SCOTTISH EXECUTIVE
Health and Wellbeing
National Health Service (Consultations)
To ask the Scottish Executive whether it considers it acceptable for an NHS board to dispense with public consultation when considering a reconfiguration of services provided by external providers. (S3O-7948)
Health boards throughout Scotland are fully committed to involving the public in the configuration of health care services. Boards continue to work closely with the Scottish health council and local public partnership forums to ensure that the public's views are taken into account.
I am sure that, in the generality, that is absolutely true. However, the cabinet secretary will be aware that, in 2000, the then Greater Glasgow Health Board consulted on the closure of Blawarthill hospital. As a consequence of the consultation, the board decided not to close the hospital, but it produced plans that had a material effect on service provision at St Margaret of Scotland Hospice. I am grateful to the cabinet secretary for ensuring that I received a copy of a letter from Greater Glasgow and Clyde NHS Board, setting out the reasons for those plans. The letter states that the board did not consider it necessary to consult on them because the service was provided by an external provider.
I acknowledge Ross Finnie's interest in the issue, and that of other members. My views on public consultation when major service change is contemplated in the NHS are well known.
As someone who has been involved in many consultations with Greater Glasgow and Clyde NHS Board in which the original proposal was what we ended up with, I ask the cabinet secretary whether the advent of directly elected health boards will go some way to improving the situation regarding Blawarthill that Mr Finnie mentions and perhaps other such situations.
Sandra White and other members will be aware that I am a believer in the principle of direct elections to health boards. I believe that it is right to involve the public in decisions in our biggest public service in that way. That is why, with the consent of the Parliament, next year we will pilot direct elections to Dumfries and Galloway NHS Board and Fife NHS Board, with alternative pilots in two other boards. I look forward to the results of those pilots. If they are as positive as I hope they will be, I am sure that the approach will provide a positive way of proceeding in other NHS boards, including Greater Glasgow and Clyde NHS Board.
I am sure that the cabinet secretary regrets that she was not able to attend the conference at St Margaret's hospice yesterday. Does she accept that not only in the 2000 consultation on Blawarthill but in the 2004-05 consultation on the future of elderly care, St Margaret's was not notified that any decision that might be taken would affect it and that the impact on St Margaret's became apparent only at a later stage? Does the cabinet secretary agree that it would be helpful if the health board had more constructive, positive and regular dialogue with St Margaret's than seems to happen at present?
I am more than happy to take on board Des McNulty's points about both 2000 and 2004-05. With the best will in the world, I cannot rewrite history or turn back the clock to times when I was not in this job and the current Government was not in office. However, I can continue to encourage Greater Glasgow and Clyde NHS Board to have a positive and, I hope, constructive dialogue with St Margaret's hospice to try to find a solution and outcome acceptable to the health board, which has a responsibility to commission services that it needs for its population, and the board of St Margaret's. I certainly encourage Greater Glasgow and Clyde NHS Board to continue to do that, and I encourage the board of St Margaret's hospice to enter into that dialogue constructively. I remain optimistic that, if both sides proceed in that manner, a mutually satisfactory outcome can be reached.
Adults with Incapacity (Scotland) Act 2000 (Consultation)
To ask the Scottish Executive what organisations it consulted before changing the code of practice in relation to part 5 of the Adults with Incapacity (Scotland) Act 2000 and whether those are the same organisations that it consulted when the original code of practice was drawn up. (S3O-7930)
The code of practice in relation to part 5 of the Adults with Incapacity (Scotland) Act 2000 has been reviewed on numerous occasions since it was introduced in May 2002. The current version of the code was informed by a far-reaching consultation started under the previous Administration and concluded under the current one. The revised code was laid before the Scottish Parliament for 21 days between December 2007 and January 2008 before its introduction in March 2008.
I would like to thank the cabinet secretary for her response, but I am not sure that I can, given that a number of organisations, especially the Catholic Church and the care not killing alliance, were not included in that consultation, even though they were in the original consultation.
I recall that debate and the vote. I think that I also recall that the previous Administration voted against that particular amendment.
In the light of the comments that the cabinet secretary has just made and the view south of the border—guidance has now been opened to consultation by the Director of Public Prosecutions—does she agree with me and some others that there is a case for a review of the guidance around the operation of the Adults with Incapacity (Scotland) Act 2000 and for the guidance on factors that would be taken into consideration by prosecutors in Scotland in relation to end-of-life issues?
