Health and Wellbeing
Welfare Reform (Health and Wellbeing Impact)
To ask the Scottish Government what assessment it has made of the impact of United Kingdom Government welfare reforms on health and wellbeing in Scotland. (S4O-02837)
The Scottish Government has serious concerns about the impact on the health and wellbeing of those negatively affected by the UK Government’s welfare benefit reforms.
In 2012, the Scottish public health network undertook a review of literature, which suggests that there are likely to be short and long-term negative health outcomes as a consequence of the reforms, although it is not possible at this stage to quantify them.
In December 2013, the Scottish public health observatory published a report on a framework and baseline measures for the evaluation of the health and health inequalities impact of the current wave of welfare changes and the economic downturn. Although it is too soon to evaluate the impacts of either the economic recession or the welfare changes using routine health data, the report will be updated when more data are available.
Does the cabinet secretary agree that the reforms are clearly having an adverse effect on people, including many young people, across Scotland? Does he share my concerns that both the coalition reforms and Labour’s recent threats to remove benefits from the under-25s will only add to the pressure on our young people and that only with independence can we assure Scotland’s people that they will have a Government that is committed to ensuring a better, fairer and healthier life for them all?
I entirely agree. Of course, if the Tories win the next UK election and there is a no vote in Scotland, the situation will get much worse because we will have our share of £25 billion-worth of cuts, £12 billion of which will be in welfare—a size of cuts that has been endorsed by the Labour Party.
The bedroom tax is one reform that is having a real impact on people’s health and wellbeing. Will the cabinet secretary therefore support Jackie Baillie’s proposed member’s bill that would help those people?
As the member knows, we have done absolutely everything in our power to help people who are the victims of the bedroom tax. I remind the member that a Labour Government introduced the bedroom tax in the private rented sector. Labour cannot therefore complain when the Tories copy it and extend the policy to another sector. Indeed, the last people who should complain are the ones who introduced the policy in the first place. We are the only party that has consistently opposed the bedroom tax and, unlike some Labour MPs, our people were present in Westminster to vote against it.
Question 2, in the name of Ken Macintosh, has not been lodged. The member has not provided an explanation.
Carers (Proposed Legislation)
To ask the Scottish Government what progress it is making on introducing its proposed legislation on carers. (S4O-02839)
Further to the First Minister’s announcement in October 2013 about the Scottish Government’s intention to introduce legislation, on 22 January we published our consultation paper on carers legislation. The consultation period will run until 16 April.
The consultation paper sets out our proposals to build on achievements to date to help ensure more consistent and sustainable support to improve outcomes for carers and young carers across Scotland. We look forward to receiving responses from carers and young carers and from the statutory and voluntary sectors.
I welcome the prominence that is given to young carers and their role throughout the consultation document. How will the Government seek to ensure that the voice of young carers is heard as we look to shape future legislation? As the minister knows, young carers encounter specific issues and challenges in their role, and I am certain that, like me, he will want to seize the opportunity presented by the consultation to set about tackling some of those issues.
I recognise the point that the member has made. As he correctly states, the consultation document clearly sets out the importance of making sure that we provide the right type of support to young carers and the opportunities that are afforded through the provision of additional legislation.
My officials have already met a range of stakeholders, including the national carers organisations, and they will be looking to ensure that the consultation document is circulated widely through the Scottish young carers services alliance and their stakeholders who work with young carers across the country.
Alongside that, we will look at how we can make sure that young carers have the opportunity to take part in any consultation events that are taking place across the country so that we can get access to the views of young carers who are under the age of 18 and the views of those who are between 18 and 25. It is absolutely crucial that we hear their voices during this consultation exercise, and we will work with stakeholders to make sure that that happens effectively.
The minister will be aware of the Scottish Youth Parliament’s care fair share campaign for young carers. Will he make sure that members of the Scottish Youth Parliament are consulted as part of the process and that their views are fed in? The campaign is great for highlighting the needs of young carers with education, help at home, and the like, and it would be helpful if the minister would see fit to include such a useful campaign in the process as much as possible.
I am of course aware of the Scottish Youth Parliament’s work in the area, and I supported the event that it held last week. I am very conscious of the issues that have been raised, and I assure the member that the Scottish Youth Parliament will have the opportunity to feed into the consultation exercise, as will many other organisations across the country.
