Scottish Medicines Consortium (Drug Appraisal Process)
To ask the Scottish Government what its assessment is of the effectiveness of the reformed Scottish Medicines Consortium drug appraisal process and whether it considers that further reform is required. (S4O-04144)
Positive progress has been made by the Scottish Medicines Consortium. The Scottish Government has been monitoring the changes very closely, and we have said that we will now review how the changes are working and are open to considering any further steps that can be taken.
Last month, the SMC rejected the use of abiraterone before chemotherapy in NHS Scotland. That was despite emphatic support from clinicians, who described the treatment as “a paradigm shift”, and from patients, who told Prostate Cancer UK that they would feel “cheated”, “dismayed”, “marginalised” and “abandoned” in the event of SMC rejection of the drug. Now that the SMC has rejected the drug, can the cabinet secretary confirm her understanding of why the drug was rejected and what steps are being taken to revisit a decision that Prostate Cancer UK has called
“an intolerable blow to hundreds of men with incurable prostate cancer”?
The first decisions under the new arrangements were made between October last year and March this year. Of the decisions on the 15 medicines that were considered under the new processes, 10 were positive and five were negative.
The Scottish Government absolutely recognises that patients and their representatives will be very disappointed by the decision on abiraterone. There is a clear demand for the drug, and around 100 patients in Scotland are already on this treatment through the reformed individual patient treatment request system. We have encouraged the Scottish Medicines Consortium and the manufacturer to find a resolution as soon as possible. We will keep the member informed on that.
The cabinet secretary will be aware that the IPTR system was supposed to end in May 2014 and PACS—the peer approved clinical system—was to come into force then. I have an email regarding a constituent’s case from NHS Lothian that says, “Thank you for your IPTR.” I thought that the use of IPTR had ended. Can the cabinet secretary clarify the status of PACS?
We have decided to carefully pilot the introduction of PACS. That is to ensure that there are no unintended consequences of reducing the increased access to medicines that is being seen at the moment. The current approach has seen hundreds more patients in Scotland accessing treatments as a result of the changes that were made last year.
Guidance is due to be issued this month to begin piloting from April. We are going to carefully monitor the situation together with the decisions being made by the Scottish Medicines Consortium under its new approach. In the longer term, as more and more decisions are made by the Scottish Medicines Consortium, the reliance on individual requests will be reduced.
Physical Activity (Teenage Girls)
To ask the Scottish Government what it is doing to encourage teenage girls to become and remain more active. (S4O-04145)
Increasing the number of girls meeting recommended levels of physical activity is a priority for the Scottish Government. That is why we invest £500,000 annually through sportscotland in the active girls programme to increase girls’ and young women’s participation in physical education, sport and physical activity.
In addition, between 2007 and 2019, Scotland will have invested some £130 million in the active schools network, which increases the number of good-quality opportunities for children and young people to get active. The healthy living survey results from 2014 confirm that, with the help of investment from sportscotland and Education Scotland, 96 per cent of schools were meeting the target level of PE provision, which is up from below 10 per cent in 2004-05.
The minister will be aware that a lot of young women drop out of physical activity. Does he agree that schools need to offer physical activity that attracts young women? We also need to develop role models to encourage them to take part. However, women in sport tend to be stereotyped when they are being interviewed and talked about in the media. The focus falls on their looks and their relationships rather than their contribution to physical activity. What is the Scottish Government doing to influence schools to ensure that they offer physical activity in a way that is attractive to young women, and to address the sexist coverage of women in sport?
I recognise the points that Rhoda Grant makes. We understand that there is an issue with the levels of physical activity of teenage girls as opposed to teenage boys. I agree with her that we must offer physical activity opportunities that young girls will engage with. I have seen first hand that that happens in many locations across the country, and we should see that rolled out elsewhere.
I also agree with Rhoda Grant’s point about the public perception of women in sport. We know that sports media coverage heavily favours men. For every 53 articles written about male sporting stars, there is just one penned about women. We need to ensure that we see better and more equitable coverage, although there is obviously a limit to what the Government can do in that regard. Part of the work of the women in sport working group, which reported last year, concerned women in the media, and sportscotland is taking forward the work of that group through its equalities group, which reports to the sportscotland board.
South Glasgow University Hospital (Dermatology)
To ask the Scottish Government how many dermatology in-patient beds will be available at the new south Glasgow university hospital. (S4O-04146)
Six in-patient dermatology beds are currently planned for the south Glasgow university hospital. However, after operating at that revised level for two months, the service will undertake a review to consider the impact on service provision and waiting times for planned admissions. Once that review has been completed, a final decision will be taken on the bed numbers.
