Health and Wellbeing
Good afternoon, everyone. The first item of business is portfolio questions. To get in as many people as possible, I would be grateful if we had short and succinct questions and answers.
NHS Scotland (Performance)
To ask the Scottish Government what information it has on how the performance of NHS Scotland compares with the national health service in other parts of the United Kingdom. (S4O-03146)
In recent years, various organisations have published analysis of how the NHS performs in the four countries of the UK. That includes the recent work that the Nuffield Trust undertook and work in 2012 by the National Audit Office. Both those reports highlighted Scotland’s strong performance in comparison with the rest of the UK on waiting times and highlighted that Scotland benefits from higher staffing levels.
The Office for National Statistics has previously compared hospital waiting times for specific procedures. We had that analysis updated and it was included in the Nuffield Trust report. It demonstrates that, for many procedures, such as hip and knee replacements and cataract surgery, average waiting times are shorter in Scotland than in both England and Wales.
Given the superior performance of NHS Scotland, will the minister outline the implications for future performance of a no vote in September’s referendum?
The NHS in Scotland already operates independently. We can point to many successes in NHS Scotland under devolution. Devolution has provided us with the opportunity to develop policies that benefit the people of Scotland. For example, we have implemented free personal care for the elderly, free eye and dental health checks and free prescriptions, which are all major achievements under devolution. Scotland has taken a different path from that of the UK Government on the NHS. We have defended the NHS against the privatisation that is happening south of the border and we have avoided multiple reorganisations, which has allowed us to focus on patient safety and the quality of care.
The Scottish Government’s vision for the NHS is to maintain our publicly owned and publicly funded health service that is provided free at the point of delivery. A no vote would put at risk the ability to protect Scotland’s NHS budget from cuts as a result of the privatisation agenda in NHS England and would reduce our ability to use the full range of levers to promote good health in Scotland.
Meanwhile, back in the real world, the Nuffield Trust’s report highlights that Scotland is falling behind other nations of the UK on a number of fronts, although it is making welcome progress on others. One concern is that we are falling behind comparator regions of the UK, such as north-east England, on life expectancy and mortality. What action has the Government taken to improve the life expectancy of all Scots and especially those who may be dying far too young?
The member will know that life expectancy in Scotland is increasing, although not as fast as we would wish. He will understand that life expectancy is a complex issue that relates to health inequalities. To tackle the issue effectively, we must tackle the social inequality that shortens life expectancy in many deprived parts of Scotland. A key aspect is not only looking to the health service to deliver some of the answers but tackling social inequalities. To do that, we must have the full range of powers, which will allow us to undermine and address effectively the inequalities that have blighted Scottish society for far too long.
Will the minister confirm that, as the Cabinet Secretary for Health and Wellbeing has told me, the Scottish Government expects to receive £1.3 billion in consequential spending for the health service as a result not of cuts but of ring fencing and increased spending in the health service in England? Does the minister not think that that additional money has contributed to the considerable efforts that the Scottish Government has made to improve Scotland’s health service?
The member will recognise that if there is a reduction in the health service budget in England as a result of its privatisation agenda, that will have a direct effect on our Barnett consequentials. It is interesting to note that neither the Labour Party nor the Tory party in London is committed to maintaining the Barnett formula. The consequences of that could be significant for the health service in Scotland, which is why we need to ensure that we protect the Barnett formula until Scotland becomes an independent country and we manage our own health budget in a way that best suits our needs.
Multiple Sclerosis
To ask the Scottish Government how it is raising awareness of multiple sclerosis. (S4O-03147)
Through the National Neurological Advisory Group, we are working closely with our stakeholders to ensure that people in Scotland living with all neurological conditions, including MS, have access to high-quality, person-centred, safe and effective healthcare services. I am pleased to advise that our third sector partners, including the MS Society, are an integral part of that group and will help to shape the priorities of the group’s work plan for the coming year.
As the minister will be aware, this is MS awareness week. This year’s focus is on the right treatment at the right time, and on how we can make Scotland a leader in ensuring that everyone with MS can access the information, support and treatment that they need. Can he assure me that the Scottish Government will work with the MS Society and other partners to ensure that people with the condition get the right treatment at the right time?
Ministers expect national health service boards to have robust processes in place to ensure the provision of safe, effective, person-centred, high-quality patient care, which should be delivered by the right professional at the right time for patients, when they require it. The Scottish Government is fully committed to working with its stakeholders. We know that people who have conditions such as MS value the support that is provided by the MS Society. As I mentioned, the MS Society is an integral part of the National Neurological Advisory Group, which oversees the work nationally to progress neurological services.
