHS Greater Glasgow and Clyde is currently working on a review of clinical services throughout its area. Any proposals arising from that review will be consulted on widely.
Inequality (Health and Wellbeing Impacts)
To ask the Scottish Government what the health and wellbeing impact is of income inequality. (S4O-02692)
The relationship between low income and poor health is well established. People on a low income are more likely to limit or simply not purchase goods and services that maintain or improve health, or are forced to purchase cheaper goods and services that may increase health risks. In other words, it affects their ability to access nutritional food, exercise facilities and affordable energy for cooking and heating, and the availability of safe and secure accommodation. It can also affect mental wellbeing, with those on low incomes prevented from participating in social activities, leaving them feeling less worthy and of a lower status.
The United Kingdom is the fourth most unequal country in the developed world. How could a fairer and more equal independent Scotland address the poor health outcomes that are caused by income inequality?
As I mentioned, it has been well established that many of the health inequalities that we experience in our society are not factors that our health service can address by itself, because so many of them are led by determinants that are outwith our health service’s abilities to control. For example, income, wealth and power are key determinants in health inequalities. If we are to tackle those issues effectively, we need to ensure that we are able to address the type of income inequality that too many of our citizens experience.
We also know that, as a direct result of the austerity measures of the UK Government, child poverty will increase in Scotland. The key consequence of that is not only the shameful fact that we will have more children in poverty but the likelihood that those young people will experience further health inequalities as they grow up. In an independent Scotland, we will be able to address those issues effectively by aligning our health and our equalities agendas. We will be able to tackle those issues much more effectively by having a welfare system that is guided by a desire to achieve that.
The minister will be aware that care staff are predominantly female and predominantly low paid. Will the Scottish Government now ensure that they are all paid the living wage so that that does not have a detrimental effect on their health and wellbeing?
The Scottish Government supports the Scottish living wage and has actively taken forward that policy. It is extremely important that we recognise that there are too many people who are in work and experiencing poverty and that the changes that have been taking place in the taxation and the welfare systems are pushing more families into poverty. That is why it is important that this Parliament has control over those matters, so that we can address them effectively rather than just talk about them or ask questions about them.
Health Board Elections (NHS Dumfries and Galloway)
To ask the Scottish Government what discussions it has had with NHS Dumfries and Galloway regarding the decision to end the pilot health board elections. (S4O-02693)
Since I announced my decision to end the pilot health board elections, there has been on-going dialogue with NHS Dumfries and Galloway on the transitional arrangements that the board must put in place to ensure strong and effective governance. However, the member will recognise that the decision to end the pilot elections is subject to parliamentary process.
I do indeed recognise that.
I have been contacted by elected members of the health board in my constituency who were greatly displeased—I put that gently—at the tone of the letter that they were sent effectively terminating their posts six months before the pilot scheme is scheduled to come to an end. Why has the pilot been terminated at what seems to be an early stage, and how can the minister ensure that the considerable expertise that elected board members have accumulated after three and a half years of hard work will not be lost with their dismissal?
The legislation setting up the pilot elections to boards required me to make a decision on whether to proceed with the extension of the pilot throughout the entire system or to terminate the pilots. I had no choice; I had to make a decision within a certain timeframe. I am making it clear to the elected members, who will be required to stand down in accordance with future appointment processes to the boards of NHS Dumfries and Galloway and NHS Fife, which is the other health board that is involved in the pilot, that they will be entirely free to reapply for membership of the health board if they wish to do so.
I should mention that we are going ahead with the extension of the other pilots, which involved unelected people, to improve the wide selection of people who are applying to and being appointed to health boards, and, in particular, to ensure that more women and members of underrepresented groups are appointed to health boards, provided that they have the merit and the ability to do the job.
Vacancies (NHS Grampian)
To ask the Scottish Government what recent assessment it has made of vacancies in NHS Grampian. (S4O-02694)
The Information Services Division, which is part of the national health service for Scotland, provides quarterly statistical reports on vacancies in all NHS boards. Vacancies are defined as unfilled posts, as of each time point, which are subject to appropriate recruitment arrangements. Vacancy management processes are in place across NHS Scotland to support the implementation of local workforce plans. Those processes inform vacancy advertising requirements.
Within NHS Grampian, reports on vacancies are regularly provided to the board’s staff governance committee, including quarterly information covering vacancies for consultants, nurses, midwives and allied health professionals. The committee met most recently on 19 November.
In recent years, NHS Grampian has found it difficult to recruit a number of key specialists and it currently has 41 whole-time equivalent consultant vacancies and 171 whole-time equivalent nursing and midwifery vacancies. The cabinet secretary might be aware that Unison’s Grampian health branch has recently undertaken research into living costs for NHS workers in the north-east, which found that, for example, childcare costs were on average £800 higher than anywhere else in Scotland. Given that a number of public sector workers, including Scottish Ambulance Service and Health and Safety Executive personnel, already receive a recruitment and retention payment, what steps are ministers taking to encourage health professionals to locate in the north-east and what has the Scottish Government made of calls for a high-cost-area supplement?
