SCOTTISH EXECUTIVE
Health and Wellbeing
Homeless People (Services)
To ask the Scottish Executive how it is supporting services for homeless people and how it will encourage local authorities to support such services. (S3O-3529)
The Scottish Government's commitment to settled accommodation for all unintentionally homeless people by 2012 is reflected in the national performance framework. We are taking forward the conclusions of the homelessness monitoring group and the 2012 support project with the Convention of Scottish Local Authorities. Local authorities have statutory duties in relation to homeless households. Funding is provided through the local government settlement and the authorities' performance in discharging those duties is monitored by the Scottish Housing Regulator.
Is the minister concerned about the situation in Aberdeen where, because of cuts of nearly £900,000 in local authority funding for the Cyrenians, vital services that support hundreds of homeless people will be closed? What action will the minister take to ensure that the Government delivers on its pledge for action on homelessness and that the pledge is not broken in Aberdeen, so that those vulnerable people continue to receive the vital services that they need to help them turn their lives round?
In responses to written questions from Richard Baker I have recognised the important role that charities play throughout Scotland, and in Aberdeen in particular, as partners in assisting local authorities to tackle and prevent homelessness. In the north-east of Scotland there are several such partners, including the Cyrenians.
How will the minister advise local authorities in general and Aberdeen City Council in particular about getting best value from homelessness services, whether they are provided at an authority's own hand or by the voluntary sector?
We want to ensure that the best value approach is adopted by all councils, including Aberdeen City Council, and for all services, including homelessness services. Local charities have an important role in delivering those services. I am sure that Aberdeen City Council will use the flexibility that is now provided through the Government's concordat with local government to ensure that services are provided flexibly and, more important, that they fit as closely as possible with the needs of people in Aberdeen. It is important that we ensure that the services are driven by the needs of people in Aberdeen. Whether the services throughout the area are delivered by one charity or by many, we must ensure that those services provide best value. They must also meet Aberdeen City Council's duty to ensure that people who are unfortunately afflicted by homelessness, or those who require any other service, are provided with services of the highest standard.
Blood Donation
To ask the Scottish Executive what action it is taking to encourage people to donate blood. (S3O-3543)
The Scottish National Blood Transfusion Service is carrying out a public consultation exercise as part of its forward strategy review of the services that it provides. A major objective of the review is to increase the donor base in Scotland by 35,000 people—an increase of 20 per cent.
The minister will no doubt be aware that blood donors are not entitled to paid time off when they give blood. When giving blood, I have met people who have taken unpaid leave to meet the critical need for blood. Does the minister agree that, although people should not be paid for giving blood, employers should be encouraged to give people paid time off to enable them to donate?
Yes, I agree.
On Wednesday 23 April, the Cabinet Secretary for Health and Wellbeing announced the public inquiry into the hepatitis C action plan. I asked about the funding of the inquiry and the cabinet secretary said that
Briefly please.
The information was clarified three days later. I am briefly coming to the point, Presiding Officer.
The money that I announced for the hepatitis C strategy—record levels of funding—is completely different funding from the funding that will be used for the hepatitis C inquiry. It is important that that is clear; I am sure that Margaret Curran would not suggest otherwise.
Deep Vein Thrombosis
To ask the Scottish Executive what measures it is currently implementing to ensure that more people are aware of the risks of deep vein thrombosis. (S3O-3481)
The Scottish Government has funded the charity Lifeblood to develop a general information leaflet on deep vein thrombosis. It was sent to every GP practice in Scotland in April, together with a covering letter from the chief medical officer and the chairman of NHS Quality Improvement Scotland drawing attention to the importance of displaying the leaflet.
The cabinet secretary is no doubt aware that thrombophilia is caused by a gene that is carried by some people and which makes them more vulnerable to an attack of DVT. Is thrombophilia screening available to those who request it, or to those who are at a higher risk of carrying the gene?
Bill Aitken will know that the Scottish Government follows the advice that the United Kingdom national screening committee offers on screening programmes. The committee does not currently recommend population screening. However, it is common in Scotland for relatives of people who have the factor V Leiden—the genetic abnormality that can cause DVT—to be offered screening and given appropriate advice. A range of advice would be offered to people considered to be at risk.
Will the cabinet secretary encourage all hospital management plans for deep vein thrombosis to include investigations as to whether a serious pre-existing medical condition—not only thrombophilia—is precipitating the development?
