Meeting of the Parliament

Meeting date: Thursday, June 21, 2012

Official Report 1131KB pdf

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Scottish Executive Question Time

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Health, Wellbeing and Cities Strategy

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National Health Service (Whistleblowing)

1. To ask the Scottish Government when it plans to review the partnership information network policy on implementing and reviewing whistleblowing arrangements in the NHS. (S4O-01159)

I take advice from the Scottish workforce and staff governance committee on those matters. SWAG normally reassesses PIN policies every two years in order to determine whether they are considered to remain fit for purpose or require further review. The PIN policy in question was first published in December 2011. It is open to SWAG to decide that individual PIN policies are subject to review, either in part or in full, outwith those timescales if it considers that to be necessary and appropriate. I have asked SWAG to review the implementing and reviewing whistleblowing arrangements in NHS Scotland PIN policy with particular reference to the prospect of introducing a whistleblowing helpline for staff, and to report back to me by the end of this year.

The cabinet secretary is to be commended for her efforts to create the right environment for whistleblowers. Constituents have raised that issue with me.

We must be seen to be open and accountable. In that regard, will the cabinet secretary confirm that she will meet Patients First, which is a new whistleblowing campaigning organisation that is just starting to operate in Scotland?

I would be happy to meet Patients First, as I am happy to meet a range of organisations. Dave Thompson will appreciate that it is not always appropriate for me to meet such organisations to discuss individual cases, but if Patients First wants to meet me to discuss general issues, I would be delighted to have my office arrange a meeting.

Dave Thompson will be aware that the Scotland Patients Association is also very active in Scotland. I meet it regularly and very much value the advice that it gives.

Many issues that relate to whistleblowing could be addressed by more understanding and supportive human resources departments in the national health service rather than by the usual approach of suspending conscientious staff. Will the cabinet secretary ensure that HR departments try to support staff rather than bully them for whistleblowing?

I hope that Mary Scanlon recognises that I would never tolerate bullying in the NHS from any source for whatever reason. HR departments exist fundamentally to be supportive of staff and to take a supportive approach to addressing any issues that staff may encounter, and to help them to address any particular problems that they are experiencing. That is absolutely the way in which I expect HR departments and, indeed, all levels of management in health boards to approach the issues, and the belief that that is the best approach underpins the PIN policy that we are talking about.

I am the first to admit that, from time to time, health boards will fall short of the standards that we expect on the issue in question and on many other issues. When they do, it is right that we take action to put things right. However, the policy and the principles on which that policy is based are very clear, and I expect all health boards to abide by them.

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Giving Voice

2. To ask the Scottish Government what discussions it has had with the Royal College of Speech and Language Therapists in Scotland regarding its giving voice campaign. (S4O-01160)

No formal discussions have taken place between the Scottish Government and the Royal College of Speech and Language Therapists in Scotland about the giving voice campaign. However, the campaign’s aims are subject to an on-going parliamentary petition, which was submitted to the Parliament’s Public Petitions Committee.

The national delivery plan for allied health professionals was published this week and was welcomed by the Royal College of Speech and Language Therapists. The delivery plan emphasises the need for AHPs to ensure that the communication needs of people who use services are effectively met. It also makes clear the need to consider how to support children with communication difficulties to access the curriculum and achieve their full potential.

As the minister said, effective speech, language and communication are fundamental to the success of our communities and our economy. People with speech, language and communication needs are likely to be unemployed or underemployed and victims or perpetrators of crime. Will the minister ask national health service boards to update their strategies to improve their SLCN services, so that we can secure an additional annual net benefit to Scotland and its economy? The benefit is currently approximately £60 million.

As I said, the national delivery plan includes actions and AHP directors in each health board should be working in partnership with colleagues in research and analysis to grow the health economics base for AHPs in Scotland, so that we can gain a clear understanding of the economic benefits that can be gained from AHPs’ intervention across the health and social care setting.

As part of the mainstreaming of the delivery plan, NHS boards have been asked to prepare local plans that detail how the actions in the national plan will be delivered locally and how that will be evidenced. The chief health professions officer will work with NHS boards and local authorities to support implementation and to ensure that activity is effectively monitored, so that we can assess progress in each board.

