SCOTTISH EXECUTIVE
Health and Wellbeing
Housing (Edinburgh)
To ask the Scottish Executive what action it is taking to support the City of Edinburgh Council in tackling the city's acute housing issues. (S3O-6286)
The Scottish Government is committed to helping tackle housing issues in Edinburgh, working closely with the City of Edinburgh Council. Support to the city is provided through a range of measures. For example, the city will receive £46 million in this financial year for a range of affordable housing measures and I recently announced that, next year, the city will receive nearly £50 million. In addition, the city will have access to a share of the demand-led £60 million national open market shared equity scheme. The recently submitted bid to help fund new council houses in the city is being examined. I expect to make announcements on that bid fairly soon.
I welcome the recent affordable housing investment programme allocation to the city and the allocation for strategic land acquisition, both of which are important. Those allocations recognise that the Scottish Government must invest more in areas where the shortage of affordable housing is most acute. What discussions does the minister intend to have with the Convention of Scottish Local Authorities to achieve a longer-term and fairer distribution of the Government's housing investment funds, so that they are distributed on the basis of need, bearing in mind the acute needs in areas such as Edinburgh?
I have instituted several meetings with COSLA and individual councils. Indeed, I met the leadership of the City of Edinburgh Council this week to discuss the long-term housing pressure on Edinburgh. I have arranged to have monthly meetings with COSLA to discuss the issues to ensure that we move ahead on all aspects of housing policy.
Two weeks ago at question time, I drew to the minister's attention the fact that 45p of every pound of rent in Edinburgh goes to paying off housing debt. I ask the minister for his thoughts on the important campaign on that issue by Edinburgh Tenants Federation, which is run by committed tenants throughout the city.
As the member knows, I have arranged in principle to meet Edinburgh Tenants Federation to discuss the issues of concern. As I said to the member two weeks ago, the Scottish Government's position remains firmly that Her Majesty's Treasury should write off the housing debt throughout Scotland with no strings attached. That would make a substantial difference to housing investment in Scotland.
I acknowledge the increase for Edinburgh, which has been achieved by bringing forward money from 2010-11. Will there be a corresponding reduction from the pre-announced indicative allocation for Edinburgh for 2010-11, or will the minister move speedily on to a new distribution formula that pays proper regard to the shortage of affordable housing as the key indicator?
We will make the announcements on the allocations for that financial year at the appropriate time and once the final decisions are made. I should point out that, as I said in an earlier answer, our decision on the bids for the £25 million-worth of investment in council housing throughout Scotland will be announced in the next few weeks. Edinburgh, being an ambitious city with an ambitious council, has applied for only 40 per cent of the total Scottish funding.
I take it that Edinburgh's ambition will not be punished in any way and that its bid will be recognised as expressing not just the city's ambition but its need, which has not been acknowledged until now. In that vein, can the minister assure me that, if the homelessness figures for Edinburgh continue to rise, there will be flexibility in any response that he might be asked for?
On Tuesday, I discussed the issues that Margo MacDonald has raised with the political leadership and housing chiefs of the City of Edinburgh Council. The Government is aware of the particular pressures on housing in Edinburgh and is keen to agree with the council a medium-term plan to address them.
Medicines (Postal Delivery)
To ask the Scottish Government what arrangements are in place to ensure the safe delivery of medicines for patients who receive them by post. (S3O-6333)
Under their code of ethics, pharmacists must ensure that medicines are delivered safely and securely. In particular, they must ensure that there is a verifiable audit trail for medicine from the point at which it leaves the pharmacy to the point at which it is handed over to the patient or carer.
Recently, a constituent of mine in Lanark reported delayed receipt of medicine in a parcel that was damaged. Does the minister agree that the public service aspect of the Royal Mail must be maintained, especially where the delivery of medicine is concerned, and that that is threatened by the United Kingdom Government's determination to press ahead with privatisation of the Royal Mail?
As my colleague the Minister for Enterprise, Energy and Tourism said at question time last week, the Scottish Government shares the widespread public concern about the UK Government's proposals to part-privatise the Royal Mail. As he explained, we will continue to express our concerns and to monitor developments, to ensure that service levels in Scotland are protected.
