SCOTTISH EXECUTIVE
Health and Wellbeing
Ambulances (Journey Distances)
To ask the Scottish Executive what assessment it has made of the safety of ambulance journey distances. (S3O-3893)
Getting to patients quickly and providing the appropriate treatment at scene are the most important objectives for the Scottish Ambulance Service as it strives to improve the clinical outcomes for patients. More generally, the Scottish Ambulance Service also recognises that patients expect it to respond quickly to all emergency calls.
The independent scrutiny panel's report into accident and emergency services in Ayrshire and Arran takes issue with the health board's claims that the distances travelled in an ambulance do not affect outcomes. On page 37 of the report, the panel identifies a number of serious concerns about the evidence that has been assembled. Does the minister agree that the implications of that extend right across Scotland and that the concerns that are expressed in the report merit a wider review of the safety of ambulance journey lengths?
I am aware of the comments in the independent scrutiny panel's report, which backs up the Government's view that health care should be provided locally wherever possible. That is why we decided, early on in government, to save the accident and emergency units at Ayr and Monklands hospitals. I appreciate the fact that the member was not a member of the Parliament under the previous Administration. I welcome the Liberal Democrats' support for our position, which we did not have when the previous Administration was trying to close the A and E units.
A dh'fhaighneachd do Riaghaltas na h-Alba dè an ìre aig a bheil na planaichean a chur às do sgiobaidhean singilte air carbaidean èiginn anns na h-Eileanan an Iar.
Alasdair Allan will recall that I stated in the chamber on 4 June that I had asked the Scottish Ambulance Service to provide me with an action plan demonstrating how it intends to achieve the elimination of single manning. I expect to receive that action plan from the Scottish Ambulance Service over the next few days, and I will discuss it in detail with the Ambulance Service board when I meet it next Wednesday.
I take the opportunity to apologise to the chamber for my absence yesterday when a statement was made on the Scottish Ambulance Service. I pressed for the statement and it is a matter of regret that I was absent. For the record, I confirm what Hugh Henry said—that I was at a family funeral. I am disappointed that a point of order was raised by a member in relation to that. I thought that my work record might lead people to assume that I would only ever be absent for a good reason.
I acknowledge Margaret Curran's comments about her absence during the statement yesterday. Of course, that is perfectly understandable. Nevertheless, she was present in the chamber for the statement that I made on the Ambulance Service on 4 June. During that statement, she heard me outline a number of inquiries and work streams that I wanted to be pursued in relation to the Ambulance Service. She will also have heard me say that I intend to keep Parliament fully informed and updated on the outcome of that work. I did not set up the inquiry into the allegations of bullying and harassment; the Scottish Ambulance Service board set that up. I hope that Margaret Curran appreciates and acknowledges that I have always been open and up front with Parliament about such issues, and I intend to continue to be so.
Aberdeen City Council <br />(Social Work Inspection Agency Report)
To ask the Scottish Executive what action it is taking with local health officials to ensure that the correct measures are taken in response to the findings of the Social Work Inspection Agency report on Aberdeen City Council, with particular reference to the provision of substance misuse services. (S3O-3907)
Officials have been working since August 2007 with NHS Grampian, Aberdeen City Council and the local alcohol and drug action team on issues raised by the SWIA-led multi-agency inspection of substance misuse services in Grampian. That work will continue and take into account the findings of this most recent inspection to which the member refers.
New figures highlighted in the Evening Express this week show that Grampian still has the longest waits for access to drug misuse treatment. What future role will the Scottish Government have in ensuring that the service failures in Aberdeen, which the SWIA report identified, will be addressed? What extra resources will be available to Grampian to help drive down waiting times? In what timescale does the minister hope to see progress?
Progress has been made in tackling the substantial drug treatment waiting lists in the city. The health board, the council and the ADAT have worked together to develop robust proposals for tackling what has been a long-standing problem that, as the member knows, goes back to at least 2006.
Will the minister also acknowledge that this is the second quarter in a row that has seen a substantial fall in the figures? At the turn of the year, the figure was around 800, then it dropped to the 600 mark and it is now down to 500. Will the minister join me in commending the work that the local team has done, particularly under the leadership of the retiring chief executive of Aberdeen City Council, Douglas Paterson, who has transformed the ridiculously long waiting times and high numbers of people on the waiting lists?