Rhoda Grant and the minister have already referred to the Scottish Youth Parliament. The event it held last Friday was excellent, as indeed is its campaign.
There is one element of the action it is looking for that surprised me, because I had not realised that this is an issue. There are anomalies in the administration of the education maintenance allowance that can result in many young carers losing their entitlement. Will the minister undertake to meet the Cabinet Secretary for Education and Lifelong Learning fairly quickly to discuss that issue?
We are already aware of the issue and have taken some action on it. Officials have met representatives from the Scottish young carers services alliance and the College Development Network, and we are undertaking a range of actions in relation to the difficulties that young carers face with access to EMAs.
We are revising the Scottish Government guidance on EMAs to ensure that it includes information that can help to support carers and that recognises some of the unique challenges that young carers might have. We are also looking to provide additional information in the school packs on EMAs, which are currently being finalised before they are distributed to schools, and at how we can provide further information to young carers about the provisions within the EMA guidance.
I recognise the concerns that have been raised, and some of the work that we are doing is aimed at addressing some of those concerns. I will of course be more than happy to discuss that with the Cabinet Secretary for Education and Lifelong Learning to make sure that we build on what we have achieved and we look at what we can do to improve things further in the future.
National Infertility Group Report
To ask the Scottish Government what progress it has made on implementing the national infertility group report. (S4O-02840)
New access criteria recommended in the national infertility group’s report, with some modifications, were given to national health service boards on 15 May 2013 and have been in place since 1 July 2013. That means that, for the first time ever, criteria for NHS in vitro fertilisation are the same regardless of where couples live in Scotland.
We are committed to providing an equitable and sustainable service across Scotland, which is why we will have a maximum waiting time in place by March 2015 of 12 months for IVF. This is the first time that a Government in Scotland has made such a commitment. It is also the first time that the Government has invested funds specifically to reduce IVF waiting times. To date, we have invested £6 million, and a further £6 million will be invested in 2014-15.
That investment has made a dramatic impact in reducing waiting times for IVF treatment in all areas across Scotland, and I am pleased to say that waiting times are now currently at or below 12 months in the vast majority of areas. In particular, waiting times in NHS Fife, NHS Forth Valley and NHS Grampian have fallen from more than three years to between six and nine months. I am sure that Sandra White will recognise that as good progress on improving the service.
It is very good progress, which we have achieved by working with the NIG. The minister will be aware that NIG recommended that the number of IVF cycles should be reviewed at the earliest possible opportunity. The minister said that the money that the Scottish Government is investing in reducing waiting times is achieving a positive result. Can he give us a timescale for when the review of the number of IVF cycles will be carried out?
Sandra White is correct to point out that the national infertility group recommended a review of the access criteria after a period of time. We are undertaking work to look at the new treatment pathways and to establish whether there is sufficient data to allow us to undertake the review at an earlier stage. The review was initially intended to take place in 2015.
This month, my officials have met the information services division, representatives of the four NHS IVF centres in Scotland and patient stakeholder groups, such as Infertility Network Scotland, to consider whether we have sufficient robust data to allow an earlier review. A further meeting will take place next month to consider that in more detail. If sufficient robust data is available, the Scottish Government is content for the review to take place and for views to be submitted to the Scottish Government by the end of this year.
I understand from the Infertility Network that National Institute for Health and Care Excellence guidelines state that three attempts at IVF can be made available to NHS patients. In Scotland, I believe that only two are recommended. Will the minister clarify how that recommendation was reached and whether it has been made on clinical or other grounds?
Nanette Milne is correct that the national infertility group recommended to the Scottish Government that two cycles should be made available, and she is correct to point out that there is a different position in England, with three cycles. However, that is NICE guidance, not what is actually being implemented by the NHS in England. In commissioning areas in the NHS in England, some 73 per cent of commissioning groups recommend fewer than three cycles, so it would be wrong to suggest that IVF is universally provided on a three-cycle basis.
However, part of the review is to consider whether there is the possibility of the NHS in Scotland providing further cycles once we have achieved the 12-month waiting period. The review will assist us in considering whether that increased capacity is something that can be achieved with the existing service delivery, staff complement and resources.