I know that Jeremy Purvis has a particular and long-standing interest in this issue, as do many others. I am sure that he will appreciate that issues about guidance to prosecutors on the factors that may or may not be taken into account in determining whether a prosecution takes place are rightly and entirely matters for the law officers. The Lord Advocate made her position clear yesterday when she outlined that, given the differences between the legal position north and south of the border, particularly the fact that in Scotland there is no statutory offence of assisted suicide, she did not consider it appropriate to issue similar guidelines to those in England and Wales. That matter is entirely for the judgment of the Lord Advocate.
Disability Organisations (Meetings)
To ask the Scottish Executive when the Minister for Housing and Communities last met disability organisations and what issues were discussed. (S3O-7923)
I met the independent living in Scotland steering group on Wednesday 9 September 2009. The group comprises disabled people from a range of disability organisations including Inclusion Scotland, the Glasgow Centre for Inclusive Living, Deafblind Scotland and many others. The main issue discussed was the Scottish Government's approach to independent living, which we are developing in partnership with disabled people.
When the minister met those groups, did he discuss the issue of the employment and training of people with disabilities, which is obviously critical to the capacity of many to live independently? Given the low level of employment of disabled people, coupled with the fact that in the 15 per cent most deprived communities the number of young people not in education, employment or training is more than twice the Scottish average, what specific actions will the minister, as the equalities minister, take to monitor the budgets of his finance, enterprise and education ministers to ensure that they address the needs of disabled workers? What discussion has he had with officials involved in public procurement to encourage them to follow article 19 of the European Union directive to encourage contracts to be awarded to sheltered workshops?
I share Johann Lamont's concern about the level of employment of people with disabilities. In Scotland, the level is around 48 per cent of the adult population, compared with a level of employment of just under 80 per cent for the adult population as a whole. The employment level of disabled people with learning difficulties is only 18 per cent, which is unacceptably low.
Has the minister had any discussions with disability groups on taxi transport for wheelchair users? Is he aware that Glasgow City Council's licensing committee yesterday agreed to license a rear-door entry and exit vehicle for use by private hire companies. Does he share my deep concerns about that decision, given that the application for the licence was made by Network Private Hire, a company that many people, including the police, have expressed concern about; that wheelchair users will have to enter and exit the vehicle from the public road; and that in the event of an accident involving a rear shunt there will be no means of escape for the disabled person?
I cannot comment on the individual licence application or the licensee, but I share a general concern that any vehicle used for the taxiing of disabled people should be appropriately designed. If that is not the case, I am happy to discuss it with the appropriate authorities to see whether there is a need to raise the issue with the council and the licensee.
Is the minister aware of the excellent work of Highland Disabled Ramblers? Access to public footpaths is a key issue for that group. What can the minister do to ensure that the interests of disabled ramblers who use scooters as well as the interests of able-bodied ramblers are considered when new footpaths are constructed?
I am not particularly au fait with that issue, but I am willing to take a briefing on it from Jamie McGrigor because it is a serious matter that should receive the appropriate attention. If the minister sends me an appropriate briefing—[Interruption.] I am sorry—I meant the prospective or shadow minister. If he and the ramblers send me an appropriate briefing, I will be more than happy to take the matter up with our friends in the Convention of Scottish Local Authorities to find out whether there is more that we can do between us.
National Health Service (Funding)
To ask the Scottish Executive what funding mechanisms are available to NHS Lothian for the development of new surgical techniques. (S3O-7953)
The principal funding source for new developments is the general allocation made by the Scottish Government to national health service boards. NHS Lothian's allocation in 2009-10 is £1.147 billion. In addition, surgical teams that are developing new techniques may be able to access funding through regional cost-sharing arrangements that have been agreed by regional planning groups, as a designated national service, or through a research project or clinical trial.
Until a few months ago, all hysterectomies for endometrial cancer at Edinburgh royal infirmary were performed through abdominal incisions, but a surgical team now performs those operations laparoscopically—in other words, it uses keyhole surgery. Patients who benefit from that keyhole technique are now discharged home the following day instead of spending up to a week in hospital. Will the cabinet secretary agree to discuss with NHS Lothian Scottish Government funding for that innovative new project? I understand that the project is new in Scotland and that the royal infirmary in Edinburgh is the only hospital in Scotland that performs the new procedure. Is the cabinet secretary willing to meet the surgical team to discuss the project and perhaps to view a procedure first hand?