I do not believe that a high-cost-area supplement would be appropriate. If we got into that, we would have to look at other parts of the country. For example, in the Western Isles, there is a major shortage of maintenance engineers, because of the renewable energy industry success there. Should we then introduce a high-cost-of-living supplement or a skills-shortage supplement for the Western Isles because we cannot find a maintenance engineer there? Going down that road would have huge ramifications. We take a robust approach to filling vacancies in Grampian and elsewhere. I receive a monthly report on all posts in the national health service that have been vacant for more than three months. In such cases, we work with the boards to ensure that we fill those vacancies. To date, we have been able to fill the vacancies, and I anticipate that continuing.
Postnatal Depression (Treatment)
To ask the Scottish Government what steps it is taking to ensure that women with postnatal depression are treated in an appropriate timescale. (S4O-02695)
It is important that women who experience postnatal depression can access appropriate and timely care, treatment and support. The national health service is responsible for providing such care on the basis of a multidisciplinary needs assessment and in line with clinical and other guidelines.
In March 2012, the Scottish intercollegiate guidelines network published guidance on the management of perinatal mood disorders, which highlights the good evidence base for psychological therapies such as cognitive behavioural therapy and interpersonal therapy as effective interventions for depression in the postnatal period.
NHS boards are making good progress towards delivering the mental health HEAT—health improvement, efficiency and governance, access and treatment—target that was introduced to improve access to such psychological therapies by ensuring that, by December 2014, no one has to wait longer than 18 weeks for access to such services.
The minister has already mentioned this, but can he say whether there are clear waiting time targets in place for NHS boards across Scotland to deal with postnatal depression? If so, what steps can the Government take to ensure that my constituents do not have to wait an inordinate amount of time, such as 21 weeks? Is the minister prepared to meet me and one of my constituents to discuss how to improve the service for her and for others?
As I mentioned, we have set down a HEAT standard to drive improvements in the way in which patients access psychological therapies. As of December 2014, boards will be expected to have services in place that patients can access within 18 weeks from referral. As I also mentioned in an earlier answer, the current average in NHS Scotland is about 10 weeks, but I want to ensure that all boards are making improvements, including NHS Lanarkshire, because 21 weeks for access to such services is unacceptable.
I should say that 18 weeks is the maximum that a patient should have to wait. If clinicians believe that a patient requires access to particular psychological services at an earlier date, they should be referred on that basis to ensure that they receive those services. It is important that we drive the improvement in psychological therapies to ensure that there is greater provision and access for all who could benefit from them. I am more than happy to meet the member and his constituent to discuss the matter further if he feels that that would be helpful.
Dementia-friendly Services (Accreditation Scheme)
To ask the Scottish Government whether it would support a national “dementia-friendly” accreditation scheme. (S4O-02696)
One of the key outcomes for Scotland’s national dementia strategy for 2013 to 2016 is dementia-friendly and dementia-enabled communities. The Scottish Government’s standards of care for dementia in Scotland, which were published in 2011, state that people with dementia have the right to remain connected to and feel involved in their community, wherever they live.
From 2014, the independent Life Changes Trust will make available about £25 million of funding from the Big Lottery Fund over 10 years to benefit people with dementia and their carers in Scotland, which will include helping to lessen the social isolation and depression that they often experience. The investment is likely to focus on areas such as developing dementia-friendly communities, and I expect the trust to consider closely the value of supporting accreditation initiatives as part of that. The trust’s investment will complement our key national activity, such as our continuing focus on timely diagnosis, more integrated community-based care and support and our world-leading commitment of a year’s worth of post-diagnostic support for everyone who has been diagnosed from 1 April this year.
I thank the cabinet secretary for his comprehensive answer. The £25 million from the Life Changes Trust is incredibly welcome. I am sure that he is aware that a lot of good work is happening around the country to build dementia-friendly communities, including work in my constituency by East Dunbartonshire Council. However, my great concern is that we will all go off and do our own thing. I have looked at the Fairtrade accreditation model. Does it provide an example of a way to accredit dementia-friendly communities?
I know that there is positive activity towards building dementia-friendly communities in East Dunbartonshire. From next year, we will work with the council there on dementia and co-production. That work will aim to create a local culture in which the approach to dementia across sectors and in the community is co-designed. That means that it is commissioned, delivered and evaluated not only with people who have a diagnosis of dementia, their families and their carers but with wider local society.
I am aware that a range of dementia-friendly and dementia-enabled models will be adopted and I look forward with great interest to seeing how the agenda is developed from next year locally and nationally through the Life Changes Trust. I am happy to pass on Fiona McLeod’s point that the Fairtrade model provides a possible example to follow.