Given his professional background, Ian McKee will know of the existence of the Scottish intercollegiate guidelines network guideline 62, which offers guidance that covers people admitted to hospital for serious trauma, for surgery or for acute illness. Aspects of the guidelines are currently under review, but the protocols that are in place for dealing with patients in those categories reflect the guidance in guideline 62. NHS Quality Improvement Scotland has done a stocktake on that already and it will conduct a follow-up exercise with NHS boards.
Betting Shop Workers
To ask the Scottish Executive what steps it is taking to monitor the impact of violence and abuse in the workplace on the mental and physical health of betting shop workers. (S3O-3562)
Acts of violence and abuse against anyone working in a public-facing role are unacceptable. The Scottish Government is continuing to support the campaign for the protection of public service workers from violence that has been run for the past four years in partnership with the Scottish Trades Union Congress.
The minister will be aware of the poster campaign highlighting violence against betting shop workers that has been run by the trade union community, the Scottish Government, retailers against crime and the STUC. We have seen a successful approach in other industries, particularly in the rail and bus industries, where there has been a joint approach between trade unions, employers and Government. That sort of approach would work well in betting shops. Will the minister pursue employers in the bookmaking industry who are not prepared to display the posters and enter into dialogue with bookmakers about displaying the posters more widely throughout the country?
I commend John Park for the work that he has done on the issue. He will be aware that officials from the Scottish centre for healthy working lives are already in discussions with the trade unions and employers in the betting trade on how best to tackle the abuse of workers. I look forward to betting-trade employers taking advantage of the support and assistance that is available to them from the centre, and I would certainly encourage any employers who have not displayed the posters to do so. I am sure that such encouragement can take place in the context of the discussions with the centre.
Population Health Trends <br />(West Dunbartonshire)
To ask the Scottish Executive what primary care and mental health care initiatives it will ensure are taken forward to reverse the adverse population health trends identified in the "Health of the People of West Dunbartonshire: Needs Assessment" report published in August 2007. (S3O-3558)
The unacceptable population health trends that were identified by the report are being addressed by a number of primary care and mental health initiatives including the keep well programme. In addition, the wider determinants of ill health affecting people in West Dunbartonshire will be addressed through the forthcoming recommendations of the ministerial task force on health inequalities.
There is some concern that the relative trends in West Dunbartonshire are worsening. That comes out not only in the report but in other research by the Glasgow centre for population health. A particular focus of concern is the number of people with severe symptoms arising from sustained alcohol abuse. Would the minister like the health board to address that issue when it implements the initiatives to which she referred?
Absolutely, which is why we are investing £85 million of new moneys over the next three years in tackling alcohol misuse, specifically with the brief interventions programme, which is an important way of identifying hazardous drinkers that will be delivered through health boards. That will be a significant element of what takes place in Des McNulty's constituency.
How does the Minister for Public Health intend to improve the mental health of people in West Dunbartonshire and other areas, given that the Government will preside over a reduction in the number of nurses entering training for mental health nursing from 550 to 340 in August 2008? Will that number remain stable or will it increase again in order to meet the various Government targets on mental health?
Those figures are based on workforce planning assessments that take into account all the Government's policy developments. The member will be aware that there are now four specific mental health targets for all NHS boards, which cover attention to reduced levels of antidepressant prescribing and suicide, the latter with an added focus on increased training of front-line care staff.
Health Services (Lanarkshire)
To ask the Scottish Executive what plans it has for local health services in Lanarkshire. (S3O-3548)
I have stated on several occasions that I want NHS Lanarkshire to deliver its planned community services. It is for NHS Lanarkshire to prioritise the services that it delivers to best meet the needs of local people within the resources that are available.
In relation to local health services, what plans does the Cabinet Secretary for Health and Wellbeing have for local general practitioner services at the Alison Lea medical centre in East Kilbride, which are currently subject to tender? I recall that the cabinet secretary's party and her colleagues made accusations about the conduct of the Harthill GP surgery tender. In the Scottish National Party's view, the tendering regime opened up GP services to privatisation. It is therefore a straightforward question for the cabinet secretary, as it is now her watch. Can private sector providers or companies such as Serco bid to run the service: yes or no?
Under the legislative framework that we inherited from the previous Administration, at the moment, technically, they can. However, I have made it clear that the Government and I are committed to a public national health service that delivers services in the public sector. That is why I am currently considering—as Andy Kerr failed to do when he was Minister for Health and Community Care—how we address the issue to ensure that the situation that he has just described cannot happen in Scotland.
The health service in Lanarkshire, as elsewhere, is testing young people for chlamydia on an occasion-arising basis. The evidence that ministers have received says that there is no need for a national screening programme yet, although the incidence of those who test positive is very high. Within that percentage, pitifully few young men are being tested, and it is young men who are spreading chlamydia. What more can be done to alert young people to the dangers that the disease potentially poses? Is there a need to increase overall the number of people that we seek to screen?
