Health, Wellbeing and Cities Strategy
Naloxone
Prior to the launch of Scotland’s national naloxone programme in June 2011, the numbers of naloxone kits that had been issued and lives saved as a result were not collected. As a Government, we have commissioned the national health service Information Services Division to collect data on all the kits issued as a result of Scotland’s take-home naloxone programme. There are plans to publish the information in June, and it will cover the period from April 2011 to March 2012.
I thank the minister for his reply. Has consideration been given to extending the range of people who are trained in the use of naloxone—in particular, police officers?
The intention is that the programme reach as widely and appropriately as possible, to both specialist and non-specialist health staff. Naloxone training and awareness sessions have already been delivered to prison staff, homelessness services, carers organisations, family and community groups, and staff in Social Care and Social Work Improvement Scotland. We have also had awareness sessions delivered through police forces and at the Scottish Police College at Tulliallan. The Scottish Crime and Drug Enforcement Agency is a member of the Scottish naloxone advisory group and of the national forum for drug-related deaths, and we continue to have dialogue on what further measures we can take to ensure that the police are aware of the role that naloxone can play.
Eating Disorders Awareness Week
I thank the member for his question. I was delighted to participate in his members’ business debate yesterday, which assisted us in placing greater focus on some of the issues of concern in eating disorders awareness week. I also had the pleasure on Tuesday of attending, at the City Art Centre in Edinburgh, the launch of a photographic exhibition demonstrating some of the experiences that young people have had while recovering from eating disorders. The “Re-capture” exhibition will be moved to a variety of locations in Scotland to try to ensure that the issue is as widely recognised as possible, and it will be here in Parliament next week. We are also considering whether we can assist in making the exhibition part of Scotland’s mental health arts and film festival later this year.
I thank the minister for his response. What further steps can the Government take to raise among general practitioners and medical students awareness of eating disorders, including through training programmes, and to ensure that the matter is higher on their agendas?
That was touched on in yesterday’s members’ business debate. We have NHS Scotland’s eating disorders education and training initiative, but I am more than happy to consider whether we can take further action to encourage medical and associated healthcare professionals to participate in it. Such education and training would increase their awareness and understanding of eating disorders, and ensure that when someone made their first point of contact with the services the disorder was identified as early as possible and they were referred to the care setting that would be most appropriate for the support and assistance that they require. I am more than happy to keep the member informed of our progress on that.
To follow on from that and from Dennis Robertson’s experience of the available service, I note from paragraphs 94 to 97 inclusive in the summary of the then Health Committee’s “5th Report, 2005 (Session 2): Eating Disorders Inquiry” that there are specific recommendations to Government and the Royal College of General Practitioners on GP training. Will the minister either advise me of progress on that or push such training forward?
I am aware of the report to which Nanette Milne refers. Her former colleague David Davidson was instrumental in consideration of the matter in a previous session of Parliament. Given the nature of the recommendations in the report, if it would be helpful I would be more than happy to write to the member detailing what progress has been made on each of the areas that are the responsibility of the Scottish Government.
Deaf and Hard-of-hearing People (Scottish Borders) (Support)
The Scottish Government works with a number of organisations to raise awareness of issues that affect the deaf community, to ensure that the views of deaf people are heard, to reduce barriers to inclusion for deaf people and to bring about an improvement in service planning and delivery.
A number of my constituents who are deaf and hard of hearing have contacted me about the difficulties that they have experienced when they need to contact emergency services and their general practitioners. Many local health services rely on text phones to solve that problem. Such phones cost in excess of £100, so residents often prefer to use text messaging on their mobile phones. However, none of the emergency services and few health centres offer that facility. Is the minister aware of such initiatives? What can be done to encourage use of text messaging from health services to deaf and hard-of-hearing people?
I recognise the issue. It is extremely important that, within the national health service in Scotland overall, we look at how we can continue to enable the public to contact the NHS in ways that are most appropriate to them and which reduce potential barriers that they may face because of disabilities. We are in the process of developing a national strategy covering a range of electronic contacts with individuals in the NHS, which would address the very issue that the member has raised. As part of that national strategy, we are looking at the various modes and methods that people could use to access the NHS in Scotland. Contact has already been made with BSL group users and an official will be inviting the Borders deaf and hard of hearing network to provide its views as we develop the strategy.
I welcome the support that the Scottish Government provides to deaf and hard-of-hearing people.
I would be more than happy to meet Jim Eadie and the organisation to which he referred.
Neurological Health Services (Clinical Standards)
It is a priority for the Scottish Government to ensure that the neurological standards are implemented, because they offer the best mechanism for achieving safe, effective and person-centred care. We have provided boards with £1.2 million to develop local neurological service improvement groups as the main vehicles for implementing the standards. Boards have already completed an assessment of their progress on the generic standards and are now conducting a peer-review evaluation, including an evaluation of the agreed multiple sclerosis standard, to gauge their progress. The findings from the peer review will be published in June and will be used by boards to inform their local neurological service improvement plans.