As Brian Adam points out, there has been a substantial reduction in waiting times. However, as I said, progress still requires to be made. On 18 June, I met those on Aberdeen City Council who have responsibility for social work services, along with Kenny MacAskill and Adam Ingram, to take forward some of the issues in the most recent SWIA report. That meeting was very constructive and the local partners are under no illusions about the need to make further progress. However, it is important to record the progress that has been made and to give praise where it is due.
Question 3 was not lodged.
Royal Hospital for Sick Children
To ask the Scottish Executive what assessment has been made of the demographic and other factors that will affect the future capacity needs of the planned new Royal hospital for sick children at Little France, Edinburgh. (S3O-3898)
NHS Lothian has worked closely with a number of stakeholders during the development of the outline business case for the new Royal hospital for sick children. The proposed activity for the new hospital includes a number of variables that will affect the future capacity needs. NHS Lothian will continue to review all the factors that may impact on children's services.
The minister will also be aware that patrons of the Little France site are subject to extortionate car parking charges of up to £7 per day. Can the minister confirm that the parking for the new, publicly funded sick kids hospital will be provided at the maximum £3 a day national health service rate? Will she consider approaching the board of Consort Healthcare to examine options for reducing parking charges across the whole site?
As Mike Pringle will be aware, when I took the decision to cap charges at £3 per day for all hospital car parks not run by private companies, I asked all NHS boards to review their policies on car parking and to submit a report to me by the end of this month. Our overall review will consider the situation at hospitals such as the Edinburgh royal infirmary. I intend to issue a full statement on car parking charges in due course.
At a recent briefing by Lothian NHS Board, MSPs were told that the management of the paediatric unit at St John's hospital will transfer from West Lothian community health and care partnership to the Royal hospital for sick children in Edinburgh. Is the cabinet secretary content with that change? What effect will the change have on the capacity of children's services at St John's in West Lothian?
Obviously, that is an issue for NHS Lothian, but I am more than happy to go away and look in detail at the point that Mary Mulligan has raised and to respond to her in writing.
Ambulances (Portable Oxygen Cylinders)
To ask the Scottish Executive what advice it has received regarding the suitability of heavier types of portable oxygen cylinders. (S3O-3922)
The Royal College of Physicians defines ambulatory oxygen equipment as items that weigh up to 4.5kg and can be carried by most patients during the activities of daily living. The Scottish Government recognises that equipment weighing 4.5kg is not suitable for all patients. The cylinders that are listed in the Scottish drug tariff weigh around 3.2kg.
The minister will be aware that many people have been provided with PD cylinders, which are not only heavier, but have a lower capacity than other cylinders. That may be acceptable to the cabinet secretary, but I have been contacted by a growing number of constituents whose mobility has been severely compromised. In one case, a constituent is now housebound. I simply ask the minister to make a priority of finding a resolution to the issue as quickly as possible, given that it has run on for some months now.
As the member will be aware—I have written to him and several other members about this—the shortages are the result of a manufacturing problem at the French company that supplies BOC. We have worked closely with BOC, NHS National Services Scotland and Community Pharmacy Scotland to ensure that there is no disruption to the supply of portable oxygen to patients. However, we are aware that maintaining the supply to patients has involved the reintroduction of older, heavier cylinders, which is causing concern to some patients, as the member mentioned. I have recently approved the use, on a temporary basis, of the home-fill system, which is a new product that offers concentrator patients the possibility of filling and refilling small cylinders without the need for repeat prescriptions from their general practitioner or the supply of portable oxygen to community pharmacists.
I thank the minister for her letter, which arrived today. However, when the new PD cylinders—which require a separate head that the patient must insert—are found not to be full, patients have no confidence that their oxygen needs will be met when they are out. That is a very serious issue.
On that last point, cylinders are sent to England by BOC for testing but they are returned to Scotland when tests confirm that they are safe to use.