I can also advise the member that officials recently met the MS Society to discuss the key themes of the treat me right campaign. Along with the national advisory group, officials will explore ways in which we can support the needs of people with MS in accessing information, support and treatment. We recognise the lessons that we can apply in supporting people with MS and ensuring that they get the right type of treatment and support at the right time.
Audiology (Waiting Times)
To ask the Scottish Government what progress it has made in reducing the time it takes for people to see a hearing specialist. (S4O-03148)
The way in which audiology services are provided has continued to evolve in recent years, with many boards now offering a one-stop clinic service. That means that some patients receive their consultation and, where appropriate, start treatment or are fitted with a hearing aid in one visit.
Progress is monitored regularly against the treatment time standards set as part of the delivery of the 18-week referral-to-treatment target. In February, the latest figures were published for all specialties for December 2013. They showed that 90.8 per cent of patients in NHS Scotland received their treatment within the current national standard of 18 weeks. The compliance rate is 90 per cent.
The figures that the minister has just mentioned, which appeared in February, point to the fact that there is considerable inconsistency in how the statistics per region are calculated. Does he plan to address that? Will he ensure that audiology departments in every health board address the issue of how quickly we can get the basic equipment to people with hearing difficulties, which would include training people in the third sector to help?
If the member has specific examples of where she feels that there is inconsistency in how the data is being collected, if she passes that information to me I would be more than happy to look at it. We expect consistency of approach across all our boards in Scotland so that we can measure their performance against the RTT.
It must be said that there has been a significant improvement in how audiology services have been delivered in the past four to five years, because of our national strategy, which has resulted in the redesign of services. I am not sure whether the member participated in yesterday evening’s debate in the chamber, but in that debate we heard examples of partnerships that have been forged between NHS boards, local authorities and the third sector to deliver audiology services that can be delivered by third sector organisations, such as the replacement of small bits of equipment, tubes and so on.
Only last week, I launched our new sensory impairment strategy, see hear, which is the first sensory impairment strategy of its type in the United Kingdom and brings together visual impairment and hearing impairment services to ensure that they are much more effectively aligned and patient focused. A key part of the work that we expect to take forward as part of the strategy will be to ensure that we have good co-ordination between the statutory sector and the third sector with regard to how the services are delivered.
Tamiflu
To ask the Scottish Government what its response is to new research that shows there to be “no good evidence” that the Tamiflu vaccine reduces flu-related hospital admissions or the complications of influenza. (S4O-03149)
Tamiflu is not a vaccine. It is an antiviral medicine for the treatment and post-exposure prevention of influenza. We will consider all new relevant scientific evidence. That will include the Cochrane collaboration reviews that were published on 9 April, which considered data from the initial trials of Tamiflu and another antiviral medicine, Relenza, dating back to the late 1990s. It will also include evidence from other studies that have been carried out since the medicines were licensed, which support the view that we can help to ensure that we are providing the right approach in this area of policy and that we are using antiviral medication that can help to reduce the risks to individuals.
How much money was spent by the Scottish Government on stockpiling Tamiflu? If, as the minister seems to be indicating, there is to be a review of the future use of the drug, can he tell us when details of that review will be made available to the public?
I can inform the member that we intend to work with other nations in the United Kingdom to review the stockpiling of the antiviral medications Tamiflu and Relenza, in order to evaluate whether that is the most appropriate approach to take in the future.
It is worth bearing in mind that the approach that we have taken in Scotland is consistent with the guidance that was issued by the World Health Organization and the approach that has been taken by other European and north American countries around stockpiling for a pandemic flu. It dates back to the approach that was set out in 2005 on the state of preparedness that the country should be in given the potential for a pandemic flu—at that time, the concern was bird flu.
The review will be carried out over the coming months and we expect it to report by the end of this year. We wish it to report on that timescale because there are some elements of the antiviral stockpile that are due for replacement next year and it would be helpful, from our perspective, for the review to be completed by that point, in order to inform that process.
On the member’s second point, we stockpile a level of antiviral medicines that is sufficient to cover 50 per cent of the population. Some 35 per cent of that is Tamiflu and 15 per cent is Relenza. The total market cost of stockpiling Tamiflu is £21.1 million. The cost of stockpiling Relenza is £12.9 million.
I welcome the minister’s considered reply in view of the fact that I recommended to the Health and Sport Committee that it should recommend to the Government the stockpiling of Tamiflu, a position for which, at the time, the evidence was strong. Will the minister now get his Government to throw its weight behind the campaign to require the pharmaceutical industry to publish all its research prior to licensing? Hitherto in this case, partial research was published, which led to Tamiflu being thought to be of huge value.
I fully agree with the member that it is in the interests of the pharmaceutical industry to be extremely open and transparent about the evidence that it has at the time that it seeks a licence for any type of vaccination or medication. I would be more than happy to offer my support to the member’s call for the pharmaceutical industry to be as transparent as it is possible for it to be.
