SCOTTISH EXECUTIVE
Health and Wellbeing
Medical Services (Decentralisation)
To ask the Scottish Executive what plans there are to decentralise in-patient and out-patient medical services to hospitals in remote areas. (S3O-7147)
We are committed to providing health care services as locally as is appropriate and possible. A network of six rural general hospitals throughout the Highlands and Islands will provide an emergency centre, which will include a place of safety for mental health emergencies and a range of out-patient, day-case, in-patient and rehabilitation services.
I welcome the cabinet secretary's positive answer, but I will press her on one point. Will she consider making it possible for consultant updates, regular appraisals and monitoring meetings to be delivered more locally, perhaps by taking full advantage of the potential of telemedicine? That will make an enormous difference to my constituents, many of whom have to travel long distances in inclement weather.
I agree with the thrust of Jamie Stone's question. I repeat that I am committed to ensuring that as many services as possible are delivered as locally as possible. People throughout Scotland understand that they need to travel for some specialist services when it is better to do so, but where a service can be delivered locally—and that includes in rural areas—it should be.
I wrote to the minister about the closure of almost a third of the beds in Portree hospital, which was done without any public consultation and has led to patients having to be transferred to Broadford hospital due to the lack of beds in Portree. Will she ensure that health boards consult on any major changes in such small hospitals and ensure that more services are delivered locally within them?
I thank Rhoda Grant for her question and acknowledge her correspondence to me. Other members have written to me on the same subject. They and Rhoda Grant will appreciate that it is ultimately a matter for local determination.
Although I appreciate that the cabinet secretary wishes to take into account the views of local people, I can honestly say that that consultation has got off to the worst possible start. The local community in Skye is losing trust and confidence, and the people believe that the result is a fait accompli. Will the health secretary discuss the issue with NHS Highland and do all that she can to ensure that the voice of local people is heard at each stage of the process?
I would be disappointed to learn that people held that view of any consultation in any part of Scotland on any service redesign. Mary Scanlon and other members are closer to the issue from a local perspective than I am although, as health secretary, I am well aware of it. As I said to Rhoda Grant, I have made my expectations of the scale and the quality of public consultation known to NHS Highland and I expect it—as I would expect any health board—to deliver a meaningful consultation when it is considering making changes to service provision.
Medical Technology
To ask the Scottish Government what steps it has taken to ensure that the best use is made of new medical technology. (S3O-7157)
We have discussed with industry representatives on the newly formed life sciences advisory board how best to support promising medical technologies. The board has agreed to hold workshops to publicise existing support mechanisms and assess where there might be gaps. The chief scientist office and the life sciences alliance will then consider whether to establish a group to address possible adoption and innovation mechanisms.
Life sciences are an important economic priority for the Scottish Government. South of the border, there is clarity about how medical devices are developed and the National Institute for Health and Clinical Excellence has given its approval. I hear what the cabinet secretary says about LiSAB; it would be good if we had the same clarity in Scotland about how new medical technologies are developed.
I echo Joe FitzPatrick's comments about the importance of the life sciences sector to Scotland generally. It is an area of potential growth for the Scottish economy and the Government is committed to supporting it. It has particular importance in Joe FitzPatrick's constituency.
Volunteer Ambulance Services
To ask the Scottish Executive what discussions it has had with the national health service about volunteer ambulance services in the past 12 months. (S3O-7078)
The Scottish Government and I, in particular, value highly the contribution of all volunteers who support the NHS. We are in regular dialogue with the Scottish Ambulance Service about the volunteer ambulance car drivers who support the patient transport service. I expect all NHS boards to work closely with the Scottish Ambulance Service to ensure that they meet the needs of patients with a medical need who require transport.
I am sure that, like me, the cabinet secretary values enormously the contribution that is made to the NHS in Scotland by the voluntary ambulance car service drivers. However, does she share my concern that the new mileage rate for volunteer drivers that was introduced on 1 April will reduce the number of people taking part in that important activity? What assessment has the Government made of the impact that the change in mileage rates will have on the Scottish Ambulance Service? Will she review the rate if evidence emerges that it is putting people off volunteering their services as drivers?