Before I call Duncan McNeil, I take the opportunity to record the work that our late and loved colleague Helen Eadie did on this issue, particularly in Fife.
Thank you for mentioning that, Presiding Officer, particularly as the minister mentioned the progress that has been made in Fife and other areas.
Some of us who took time last week to meet the Infertility Network heard about the issue of the number of cycles, and we also heard that although very good progress is taking place across Scotland, progress is very slow in one of the biggest health authorities in Scotland, NHS Greater Glasgow and Clyde. I am going out on a limb here, but I am sure that it was reported to us last week that waiting times there are around 22 months. Will the minister confirm whether that is the case? If it is, what can he do to ensure that the board catches up with the rest of Scotland?
A couple of boards, one of which is NHS Greater Glasgow and Clyde, are still not meeting the 12-month target that was set nationally. At present, the assisted conception unit in Glasgow infirmary has a 19-month waiting period. Patients have been offered the opportunity to have services provided in other health board areas, in places such as Dundee, Aberdeen or Edinburgh. There is additional capacity, particularly in NHS Lothian, to assist the board in meeting the timeframe. The board is doing a considerable amount of work to ensure that it complies with the 12-month target, but patients who have unfortunately had to wait for a longer period are being offered alternative options in other health board areas to speed up access to treatment.
Diabetes Action Plan
To ask the Scottish Government what recent discussions it has had with the national health service about the progress of the diabetes action plan. (S4O-02841)
The Scottish Government is in regular dialogue with NHS boards regarding the delivery of the actions in the diabetes action plan. The NHS boards’ diabetes managed clinical networks have each provided a comprehensive report to the Scottish diabetes group. Overall, good progress has been made, and boards are on track to meet the vast majority of actions for which they are responsible. A summary of the reports will be published on the diabetes in Scotland website in April.
The minister will be well aware that nearly 1 million people in Scotland are directly affected by diabetes, either by having it or by being at high risk of developing type 2 diabetes. How will people with diabetes be at the heart of the new diabetes action plan? Does the minister share my view that we must urgently tackle the ticking time bomb of diabetes in Scotland?
The member raises an important point. There are a couple of aspects to the issue. One is that we need to ensure that we take a range of actions to reduce the chances and risks of individuals developing type 2 diabetes. We have a range of programmes in our obesity route map to help to reduce the risk of individuals developing diabetes in the first place.
We also need to ensure that those who are diabetic get the best possible service. The action plan, which I know the member is well aware of, is aimed at ensuring that those people receive the right type and quality of services in their health board area. As I mentioned, good progress has been made on that, and we are now evaluating the impact, which will help to inform the next step that we must take as part of the second phase of the action plan. I have no doubt that the cross-party group in the Scottish Parliament on diabetes will wish to feed into that process once it has started. The aim is to ensure that the next action plan allows us to build on and continue to make good progress.
Voluntary Register of Interests for Doctors
To ask the Scottish Government what its position is on the establishment of a voluntary register of interests for doctors. (S4O-02842)
The regulation of medical doctors is reserved to the United Kingdom Government. However, healthcare professionals, subject to statutory regulation, are required to adhere to standards of ethical and professional conduct that are set by their regulatory bodies, whether they work in the national health service in Scotland or in the private sector. Registered doctors are required by the General Medical Council to work to the standards in “Good medical practice”. Since the introduction of the new general medical services contract in April 2004, general practices have been contractually obliged to keep a register of gifts that have an individual value of more than £100.
Does the cabinet secretary agree that doctors should register gifts and payments that they receive from drugs companies in a more formal way, similar to the way in which we members of the Scottish Parliament have to register our interests? As a recent letter to the British Medical Journal from a campaigning group of health professionals suggested, that would allow patients to check as a matter of routine whether their doctor is benefiting financially from the pharmaceutical industry. Does the cabinet secretary agree that there is potential for prescribing practices to be affected by such financial interests?
As I said, that is a reserved issue for the United Kingdom Government. Although I agree that doctors should register gifts and payments that they receive from drugs companies, that would require full and proper investigation. Anyone who has any suspicions, concerns or evidence that prescribing is being influenced by such gifts should report the matter to the right authorities.