Sexual Health Services (Young People)
To ask the Scottish Government whether it advocates dedicated sexual health services for young people. (S4O-02697)
Scottish Government policy states that it is essential that young people have access to sexual health services, advice and information when they require it. That may consist of services that cater specifically for young people, or it may involve signposting and referral to generic services with easy access for young people. The decisions on the procedures, tests and facilities that are available locally are based on local needs assessments and the decisions are for national health service boards and local authorities.
The minister will be aware that Caledonia Youth is no longer funded by NHS Lothian to provide dedicated sexual health services in the Lothians. I am concerned that, without that specialist support, young people will not access the sexual health services that they need. As a consequence, we might see bad results in the sexually transmitted infection statistics. Will the minister look at the issue and ensure that we have the services for young people in the Lothians that we desperately need?
I am aware that Caledonia Youth no longer receives funding from NHS Lothian for such services. I understand that that is because NHS Lothian is providing the services directly rather than through Caledonia Youth.
As part of our sexual health and blood-borne viruses framework, it is important that boards implement a range of measures to continue to improve sexual health and to reduce the incidence of blood-borne viruses. Boards are doing that with the support of £29 million in this financial year for a range of measures.
I have no doubt that Caledonia Youth might wish to discuss with NHS Lothian how they can work in partnership, but NHS Lothian is taking forward services to meet local needs.
The issue is quite worrying. I know that local needs vary, but young people’s needs are specific. I thought that we had got to a point at which everybody recognised the value in having dedicated young people’s sexual health services, which should be easier to deliver in cities than in many other parts of Scotland. What proportion of young people have access to a local dedicated young people’s sexual health service? If the minister cannot tell us that, will he find out the figure and publish it?
The member should be aware that there have always been a variety of different services—there have not always been dedicated youth services. In some local areas, dedicated youth services have been provided. NHS Lothian is providing services that young people can access for sexual health needs as well.
It has never been the case that all boards have provided dedicated sexual health services. What is important is that boards look at what is required in their local area and that they ensure that they have services arranged in a way that can meet the needs of young people in that particular area.
Community Sports Hubs (North East Scotland)
Plans have been developed for 19 community sports hubs across the four local authority areas in the north-east, 14 of which are already up and running, delivering opportunities for their local communities to take part in sport and be physically active.
I thank the minister for her answer. How are communities and individuals in the north-east benefiting as a result of the development of community sports hubs?
There are many benefits from community sports hubs. I will highlight one in particular—the development of the Garioch hub, which has seen a number of sports clubs brought together under the one roof, with a clear focus on driving participation in sport and physical activity. The hub, in addition to the new 3G pitch in Inverurie, will undoubtedly further enable sports development. Active schools clubs and the community will be able to come together and build upon the good work that is already being done.
If members do not have hubs being developed in their areas, they should certainly be making inquiries and requesting a hub. They are absolutely the way to make it easier for people to be more active and, of course, they are also affordable for people.
Medicines (Peer-approved Clinical System)
To ask the Scottish Government what the timetable is for the transition from the individual patient treatment request system to the peer-approved clinical system. (S4O-02699)
The Scottish Government set out a package of changes to improve access to medicines following the extensive work of the Health and Sport Committee. A pivotal part of that—with the potential for the greatest impact on access—is the work that is being done by the Scottish Medicines Consortium, which will report to me before Christmas. The new PACS will be fully rolled out once we have national changes in place.
I thank the cabinet secretary for that answer, but he will be aware that there are many anxious patients out there who have not had IPTRs approved. They feel that time might be running out for them to take advantage of the more patient-friendly climate that PACS promises. Can the cabinet secretary provide any reassurances for those patients?
I understand Adam Ingram’s point. That is why I have asked national health service boards to act flexibly in view of the on-going work at a national level and why I have made it clear that I do not expect patients to be disadvantaged in any way because of the timing of events.
We are talking about a relatively small number of patients and I know that the NHS boards have taken on board the request for flexibility and that IPTRs are being put forward. Ultimately, decisions need to be made on a clinical basis but I am absolutely clear that no patient should be disadvantaged because we are in a transitional period from one system to another.
Carers (Practical Support and Technology)
To ask the Scottish Government what action it takes to provide carers with information and advice on accessing practical support and technology. (S4O-02700)
The Scottish Government funds health boards through carer information strategies to provide carers with information and advice. We also fund the national carers organisations to do likewise.
Through Carers Scotland, we provide a range of resources and training materials for carers on the use of technology, particularly telehealth and telecare. We recently launched the first prototype portal, “Living it Up”—an online resource that will allow service users and carers to access a range of information, advice and support about local services, information and products. Moreover, subject to the outcome of consultation and parliamentary approval, the Scottish Government intends to introduce new legislation to support carers and young carers.