Scottish Centre for Healthy Working Lives
To ask the Scottish Executive what financial support will be received by healthy working lives in 2008-09, with particular reference to the operation of Salus occupational health and safety. (S3O-3976)
The principal funding for the Scottish centre for healthy working lives is provided through the core budget of NHS Health Scotland. Salus operates the healthy working lives national advice line under contract to the centre.
I draw the minister's attention to the work of Salus, particularly its work on occupational health. Will the minister assure us that the recent decision by certain local authorities to award the delivery of occupational health support services to private companies will not impact on Salus's innovative work?
Arrangements for the purchase and provision of occupational health services are a contractual matter between the organisations concerned. However, we would expect any occupational health service provision to promote the health and wellbeing of employees. I have every confidence that Salus's good work will continue. I will keep an eye on that to ensure that it does.
The healthy working lives plan for action—which was introduced by the previous Executive—acknowledges the importance of workplace occupational health provision, such as that offered by Salus, which is based in Coatbridge in my constituency. Does the minister believe that occupational health services in the public sector—in the health sector specifically—should be provided by private companies or should be provided in-house? Will she commit to intervening to stop the threat of privatisation that is currently hanging over some services? Will she look favourably on the Scottish Trades Union Congress's call for formal recognition of international workers memorial day, which could provide an annual opportunity to review progress on healthy working lives and on health and safety at work in general?
On that latter point, I intimated some time ago to the member that I would be prepared to meet her to discuss the matter.
Marlyn Glen is unable to be here, for entirely understandable reasons. Question 7 is therefore withdrawn.
Infertility Treatment
To ask the Scottish Executive what progress has been made on reviewing the eligibility criteria for infertility treatment. (S3O-3890)
We provided national health service boards with an update on eligibility criteria guidelines for access to specialist infertility treatment last year, including guidance on maternal age and timing of cycles. We have not committed to any further review of eligibility criteria at present.
Some health boards in Scotland have an age limit of 38 while others have an age limit of 40; and some provide two cycles of treatment while others provide three. Waiting times are up to 20 months in Glasgow and up to three years in Lothian, which forces many women to fund their treatment privately. Will all those differences be addressed to give equality of access to fertility treatment across Scotland?
I recognise the importance of the issue. The variations throughout Scotland that Mary Scanlon mentions must be addressed. She will be aware that the updated guidance changed the position on maternal age. The 2000 guidance said that a woman could receive treatment until her 38th birthday. The current guidance says that it should be her 40th birthday, although there are some exceptions to that, for example when frozen embryos are being used. Mary Scanlon also rightly pointed to some variation in waiting times. Waiting times are of particular concern to me, especially the fact that until now we have not routinely gathered or recorded data on the issue. I have asked for some work to be done on that. We must ensure that we are getting accurate information. I want to consider how we can make vast improvements in this important area of treatment over the next few years.
I am grateful for the minister's comments about waiting times and for the steps that she is taking on the issue. Will the minister also consider the availability of services in areas such as the Highlands and Islands, where people routinely have to travel to access treatment, and whether even part of the treatment could be delivered closer to home?
I am happy to undertake to consider that. Rhoda Grant raises an important point. The difficulties that some women face in accessing infertility treatment will be particularly acute in remote and rural areas of the country. I am happy to take the member's points into account in the context of our overall efforts to improve access to that kind of treatment and to ensure more consistency throughout the country.
Glasgow Housing Association
To ask the Scottish Executive what steps it is taking to ensure that Glasgow Housing Association transfers its housing stock to community-based and locally accountable housing bodies. (S3O-3891)
I recently met Glasgow Housing Association and the Glasgow and west of Scotland forum of housing associations and secured their commitment to working together to make transfer happen. A first meeting has taken place, which included the local housing organisations that are developing transfer proposals. I welcome that as a step forward.