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Post-natal Depression

3. To ask the Scottish Executive how many women had post-natal depression in 2011. (S4O-01161)

The information is not held centrally. The Scottish intercollegiate guidelines network guideline on the management of perinatal mood disorders refers to a range of evidence that shows a post-natal depression prevalence rate of around 10 to 15 per cent. The figures encompass people who experience mild, moderate and severe post-natal depression.

The minister will be aware that SIGN guidelines on post-natal depression focus on cognitive behavioural therapy. However, CBT is inappropriate for some sufferers, who would be better served by art therapy and counselling. The post-natal depression group PND Borders offers such services but receives no funding from NHS Borders or Scottish Borders Council, even though it had 80 referrals from those two organisations during its first year of existence. The reason for the lack of funding is that the therapy that the group offers does not conform to Government guidelines.

This week is Action on Depression week in Scotland. Will the minister agree to meet me and Jenny Copsey, of PND Borders, to discuss the group’s funding anomaly and the Government’s guidelines on post-natal depression?

The new SIGN guidelines were published only in March, after careful consideration.

The decision about the approach that should be taken with a patient who is experiencing post-natal depression is primarily a clinical one and involves a multidisciplinary team in considering the most appropriate treatment programme for the patient.

I am aware of the concerns that have been expressed on behalf of the organisation in the Borders to which Jim Hume referred, which supports individuals who are experiencing post-natal depression. However, the member will acknowledge that it is the responsibility of local health boards and local authorities to decide how to provide services locally and which organisations will deliver services. The decision on funding the organisation is therefore a matter for the local health board and local authority. I will be happy to discuss the matter in more detail if the member wants me to do so, but I am sure that the member recognises that the primary responsibility for the matter lies with the local health board and local authority.

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Shingles (Vaccination Programme)

4. To ask the Scottish Government what progress is being made regarding the introduction of a shingles vaccination for all 70 to 79-year-olds. (S4O-01162)

The Joint Committee on Vaccination and Immunisation has recommended that people aged 70 to 79 should be vaccinated against shingles if the vaccine can be purchased at a cost-effective price. The United Kingdom Department of Health, which procures vaccines on behalf of the four UK health departments, has started work on the vaccine procurement process, which will establish whether a cost-effective shingles vaccination programme can be introduced.

The minister will be aware that a chicken pox vaccine is available in Australia, the United States of America and Japan. Can he say what implications his answer to my first question has in relation to a chicken pox vaccine?

I am aware that the chicken pox vaccine is available in a number of countries. We are guided on such matters by the Joint Committee on Vaccination and Immunisation, whose current advice is that the universal varicella vaccine for chicken pox is not recommended. I assure the member that those recommendations are kept under review in light of any data that may emerge. If further recommendations come from the Joint Committee on Vaccination and Immunisation that we should act upon as a Government, we will take the appropriate action at that particular time.

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NHS Grampian (Maternity Services)

5. To ask the Scottish Executive what discussions it has had with NHS Grampian regarding its plans for the provision of maternity services. (S4O-01163)

Scottish Government ministers and officials regularly discuss matters relating to service provision with national health service boards.

I am aware that following a full public consultation, NHS Grampian has reached a view on its preferred maternity service configuration. As the proposals would involve major service change, the board will now submit the proposals to the Government for a final decision. The member will appreciate that, due to my formal part in that process, it is important that I do not pre-empt consideration at this stage. However, upon receipt of the proposals, I will carefully consider all the evidence and representations before coming to a final decision.

When the Fraserburgh and Aboyne maternity units were threatened with closure in 2006, Andy Kerr intervened as health minister and they remained open because fears had been expressed over expectant mothers having to travel long distances to give birth.

Will the cabinet secretary consider carefully new plans that have now been submitted to her that are different from 2006, but still include proposals to close the Aboyne and Fraserburgh units? Will she ensure that before those plans are put into action, she is personally satisfied that they are genuinely about better maternity services and not about reducing budgets?

I will say three things quickly to Richard Baker. First, when this issue was under consideration previously, Andy Kerr had exactly the same role in the process as I do now. He considered proposals that came to him and took a decision. That is what I will do when the proposals come to me. Secondly, to correct something that Richard Baker said, I have not yet received the proposals. Thirdly, when I receive the proposals I will, as I said in my previous answer, give him and other members with an interest an absolute assurance—as I always do on such issues—that I will look very carefully at the proposals, I will consider carefully all representations that are made and I will reach a decision only when I am absolutely satisfied in my own mind that it is the right decision to take.