I appreciate and acknowledge John Scott's interest in the issue. I will explain briefly the new guidance now in force that changes the mileage rate that is payable to volunteers. The rate is now 40p per mile for the first 10,000 miles and 25p per mile thereafter. That is a revision of the previous rates that allowed for 30.5p per mile for cars under 1,500cc and 36.9p for cars with engines above that size. Overall, there has been an increase in the mileage rate for volunteer drivers. However, as John Scott has asked me to do, I will ensure that the Scottish Ambulance Service keeps the issue under review to ensure not only that we are recruiting sufficient volunteers to help with that vital task but that they are being compensated appropriately for the expenses that they incur.
Notwithstanding what the cabinet secretary said in her response to John Scott, several of my constituents have approached me with concerns that, in some instances, they would be paid more as volunteers to attend meetings in the health service than to transport patients. That is a clear concern and could be offputting. If people did not volunteer, I imagine that that would have a big impact on patient transport services. Will the cabinet secretary assure me that there will be no situation in which someone who transports patients is paid a lesser rate of mileage than someone who attends a meeting?
I am happy to look into that specific point, as that is not a circumstance that any of us would wish. I hope that all members will accept my assurance that I value very highly the work that volunteers do, particularly those who transport patients to hospital appointments. That is an essential role, particularly in rural areas.
The cabinet secretary will be aware of efforts in Braemar to re-establish a volunteer ambulance service in the village. Will she update me on what progress is being made?
I am delighted to do so. As Nigel Don and other members with an interest in the matter are aware, the Scottish Ambulance Service is committed to introducing a retained service for Braemar. Nigel Don, Alex Johnstone and other members have been strong supporters of that.
CT Scanner (Orkney)
To ask the Scottish Executive what representations it has received regarding the case for a computed tomography scanner to be located in Orkney. (S3O-7137)
The director and the secretary of the Scottish Islands Federation have both written to me recently supporting the case for a CT scanner in Orkney. The member wrote to me on the subject on 24 October last year, and I replied on 15 November. He also asked me about the issue during question time on 4 December.
Since I last raised the issue at health questions in December, my constituent Mike Craigie has suffered a stroke. Thankfully, Mr Craigie has made an excellent recovery and is now using his skills as a successful local businessman to spearhead the campaign for a CT scanner to be located in Orkney. Will the cabinet secretary agree to meet Mr Craigie and local clinicians to discuss the case for an Orkney-based scanner? Does she accept the view of Peter Malcolmson, chair of the Shetland community action for trauma support group—or CATS group—that the example of Shetland proves how a locally based scanner
I met local clinicians as part of the annual review last year, when the issue of a scanner was among the topics of discussion. I am sure that either the Minister for Public Health or I—I cannot immediately recall which one of us will be chairing the annual review this year—will be happy to meet the member's constituent when we are on the islands.
Given that there is a scanner in Wick, whose population is similar to Orkney's, that the possibility of treating strokes is much improved if the patient can have a scan and that injections within four hours of a stroke can be effective, does the cabinet secretary agree that there is an open-and-shut case why places with around 20,000 people, such as Orkney, should have a scanner?
In some respects, my answer to that relates to the answer that I gave to Jamie Stone on an earlier question. I want to see services being provided locally where possible; equipment such as telehealth equipment and scanners are crucial in ensuring that that can happen. Ultimately, though, it is for NHS boards to assess the demand for, and the benefits of, scanners or other items of equipment. I am sure that all members would agree that it would be wrong for me to try to micromanage around the country and say where every piece of medical equipment goes. However, in the interests of ensuring local delivery of health care where possible, NHS boards are encouraged to, and do, take decisions that as far as possible facilitate that.
Stobhill Hospital (Proposed Extension)
To ask the Scottish Executive how it intends to procure the proposed extension to Stobhill hospital in north Glasgow. (S3O-7114)
Greater Glasgow and Clyde NHS Board is progressing the extension of the new Stobhill hospital as a variation to the existing contract, in accordance with the conditions of the existing project agreement.
Will the minister join me in welcoming the £100 million investment in Stobhill hospital that was procured by the previous Scottish Executive? Will she bring forward proposals for the proposed extension, which will provide up to 60 short-stay beds? Does she propose to procure that investment by public-private partnership or by direct funding from the Government?
As I am sure the member is aware, our options are very limited in terms of how we procure the investment. The board is bound by the terms of the original project agreement with regard to proposed variations. As I said in my original answer, the extension will therefore be procured through a variation to the existing contract. That is something that the board is required to do.