I am surprised to hear that a review will take place after a cut in the number of dermatology beds, because Greater Glasgow and Clyde NHS Board has told me that the dermatology in-patient beds currently have an 81 per cent occupancy rate, which means that the new south Glasgow university hospital will see a cut of 57 per cent in the number of beds available, from 14 to six, as the cabinet secretary said. Can she reassure my constituents whose treatment plans require them to be treated as in-patients that that will continue, in spite of the large reduction in the number of beds in that specialty?
Medical advances, more effective treatments and the increased use of out-patient treatments have dramatically reduced the need for in-patient beds in dermatology. As a result, we have seen across Scotland a dramatic decrease in the number of dermatology beds required. Importantly, the dermatology service in Glasgow has received additional funding for four additional nurse specialist posts to support an increased day-patient and out-patient service, and the development of the day-patient and out-patient service will mean that there is less reliance on in-patient beds. The ward has a dedicated day treatment area, which will allow many patients to attend for treatment and return to their homes rather than being admitted, but I appreciate that in-patient care and treatment will still be required for a number of patients. The board will make its final decision on the number of appropriate beds after the two-month review and, if six is not adequate, more beds will be provided.
“Beef 2020 Report”
To ask the Scottish Government when it will implement the recommendations of the “Beef 2020 Report”. (S4O-04147)
We plan to publish our response to the recommendations of the “Beef 2020 Report” next Friday.
It is amazing how a well-timed parliamentary question can bring about a response like that.
I am sure that the cabinet secretary does not need me to tell him that the beef sector faces a particularly uncertain future under the common agricultural policy reforms and that it is not being done any favours by the continuing lack of detail from his department on many aspects of the reforms or on the apparent inability of the new information technology system to cope with the demands that are being made of it.
The recommendations of the “Beef 2020 Report”, which the cabinet secretary commissioned and warmly welcomed when it was published last August, could give a much-needed boost to the sector’s confidence. One of the principal recommendations was that a full electronic identification system for cattle be implemented by 2016. If that is to be done, it surely needs to be put under way now. Has it been done? If not, why not? If it has not been started, what is stopping him?
I like the idea that I timetabled the announcement for next Friday because of the parliamentary question from Alex Fergusson, but I am afraid that that is not true.
Alex Fergusson raises a number of issues. The “Beef 2020 Report” is very important to the future of the beef sector in Scotland. As he is aware, some of the recommendations for the Scottish Government—not all of them are for the Government, as some of them are for the red meat sector itself—require discussion with the European Commission. As he is also aware, those discussions are sometimes tricky and take time. However, we are now confident that we can make a number of announcements next week, as I have indicated.
On the IT system, Alex Fergusson will know that we have a particularly complex common agricultural policy to implement this year. All Administrations are facing similar challenges to those that are faced by the Scottish Government. The good news is that our IT system for filling in the single application forms opened this week. There may well be teething problems during these first few days of the system, but they will be sorted as quickly as possible. There are many advantages to the online system that did not exist before.
Along with many other members of the Parliament and representatives of the wider industry, Alex Fergusson asked for many of the additional complexities that are characteristic of the new common agricultural policy, to ensure that it was suited to Scottish circumstances. We have a complex policy to implement, but we are going to implement it and it will make a positive difference to Scottish agriculture.
Aberdeen City Region Deal Bid
To ask the Scottish Government what discussions it has had with Aberdeen City and Aberdeenshire councils on the Aberdeen city region deal bid and what assistance it will provide to support the bid. (S4O-04148)
I refer the member to the answer that I gave to Lewis Macdonald’s question S4O-04104 during portfolio question time on Wednesday 11 March, in which I highlighted:
“We are working with Aberdeen City Council and Aberdeenshire Council to establish the detail of what a city deal for their region is intended to deliver.”—[Official Report, 11 March 2015; c 10.]
Given the announcement by the United Kingdom Government yesterday that it will start negotiations now on an Aberdeen city region deal, does the cabinet secretary recognise that a clear statement from the Scottish Government that it supports the deal in principle will be vital to its success? Will he give that clear indication today?
Does the cabinet secretary agree that the Scottish Government must stand ready to provide financial support for the deal, along with the UK Government and the local authorities?
I have made that support clear to Aberdeen City Council by writing directly to its leader, who had written to us previously. I also met the leader of Aberdeen City Council yesterday at the Scottish cities alliance. We have made it clear that we are more than happy to work with Aberdeen City and Aberdeenshire councils.
This all comes on the back of substantial investment in the north-east: the £187 million investment in transport infrastructure; the construction that has started on the Aberdeen western peripheral route, with £745 million-worth of investment; the £3 billion of investment in the A96 Aberdeen to Inverness road; and the £407 million of health infrastructure investment since 2007. We have a track record of providing infrastructure in the area, and we are more than happy to work with our colleagues in Aberdeen City Council and Aberdeenshire Council to see what more we can do in terms of a city region deal.
I am sure that the cabinet secretary agrees with me that a city region deal could help the region to remain competitive. To drive that forward and to ensure that momentum is not lost, will he ensure that, following the announcement yesterday, his civil servants and Government agencies put themselves at the disposal of the team that is developing the detail of the bid?