Question 6 in the name of Linda Fabiani has been withdrawn for understandable reasons.

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Edington Cottage Hospital

7. To ask the Scottish Executive what its position is on the value of Edington cottage hospital to North Berwick and its neighbouring communities. (S4O-01165)

I am very well aware that the hospital is very valued by the local community.

As Iain Gray knows, national health service boards are responsible for planning and providing the best possible quality and safe local services. It is right that they keep those services under review to ensure that they continue to reflect local needs.

It is in the context of East Lothian’s older people strategy that the East Lothian community health partnership is at an early stage of discussions with local stakeholders about future service provision at Edington cottage hospital. If those discussions result in a specific proposal to change current services, I expect the health board to engage appropriately with local stakeholders in line with national guidance.

I wanted to thank the cabinet secretary for her endorsement, but I fear that organisations such as the friends of the Edington hospital in North Berwick will find that endorsement rather less strong than they hoped for.

Two weeks ago, the Edington celebrated 100 years of serving the people of North Berwick. It continues to provide crucial services close to home. It allows for short-term in-patient care; it allows people to return from surgery in Edinburgh earlier than they would have done otherwise; and most important of all, it provides palliative care close to families.

The Edington hospital has served its community for 100 years. It would be unfair to ask the cabinet secretary to promise another 100 years of life for the Edington, but it would be good to hear her suggest that for the foreseeable future, it is a facility that will remain available to serve my constituents in North Berwick.

I appreciate and respect Iain Gray’s role as a constituency member to speak up for the hospital, although I am a bit disappointed at his tone. I was clear in my answer and I will say again that I fully appreciate how highly valued the hospital is by people in the community. I am aware that the hospital celebrated its centenary recently. It has done a sterling job for the people of the community that it serves and I fully understand the sense of anxiety that there will always be if people have a sense that there may be change on the horizon.

I expect the NHS board to take full cognisance of the value that people place on the hospital, but I am sure that Iain Gray agrees that it would be wrong for any health board to refuse to consider whether services can be improved in any way at any hospital in any part of the country. For example, there are no en suite facilities at the hospital and not all provision is in single rooms. It is right that the health board considers how it provides services and whether those services can be provided better to local people. However, in doing that, the board must be mindful of the important place that the hospital has at the heart of its community.

Finally, I point out that no proposals for change are on the table. If such proposals emerge, they would have to go through the robust consultation and decision-making process that any change proposal has to go through.

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Read Classifications

8. To ask the Scottish Executive what representations it has received regarding Read classifications for general practitioners. (S4O-01166)

The Government has had no recent representations about the United Kingdom Read classification system for GPs. NHS National Services Scotland, which is responsible for Scottish input on the issue, has received representations about the way in which version 2 of the Read codes classifies homosexuality. NSS is taking forward the issue with the UK authority that is responsible for the matter.?? The Scottish Government agrees, and I certainly agree, that the current situation does not reflect our equalities aims and I support change to bring systems into line with those aims.

I thank the cabinet secretary for that somewhat pre-emptive response. I recently met Stonewall Scotland and was horrified to discover that gay men are classified under mental health and paedophilia. In the 21st century, that should not be the case. I look forward to that changing quickly.

I do not think that an answer is required.

I am happy to respond. Obviously, the classification is 20 years old, but that is no justification if it does not reflect our values and commitment to equalities. I am happy to keep Mary Fee updated on the efforts that NSS makes to bring the classification into line with the current situation.

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Coeliac Disease (Prescription of Gluten-free Foods)

9. To ask the Scottish Executive what action it has taken to ensure that a full range of staple gluten-free foods is available on prescription to people with coeliac disease in all national health service board areas. (S4O-01167)

The Scottish Government is committed to ensuring that people who are living with long-term conditions such as coeliac disease receive the care and support that they need. A range of gluten-free food products is available on prescription to patients who are diagnosed with coeliac disease.

Thanks to the resources that have been put in and the research that has been done by food manufacturing companies, the range and quality of foods that are available to coeliac sufferers has greatly improved in recent years. A balanced and nutritious diet is more likely to be followed if it is enjoyable. It takes a great deal of time and investment to create successful new gluten-free foods and to gain approval from the Advisory Committee on Borderline Substances. It is therefore disappointing that products that have ACBS endorsement are being denied to coeliac sufferers in some parts of Scotland.