Health and Wellbeing Policy (Academic Research)
To ask the Scottish Government what use it makes of academic research from Scottish universities and colleges in formulating health and wellbeing policy. (S4O-02843)
Many of the outputs of clinical research are universal and therefore research from academic sources from both within and outwith Scotland is of value in formulating the Scottish Government’s health and wellbeing policy.
The chief scientist office, through its two research funding committees, funds high-quality, peer-reviewed research of relevance to the health and wellbeing of the people of Scotland. Lay summaries of the outputs of that research are made available to Scottish Government health policy colleagues. More generally, the Scottish intercollegiate guidelines network develops evidence-based clinical practice guidelines for the national health service in Scotland. SIGN guidelines are derived from a systematic review of all the scientific literature available.
A few years ago, through the University of the Highlands and Islands, a couple of doctors conducted research over a three-year period into the health and wellbeing of older people in the Highlands and Islands, the net result of which has been positive in various communities. My understanding—I do not have evidence for this, but it is my belief—is that about 11 per cent of university research in that field is used by the Scottish Government. That leaves almost 90 per cent not being recognised, and I wonder whether the cabinet secretary feels that there is room to make more use of the experience of health boards of using research across the country.
We make extensive use of medical professionals in our health boards and they are heavily involved in all the scientific work that we do. I can give one example relating to the science of informatics, which has been important in informing our policy on diabetes. As a result of the involvement of the health boards and their medics in informatics in looking at how we can better treat diabetes, Scotland has seen in recent years a 40 per cent reduction in amputation resulting from diabetes, and a substantial reduction in blindness resulting from diabetes. That is a direct result of the application of the science of informatics throughout the health service in Scotland, in co-operation with the CSO.
Independence (Life Expectancy)
To ask the Scottish Government how it would use policy levers in an independent Scotland to increase life expectancy. (S4O-02844)
An independent Scotland would have at its disposal the full range of policy levers to promote good health and increase life expectancy. As well as maintaining free healthcare delivery through our national health service, independence will allow us to take responsibility for our society’s wellbeing and welfare. An independent Scotland will have greater powers to regulate alcohol and tobacco through taxation, while control over tax policy and advertising regulation will help us achieve a coherent approach to the problems of obesity and poor diet. Most important, with independence Scotland can address poverty and socioeconomic inequalities, which are at the root of preventable ill health, which successive Westminster Governments have systematically failed to tackle.
To what extent does the cabinet secretary attribute our relatively poorer life expectancy to economic inequality, and how far is it attributable to behavioural factors that are distinct to Scotland, such as the drinking culture? What relative weight is given to them?
International research led by Professor Harry Burns, the chief medical officer for Scotland, who is unfortunately about to move on to pastures new, provides overwhelming evidence that the major contributing factor to the disparity in life expectancy within Scotland, as well as between the likes of Glasgow and similar cities elsewhere, is almost entirely the levels of deep-seated poverty and unemployment in those cities.
Like Harry Burns, I believe that we will only seriously reduce health inequalities when we are able to reduce social and economic inequalities in our society, and we can only achieve that when we are independent.
The cabinet secretary used to be a socialist. In a quiet moment, such as today, will he tell us—just us, nobody else—what his real view is of John Swinney’s voodoo economics, which will rip £350 million a year out of public services in corporate tax cuts? That policy will have a real detrimental impact on health and social policies, which in turn will impact on life expectancy.
One of the big campaigns in which Neil Findlay is involved is the campaign to get rid of nuclear weapons from the Clyde—he has said that the resources could be freed up for investment in education, health and helping poorer people in our society.
The reality is, of course, that Neil Findlay is going to vote no. That means that, despite his campaigning, he is going to vote to retain nuclear weapons on the Clyde, so the money—£100 billion—will be spent on nuclear weapons instead of on education, health and anti-poverty measures. Therefore, I do not think that Mr Findlay can claim to be either consistent or, indeed, a socialist.
Young Transgender People (Health Support)
To ask the Scottish Government how it supports the health of young transgender people before gender recognition is granted. (S4O-02845)
The Scottish Government recognises the importance of young transgender patients getting the necessary support that they require, and we expect all boards to ensure that the appropriate services are in place to help and support them.