Asylum (Alternatives to Detention)
To ask the Scottish Government what progress there has been on the alternatives-to-detention pilot for asylum-seeking families. (S3O-7169)
I am glad to say that the family return project was launched on 12 May. The first families are expected to enter the project in mid-June. The project will encourage refused asylum seekers to return home voluntarily and is a step towards ending the detention of children in Dungavel.
Does the minister agree that Fatou Felicite Gaye and her United Kingdom-born four-year-old son, Arouna, would have been excellent candidates for such a pilot? I have been unable to confirm whether Fatou and Arouna were deported to the Ivory Coast at 8.30 this morning. Will he join me in deploring that situation?
I can confirm that the Gaye family have now left the UK and that they did so at 8.30 this morning. I share the same concerns as Christina McKelvie about how that family, particularly the four-year-old child, have been dealt with. I underline the Scottish Government's opposition to the detention of children at Dungavel.
Well Man Clinics (Sports Clubs)
To ask the Scottish Executive, given the success of the well man clinics run by Rangers and Celtic football clubs, whether it plans to encourage and assist other sports clubs to replicate these. (S3O-7090)
I am pleased that the well man clinic that Rangers and Celtic football clubs have run in partnership with the Royal College of Physicians and Surgeons of Glasgow is proving a success. I look forward to receiving their final report as funders of the project later this year. It is clear that significant potential exists to use football clubs to get healthy living messages across to hard-to-reach groups and we will explore that with the Scottish Football Association through the citizenship through football group.
I suggest that the minister should explore the idea further with the Scottish Premier League, which is also considering ways of rolling out the programme, given the proven success of the Rangers clinic, which achieved a 10 per cent reduction in cholesterol levels and a 7.5 per drop in blood pressure in a short time. Mind you, I cannot give figures for the depression that might be around Celtic Football Club.
The citizenship through football partnership includes the SFA, the Scottish Premier League, the Scottish Football League, sportscotland, the Association of Chief Police Officers in Scotland and us. My officials will meet the group's project lead from the SFA next week to discuss progressing health improvement issues through the group. I am happy to feed Margo MacDonald's comments into that meeting. We might well be able to apply lessons to other sports from the work that has been done. As Margo MacDonald said, the results have been impressive. We certainly want to learn from that and take that elsewhere.
Role models in football clubs can do much to improve young men's awareness of sexual health and to reduce chlamydia infection rates in particular. I understand that St Mirren players agreed to be tested for chlamydia in an effort to encourage other young men to take advantage of available opportunistic screening, whereas players from other football clubs were—shall we say—more reluctant.
I agree with Jackson Carlaw and I pay tribute to the St Mirren players. I hope that what they did will encourage young men to behave likewise. Role models can be positive and negative. In football and in sport in general, it is always good to see positive role models. We will consider how to discuss—perhaps through the citizenship through football group—opportunities to examine sexual health matters.
Parkinson's Disease (Lothians)
To ask the Scottish Executive what plans it has to improve care for people with Parkinson's disease in the Lothians region. (S3O-7088)
NHS Quality Improvement Scotland is developing clinical standards for neurological conditions, including standards that are specific to Parkinson's disease. They will improve the care and support that are available to people with Parkinson's in all NHS board areas. The Scottish intercollegiate guidelines network is also developing a clinical guideline on the diagnosis and treatment of Parkinson's. We have funded the appointment of a rehabilitation co-ordinator in each NHS board area. The NHS Lothian co-ordinator will consider issues such as the longer-term rehabilitation needs of those with Parkinson's.
The minister will know of the important role that allied health professionals play in supporting people with Parkinson's and of the shortage of suitable allied health professionals in Edinburgh, where the gaps in national health service provision are being filled by a multidisciplinary clinic that is funded by the Edinburgh branch of the Parkinson's Disease Society. What action will the Government take to ensure that people with Parkinson's in Edinburgh and the Lothians have access to support from allied health professionals?
The member will be aware that NHS Lothian and the Parkinson's Disease Society have recruited two new Parkinson's disease specialist nurses; I am sure that he welcomes that. We appreciate the support that allied health professionals such as physiotherapists and occupational therapists provide to people with Parkinson's disease, their families and their carers. We have made £1.2 million available to support the appointment of the rehabilitation co-ordinators whom I mentioned in my original answer; the NHS Lothian co-ordinator was appointed in April this year. Rehabilitation co-ordinators will be responsible for identifying gaps in rehabilitation service delivery and the redesign of services, where necessary, to ensure that gaps—including gaps involving AHPs—are addressed. I am happy to keep the member updated on the issue.