For example, Nairn’s Oatcakes recently developed a gluten-free porridge, but it is not available on prescription in all NHS areas. Such disparities are unfair for coeliac sufferers and, if they go unchecked, are likely to have an impact on companies’ willingness to fund future research and development. Will the minister review the current patchwork of provision with a view to ensuring that people throughout Scotland have equal access to staple products? Will he consider the merits of a community pharmacy supply model as an alternative way of delivering a more cost-effective service?

The member is correct that there is a process through which the United Kingdom Advisory Committee on Borderline Substances is responsible for deciding on which products could be considered as appropriate for the prescribed list of gluten-free products. It is important to recognise that the current guidelines focus on prescriptions for staple food products. That is the arrangement that has been put in place across the NHS, which I believe is consistent with Coeliac UK’s prescribing guidelines. We are about to undertake a review of the processes in Scotland, which we will do in consultation with a range of stakeholders to see how we can continue to improve the range of services and products that are available to patients who require access to gluten-free products.

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Olympic and Paralympic Games

10. To ask the Scottish Government what message it has for the public and competitors from Scotland with regard to the forthcoming Olympic and Paralympic games. (S4O-01168)

As the great turnout for the Olympic torch demonstrated, people across Scotland are looking forward to the fantastic festival of sport and culture that the Olympic and Paralympic games will offer. The Scottish Government congratulates all those Scottish athletes who have been selected to compete at the 2012 Olympic and Paralympic games and we wish them good luck when they compete in London.

How will the Scottish Government capitalise on the opportunities presented by the Olympic and Paralympic games to ensure that the Scottish public are aware of the benefits of participation in sport to their personal health and wellbeing?

That is a very good question. We must ensure that the spirit and enthusiasm that are already evident as we head towards the Olympics are captured and, more important, rolled on for the two years up to the Commonwealth games. Much of the work that is going on in communities on the back of the Olympics—and indeed the Commonwealth games in two years’ time—will give children and people of all ages the opportunity to take part in sport. For example, the 150 community sports hubs that will be established will provide a lasting legacy for young people, in particular, to get involved in sport. I should also remind members that the Olympics will kick off in Scotland on 25 July—even before the opening ceremony—with the first football match at Hampden. I encourage everyone to go along and see some great football.

The whole chamber will rejoice as the Scottish saltire flutters high above every Olympic stadium with every British success—at the heart of the union flag where it belongs. Of course, these games are not political. Does the minister agree that the principal success for every competitor and athlete in the games is the triumph of their own commitment and sustained effort over many years, and will she and everyone in this chamber be cheering on their every effort?

The good thing about the Olympics is that politics is left at the door and that it is all about people coming together to compete. Those are the values of the games, and I certainly believe that they provide a fantastic opportunity for some of our young athletes who have never performed at that level. For example, Craig Benson, who is only 17 years old, has made it into the Great Britain swimming team. The fact that the games will provide new and hugely inspirational role models to inspire the next generation of young athletes coming through in Scotland can be only a good thing.

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Patient Consultation (Changes to Care at Home Services)

11. To ask the Scottish Executive what guidance it gives to national health service boards on consulting patients when changes are proposed to services delivered to patients at home. (S4O-01169)

NHS boards must involve the communities they serve in planning and developing health and care services whatever the setting, no matter whether those services are delivered in hospital, in the community or at home. Involving patients, carers and the public is an important aspect of our ambitions for improving the quality of NHS Scotland’s services. Scottish Government guidance, which was introduced in February 2010, sets out boards’ responsibilities to inform, engage and consult their patients and the wider public and how they should progress such work. That guidance applies to all boards, which are further supported in their involving people practices by the Scottish Health Council and its proactive and tailored advice.

Is the cabinet secretary aware that constituents in Lanarkshire who rely on incontinence support services delivered to their homes were given just over a week’s notice of, and no consultation on, a change to that service? Many of those who rely on the service are frail and elderly, and they valued the personal approach to delivery that they received until 1 June. Patients now have to call an 0845 automated number in Bradford and key in their patient identification number—their date of birth—before they can key in a product number. That might be easy for some, but not for the majority of those frail and elderly patients. Will the cabinet secretary investigate why NHS Lanarkshire introduced that service change without consultation, and is she able to tell me whether the same approach is being rolled out across Scotland?