Fuel Poverty Programme
To ask the Scottish Executive what progress has been made with the fuel poverty programme. (S3O-6292)
Our review last year identified that the programmes that we inherited from the previous Administration were not targeting the fuel poor effectively. We re-established the Scottish fuel poverty forum and announced in November that we will adopt its key recommendation, which is to replace the central heating and warm deal programmes with the energy assistance package. The package will start next month and will present an holistic approach, targeting a wider range of fuel-poor groups, better addressing energy-inefficient homes and, for the first time, tackling rural fuel poverty.
We all want measures that will tackle fuel poverty effectively. However, the minister will be aware that the number of central heating installations fell from 1,236 in October last year to 520 in November—a fall of more than 50 per cent. Can the minister justify a cut of such magnitude five months before the new fuel poverty programme is scheduled to start?
Last year we installed a record number of central heating systems in Scotland. When the member gets this year's figures for the warm deal and the central heating programme, I trust that he will be satisfied by another record achievement over the piece in the remainder of both programmes. I hope that he is looking forward to the new programme, which, for the first time, will make the service available to families with children under five and families with disabled children under the age of 16.
The minister makes the point that we must ensure that fuel poverty schemes target those who are most fuel poor. Can he provide me with more information on the efforts that will be made to ensure that household fuel prices are affordable and that energy efficiency measures are implemented for young families that are vulnerable to fuel poverty?
I am happy to give that undertaking. The new programme involves a four-stage approach that will ensure that even those who do not qualify for the fourth stage receive advice. If they get to stage 3, they will receive assistance with insulation from energy providers under the carbon emissions reduction target programme, to help to make their homes fuel and energy efficient.
Is the minister aware of the concerns of pensioners in rural Argyll, who faced days of continuous freezing weather but did not receive cold weather payments? One of my constituents has a sister who lives in the midlands and received £100 in cold weather payments. However, the pension service told my constituent that people in the Paisley postcode area, which covers Argyll, would not receive any payments, because they were not affected by cold weather. Would the minister like to comment on that?
I agree with Jamie McGrigor and share his concerns that the United Kingdom Government is not recognising the particular needs of people in Scotland, where temperatures are colder and the weather is damper. We have taken up, and will take up again, with Her Majesty's Treasury the need to reconsider cold-weather payments and ensure that people in situations such as those in which Mr McGrigor finds his constituents get a fair reward from cold-weather payments in future.
I am sure that the minister is aware of the advice that is given to individuals who apply to the central heating programme. I am also sure that he is aware that many people who could be categorised as fuel poor or who have children already receive central heating through schemes to which their local authority housing provider or other registered social landlords apply. How will RSLs and other housing providers in the social rented sector benefit through the new scheme?
The scheme has four stages. Anyone is free to contact it and get the initial advice that is given at stage 1. In some cases, they will be able to take their inquiry to stage 2 and possibly even stage 3. The issue is that existing programmes are mainly targeted at private sector owners because we rely on local authorities and housing associations to ensure that the homes that they own are properly heated.
Human Papilloma Virus (Immunisation)
To ask the Scottish Executive what progress is being made in immunising eligible women against the human papilloma virus. (S3O-6348)
The first year of the human papilloma virus vaccination programme is proceeding well. National health service boards are currently administering the third dose of the vaccine for girls in school, and we understand that uptake has been very good. ISD Scotland will publish the first set of uptake statistics for school-age girls on 26 March.
Recent press comment suggests that some young women who are not immunised at school will miss out on the HPV immunisation catch-up programme because of the refusal of general practitioners to take part. Will the minister provide an update on the situation and inform the Parliament what arrangements are in place to ensure the success of the catch-up programme?
We have worked closely with NHS boards to ensure that alternative arrangements are provided. Some GPs are taking part in the programme and co-operating with their local boards. However, in most areas, NHS boards have put in place alternative arrangements based around additional community clinics, which are provided in a variety of ways according to identified local needs. We will continue to monitor progress.
NHS Scotland (Dignity at Work Programme)
To ask the Scottish Executive whether statistical information is available on complaints raised under the dignity at work programme and their outcomes for representative authorities within NHS Scotland and what external monitoring or mediation is being undertaken in contentious cases. (S3O-6342)
Statistical information on complaints about dignity at work is available at individual board level. However, information is also collected every two years by the staff survey that the staff governance team within the health workforce directorate carries out. The staff survey results that were published in January 2009 showed a decrease in the number of staff who indicated that they had been subject to bullying and harassment in the workplace. However, because of the seriousness of the issue, the Scottish Government is putting in place a pilot project for dignity at work, which will form part of the partnership information network policy, which is currently under review. Individual boards have their own processes through their staff governance committees for monitoring and mediation in contentious cases.