I can confirm that civil servants have already been engaging with Aberdeen City Council. That will continue as we work our way through the bid. We received the bid itself around 10 days ago. There is quite a lot in it, but that continual support from Scottish Government civil servants and other Government-related bodies will be assured as we go forward.
Homelessness (Benefit Sanctions)
To ask the Scottish Government what its response is to the Crisis report “Benefit sanctions and homelessness: a scoping report”. (S4O-04149)
The report contains yet more evidence that the current sanctions regime is not working and emerging evidence that sanctions may increase the risk of homelessness, potentially undermining the substantial progress that we have made in tackling homelessness in Scotland in recent years. We have long made our concerns clear that sanctions are unfair, punitive and do nothing to help people who are already struggling to cope.
The Scottish Government is doing what it can with the resources and powers that it has to help those who are affected. That includes investing about £296 million from 2013-14 to 2015-16 to limit the damage caused by the United Kingdom Government’s reforms. We cannot fully mitigate all the effects of the welfare changes, but we will continue to make the argument for a fairer welfare system.
Does the minister share my concerns not only that the welfare reforms are very damaging to folk in Scotland but that the level of sanctions appears to be higher in different areas, including, in particular, areas of Aberdeenshire in my constituency?
I share the member’s concerns. The Crisis report indicates that there are discrepancies across the country in how sanctions are being applied, and it illustrates that their application is not determined by the economic geography of the area, the strength of its labour market or even whether it is urban or rural. That suggests that the Department for Work and Pensions is not consistent in applying sanctions and further confirms that the system is unfair and unjust.
As we have made clear, sanctions are causing hardship to many people in Scotland who are in difficult circumstances and who often have to turn to food banks for help. The sanctions system should be changed and replaced with a system that is fairer and which helps people, rather than punishing them.
Oil and Gas Analytical Bulletin
To ask the Scottish Government what plans it has to publish an oil and gas analytical bulletin. (S4O-04150)
The Scottish Government will publish an oil and gas bulletin once we have completed our analysis of the changes made in the United Kingdom budget and assessed their implications for investment and production.
Some perspective helps here. The Scottish Government’s white paper estimated oil and gas revenues over the next four years at £27.5 billion. In May last year, the Scottish Government boosted that to more than £28 billion. Meanwhile, it mocked the Office for Budget Responsibility’s initial estimate for the four years of £14 billion, which yesterday was further revised down to £5 billion.
Surely now is the time for the Scottish Government to show some contrition and humility, given the plunge in oil prices, and to bring forward a new, more realistic assessment of oil and gas revenues—or is that too embarrassing?
I say to Ms Goldie—I thought that I had covered it in my original answer—that the Government will consider the changes made in the UK budget yesterday, which will have an effect on the revenues that can be realised because of their significance. Of course, they reverse decisions that the chancellor put in place in the first place, in 2011, which have contributed to the difficulties that the sector faces.
The Government will consider all those issues. We will ensure that the analysis is undertaken effectively and we will assess the implications of the changes for investment and production and publish a bulletin accordingly.
Cancer Treatment Referral Waiting Times (NHS Fife)
To ask the Scottish Government what action it is taking to reduce cancer treatment referral waiting times for NHS Fife patients. (S4O-04151)
Our cancer delivery team is working with NHS Fife to support performance recovery. A performance recovery action plan has been developed and progress against actions is regularly monitored and updated. The plan includes the allocation of more than £103,000 through cancer modernisation funds and more than £400,000 through the detect cancer early programme in 2014-15 to support diagnostic capacity and cancer services in NHS Fife.
I was recently contacted by a constituent who has been diagnosed with lung cancer. She was referred to the Western general hospital for radiotherapy and chemotherapy, and was told that she would get an appointment within two weeks, yet after six weeks she had heard nothing. She contacted her general practitioner, who discovered that the consultant she had been referred to was on long-term sick leave, so no action had been taken to schedule her appointment.
Will the cabinet secretary take action to improve the referral process for cancer treatment in the NHS to avoid such situations? Right now, it not only seems that NHS patients in Fife have the second-longest waiting times in Scotland for treatment, but it looks like lives are being put at risk due to inadequate administrative arrangements.
I will look into the specific case that Cara Hilton raises and write to her.
On the 31-day target, NHS Fife has performed at 96.1 per cent. Although improvements have to be made, we should recognise that level of performance. There are issues in colorectal, lung and neurological cancer types, which are causing concerns within NHS Fife. There are various reasons for the situation, including some staffing issues. Support has been provided, with senior management going out and visiting clinicians to understand the local challenges and, importantly, identify solutions to them. The most recent example of that took place on 12 February.
We will continue to support NHS Fife to make those improvements, but I will write to Cara Hilton about the case that she highlighted.