In light of the Parkinson's Disease Society's statements and campaign on the need to ensure that hospital patients with Parkinson's receive their medication in a timely manner—especially as that medication can be very time sensitive—what steps has the minister taken, even prior to the appearance of the guidelines, to ensure that that happens?
I am aware of the distressing problems experienced by some people with Parkinson's who are unable to follow their medication regime in hospital; the issue has been raised in the chamber. Whenever possible, people should be able to self-administer their medicines while they are in hospital. Self-medication is a good example of the principle of self-management, which we are promoting and which lies at the heart of our work on long-term conditions. We are committed to ensuring that the NHS makes the shift in culture and attitude that is required to make that happen. I am happy to keep the member updated on progress on the issue.
Obviously, I declare an interest in the subject. Will the minister take on board the idea of extending self-management to carer management? There are physical tasks that can be undertaken by carers and in which allied health professionals do not need to be involved. However, allied health professionals must instruct or teach carers how to perform those tasks. I commend that approach to the minister as one way of using resources.
I am happy to look into the matter. Margo MacDonald may be aware that we are developing a carers strategy. We could consider the approach that she suggests as part of that work.
Affordable Homes for Rent (Midlothian)
To ask the Scottish Executive what steps it is taking to increase the availability of affordable homes for rent in Midlothian. (S3O-7096)
The Scottish Government has announced a record amount of funding in 2009-10 to help with the provision of affordable homes for rent in Midlothian. We have awarded £2.5 million to assist the council house new-build programme in Midlothian and a further £5.2 million of affordable housing investment programme funding for housing association new-build properties in the area.
Although the current Scottish Executive has been keen to take credit for increased council house building, is it not the case that Labour-run Midlothian Council's house building programme commenced in 2006, before the current Executive came into office? Midlothian Council is the second smallest mainland local authority in Scotland, but it built 78 per cent of all the council houses that were completed in Scotland in the past financial year. I am sure that the minister will agree that it should be congratulated on that. If the Executive is really committed to building more affordable homes, why did he recently reject Midlothian Council's bid for £12 million to build more affordable homes and instead provide the council with only a fifth of that sum? Does he think that that is enough to deal with the 3,000 people who are currently on the waiting list for affordable houses in Midlothian?
The funding that was awarded to Midlothian Council in the first round of council house funding equates to 15 per cent of all the available funding that has been awarded to date and is the second highest award that has been made in Scotland. I point out how that compares with the record during the time—[Interruption.] That is not mine; perhaps it is a second fire alarm.
It is someone's. I would be grateful if members would check their communications equipment.
Just as I was coming to the punch line.
On affordable homes in Glasgow, the minister will know that I have been working closely with Maryhill Housing Association to ensure that, as a key stakeholder, it is central to plans for transformational regeneration area status there. Will the minister ensure that community-based housing associations are central to transformational regeneration areas and the development of affordable housing?
I am sorry to interrupt, Mr Doris, but the question was on housing in Midlothian. I am afraid that supplementary questions must refer to that.
Well, it was on affordable housing.
No. The subject is houses in Midlothian, Mr Doris. I am afraid that we must move on.
Can the minister tell the chamber why he has removed a further £1,000 per unit from housing association grants and how that will affect housing associations in Midlothian?
I do not know exactly what that question has to do with Midlothian, Presiding Officer. I advise Mary Mulligan that there is a clear distinction between the average subsidy target and the level of the housing association grant. Perhaps if she understood the difference, she would realise that there is no planned reduction in HAG funding for housing associations.
Cancer (Treatment and Survivability Rates)
To ask the Scottish Government what the most improved areas of treatment and survivability rates are for cancer in Scotland. (S3O-7152)
Treatment for cancer includes surgery, chemotherapy or radiotherapy and sometimes a combination of those. Improvements in all those treatments have resulted in increased survival rates being achieved for all cancer patients. Overall, for all cancers—excluding non-melanoma skin cancer—the male five-year relative survival rate increased by 17 per cent between 1980 to 1984 and 2000 to 2004. The female five-year survival rate increased by 13 per cent over the same period.