Will the cabinet secretary consider further whether there is a uniform approach to this sensitive issue across NHS Scotland? Issues have been raised about cases of bullying-induced stress at work being settled without external reference, with the authorities under question acting as judge and jury. That is something for further investigation.
Chris Harvie raises an important point. I put on record the fact that bullying, harassment and intimidation should not be condoned in any way, shape or form in the NHS. Well-established research shows that staff who are subject to such conduct are more likely to suffer from work-related stress or to take time off work sick.
Junior Doctors (Ayrshire and Arran)
To ask the Scottish Executive what steps it is taking to encourage the deployment of junior doctors to work and train in Ayrshire and Arran. (S3O-6339)
Junior doctors are employed in training posts in national health service boards after graduating from medical school. Selection and recruitment into such posts is organised initially on a regional basis to ensure that the ultimate allocation of junior doctors to individual NHS boards is fair and equitable. The deployment of junior doctors to Ayrshire and Arran is part of that process.
I am sure that the cabinet secretary will accept that there are concerns that the Ayrshire and Arran area is not getting its fair share of junior doctors. The health board has raised its concerns about that directly with me. Perhaps the bright lights of Edinburgh and Glasgow attract more junior doctors than they should.
Kenneth Gibson raises an important point. As he will be aware, in 2008 there were issues about selection and recruitment into junior doctor posts. NHS Ayrshire and Arran had particular difficulties in that regard. It put in place contingency arrangements to ensure that service provision was not compromised. I understand that NHS Ayrshire and Arran is currently carrying a small number of vacancies out of its 272 training-grade posts across a range of specialties and sites and that it has in place contingency plans. In addition, recruitment for 2009 is now under way.
I thank the cabinet secretary for the extensive information that she has just given us. I point her to work that is on-going in Ayrshire and Arran, which identifies that a number of risks can arise from a failure to recruit people for all of the training posts and suggests that there could be a knock-on impact on rotas and compliance rates, particularly around the requirement for consultants to cover more work out of hours, leading to a subsequent knock-on effect on work that is delivered during the day. In turn, that could impact on waiting times, for example. What specific discussions has the cabinet secretary had around that issue?
My officials and I discuss those issues with all health boards. The contingency measures that I said NHS Ayrshire and Arran has put in place are meant to ensure that the board can manage the situation regarding junior doctor vacancies without compromising the provision of services. NHS Ayrshire and Arran should be supported in that regard. As I said earlier, it is carrying only a small number of vacancies out of its 272 training-grade posts. In addition, attention is very much focused on recruitment for 2009. National application to vacancy ratios were high in every speciality across Scotland, but we still have some way to go. The issues that the member raises are matters of on-going discussion with NHS boards, because the most important factor is to ensure that high-quality services are delivered to patients.
I was contacted recently by a constituent who is employed at Crosshouse hospital, who highlighted the increased workload that is being placed on staff as a result of the need to meet Government waiting list targets. Although it is clear that there is a need to reduce waiting lists, it seems equally clear that additional staff are required so that the reduction can be achieved without placing unreasonable workloads on existing staff. Will the cabinet secretary consider the situation at Crosshouse and throughout Ayrshire and Arran, with a view to ensuring that additional staff are provided?
I will always consider situations about which concerns have been expressed. Everybody who works in the NHS does a sterling job, so if someone expresses concern or raises an issue it is my duty to listen and to respond.
National Health Service Boards (Elections)
To ask the Scottish Government what progress has been made in reducing any democratic deficit in the provision of health care by establishing elected NHS boards. (S3O-6347)
Many people in Scotland think that there is a democratic deficit in the operation of our health boards. We started to change the situation on 12 March, when the Parliament gave unanimous support to the Health Boards (Membership and Elections) (Scotland) Bill, which will introduce, by way of pilots, direct elections to health boards, thereby ensuring that the public's voice is heard and listened to at the heart of the decision-making process.
Last week's unanimous vote showed members' strength of feeling on the issue.