Jackson Carlaw raises a very important issue. We are encouraging the opportunistic testing that he mentions; there is also work around partner tracing and the use of postal testing kits. As I said in my answer to a previous question, we follow expert guidance in terms of national screening programmes and we will continue to keep all those issues under close consideration. If Jackson Carlaw wants to discuss the issues further, I am sure that the Minister for Public Health will be happy to do so.
Respite Care (Brora)
To ask the Scottish Executive what action it will take to ensure Highland Council maintains the current level of respite care at Beachview Lodge, Brora. (S3O-3526)
The Scottish Government recognises the importance of respite in supporting unpaid carers and those with care needs, and in sustaining caring relationships. That is why our concordat with local government includes a commitment to make progress towards an extra 10,000 respite weeks per year.
Local carers are upset in that particular case because it involves their loved ones being taken far further from their homes for respite. Will the minister instruct her officials to examine copies of representations that I have received from my constituents and evaluate the plans in terms of whether they really are in accordance with the Scottish Government's best intentions?
I am aware that Highland Council is considering whether Beachview Lodge could be adapted to provide small group living for those people with learning disabilities who are currently supported outside the area. However, it is important to stress that no decision has yet been taken on the issue. Any plans that are taken forward must be within the context of the policy of "The same as you?" and the changing lives agenda.
The minister will acknowledge that service change can be unsettling for service users and their carers. In such circumstances, the clarity of the information that is provided by the council to services users becomes important. As she says that she cannot intervene directly, will she consider issuing guidance to local authorities on appropriate consultation regarding change in such areas of service delivery to ensure that any change does not result in a diminution of the care that is on offer?
I expect any local authority to undertake service change in a way that is clear and that offers service users and their carers a full input into the decision-making process. As I said, consultation events have been planned for June, and I expect those to take full account of the views of service users and carers. I agree with Peter Peacock that service change is difficult, but it is sometimes necessary in order to provide services in a better way. However, it must involve the full co-operation of service users and carers.
Given the fact that respite care is not mentioned specifically in Highland Council's single outcome agreements but appears in another document that has a primary focus on older people, can the minister advise members how we can scrutinise the single outcome agreements to ensure that, over the next three years, the additional 10,000 weeks of respite care that the SNP Government has promised are delivered?
The Scottish Government is examining each of the single outcome agreements of the 32 local authorities to ensure that they reflect and are robust and ambitious enough to meet the targets and outcomes that have been agreed. I will give particular attention to where respite care sits within Highland Council's single outcome agreement. The important thing is that the outcomes are robust and reflect the needs of local carers and services users. I also expect the single outcome agreements to be discussed fully with those who receive services in those areas—that would be good practice on the part of local authorities.
Hospital Meals (Assistance)
To ask the Scottish Executive what arrangements are currently in place in hospitals to assist elderly people with eating their meals. (S3O-3468)
It is the responsibility of the nurse who is in charge of a ward to ensure that all patients are assisted in eating their meals. The current arrangements include the assessment of patients on their admission to hospital to determine their nutritional needs, including assistance with meals. A care plan is developed for those who need one, which is implemented and evaluated to ensure that any changes in the patient's condition are taken into account and acted on. The Scottish Government is developing national catering and nutrition standards, which will be launched over the summer.
The minister will be aware that the nurses who are in charge of wards frankly are often too busy to pay much attention to assisting elderly people to eat their meals, and that consequently there is a lack of support for elderly patients in that regard, which is widespread throughout Scotland. Does she acknowledge that there is little prospect of addressing this vexing issue without accurate assessment of the extent of the problem? If so, what action is being taken to record the number of elderly patients who are either too weak or lack the motivation to feed themselves, to ensure that they have access to the necessary assistance?
The development of the new national catering and nutrition standards followed a review by NHS Quality Improvement Scotland in 2005-06 into standards for food, fluid and nutritional care in hospitals, which recommended that the quality of nutritional care in hospitals be improved. A monitoring tool is being developed that will be tested in three national health service boards from July to September, prior to being rolled out to all NHS boards. It will measure boards' compliance with the new national catering and nutrition standards and assess patients' experience of their nutritional care, which will include assistance with their meals. We will therefore be able to get a picture of the improvements that are taking place, and take appropriate action if they are not taking place quickly enough.