Will the cabinet secretary join me in congratulating all those involved in the breast way round motorcycle group who spent last weekend fundraising for Macmillan Cancer Relief? As she knows, the early detection of breast cancer and the faster treatment that is being delivered by the Government can increase survival rates. With that in mind, and in the 21st anniversary year of the Scottish breast screening programme, will she confirm that she places a high priority on increasing the uptake of screening, particularly among women in deprived communities?
I will deal with the second part of Willie Coffey's question first. I place an extremely high priority on breast screening, as I do on all the cancer screening programmes. He is absolutely right to emphasise the importance of increasing the uptake of such screening, particularly in our deprived communities. In the 21st anniversary year of the breast screening programme, it is right that we all do our bit to encourage people to take advantage of it.
I associate myself with the cabinet secretary's thanks to those who were involved in the breast way round event. I declare an interest as an honorary member of one of the motorcycle clubs that was involved—although I should point out, for the avoidance of doubt, that I was not on a motorcycle.
Early detection is important for all cancers. Cathy Jamieson is right to point out—as I did in my initial answer—that the trend for non-melanoma skin cancer is not going in the direction that we would want. The Government has made it a priority to tackle that. I do not have time to go through the range of activities that we are undertaking, but Cathy Jamieson and other members will be aware of the important legislation that we initiated—which the Parliament passed—with the support and encouragement of Ken Macintosh to restrict the use of sunbeds, particularly by younger people. There is widespread support for that legislation. It is not the only thing that we can do, but it will make an important contribution. Beyond that, it will continue to be extremely important that we raise awareness of the dangers of exposure to the sun and the need to be sensible in that regard.
Osteoporosis Services <br />(Community Health Partnerships)
To ask the Scottish Executive what importance it places on having combined falls prevention and bone health strategies in community health partnerships in relation to osteoporosis services. (S3O-7156)
The Scottish Government considers osteoporosis and its association with fractures to be an important health issue, and as most fractures occur following a fall, falls and fracture management and prevention strategies are imperative. That is why, in February 2007, the Government published guidance for health boards and community health partnerships on actions to prevent falls. The guidance highlights specific actions that boards and CHPs can take, including working with local partners to raise awareness, improving the recording of falls and appointing a network of local falls co-ordinators to share good practice and develop a combined local falls strategy.
I thank the minister for her detailed answer. On the basis of that information, is it possible for her department to identify whether strategic and operational plans on falls and bone health are linking effectively to osteoporosis fragility and fracture services throughout Scotland?
Yes, I expect that information to give us such a picture. It is certainly extremely important that those services are linked up. I am happy to update members on progress on that important work as we move forward. Some excellent work is being done, which is producing highly significant results for people by reducing the number of falls and fractures. That must be good news.
Cancer (Waiting Time Targets)
To ask the Scottish Government whether it will provide an update on progress being made towards meeting cancer waiting time targets. (S3O-7168)
I am pleased to advise that the latest statistics show that NHS Scotland has, for the first time, met the national 62-day target to treat 95 per cent of urgently referred cancer patients within two months.
How close does the cabinet secretary think that we could get to treating 100 per cent of patients within the target period, given that we were the party that abolished availability status codes?
As Ian McKee rightly says, it is extremely important to have complete transparency around waiting-time statistics, whether for cancer or any other condition. This Government has ensured that that is the case through the new ways system of measuring waiting times.
Ambulance Response Times (Rural Areas)
To ask the Scottish Executive what action it is taking to monitor ambulance response times in rural areas and what action can be taken to ensure that these times are reduced. (S3O-7079)
The Scottish Ambulance Service and the Scottish Government monitor performance across all parts of Scotland, including rural areas.
I thank the minister for her remarks and for her answer to an earlier question, in which she indicated her support for the activities on Deeside. However, given that anecdotal reports from Deeside, Kincardine and the Mearns indicate that some people still wait an extremely long time for an ambulance, what methods does she have in place to ensure that such cases are reported back and action is taken accordingly?
When an ambulance has taken an unusually long time to turn up that is not explicable by obvious circumstances, I have no doubt that the Scottish Ambulance Service would review all the circumstances. It is important that we continue to drive down ambulance response times in all parts of the country. The member will be interested to know that, in April 2009, the average response time in the north-east for an emergency category A call was 6.3 minutes—although I accept that, as that was the average, there will have been times when the response took longer than that. Our intention is to continue to reduce response times. As I have said on previous occasions, I am happy to keep members fully updated on progress.