I am always happy to meet teams of people who do fantastic work in the NHS. That applies to the surgical team in question.
Convention of Scottish Local Authorities (Personal Care Services)
To ask the Scottish Executive what recent discussions it has had with COSLA regarding the provision and funding of personal care services. (S3O-7894)
The Scottish Government is in regular contact with the COSLA through a series of working groups to improve the clarity and strategic implementation of the free personal and nursing care policy. Some £40 million in additional funding has been provided to local authorities from 1 April to deliver a package of measures to stabilise the policy in the immediate term.
Is the minister aware that COSLA has so far failed to respond to my inquiries about the action that it and its member councils are taking to deal with the implications of the judgment in the case of Boath v Perth and Kinross Council as regards meal preparation and free personal care? Coupled with the laissez-faire attitude of her Government, that means that no concerted attempt is being made to refund the thousands of Scottish pensioners who were illegally charged for assistance with meal preparation prior to April this year, when the new regulations came into force. Is there a COSLA working group, on which the Scottish Executive is represented, looking into the issue? Will the minister advise COSLA and the councils concerned that it is about time that they faced up to their responsibilities and stopped treating our older people in such a shabby manner?
On the issue of refunds, the cabinet secretary made it clear to the Parliament on 7 May last year that our intention was to introduce revised legislation to clarify the issue of charging for food preparation from April 2009. That is exactly what we did.
It is extremely disappointing that the Scottish Government is forced to fund the £40 million shortfall in its free personal care budget that is caused by Westminster's continued withholding of the attendance allowance. I hope that the minister and her colleague the Cabinet Secretary for Health and Wellbeing will not be put off by that. Will they continue to engage, perhaps with a future Administration at Westminster, to recover the money and put it to good and useful work in Scotland?
I assure Gil Paterson that we continue to raise concerns on the attendance allowance with the United Kingdom Government. We still believe that the money belongs to Scotland—to our older people—and that it should never have been removed from Scotland. Given that the UK Government has published a green paper on the future of social care and benefits such as the attendance allowance, changes to which will have major implications in Scotland, we will take the opportunity to continue to press it on the issue.
Question 6 is withdrawn.
In Vitro Fertilisation Treatment <br />(Waiting Time Guarantee)
To ask the Scottish Executive whether in vitro fertilisation treatment will be subject to a waiting time guarantee. (S3O-7904)
It is not currently possible to have a waiting time guarantee for IVF as national health service boards do not report this information to the Information Services Division as the patient data belong to the Human Fertilisation and Embryology Authority. Scottish Government officials are in preliminary discussions with colleagues in the ISD to consider whether it is possible to develop definitions and data to enable the reporting of patient access to infertility services without breaching Human Fertilisation and Embryology Authority guidelines.
I welcome the minister's response and recognise her commitment to tackling waiting times for IVF treatment. However, it remains the case that waiting times are a challenge for many of our constituents. Given that many couples in the NHS Greater Glasgow and Clyde area still face a wait of at least two years, does she agree that setting a waiting time guarantee would improve matters by focusing attention on the issue? How long will it be before we know whether such a guarantee can be given?
The issue is a long-standing one. The Government has begun to take action for the first time on waiting times for IVF treatment. I believe that NHS boards are always looking for ways to reduce waiting times in this area. For example, NHS Greater Glasgow and Clyde has reduced the waiting time between referral and the first out-patient appointment from approximately one year to six months. We should welcome that progress. There is more work to be done. We expect that the work that the Infertility Network Scotland is undertaking on behalf of the Government will help to address the complex and long-standing issues that are involved in waiting times for IVF treatment.
In response to Helen Eadie's recent members' business debate on infertility treatment, the minister stated:
I recognise that there is a mixed picture across Scotland. Some boards, including NHS Borders, NHS Dumfries and Galloway and NHS Lanarkshire, have invested to reduce waiting times. In our work with the Infertility Network Scotland, we are focusing on the boards with the longest waiting times in order to ensure that there is a reduction in waiting times in those areas. In response to Jackie Baillie's question, I underlined some of the complexities of developing a waiting time target in future, but we will keep the matter under consideration.
Given that waiting times across health boards in Scotland are two, sometimes three, years, what is the minister's view of couples being required to pay £900 for their drugs prescription because they have been compelled to seek private treatment? Does the denial of such treatment in the NHS constitute a breach of the right to treatment under the European convention on human rights?