I will be delighted to meet the member to discuss that or any other issue. I have not yet decided which boards will be included in the pilot. I have said that the two boards that will be included will be representative of Scotland's geography. It is likely that one board will cover a predominantly urban area and the other a predominantly rural area. I am considering all options and would be happy for Anne McLaughlin or any other member to make a case for the inclusion of a particular board.
Dentists (Fife)
To ask the Scottish Government what proposals it has to improve levels of dental provision in Fife. (S3O-6345)
Responsibility for the overall provision of national health service dental services in the area rests with NHS Fife. The board has put in place a number of measures to improve access to NHS dental services, including expansion of the salaried dental service.
I thank the minister for her reply and for the Government's commitment to improving dental health provision not only in my constituency but throughout Fife.
NHS Fife has been allocated funding under the primary and community care premises modernisation programme for 2009 to 2011 to develop the projects to which the member referred. It is currently in initial discussions on proposed sites in those areas. Given that the projects are only in the initial stages, it is estimated that it will be early 2011 before they are completed.
Is the minister aware of the previous Administration's commitment in injecting £4.5 million of funding, which was made available to NHS Fife and which resulted in development of a new dental clinic in each of the five constituencies across Fife? Since that injection of funding in 2006, nothing more has been announced for the Dunfermline East constituency. What plans does the minister have to address the unacceptable situation in my constituency, which is one of the most deprived and disadvantaged constituencies outside Glasgow and has the highest—and record—disadvantage and unemployment in the whole of Fife?
This Government inherited a situation of neglect in investment in NHS dentistry. It was neglected over a number of years, which led to the situation that began to be rectified at the latter end of the previous Administration's tenure and which has been picked up very much by our Government—so much so that it has been made clear to boards that investment in dental premises should be a priority for the primary and community care premises modernisation programme. I would have thought that the member would welcome that.
I refer the minister to an article in The Scotsman on 28 December last year that referred to more than 80,000 Scots being stuck on waiting lists for an NHS dentist. Despite my best efforts, I cannot find how many are on the waiting lists in Fife. Can the minister obtain those figures so that we can judge how many more NHS dentists might be required and, specifically, whether adequate dental provision has been made for the new St Andrews community hospital and health centre?
NHS boards are very active in ensuring that they address the needs of their areas. I can say to the member that six salaried surgeries are to be opened, probably this summer, at the new St Andrews hospital. Including those, a total of 27 new salaried surgeries will have opened since autumn 2008. Again, I would have thought that the member would welcome that.
Early Years Strategy (Health Visitors)
To ask the Scottish Executive what further steps have been taken to ensure that the deployment, training and recruitment of health visitors is at the centre of the early years strategy. (S3O-6273)
The delivery and implementation of the early years framework will be taken forward in partnership between the Scottish Government and local partners. Health visitors, who are key to the delivery of the early years framework, work as part of multidisciplinary, multi-agency teams to support parents and identify risks to health. Working with others, NHS Education for Scotland is running a number of education initiatives to ensure that the training and development needs of health visitors and practitioners are met.
I am also looking for some comfort about whether the relevant ministers concerned with the early years strategy, notably the Minister for Public Health and Sport, the Minister for Children and Early Years and the Minister for Schools and Skills, consult one another on the strategy's development and, in particular, whether there is recognition not just that health visitors are an important part of the strategy but that the health visitor service requires much increased staffing and that health visitors are critical to the success of the early years strategy.
I reassure the member that ministers have been discussing the early years framework across the ministerial portfolios. We also worked together to produce the report "Equally Well: Report of the Ministerial Task Force on Health Inequalities", which focuses on early years and early intervention. We recognise that there is a clear need to support parents with children at that stage of life, and the framework asks local partnerships to ensure that they develop clear leadership for zero-to-three services over the next few years.
Junior Doctors (Support)
To ask the Scottish Executive what it is doing to ensure that junior doctors are given the right support to allow them to carry out their duties. (S3O-6277)
Junior doctors are employed in training posts after graduation from medical school and work as part of integrated health care teams. Through arrangements between NHS Education for Scotland postgraduate deaneries and NHS boards, a network of consultant doctors provides support, supervision and guidance to junior doctors throughout their training.
Newly qualified doctors recently lost their right to accommodation allowance. That has placed an extra burden on those young doctors. Although the accommodation allowance scheme is UK wide, does the cabinet secretary not agree that there is scope for a Scottish solution to address the significant financial difficulties that some junior doctors experience? Should the Scottish Government not now confer with medical professionals and organisations to discuss the best solution for Scottish doctors? Will such discussions form part of a review?