I thank the cabinet secretary for her helpful answer. I understand that the prevalence of multiple sclerosis in the Borders is higher than the national average but that, at present, there is no specialist neurological consultant provision for patients with the condition in the NHS Borders area. I respect the autonomy of NHS boards to make clinical decisions, but will the cabinet secretary clarify the Scottish Government’s expectations on the availability of dedicated specialist consultant provision in rural areas such as the Borders?
Paul Wheelhouse raises an important point about the prevalence of multiple sclerosis, which is higher in Scotland than it is in many other parts of the world. Within Scotland, there are areas of particularly high prevalence; as Paul Wheelhouse pointed out, that is the case in the Borders.
NHS Dumfries and Galloway (Backlog Maintenance Risk Profile)
The “State of the NHSScotland Estate 2011” report is the first survey of the NHS Scotland estate since 2000 and the most comprehensive ever undertaken. The report gives a snapshot of the position at the time when the data for the report were collated, as well as a clear foundation on which to build and to measure progress.
The cabinet secretary will be aware that more than 50 per cent of the backlog maintenance in NHS Dumfries and Galloway is in the “high risk” and “significant risk” categories and that NHS Dumfries and Galloway has the highest backlog maintenance cost per square metre of any board in Scotland. I am aware of the plans for the new Dumfries and Galloway royal infirmary, but it is anticipated that the new hospital will not be completed before 2016-17. Is the cabinet secretary confident that the current facilities will remain fit for purpose until the new hospital is in operation? I seek her reassurance that the statistics pose no threat to community facilities in the region, such as cottage hospitals.
It is the responsibility of every health board in Scotland to ensure good quality services for the patients whom they exist to serve, and to ensure patient safety. I expect that of NHS Dumfries and Galloway, just as I expect it of every health board. I am well aware of the contents of the state of the estate report and I do not underestimate the challenges that are presented in it.
I welcome the survey that the cabinet secretary mentioned. The backlog of maintenance in Dumfries and Galloway is £58 million, but NHS Greater Glasgow and Clyde’s backlog is £175 million, which includes the £27 million of work that is required at the Vale of Leven hospital, the £18 million that is required at the Royal Alexandra hospital and the £17 million that needs to be spent at Inverclyde royal hospital. What steps is the cabinet secretary taking to address the backlog? What is the likely timescale for dealing with the backlog in NHS Greater Glasgow and Clyde and, in reference to the original question, in NHS Dumfries and Galloway?
I am sure that Jackie Baillie will be popular with the colleague who will ask specifically about NHS Greater Glasgow and Clyde later.
Question 6 has been withdrawn for what I hope are understandable reasons.
Cancer Prevention (Lifestyle and Environmental Risks)
Trends and scientific evidence suggest that lifestyle factors such as smoking, poor diet, low physical activity, obesity and excess alcohol consumption can all increase a person’s risk of getting cancer. To tackle those issues, we have implemented a framework for action on changing Scotland’s relationship with alcohol, together with a comprehensive package of measures to prevent smoking uptake and to help smokers to quit, as well as taking action on healthy eating and increased physical activity.
I thank the minister for the actions that are being taken.
I assure the member that we consider all the necessary appropriate scientific data in relation to risk factors in development of cancers. We believe that the balance that we have struck appropriately addresses the scientific evidence to date.
Neurological Health Services (Clinical Standards) (Monitoring)
As I said in response to Paul Wheelhouse, we are determined to ensure that the neurological standards are implemented. Healthcare Improvement Scotland is actively supporting boards in implementing the standards and has been closely monitoring their progress. Of course, from April 2012, it will be for NHS boards to decide how to implement the standards to reflect local priorities. I expect NHS boards to continue their improvement work to ensure that people who are living with neurological conditions receive the care and support that they need and deserve.
I thank the cabinet secretary for that answer and for her detailed answer to Paul Wheelhouse. We all recognise the recent progress that has been made with the implementation programme, but the cabinet secretary will know about the concerns of several organisations that work in neurological health about what will happen in the future. She referred to a peer review that is being conducted, but will peer reviews be conducted subsequently? I suppose that that relates to a more general issue about the role of Healthcare Improvement Scotland, which has done great improvement work in neurological standards. Will it have a continuing scrutiny role in their implementation?
I thank Malcolm Chisholm for a valid and legitimate question. As part of the peer-review evaluation, Healthcare Improvement Scotland will be looking for boards to evidence their linkages to planning services in their three-year plans. Following publication of the peer review report in June, Healthcare Improvement Scotland expects boards to put in place action plans to ensure the sustainability of improvements and to ensure that they continue well beyond the end of the programme. I assure Malcolm Chisholm that, although the implementation programme will end in March, there will be no let up in ensuring that health boards continue to deliver improvements. As I said in response to Paul Wheelhouse, through the normal performance-management processes, we will ensure that those improvements continue, and I am more than happy to keep interested members up to date and to hear from them at any time if they have any concerns about their NHS areas.
NHS Ayrshire and Arran (Meetings)
Ministers and Government officials regularly meet representatives of all NHS boards and discuss issues of importance to local people. I spoke to the chair of NHS Ayrshire and Arran by telephone yesterday.