No more than it would have when Helen Eadie's party was in government, I suspect. These are long-standing issues; I am sure that Helen Eadie has raised them over a number of years. However, the Government has begun to make the area a priority for the first time. I have no evidence to suggest that that was done previously, but I am sure that Helen Eadie will correct me if I am wrong. That cannot be achieved overnight—it will take time—but the measures that we are putting in place, which I outlined in answer to the two previous questions, are the right way forward and will deliver results in Helen Eadie's area and elsewhere.
NHS Fife (General Practitioner Practices)
To ask the Scottish Executive what recent discussions it has had with NHS Fife regarding GP practices. (S3O-7961)
We have on-going dialogue with every health board in Scotland, including NHS Fife.
The cabinet secretary will recall that, before she opened the new St Andrews community hospital on Tuesday, she had to face a demonstration by irate patients of dispensing doctors in Balmullo and Leuchars. They were complaining about the lack of consultation in relation to a planned community pharmacy for Leuchars that could affect the excellent service that they receive from their local dispensing doctors. Given that 60 per cent of the local GPs' remuneration comes from dispensing, will the cabinet secretary intervene with NHS Fife to resolve the dispute, as the new pharmacy application is virtually identical to one that was rejected less than six months ago?
My recollection of Tuesday is slightly different from Ted Brocklebank's. I remember having a nice discussion with some nice people from Leuchars and Balmullo and complimenting them—as I am sure all members will—on taking the time to make me aware of the strength of their feelings on the issue. I am grateful to them for doing that. I took the opportunity to explain to them—Ted Brocklebank may be aware of this, because he was listening in at the time—that, as a general rule, the Scottish Government sees it as desirable that, where possible, patients should have access to the wider range of pharmaceutical services that can be delivered through a community pharmacy. Where that is not possible, national health service boards can require GP practices to dispense. However, as a rule, the income from dispensing should be used to cover dispensing and not to cross-subsidise other parts of a GP's service.
Is the cabinet secretary aware that Glenwood health centre in Glenrothes was deemed unfit for purpose as far back as 2000? I raised the issue with her last year, when I expressed concern about the timescale for rebuilding Glenwood, and have done so repeatedly with NHS Fife. Is she aware that the timescale has slipped yet again, with building work now not expected to be completed until late 2011? Will she raise the issue with NHS Fife at the earliest opportunity?
I commend Tricia Marwick for her attention to the issue on behalf of her constituents; she has raised it on a number of occasions. The member will be aware that, fundamentally, this is a matter for NHS Fife, which receives funding from the Scottish Government to cover various items of expenditure, including primary care premises costs. This year, £7.2 million, including £3.4 million for premises, has been allocated to NHS Fife under that funding stream.
In light of the low rate of response by general practitioners in Fife when it comes to joining the new extended hours contract, which improves access for patients, what further steps is the cabinet secretary taking to ensure equal access by all patients across Scotland?
I can tell Richard Simpson and the Parliament that 49 per cent of practices in Fife have signed up to extended hours. That is lower than the Scottish national average of 66 per cent. I encourage GP practices, not just in Fife but throughout Scotland, that have not yet signed up to providing that service to patients to do so, as it is desirable for patients to have flexibility of access to GP services. Where they have it, patients appreciate it. I hope that Richard Simpson and other members will send similar encouraging messages.
Question 9 was withdrawn.
Private Rented Housing (Regulation)
To ask the Scottish Executive what changes it intends to make to the regulation of private rented housing in its forthcoming housing bill. (S3O-7946)
The draft housing (Scotland) bill, on which consultation has taken place, deals primarily with social housing issues. We are consulting until 27 September on proposals relating to private housing that might be included in the bill when it is introduced. Four of those relate to possible ways of strengthening landlord registration, and two to the licensing of houses in multiple occupation.
I look forward to seeing the detail when the bill is finally introduced. I ask the minister to go further and to look again at proposals that I lodged and discussed in committee during consideration of the previous Housing (Scotland) Bill in 2005 to introduce stronger enforcement of management standards—landlord standards—so that, in areas such as Govanhill in my region, where a chronic problem has developed, people have better access to the enforcement of basic minimum standards from their landlords, without having to access the courts. Will the minister look at those proposals and maintain an open mind about debating similar options for the forthcoming bill?