Having difficulty with eating meals is a major issue for Parkinson's disease sufferers, not all of whom are elderly. They can often have off-periods when their movements are uncontrolled and they are unable to feed themselves. What action can the minister take to support Parkinson's sufferers who have to endure a difficult situation?
Patients' needs should be assessed when they come into hospital, and any change in their condition should be monitored to determine how able or otherwise they are to feed themselves and what assistance they require. I am confident that the standards that I have described will ensure that all patients, including those who have Parkinson's disease, get the support and assistance that they require. We will monitor the situation very closely indeed.
Below Tolerable Standard Housing (Glasgow)
To ask the Scottish Executive what specific proposals the Cabinet Secretary for Health and Wellbeing has for tackling below tolerable standard housing in the south side of Glasgow. (S3O-3551)
The responsibility for tackling below tolerable standard houses lies with the local authority. By implementing the Housing (Scotland) Act 2006, we will give it a wider and more effective range of tools.
Recently, I met tenants and residents of Govanhill Housing Association to talk about their concerns about the condition of the housing stock. Will the cabinet secretary consider making available the level of resources that was made available during the first session of the Scottish Parliament for housing in an area with many black and ethnic minority communities? Will she consider putting aside a sum of money, as she did last week to target central heating, to target BTS housing, specifically to enable us to remove as much of that unsatisfactory stock as possible? Finally, will the cabinet secretary consider visiting the area to meet tenants and hear their views about why something more needs to be done to tackle BTS housing in Govanhill?
I thank Frank McAveety for raising the issues, which I take very seriously indeed. He is right to bring them to the chamber. I am aware of the tenants of Govanhill Housing Association and their concerns and I know that the local authority has been working with them.
Elder-care Homes (Argyll and Bute)
To ask the Scottish Executive what support it gives to the elderly care home sector in Argyll and Bute. (S3O-3482)
We have provided record levels of support to local authorities for their responsibilities, including the commissioning of care services for older people. Our concordat with local government includes a shared commitment to work to improve the quality of care in care homes. Decisions about the levels and provision of care services in local areas are ultimately the responsibility of local authorities and their planning and commissioning partners.
The minister will be aware of the recent regrettable confusion surrounding the future of the Argyll and Bute Council-run Eader Glinn home in Oban, which caused great distress to patients, relatives and staff. Given the increased level of nursing care that traditional care homes for the elderly have to provide, can the minister guarantee that enough funding has been provided through the concordat to enable Argyll and Bute Council and other local authorities in the Highlands and Islands to upgrade their existing buildings to meet the requirements of the current fire safety and physical environment legislation, thus preventing further closures of otherwise excellent establishments such as Eader Glinn?
I understand that Argyll and Bute Council is currently reviewing its care home provision, including the development of progressive care centres and more integrated care home services to help more people to remain in their own home and to reduce the risk of people who live in care homes having to move if their needs increase. Clearly, much of that links back to the action plan that came out of last year's Social Work Inspection Agency report, on which Argyll and Bute Council has since taken action.
Cardiovascular Disease
To ask the Scottish Executive how use of the ASSIGN risk score would be likely to affect the overall number of people being treated for cardiovascular disease. (S3O-3534)
ASSIGN—assessing cardiovascular risk using Scottish intercollegiate guidelines network guidelines to assign preventive treatment—is being implemented and assessed initially through general practices that are involved in the keep well pilot in south-west Glasgow. Given that ASSIGN factors in social deprivation and family history as part of the risk assessment, we expect that it will identify a greater number of people who are at risk of developing cardiovascular disease than did the previous approach. Once people have been identified, action can be taken to provide them with the prevention or treatment measures that they need.
I welcome ASSIGN's weighting for deprivation, which is consistent with many studies, including the exciting work of the Glasgow Centre for Population Health. To allay public concerns and some misreporting, will the minister confirm that the effect of ASSIGN will be to increase the numbers of people in deprived areas who are likely to be treated without having any effect on the numbers who are treated from elsewhere?
I am delighted to have the opportunity to give that assurance. ASSIGN does not mean that people in better-off areas will be less likely to get the treatment that they need; rather, it means that more people in disadvantaged areas will get access to the treatment that they need. As I said in my initial answer, I expect that the overall number of people who are treated will increase as a result. I believe that the ASSIGN risk assessment approach can be a powerful tool in helping us to tackle health inequalities, given that, as well as the lifestyle factors that can lead to people in disadvantaged areas having poorer health outcomes, in many cases people who most need treatment are least likely to receive it. That is what the ASSIGN approach is designed to tackle.