Will the Scottish Government give a commitment to consult national health service gender specialists and equality organisations to find out how the gender identities of young people can be recognised and supported?
A great deal of discussion has been undertaken—in particular in the Equal Opportunities Committee—in relation to that issue. It has been part of our discussions on the bill on same-sex marriage—the Marriage and Civil Partnership (Scotland) Bill—which includes wide-ranging provision as regards transgender services and support.
We have been consulting the transgender community at every stage and we will continue to have dialogue with the transgender community to identify ways in which we can continue to support and help people in that community, particularly those such as young people in their teens who are at the stage in life of seeking to manage the situation that they find themselves in.
Alcohol Abuse
To ask the Scottish Government when it expects a decision by the European Commission on the provisions of the Alcohol (Minimum Pricing) (Scotland) Act 2012, and what action it has taken in the interim to tackle alcohol abuse. (S4O-02846)
We remain in dialogue with the European Commission and we are committed to introducing minimum unit pricing.
Minimum unit pricing is just one of more than 40 measures in our framework for action document—measures that seek to reduce consumption, support families and communities, encourage more positive attitudes and positive choices, and improve treatment and support services.
Considerable progress has been made on implementing key aspects of the alcohol framework, including: a record investment of more than £237 million in the past five years to tackle alcohol misuse; the delivery of more than 366,000 alcohol brief interventions by NHS Scotland; the establishment of 30 alcohol and drug partnerships; the development of an implementation plan to deliver the recommendations in the quality alcohol treatment and support report; the commencement of the Alcohol etc (Scotland) Act 2010; the passing of the Alcohol (Minimum Pricing) (Scotland) Act 2012; and, most recently, the launch last week of a campaign to promote the availability of a smaller wine measure in the on-trade.
I thank the cabinet secretary for that comprehensive reply. I express frustration—even if he does not—at the length of time that it is taking to secure support for the Alcohol (Minimum Pricing) (Scotland) Act 2012.
Why has the cabinet secretary not pursued the industry’s offer to expedite an early legal resolution of the matter? It is now 20 months since we passed the 2012 act. Why has Parliament not debated alcohol again since then, given the very considerable cross-party support for pursuing the agenda that there was and the very useful and constructive suggestions made by Richard Simpson, many of which members on all sides of the chamber would be prepared to explore and support?
I share the member’s frustration at the time that it is taking for us to be able to implement our legislation. Two processes are currently under way. One is taking place in the domestic courts, in which there will be a further hearing in the next two weeks on the Scotch Whisky Association’s action in relation to the implementation of minimum unit pricing. I am sure that the member will understand if I do not go into the legal arguments as to why we have not responded positively to the SWA’s proposal.
The other process concerns the European Commission. Three directorates-general are involved in considering the question: the internal market directorate-general is formally neutral on the issue; the health directorate-general is in favour of minimum unit pricing; and, if not hostile, the enterprise directorate-general is not exactly pro minimum unit pricing.
We believe that the enterprise directorate-general’s arguments are entirely without foundation. However, we need to persuade the Commission, and in doing so we have recruited the support of other Governments, in particular the Estonian and Irish Governments. In addition, although minimum unit pricing will not apply in Denmark, the Danish Government and the Danish health minister have been very supportive of what we are doing in Scotland.
I gently point out, of course, that if we were an independent member state we would have made substantially more progress than we have been able to make so far.
NHS Lanarkshire (Meetings)
To ask the Scottish Government when it last met NHS Lanarkshire and what issues were discussed. (S4O-02847)
Ministers and Government officials meet regularly with representatives of all national health service boards, including NHS Lanarkshire, to discuss matters of importance to local people.
I am delighted to hear that. Can the cabinet secretary confirm whether he has met directly with members of NHS Lanarkshire’s board, the expert team or Healthcare Improvement Scotland specifically to discuss the recent assessment of patient safety and quality of care in NHS Lanarkshire?
I asked the whole board to come to a meeting in St Andrew’s house just before Christmas to discuss the report that Healthcare Improvement Scotland produced, and I made it clear to the board members that I expected them to take the report’s findings very seriously and to implement its recommendations.
I have given the board until the end of March to make significant progress. At that point, I and my officials, along with Michael Matheson, will review progress and decide whether any further action on our part is required.