I am very well aware of the importance of services that are delivered at home, which are often vital not only to an individual’s health and wellbeing but to their ability to continue to live independently at home. I also understand that health boards have to be very careful in changing service delivery and that they are under a real obligation to properly consult, engage and inform patients with regard to any such changes.

I am happy to pass on to the health board the member’s particular concerns about the change to the incontinence service in Lanarkshire, and to let him have its response. To my knowledge, that change has not been rolled out uniformly across Scotland, although it may well be that other health boards are making similar changes. I am more than happy to express his concerns to the health board and to have further correspondence with him, based on its response.

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Royal Hospital for Sick Children (Edinburgh)

12. To ask the Scottish Government what progress has been made regarding the development of the new Royal hospital for sick children in Edinburgh. (S4O-01170)

Since the issue was last raised in the chamber on 24 May 2012, discussions and exchanges have taken place between NHS Lothian, the Scottish Futures Trust and providers. Positive progress has been made and the substantive commercial issue has now been removed. Other remaining issues are being addressed, with a view to achieving a swift resolution to enable the project to progress as quickly as possible.

Understandably, there has been public concern that the Royal hospital for sick children should progress as quickly as possible. The construction of the new facility is sorely needed. Although I understand the complexity of the negotiations with stakeholders, I ask the cabinet secretary whether she has any broad timescale for the completion of the project towards which the national health service is now working.

I reiterate—as the First Minister did in the chamber a couple of weeks ago—the absolute commitment of the Scottish Government and NHS Lothian to delivering the new sick kids hospital. I repeat the commitment that that hospital will be built and will serve young people in this part of Scotland.

As the member will be aware, completion of the project was being sought for September 2016. There are delays in negotiations with the funders of the existing private finance initiative contract regarding land and associated commercial issues, which have yet to be fully resolved, although I indicated positive progress in my initial answer. Latest estimates indicate that practical completion can be achieved by the end of 2016, with operations commencing in spring 2017, following a period of commissioning the new facility and transferring services to it.

The cabinet secretary will know that, back in May, NHS Lothian commissioned a paper to look at the option of staying on the current site at Sciennes. That site was rejected as not being fit for purpose for the Royal hospital for sick children in 2003. Does the progress that the cabinet secretary has indicated today mean that that is no longer an option, and can she guarantee that the new hospital will be built on the appropriate site at Little France?

I hope that Iain Gray will have taken that reassurance from my answer to Colin Beattie. NHS Lothian has been experiencing delays that are not of its making. It has been working extremely hard with the Scottish Futures Trust, with the Government’s help, where appropriate, to get over the delays. Continuing on the current site has never been NHS Lothian’s preferred option, but it is planning for contingencies, as all responsible health boards do. Let me make it absolutely clear that the new sick kids hospital on the new site is a commitment of the Government and NHS Lothian. I hope that Iain Gray takes heart from the progress report that I have given today. There is a 100 per cent commitment to see the hospital go ahead, see it built and see it deliver the quality services for children and young people across this part of Scotland that I am absolutely sure it will deliver.

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Dialysis Facilities (Rural Areas)

13. To ask the Scottish Government what plans it has to improve dialysis facilities for patients in rural areas. (S4O-01171)

All hospitals are aware of the need to provide dialysis services that respond to the needs of individual patients. Health boards have responded by developing satellite dialysis units where appropriate, so that as many people as possible get that form of renal replacement therapy near their home or place of work. There are now nine adult renal units and one paediatric renal unit in Scotland, which are complemented by 24 satellite dialysis units across the country.

The Scottish Government has also helped to fund the development of renal patientview, which allows individual patients electronic access to their treatment files, so that they can gain a better understanding of their condition and an opportunity to participate in decisions about the management of their care.

I am sure that the cabinet secretary is aware of the campaign to provide a dialysis facility in the Lorn and Islands district general hospital in Oban. Can she offer any hope for those who have campaigned for that facility for many years?

I thank Mike MacKenzie for raising an important issue. I completely understand the desire of people who require renal dialysis to have that as close to home as possible. Some people have to go through that procedure three or more times a week, every single week of their life, so if we can reduce the associated travelling, that incredibly disruptive impact on people’s lives will be minimised to some extent. I understand how important that is.

I am well aware of the calls for a renal dialysis unit in Oban. I recently had the opportunity, along with Mike Russell, to meet some of Mr Russell’s constituents from Taynuilt to hear their concerns at first hand. I was able to reassure them that NHS Highland is taking the issue very seriously.