I will follow up on that telephone conversation.
I thank Adam Ingram for his question and for the close and diligent interest that he takes in all matters relating to NHS Ayrshire and Arran. I should also mention the close interest in this issue that is being taken by the Deputy Presiding Officer. I would be very happy to meet Adam Ingram and his constituent Rab Wilson, and I am more than happy to ensure that my office sets up that meeting as quickly as possible.
I note what the cabinet secretary said about patient safety. The matters that were touched on by Mr Ingram, and earlier by Mr Scott at First Minister’s question time, are clearly of the utmost seriousness.
I will act on any findings or recommendations from the inquiry.
The cabinet secretary might remember that I wrote to her on 1 February expressing concerns about the lack of representation from East Ayrshire Council on the board of NHS Ayrshire and Arran, and I recorded that the council representative had been absent through disqualification since December last year. Does she agree that events at the board show the need for effective governance, and that East Ayrshire Council would do well to reconsider its current situation, whereby it has no representation on the board of that important body?
I recall Graeme Pearson’s letter, and I know that I replied to it. I do not have the text of my reply in front of me, so I apologise in advance if I get any of the details wrong, but my recollection is—Graeme Pearson’s question indicates that it is correct—that East Ayrshire Council took the decision not to fill its place on NHS Ayrshire and Arran until after the local authority elections in May. It is not for me to tell a local authority what to do in that regard but—notwithstanding the position in respect of the local authority member—I hope that Graeme Pearson and all members are assured that the board of NHS Ayrshire and Arran, the Government and I take these matters seriously and that action is being taken to ensure that deficiencies that existed in the past are being fully rectified.
Individual Patient Treatment Request Process (Review)
National health service boards are expected to maintain an overview of the effectiveness of their local arrangements for the introduction of new medicines, including board management of individual patient treatment requests. Boards were reminded of their responsibilities in that regard in additional guidance that was published on 13 February. It clarifies that NHS board clinicians, as a matter of good practice, should use peer support to sense-check their individual patient treatment applications, and that panels should include a practising medical consultant who has, or who has access to, specialist knowledge of the relevant clinical area. The guidance reflects recommendations that emanated from a clinically led short-life working group to consider the safe and effective use of new medicines.
I am encouraged to hear that guidance has been recirculated.
I am grateful to Ken Macintosh for organising the meeting with the PNH alliance; I am actively considering the issues that the group raised.
The cabinet secretary is aware that we very much welcomed the new system that was brought in to be Scotland’s answer to dealing with the issues—I realise how difficult they are.
We are gathering national data, which I think will be useful in ensuring that there is equity across the country. Decisions come down to local decision making—that is inevitable—but I want to be assured, as does everyone, that systems are working as equitably as possible.
Tackling Poverty
We report progress on tackling poverty in the national performance framework and in the annual “Poverty and income inequality in Scotland” publication. The most recent figures, for 2009-10, show that the overall poverty level is unchanged at 17 per cent, although that figure is too high.
The minister will be aware that I have asked the Scottish Government and the First Minister on a number of occasions about the tackling poverty board and the role that it plays. I cannot understand why that board has not been meeting regularly; I understand that its last meeting was on 13 April last year. It could have a role in monitoring the progress of the Scottish Government’s achieving our potential strategy, given the change in economic circumstances since the strategy was agreed. Can the minister confirm whether the board has met more recently than 13 April last year? Are there any plans to arrange a meeting?
We intend to publish in the next few weeks our first annual report on the child poverty element of our overall strategy on tackling poverty in Scotland. We have given a commitment to consider, following that report’s publication, the further measures that we must put in place to continue to address poverty.
Although I have some sympathy with the minister’s last point, one thing that we can do now is provide advice services, which are crucial for people who are facing poverty.
It is not necessarily for me to comment on the “shambles” in which Glasgow City Council seems to find itself not only in relation to money advice services and information advice services, but in its own chambers. However, I am happy to confirm that, as a Government, we continue to provide support to organisations such as Citizens Advice Scotland and Money Advice Scotland so that they can carry out their important work in helping to minimise people’s risk of falling into poverty, maximise benefits and provide people with debt information.
Scottish Care Information Gateway
The Scottish care information gateway was designed to support electronic referrals between general practice and consultant-led services. It is a Scottish success story that has been adopted by colleagues in Wales and Northern Ireland. By the end of 2011, 98 per cent of all general practitioner referrals to national health service hospitals were received through the SCI gateway. Access to the SCI gateway referral pathway for other services is an operational matter for NHS boards.
Midlothian Physiotherapy in my constituency has been attempting to gain access to the SCI gateway referral pathway for more than 18 months, but has made extremely slow progress, to the frustration of all those involved. Does the minister agree that quicker action must be taken to ensure that local practices become part of the referral system?
I am very sympathetic to the thrust of Colin Beattie’s question. As I said in my original answer, the gateway system is designed to facilitate referrals from GPs to NHS hospitals. However, if a board has an operational requirement that would make using the gateway for referrals to non-NHS contractors desirable, it can arrange that, subject to suitable cost and information-governance arrangements.
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