Linda Fabiani has asked for a supplementary, which I will take after the next question.
NHS Lanarkshire (Meetings)
To ask the Scottish Government when ministers will next meet the board of NHS Lanarkshire. (S4O-02848)
This will come as no surprise. Both ministers and Government officials regularly meet representatives of all national health service boards, including NHS Lanarkshire.
That is a very surprising answer. Healthcare Improvement Scotland produced 21 recommendations to address the problems that were identified in NHS Lanarkshire. Some of those recommendations are quite vague, which makes it difficult to establish exactly what criteria will be used to show that progress has been made in improving certain aspects—for example, in involving the staff and making them feel part of the way forward.
Will the cabinet secretary make known the criteria that will be set and the targets that have been given to NHS Lanarkshire, so that we know whether it will meet the challenges that HIS has laid down for it?
I and my officials have had dialogue with NHS Lanarkshire to spell out in no uncertain terms the progress that we expect to be made on each of the 21 recommendations—and indeed on other elements in the report that are not covered precisely in specific recommendations—by the end of March. Beyond that, we have made clear how we expect the board to get NHS Lanarkshire into better shape.
To be fair, the board and senior management team of NHS Lanarkshire have taken on board the recommendations and comments in the report and the additional points that we have made to them in subsequent discussions. I believe that they are committed to implementing all 21 of those recommendations to a high standard.
Michael McMahon is quite right: beneath the 21 recommendations and all that is going on in NHS Lanarkshire, there are a lot of staff doing an absolutely excellent job. Is the cabinet secretary aware that an NHS Lanarkshire initiative—the integrated community support team, which is based in East Kilbride—won the older people award at the 2013 Scottish health awards? That is about providing more care at home, in communities, and trying to keep elderly people out of hospital or reduce their stay in hospital. It has been a great success and has a great staff team. Would the cabinet secretary or the Minister for Public Health like to visit the team in East Kilbride to see what great work is being done?
We are always glad to accept an invitation to East Kilbride.
One of the frustrating things about the findings of the HIS report with regard to the deficiencies in NHS Lanarkshire is that, in a way, they distracted attention from many of the good things that are going on there. The member refers to one service; another would be the special dementia unit in the accident and emergency department in Monklands hospital. It is the first of its kind in Scotland, and perhaps in the United Kingdom. It is a great pity that the deficiencies that are identified in the report are distracting public attention from the good things that are happening in NHS Lanarkshire. We have to keep a balanced point of view and take a balanced approach.
That said, the deficiencies are serious and they need to be sorted as soon as possible.
Question 13, in the name of Christina McKelvie, has not been lodged. The member has provided an explanation.
Emergency Admissions (People over 75)
To ask the Scottish Government what action it is taking to address reported increases in emergency admissions for people over 75. (S4O-02850)
The rate per 1,000 people aged over 75 admitted to hospital as an emergency had been rising for many years. That was one of the reasons why we introduced our reshaping care for older people programme and the £300 million change fund. Most recent data shows a levelling off of admission rates.
We are seeing impacts from interventions such as intermediate care alternatives to emergency admission, Scottish Ambulance Service see and treat models, anticipatory care plans and key information systems, the falls programme, carer support, the unscheduled care action plan and local unscheduled care action plans.
Bed days spent in hospital following an emergency admission are a better measure of how the whole system supports the rising number of older people with multiple and chronic illnesses. In the period from 2009-10, there has been a year-on-year reduction in the days spent in hospital following emergency admission per 1,000 people aged over 75. That reduction has been one of 9.5 per cent between 2009-10 and 2012-13.
I thank the cabinet secretary for what was a comprehensive answer and a good news story from the Scottish Government.
Notwithstanding the answer that the cabinet secretary has just given, an increasing proportion of people in the post-75 age group are going into accident and emergency departments with dementia concerns. What steps is the Scottish Government taking to provide the specialist nursing care that is required for those patients in acute hospitals?
Under the dementia strategy, we now have a great deal of support that was not there even a few years ago. We have dementia consultants, dementia ambassadors and dementia champions, all of whom play different roles in different parts of the health service. The question was specifically about acute care, but the relationship between acute care and primary care is critical.