I am grateful for the minister's reply. I welcome the cabinet secretary's statement yesterday that she sees Glasgow Housing Association as a transitional organisation. However, I invite the minister to go a little further. In particular, I remind him of the Mazars report's indication that if GHA transferred all of its stock on its valuation basis, it would be left with no houses, a substantial organisation and hundreds of millions of pounds of unused funding. Notwithstanding the welcome progress on some issues that the minister mentions, does he agree that, in reality, the GHA valuation method so criticised in the Mazars report imposes a restrictive glass ceiling on the potential for second-stage transfer? Does he agree that that issue is so fundamental, and so undermines the potential for second-stage transfer, that it requires to be resolved on a valid and equitable basis? If necessary, will he consider the option of legislating to establish a community right to buy or some other mechanism to impose a facility for binding arbitration on agreed principles?
I remind the member that as well as the Mazars report, we have the Scottish Housing Regulator's report, which identified areas for further exploration. We have encouraged the GHA, the west of Scotland forum and the LHOs to discuss those issues. Among the issues identified by the regulator were revisions of the final sale prices where a number of positive SST ballots are achieved, and GHA can disaggregate more costs to the benefit of purchasers; the disaggregation of contingencies where greater certainty can be achieved; and the disaggregation of the financial benefits of Glasgow gold. The issues that have been identified by the regulator are under discussion.
The minister will be aware of the Glasgow homelessness partnership's important work in meeting Glasgow's housing needs. Sadly, the partnership has no secure funding beyond September this year. Will he agree to put in place measures to secure funding for it to continue its important work, which has included measures to ensure that 1,000 households were not homeless this year?
I am sure that James Kelly is aware that that decision is a matter for Glasgow City Council. As far as I am aware, a pilot has taken place, but no final decisions have been made. I am sure that he also supports yesterday's statement on housing, which takes forward the Government's vision for improving the housing stock in Scotland and dealing with homelessness. I issued a consultation on making greater use of the private rented sector earlier this week, and I am sure that he agrees that we need to concentrate long term on the supply side of the problem.
Plagiocephaly
To ask the Scottish Government what steps have been taken to raise awareness of plagiocephaly. (S3O-3958)
Last year, we developed with colleagues in NHS Scotland a leaflet on plagiocephaly for all new parents to help raise awareness of the condition. The leaflet, "Protect your baby's natural headshape: tummy time to play, back to sleep", gives information on tummy time and repositioning advice, while strongly reinforcing the back to sleep message.
I welcome the leaflet's publication, but I have received anecdotal evidence that although the leaflet is available to all health boards, they are not all distributing it as widely as could have been hoped. What will the minister do to ensure that all new parents throughout Scotland are given a copy of the plagiocephaly leaflet?
The majority of health boards give out the leaflet to all new parents antenatally or soon after birth, but I am aware that a few boards currently do not and I am taking steps to ensure that all boards give a copy to all expectant parents or new parents and to ensure that it is on display. At the beginning of June, more than 65,000 copies of the leaflet were issued to boards throughout Scotland. That is being followed up with a letter at director level asking boards to ensure that all new parents are given a copy of it. We will ask for confirmation from boards that that is happening.
National Health Service Treatment (Charges)
To ask the Scottish Executive whether anyone has been charged for their NHS treatment because they have decided to pay for medication privately. (S3O-3896)
A fundamental principle of the national health service is that care is free at the point of delivery on the basis of clinical need. NHS boards have responsibility for the planning and provision of NHS services and for ensuring that they are available equitably. However, it remains the case that all patients can exercise their choice to use the services that are available in the independent health care sector.
I am sure that the minister agrees that we all want access to medicine to be as wide as possible in Scotland. It is understandable that some patients will choose to purchase medicines privately, especially in the most serious circumstances. Without seeking in any way to encourage a two-tier national health service, I wonder whether the cabinet secretary is able to assure the Parliament that constituents of mine who choose to take this route will not be penalised by the NHS.
I thank John Farquhar Munro for that question and for taking such a constructive approach to the issue.
Is the cabinet secretary aware that many patients who pay privately for medication are still getting it cheaper than they would if it were being dispensed under an NHS prescription and that, for that reason, NHS patients are eagerly awaiting the further reduction in NHS prescription charges promised by the Scottish National Party Government?
Can I thank—
I think that "Yes" would do, cabinet secretary.
I agree with the member that the abolition of prescription charges delivers not only an SNP manifesto commitment but great benefits to patients all over Scotland.