My question relates to the scanners that are often used in diagnosis and which can be used for research into cardiovascular conditions. The minister will be aware of the generous donation of a scanner to Lothian NHS Board during the week. Can she put my mind at rest by assuring me and others that—this in no way affects the propriety of that donation to NHS Lothian—the conditional donation will not be seen as a precedent? Will guidelines be issued to health boards on the conditions that may appropriately be associated with such donations?
I agree with Margo MacDonald entirely. First, it is appropriate to put on record my thanks to the Royal Bank of Scotland for its donation to the national health service. The bank had always intended to purchase a scanner for the benefit of its own staff, but it decided—absolutely correctly, I think—that instead of 75 per cent of the scanner's capacity lying idle it could be used to the benefit of the research sector and NHS patients. I emphasise that that is at no cost to the NHS. However, I agree with Margo MacDonald that each case needs to be treated on its merits, and I certainly listened carefully to her comments on Monday after the Royal Bank of Scotland announcement. I am more than happy to consider further what guidance needs to be issued to health boards and to seek a debate in the Parliament to allow all members to contribute their thoughts to that process.
Alcohol Misuse (Services)
To ask the Scottish Executive how national health service boards and local authorities should support services for people affected by alcohol misuse. (S3O-3553)
We have made tackling alcohol misuse a priority for NHS boards through the introduction of a new target on delivering alcohol brief interventions. We have also agreed a national indicator on reducing alcohol-related hospital admissions as part of the national performance framework agreed with the Convention of Scottish Local Authorities. We are investing significantly increased resources to help achieve those targets—from £10 million in 2007-08 to almost £25 million in 2008-09—and that money will be routed through NHS boards.
Does the minister recognise that a brief interventions approach will be of benefit mainly to those in the lowest tiers of need, as defined in the national plan for action on alcohol problems and elsewhere? Does she accept that, often, those who have more complex and highly specialised needs have the greatest impact on health services, short of hospital admission, and on social work services? How much latitude will joint alcohol and drug action teams be allowed to apply funding to best meet what they identify as local priority needs?
Of course alcohol and drug action teams will have latitude to meet the local needs of their population. However, the policy context and direction that we have set is clear that many people who would be classified as hazardous drinkers might not see themselves as such, and that when they access the health service for other reasons the opportunity should be taken to address their hazardous drinking. That has support across the chamber. Around that, alcohol and drug action teams will be able to tackle other areas within their remits, particularly with regard to greatest need, and of course they will have the opportunity to help those who require additional support.
Human Fertilisation and Embryology Bill
To ask the Scottish Executive what impact the Human Fertilisation and Embryology Bill will have on the delivery of services related to sexual and reproductive health and rights in Scotland. (S3O-3484)
Until the Human Fertilisation and Embryology Bill has completed its parliamentary passage and become law, it is not possible to assess precisely what implications there might be, although we do not foresee the current legislative proposals having a significant impact on the delivery of sexual health services in Scotland. The Scottish Government will, however, continue to monitor the bill's progress to ensure that any changes that ultimately are made to the current legislative framework are identified and reflected in service delivery in Scotland.
I am sure that members will be aware of the recent decision by the Westminster Parliament to resist pressure to restrict access to safe, legal abortion. I strongly support that decision, but whichever side of that debate one is on I hope that we can all agree on the need to reduce the level of unnecessary abortion and to address the services that are in place to achieve that.
Patrick Harvie raises some extremely serious issues. Obviously, the issues that were debated and voted on in Westminster last week were issues of conscience, and members who had the opportunity to vote reached their own conclusions. However, it is important that we monitor closely the decisions that are made, because the issues impact strongly on our devolved responsibilities.
We will squeeze in question 14.
Homeless People
Thank you, Presiding Officer.
The Scottish Government, local authorities and their range of partners are working together to prevent homelessness where possible and to ensure that it is tackled effectively where it occurs.
The minister will know that housing organisations have expressed concerns about Government proposals to extend the use of six-month tenancies to house homeless people in the private sector. They have said that, at the least, that period should be significantly extended. Will he assure us that that period will be extended significantly and that homeless people who are housed in the private sector will not get a worse deal than homeless people who are housed in the social rented sector?
David Whitton is probably aware that we will shortly consult all relevant stakeholders on proposals to enable local authorities to discharge their duty to homeless households by using short assured tenancies in the private rented sector, when that outcome is appropriate and sustainable for such households. That additional flexibility would help local authorities to increase the housing supply options in their areas and would provide more choice for applicants. The consultation will explore circumstances in which local authorities could invoke that power and will invite views on the conditions that should be attached to its use.
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First Minister's Question Time