I always maintain an open mind. We will be considering landlord registration in the context of the housing bill, with stronger powers for local authorities in obtaining information, higher maximum fines, more information for the public with regard to the landlord register and the power to charge a fee for adding an unregistered agent to a registration. We also intend to review the operation of the landlord registration scheme in 2010. That will inform us as to any additional powers that we require to take to ensure that rogue landlords are dealt with sufficiently.
National Health Service<br />(Older and Disabled People)
To ask the Scottish Executive what action it has taken to support the needs of older and disabled people arriving at hospital and other NHS facilities. (S3O-7958)
NHS Scotland, as a provider of services, is subject to equality legislation, which requires the provision of services that are accessible to everyone. Guidance entitled "Achieving fair access" has been produced for health boards regarding the implementation of part 3 of the Disability Discrimination Act 1995, which requires service providers to make reasonable adjustments for disabled people in accessing goods, facilities, services and premises.
My concern on the issue follows from a recent constituency case. Does the minister recognise that access to national health service facilities can be challenging for many elderly and disabled people? Does she accept that, particularly when arriving at large hospitals such as Aberdeen royal infirmary—whether by car or by public transport—patients can face a long and difficult walk to the appropriate ward or clinic, especially in poor weather? Does she accept that such problems can be made worse by new hospital traffic management initiatives? Does she agree that access arrangements can be confusing, difficult and, at times, dangerous for a number of patients? Covered walkways, improved signposting and better drop-off areas would make a big difference. Will the minister ask health boards and hospitals to review their arrangements and to do everything possible to make the arrival at hospital of elderly and disabled patients safer and less stressful?
I understand that brief guidance is issued with out-patient appointment cards, and that the NHS Grampian website provides advice on parking at the Aberdeen royal infirmary site, which includes details of drop-off points and parking for people who have disabilities and provides the telephone number of the hospital concourse reception for anyone who needs advice on access to the hospital by car.
Proposed National Centre for Asbestos-related Diseases
To ask the Scottish Executive whether it has had any involvement in the plans to develop a national centre for asbestos-related diseases. (S3O-7937)
The Government has not been involved in discussions about the development of a national centre for asbestos-related diseases. However, the Scottish Parliament has passed two groundbreaking pieces of legislation on asbestos-related damages claims, to ensure that individuals can hold to account and seek compensation from those who have negligently exposed them to asbestos.
I thank the cabinet secretary for highlighting those pieces of legislation. We are all proud of what the Scottish Parliament achieved on asbestos-related illness, particularly in relation to damages.
I acknowledge John Park's personal and constituency interest in the issue. I have a constituency shipbuilding interest of my own, so I am well aware of the importance of the issues.
Audiology Modernisation Programme
To ask the Scottish Executive what progress is being made in its audiology modernisation programme. (S3O-7927)
The audiology modernisation programme is delivering significant improvements to patients. All national health service boards can now fit digital hearing aids as standard. Central investment, which totals £19 million, has improved the equipment, infrastructure, staffing levels and training of staff throughout Scotland to deliver that service. All NHS boards are working towards meeting the 18-week referral-to-fitting target by 2011 and it is anticipated that they will meet the target. The current status will be published on the Information Services Division website in November 2009.
I thank the minister for outlining the progress that has been made. As the minister knows, universal hearing screening for newborns has resulted in hearing loss being diagnosed earlier than ever before. In consequence, there is more pressure on the support services on which deaf children and their families rely.
I commend the work of the NDCS. Much good work is going on in adult and paediatric audiology and we are reaping the benefits of investment and the hard efforts of people on the front line. I am happy to provide that assurance and to discuss the detail of the issue with the member, if he wants me to do so.
It may seem obvious, but does the minister share the concerns of constituents of mine who have difficulty accessing the audiology service because of a lack of textphone technology or other aids to allow patients the required clarity of assistance within hospital and in making appointments? What is the Government doing to ensure not only that the services are of the best quality but that patients are able to access the advice and assistance in the first place?
I understand the point that Jeremy Purvis makes. We hope that health boards and providers of public services in general look to remove any barriers to communication whatever they may be. The NHS has put a lot of effort into doing so, but there is certainly more work to be done. Sometimes, it is simple things, such as putting a bit of thought into appointments and general communication. With a bit of thought, things can be achieved that make it much easier for patients.
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