I thank the cabinet secretary for her responses so far and for her evidence to the Public Petitions Committee's inquiry, which acknowledged the case that Michael Gray and his family presented to the committee.
Like Frank McAveety, I pay tribute to Michael Gray, who instigated the petition in question. Although we should not pre-empt any decisions, any changes that might flow from the petition and the inquiry will be part of the legacy that Mr Gray has left.
NHS Boards (Meetings)
To ask the Scottish Executive when the Cabinet Secretary for Health and Wellbeing last met the chairs of national health service boards. (S3O-3914)
I last met chairs of NHS boards on Monday 2 June, and my next meeting with them will take place next Monday.
I presume that representatives of NHS Greater Glasgow and Clyde will be present at that meeting and that, at that meeting or in some other forum, the cabinet secretary will have the opportunity to discuss with them the outbreak of clostridium difficile that has been so much in the public mind in recent months. Will she confirm that the inquiry that she has initiated will cover not only the apparent lack of surveillance systems at board level but the apparent failure of systems at Health Protection Scotland, which is part of her department, and, indeed, her own role in all of this? Finally, will she confirm to Scots that she will take action to ensure that all hospitals in Scotland have effective procedures in place to tackle as much as is humanly possible C difficile infections?
This issue is very serious and I have to say, in passing, that it is a matter of regret that over the past couple of weeks Margaret Curran has at times appeared more interested in attacking me than she has been in the interests of the patients concerned. I find that unfortunate.
I add my welcome for this week's announcement by the cabinet secretary that Scotland will have its first male screening programme for abdominal aortic aneurysms in older men, which I have recently called for. Given that my own father died of AAA, I welcome the fact that many families might now be spared the pain of an avoidable loss.
I acknowledge Jackson Carlaw's interest in the subject and his pursuit of screening for the condition.
Order. Could members who are coming into the chamber please respect the fact that a question-and-answer session is going on?
The National Screening Committee has made it clear that it thinks that screening of the male population for AAA at the age of 65 is effective, which is why we have decided to introduce such a programme in 2011, although it is already being piloted in NHS Highland. I will continue to consider any representations that are made on the possible extension of that programme, but I stress that I think that it is right that such decisions are based on expert evidence and recommendations, which in this case are provided by the National Screening Committee.
Housing Strategy
To ask the Scottish Executive what discussions it has had with professional agencies about housing strategy. (S3O-3915)
The Scottish Government has engaged with a wide range of professional bodies on the proposals that are set out in the "Firm Foundations" consultation document. In her statement to Parliament yesterday, the Deputy First Minister set out our plans for housing in Scotland and our commitment to work closely with all stakeholders as we progress them.
Does the Scottish Government plan to implement the proposals of the 2003 housing strategy report which, following work in partnership with the conveyancing committee of the Law Society of Scotland, recommended that legislation be introduced to ensure that protection on dates of entry be provided for purchasers of new-build homes, who currently have no such protection, and that the existing legislation be amended to cover missives for new-build properties?
That was a detailed question about our future policy on the regulations. If it would be acceptable to the member, I suggest that I write to her or sit down with her to discuss the matter in detail so that I can gain a clear understanding of her concerns, which I know she has pursued over a number of years.
Health (Children and Young People)
To ask the Scottish Executive what steps it is taking in partnership with local authorities to improve the health of children and young people. (S3O-3902)
The early years and early intervention framework sets out a joint approach to early years and early intervention by the Scottish Government and the Convention of Scottish Local Authorities. Improving health outcomes for children and young people and tackling inequality through early intervention are integral to the framework. We aim to create environments for pre-school and school-age children that promote their physical, social, spiritual, mental and emotional wellbeing, both in school and in other settings.
There seems to be serious confusion about the Government's ambition for improving the health of Scotland's children. In its manifesto, the Scottish National Party said:
That outcome was devised when the member's party was in government. We thought that it would be appropriate to continue with it, given the difficulty of addressing the issue. We thought that the previous Executive had got that outcome right. We believe that it is achievable. I am very surprised that Iain Smith is dissing his own previous commitment in such brutal terms.