Over the next 20 years or so, the number of over 75-year-olds in Scotland will rise by between 60 and 80 per cent. Clearly, unless a cure is found in the meantime, which is unlikely, many of those patients are likely to have dementia. The total number of people with dementia in Scotland at the moment is 77,000. If my memory serves me correctly, only 3,000 of those people are under 65. By definition, therefore, 74,000 of them are 65 or over, and a large proportion of them will be over 75.
It is an area of priority in primary care services and in acute care services. We are building on the dementia strategy to ensure that the complete panoply of services and support that is required for dementia hospitals is provided in each of our 38 acute and general hospitals.
Excess Sugar Consumption
To ask the Scottish Government what steps it is taking to tackle the effects of excess sugar consumption. (S4O-02851)
I am aware of recent reports in the media that link excessive sugar consumption with obesity, type 2 diabetes and a range of other conditions, including heart disease and stroke. It is, of course, also linked to poor dental health.
The Scottish Government is spending more than £7.5 million in the three years to 2015 on projects to encourage healthy eating, which include the healthy living award, the healthy living programme, the healthier Scotland cooking bus and the community food and health (Scotland) programme. Alongside those, the Scottish Government has published the Scottish dietary goal of reducing the average intake of added sugars to less than 11 per cent of food energy in children and adults.
I thank the minister for his answer, but he might be aware of research that was published in the British Medical Journal in October that said that a 20 per cent tax at a United Kingdom level on soft drinks with a high sugar content would reduce the number of obese adults by around 1 per cent. What consideration has the Scottish Government given to such measures? What further steps can it take to reduce the health problems that are associated with excess sugar consumption?
I am aware that the latest data from the Kantar Worldpanel shows that there has been a reduction of some 10 per cent in the volume of soft drink sales since 2010, although I agree and recognise that much more still has to be done.
Under the current devolved powers, the Scottish ministers are unable to create taxes on food or drink with a higher fat or sugar content, which is why we articulated in the white paper on Scotland’s future our desire to have the ability to consider such a policy as part of a coherent and concerted approach to tackling issues such as obesity and poor diet.
In the meantime, we are asking the food industry to take specific voluntary action to help rebalance Scotland’s diet. Our supporting healthy choices voluntary framework will be launched in the spring, following a period of consultation. The framework sets out voluntary actions for the food industry, which includes manufacturers, retailers and caterers, to encourage and support consumers to make healthier choices.
Attention Deficit Hyperactivity Disorder
To ask the Scottish Government what its strategy is for tackling ADHD among young people. (S4O-02852)
Children and young people with developmental disorders will be treated by their local child and adolescent mental health services team in the community.
In the mental health strategy, we made a commitment to undertake work to develop appropriate specialist capacity in respect of developmental disorders such as ADHD, as well as to improve awareness in general settings. As part of that work, we will review the need for specialist in-patient services in Scotland.
Education authorities have a duty to identify, meet and keep under review the additional support needs of all their pupils and to tailor provision to their individual circumstances.
If you could be brief, Mr Lamont.
The minister will be aware of the high rate of use of ADHD drugs in the NHS Borders area—at 17.2 per cent, the rate there is the highest of any NHS board in Scotland. I accept that such drugs have a use and should be part of the range of treatment options that are available, but is the minister aware of the recently reissued National Institute for Health and Care Excellence guidance, which raises concerns about the use of such drugs and recommends that drugs should not be used as the first line of treatment for school-aged children and young people with moderate ADHD? The British Medical Journal has recently raised similar concerns.
Does the minister accept that the rate of use of such drugs in the Borders is unusually high? Does he believe that more should be done to reduce it?
I ask you to be brief, minister.
It is important that the member recognises that the type of clinical intervention that is provided for a patient is a matter for clinicians, rather than something for the Government to direct.
Scottish intercollegiate guidelines network guideline 112—which, unlike the NICE guidance, applies in Scotland—sets out for clinicians detail on the management of children with ADHD and other behavioural problems. It sets out the criteria that should be used, how such children should be supported and how their condition can be dealt with appropriately. However, I reiterate that the final judgment on clinical provision is a matter for clinicians.
We move to the next item of business, which is a debate on the common agricultural policy.
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