The board is currently conducting a detailed review of renal services and has been working with local stakeholders to take the issues forward. The review is expected to conclude in September. I hope that Mike MacKenzie will rest assured that the board is committed to providing person-centred services that are safe, sustainable and delivered as locally as possible.

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Primary Care Facilities (NHS Lothian)

14. To ask the Scottish Government what new primary care facilities have been completed recently by NHS Lothian. (S4O-01172)

Most recently, the new £18 million Musselburgh primary care centre was completed on time at the end of April. On 6 June, I had the pleasure of officially opening the new £3 million Dalkeith health centre, which was also completed on time, in September 2011. Those new facilities ensure that service providers have modern, first-class facilities within which they can continue to deliver quality care to patients.

In a time of financial constraint, the Government is using every lever to maintain capital investment. A number of primary and community care facilities will be built in the following years with a value in excess of £200 million under the hub programme, which represents one of the largest ever investments of its kind in the national health service estate.

NHS Lothian has identified five primary care projects for delivery through revenue finance via the hub initiative. Those include Blackburn health centre, Firrhill, the north-west Edinburgh partnership centre, the Wester Hailes healthy living centre and Gullane surgery and day care centre.

Although I welcome those new facilities, there is increasing concern in the Oxgangs and Firrhill areas of my constituency that there has been no or little progress on the proposed Firrhill partnership centre project.

Can the cabinet secretary provide an update on the scheme and tell us whether a finalised business plan is in place and whether the commencement of the project is dependent on any other health proposals in the NHS Lothian area?

I appreciate Gordon MacDonald’s concern about the issue, and I am pleased to tell him that the Scottish Government approved the initial agreement for the Firrhill partnership centre project on 6 June. The project has been included in the pipeline for the south-east Scotland territory hub programme, and the Scottish Futures Trust has awarded £0.82 million in enabling moneys to facilitate its delivery. A programme will be developed by hubco following the issuing of the new project request, and it is anticipated that work will start on the site in 2015.

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Health and Social Care Integration (Highlands)

15. To ask the Scottish Government what progress has been made regarding the integration of health and social care in the Highlands. (S4O-01173)

On 1 April this year, Highland Council and NHS Highland transferred staff, resources and functions to enable the council to develop integrated children’s services across health, education and social care and to enable NHS Highland to develop integrated adult services across health and social care.

The early indications from Highland are that progress is positive and that staff are already seeing the benefits of integrated working.

Can the cabinet secretary advise me to what extent the Scottish Ambulance Service patient transport improvement plan 2012 had regard to the integration of health and social care in the Highlands?

The head of healthcare strategy for NHS Highland was a member of the Scottish Ambulance Service scheduled care board, which developed the service’s patient transport improvement programme 2012. At an operational level, the Scottish Ambulance Service is working in partnership with NHS Highland, Highland Council and the Highland and Islands transport partnership to develop an integrated transport model and to support the health and social care integration agenda in the Highlands.

A project manager has recently been appointed by Highland Council and NHS Highland to lead that work, which includes the development of an integrated transport hub for health and social care. I am sure that all the partners that are engaged in that work would be happy to brief John Finnie further on its progress.

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Follow-on Milk (Advertising)

16. To ask the Scottish Government what discussions it has had with the United Kingdom Government regarding the advertising of follow-on milk. (S4O-01174)

The Scottish Government has had no discussions with the UK Government specifically on the advertising of follow-on milk. The Food Standards Agency in Scotland has policy responsibility for the legislation that covers the advertising of follow-on formula, and it provides advice to the Scottish Government on those matters.

The minister will be aware that the World Health Organization’s “International Code of Marketing of Breast-milk Substitutes” recommends that there should be no commercial promotion of alternatives to breast milk. In Norway, where there is no such commercial promotion, 99 per cent of babies are breastfed at birth and more than 90 per cent are still breastfed at the age of four months. There is a feeling that allowing the promotion of follow-on milk clouds the judgment of mothers who may otherwise breastfeed their child and leads them to choose formula instead. Will the minister take that on board and meet me to discuss these matters further?

The legislation governing infant and follow-on formula is currently being reviewed by the European Union. The Food Standards Agency is in regular contact with the relevant departments at a UK level to reflect Scottish interests in the on-going discussions. We will consider anything that may emerge from that review process that we need to address here in Scotland.