The accommodation issue stems from the fact that it is no longer a requirement for certain junior doctors to be resident on site, so there is no longer a contractual requirement to provide them with accommodation.
Question 11 was not lodged.
Hospital-acquired Infections
To ask the Scottish Government what further action ministers are taking to combat hospital-acquired infections. (S3O-6338)
The Scottish Government's health care associated infection task force has published its third programme of work, which sets out the detail of the actions to be taken. The programme, which covers the period March 2008 to April 2011, is available on the Scottish Government website.
The cabinet secretary has announced the establishment of a new care environment inspectorate. Can she explain the inspectorate's role in combating health care associated infections and how the public can use the inspectorate?
The care environment inspectorate will have an extremely important role to play in tackling health care associated infection. It is intended that it will build on established processes for quality assurance and improvement. In particular, it will ensure robust scrutiny and appropriate follow-up and escalation procedures where appropriate. Every acute hospital will be visited once every three years on an announced basis and once every three years on an unannounced basis, and additional visits will be factored in, depending on circumstances. Reports and recommendations for improvement will be published, and boards will have an obligation to respond to them. In addition, an annual overview report on the national picture and the picture in individual boards will be presented to the Parliament.
Given the 25 per cent mortality rate for the first 16 cases of C difficile ribotype 078 that have been identified in Scotland and Health Protection Scotland's view that ribotype 078 is as toxic as ribotype 027, why will the protocol that requires samples to be submitted for typing to the national laboratory not be amended to include a requirement to submit samples from any hospital where ribotype 078 is identified?
Richard Simpson knows, from the large number of written answers that I have given, that Health Protection Scotland has considered its guidance and considers that it is appropriate to the circumstances. He is also aware of the work that HPS is doing on that particular strain. I am more than happy to discuss with any member of Parliament, in as constructive a way as possible, what additional steps we require to take to beat infections. I have made it clear that that is my top priority. I do not have a monopoly on wisdom, but I hope that the Parliament can take the issue forward in a united fashion, such is its importance to the public.
Oesophageal Cancer
To ask the Scottish Executive what organisations it has met to discuss the need to raise awareness of oesophageal cancer. (S3O-6296)
Since the publication of "Better Cancer Care, An Action Plan", the Scottish Government has not met any specific organisations to discuss the need to raise awareness of oesophageal cancer. However, cancer prevention and awareness raising are key aspects of "Better Cancer Care", so opportunities are being taken to discuss raising awareness of cancer more generally at, for example, cancer-related meetings, conferences and ministerial visits.
Earlier this year, I met representatives of Ochre, a charity that aims to raise awareness of oesophageal cancer and provide advice for sufferers and their families. The charity highlighted the fact that oesophageal cancer is difficult to diagnose and challenging to treat, which often results in poor prognoses and outcomes for most sufferers. It is the ninth most common cancer in the United Kingdom, with an even higher incidence in Scotland, and is predicted to rise by 64.3 per cent by 2020.
I would be delighted to undertake such a meeting, and if the organisation—or indeed Bill Butler—wants to contact me, I am sure that that can be arranged.
Asbestos-related Diseases (Screening)
To ask the Scottish Government whether it has plans to screen for asbestos-related diseases. (S3O-6352)
There are currently no plans to introduce a national screening programme for asbestos-related diseases. The Scottish Government has been committed to an evidence-based approach to screening and is given expert, independent advice on screening programmes by the United Kingdom National Screening Committee. The UKNSC sets out the criteria to assess screening programmes, the introduction of proposed new population screening programmes, the modification and withdrawal of existing programmes, and the quality and management of such programmes. It keeps a watching brief on and an on-going review of developments in the field.
Since early diagnosis clearly produces good outcomes, will the Government consider an initiative to encourage those who have come into contact with asbestos to come forward for screening?
No useful test is currently available that detects people who have been exposed to asbestos and are likely to get mesothelioma, although we hope that there will be such a test in time. The Scottish Government has a policy to encourage clinicians to ensure that as many patients as possible are included in relevant clinical trials, and there is significant evidence that outcomes are improved for patients treated in environments where research is the norm and for patients who are involved in cancer trials.
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