I thank the minister for that detailed answer. As he will know, the United Kingdom carers rights day was held at the end of November. Recent research by Carers UK and YouGov has found that fewer than 30 per cent of carers use technology to support health and care issues, whereas 70 per cent use it for other aspects of their life such as going shopping.
Will the Scottish Government introduce statutory provision? The minister mentioned that in his answer, but perhaps he could give more detail on whether it would be possible to introduce practical support for carers and to give advice on the matter in the forthcoming carers bill, and tell us how he will ensure that there will be equal access throughout Scotland in different local authority areas.
If I understand Claudia Beamish correctly, she is asking about access to information and advice services and how we can ensure that there is greater consistency in that access across all local authority areas.
Without wanting to pre-empt the consultation on the subject, it is clear to me that carers are often unaware of what is or may be available to them. I want to look at how we can ensure that there is a greater consistency in awareness. We will consult on how we go about achieving that and whether a legislative provision can assist us in that regard. We can consider, as part of the consultation, whether legislation is the best way to ensure that there is consistency in access to advice and information for carers.
Going back to the original question about providing support for carers to use information technology, I take this opportunity to make the minister aware of the fantastic work that Carers Link East Dunbartonshire is doing in my constituency through one-to-one IT training, the link and learn project, and the meet and geek group. We are already skilling our carers greatly to be able to use IT.
That was not really a question, but the minister may comment briefly if he wishes to do so.
That seems to be a very worthwhile project, and I encourage other carers organisations in Scotland to consider participating in similar projects.
Myasthenia Gravis
To ask the Scottish Government what assistance it provides to people with myasthenia gravis. (S4O-02701)
We want to ensure that people who are living with neuromuscular conditions, such as myasthenia gravis, and their families have access to the best possible care and support. We are currently supporting the national neurological advisory group in raising the profile of all neurological and neuromuscular conditions in the national health service and the third sector and among the public.
The advisory group aims to drive forward implementation of the neurological standards, which aim to improve the patient journey from the point of referral to the service and to ensure that every patient with neurological or neuromuscular conditions experiences a quality of care that gives confidence to the patient, clinician and carer.
The minister will be aware that myasthenia gravis is an autoimmune neuromuscular disease that leads to fluctuating muscle weakness and fatigue, and yet awareness of it among general practitioners appears to be limited, as does the availability of specialist training in the nursing profession.
Will the minister consider what could be done to assist in that regard, and whether more specialist training can be offered to nurses, not only to develop their own skills but to provide much-needed support for sufferers?
I recognise that awareness of myasthenia gravis—which is fortunately a relatively rare condition—is very limited. There is a specialist nurse based at the Southern general in Glasgow who is able to provide specific clinical advice on that particular condition to patients and their families and to other nurses in the field.
I am always happy to look at what measures can be taken to help to raise further awareness of such issues. The national neurological advisory group has an important role to play in ensuring that we do everything possible to make sure that patients who have neuromuscular conditions such as myasthenia gravis are receiving the best possible care, and that those who are providing patients with the necessary clinical support have the right advice and information to enable them to provide the right clinical input. The specialist nurse at the Southern general in Glasgow has an important role to play in helping to support that area of work.
Question 16 is from Margaret McCulloch—I ask her to be brief.
NHS Lanarkshire (Rapid Review Assessment)
To ask the Scottish Government whether it will provide an update on the NHS Lanarkshire rapid review assessment by Healthcare Improvement Scotland. (S4O-02702)
The Scottish Government announced on 27 August that we had commissioned Healthcare Improvement Scotland to undertake a rapid review of the safety and quality of patient care in NHS Lanarkshire. I am aware that HIS has kept all Lanarkshire MSPs informed of its progress, as well as giving them opportunities to input to the review.
In addition to considering a substantial amount of information and data, the review team has visited 43 clinical areas, spoken to more than 200 people—including patients, their families, carers and members of staff—received feedback from more than 300 patients and carers about their experience of the care that was received, and reviewed 152 records of patients who died within 30 days of admission across the three hospitals. I can confirm that HIS will publish its report by the end of the year.
Papers from NHS Lanarkshire confirm that an examination of unscheduled care and accident and emergency is a critical part of the HIS inquiry. Performance against A and E targets has deteriorated across Lanarkshire’s three acute sites while the inquiry has been going on, according to figures that were collected over the autumn.
In light of the scale and urgency of the situation in Lanarkshire, will the Government press for the timely completion of the review and commit to providing a timely response?
I am sure that there will be a timely response, and the report will be published by the end of the year.
It is rather hypocritical of anyone in the Labour Party to criticise A and E turnaround times in Lanarkshire, when Labour wanted to close down Monklands hospital’s A and E department.