The member requested a meeting to discuss the matter in more detail. I would be more than happy to arrange for such a meeting to take place, but some of the work that is being done at an EU level may assist in informing any discussion that takes place in due course.

Given the efforts of manufacturers to circumvent the law preventing the advertising of their artificial milk and their complete disregard for the principles of the Innocenti declaration and the international code, what action can the minister take to help to mitigate the damage of such advertising and to ensure—given that next week is national breastfeeding awareness week—that parents are in no doubt about the unique health benefits of breastfeeding?

The member will be aware that we have a range of provisions in place at health board level to encourage mothers to breastfeed. There is a range of programmes to support them in doing so.

I note the point that the member makes about advertising and the impact that it can have on people’s attitude to breastfeeding, which is why I think that the review that is taking place at an EU level will assist us in looking at whether there are further measures that we can take in Scotland to address some of the issues. Given that the member’s long-standing interest in the matter resulted in the passing in this place of legislation to support breastfeeding, it is extremely important that we do everything that we can to encourage mothers to breastfeed, when they wish to. As a Government, we are prepared to do that, in partnership with our local health boards, and to look at what the EU review comes up with, to see what further measures can be taken to address the issue.

Questions 17 and 18 have not been lodged, although the members have provided explanations.

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Post Mortems

19. To ask the Scottish Executive which national health service boards do not employ or contract pathologists in their own area who are qualified to conduct NHS or procurator fiscal post mortems. (S4O-01177)

That is a matter for NHS boards. The information requested is not held centrally by the Scottish Government.

Since the death of North Lanarkshire’s only specialist pathologist, all post mortems are now being dealt with in Glasgow. It has been reported that bereaved families in Lanarkshire now have to wait up to three weeks to bury their loved ones. That is a major concern for people at a very stressful time. Will the cabinet secretary please look at the situation with a view to ensuring that it is properly addressed?

I am aware of the unexpected death of the pathologist in Wishaw and the fact he has not been replaced. I am more than happy to convey John Pentland’s concerns directly to the health board, and I am sure that it would be happy to discuss the matter with him.

More generally, there will be reasons—I am not necessarily saying that this applies in the case in question—why it would not be cost efficient for a board to employ a pathologist solely to perform post mortems. One such reason would be that the number of cases was too small. In some cases, boards will put in place arrangements with other boards or with universities that can offer the service.

John Pentland is absolutely right about the importance to families of having post mortems carried out quickly. In relation to NHS post mortems, I am not aware of any problems nationally that are causing post mortems to be delayed. However, the majority of post mortems in Scotland are carried out under the instruction of a procurator fiscal. While they do that work as quickly as possible, on occasion there may be factors that have to be taken into account or stakeholder engagement that may need to take place, which may lead to some delay. I fully understand the importance and the sensitivity of the issue, and I am more than happy to have the health board concerned liaise directly with John Pentland on it.

We have time for question 20, but I ask Annabel Goldie and the cabinet secretary to be brief.

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General Practitioner Services (Internet Access)

20. To ask the Scottish Executive what plans it has to increase the provision of internet access to GP services. (S4O-01178)

In September 2011, we published the “eHealth Strategy for NHS Scotland 2011-2017”. One of its strategic objectives is to support people in all forms of communication that they have with the national health service in Scotland to help them to manage their own care, but also to promote ease of communication. Work is under way on both the e-health strategy and the associated action plan, which will be in place by March 2014. One of the areas in which improvements will be made is the provision of internet access to GP services.

By 2015, patients in England will be able to book GP appointments, obtain repeat prescriptions, procure their test results and access their medical records online. It all sounds absolutely marvellous. When will that facility be available to patients in Scotland?

As Scottish health secretary, I am not completely au fait with the situation in England. Annabel Goldie will bear that in mind as I answer her question. I also note that, often, what we read in the headlines about developments in England or elsewhere does not reflect the reality.

I say to Annabel Goldie in all sincerity that Scotland has a well-deserved international reputation for e-health, but she is absolutely right: we have to ensure that the way in which we deliver services keeps pace with technology. Recently—although I say that, it was probably not as recently as it seems in my memory—I visited my old GP practice in Irvine, and it was piloting the very service that Annabel Goldie talks about, which enables people to access services online. I am absolutely committed to our getting more of that in more GP practices across the country as quickly as possible.