It is worth keeping in mind that some elements of research were not included in the Cochrane collaboration reviews, particularly observational studies that were undertaken and which will also have to form part of the review that will take place this year. The process gives us an opportunity to take time out to evaluate the types of medication that we are stockpiling in order to assess whether we are doing so in the most effective way and, if we are not, what other options might be available to us, and to consider how we can take that forward in the years to come.
Defibrillators in Public Places
To ask the Scottish Government what action it is taking to increase the number of automated external defibrillators in public places. (S4O-03150)
Substantial investment in heart disease services has reduced Scotland’s premature death rate from coronary heart disease by more than 40 per cent in the past 10 years. In February 2014, the Cabinet Secretary for Health and Wellbeing announced £100,000 for public access defibrillators throughout Scotland to support the Scottish Ambulance Service’s community resilience strategy. In March, I announced a further £1 million for the installation of defibrillators in national health service dental practices. Together, those investments represent an important contribution to our goal of reducing the number of out-of-hospital cardiac deaths.
I welcome the progress that the minister has outlined. Public access defibrillators make a positive contribution to safer and sustainable communities around the country. I have also been made aware of the community initiatives in a neighbouring constituency—in fact, my colleague Bruce Crawford’s constituency—where telephone kiosks have been used to host AEDs.
You should come to the question, please.
Will the Scottish Government continue to work with third sector, private partners and community groups to ensure that AEDs are ultimately available in every public place where people gather?
I have no doubt that members around the chamber have come across AEDs in a variety of locations throughout the country. I was surprised to come across one recently at the cash machine in Portree in Skye, which is also part of the national network that is being rolled out across the country.
The Government recognises the value of AEDs. That is why we made the recent funding announcements to support the roll-out across the country. We will work with third sector organisations, which have been active on the matter, to ensure that we have a co-ordinated approach to the policy. It is important that, once an AED has been installed at a particular location, the Scottish Ambulance Service is aware of its location so that it can direct patients or individuals to a particular unit at a given time.
I am more than happy to assure the member that we will continue to work with the Scottish Ambulance Service and the third and private sectors to ensure that we get a proper network of AEDs across Scotland’s communities.
Dialysis Services (Accessibility)
To ask the Scottish Government how it ensures that dialysis services are accessible. (S4O-03151)
The Scottish Government is committed to ensuring that all people in Scotland who live with long-term conditions are able to access the best possible care and support. Our quality strategy sets out our vision for healthcare services that are safe, effective and person centred.
We provide policies, frameworks and resources to national health service boards so that they can deliver services that meet the needs of their local populations. Within that context, the delivery of local services, including the provision of dialysis treatment, is the responsibility of individual NHS boards, which take decisions based on local priorities as well as evidence-based national clinical guidelines.
For many years, there has been a national target that NHS boards should provide hospital dialysis within 30 minutes’ travelling time of all patients’ homes where possible. However, a number of kidney dialysis patients in the Campbeltown area have to travel three times a week to the Vale of Leven hospital for treatment—a round trip of more than 230 miles each time, which takes two hours and 40 minutes each way. What can the minister do to help to reduce those lengthy travelling times? Does he agree with my constituents that a satellite dialysis unit in Argyll and Bute—either in Campbeltown hospital itself or at the Lochgilphead hospital in mid Argyll—would be a significant improvement?
I appreciate the concerns about the length of time and the energy that are involved in travelling to get access to dialysis that Jamie McGrigor has raised on behalf of his constituents, particularly those who stay in remote and rural areas.
The target is national, but there are specific difficulties in rural areas in being able to achieve it and in ensuring that services can be delivered safely and effectively for the patients who require access to them.
I understand that NHS Highland recognises the particular problems that some patients are experiencing, and I have been in dialogue with the health board directly to see if there are any measures that it can take to address some of the disproportionate travel times and costs that are involved.
I also understand that NHS Highland has undertaken to consider again the case for a low-maintenance dialysis unit in Argyll and Bute in 2015-16. I am keen to see that proceed as quickly as possible. If there is an opportunity for a satellite dialysis unit to be provided safely, effectively and appropriately for the patients of that area, I expect the NHS board to consider pursuing that opportunity once it has undertaken its review work in the area.
NHS Greater Glasgow and Clyde (Dentistry)
To ask the Scottish Government when the Cabinet Secretary for Health and Wellbeing last met representatives of NHS Greater Glasgow and Clyde to discuss dentistry. (S4O-03152)
Ministers and Government officials regularly meet national health service boards, including NHS Greater Glasgow and Clyde, to discuss health matters, including dentistry.
I am concerned about a number of gravely ill and vulnerable people who have been forced to wait months for approval for dental treatment. A seriously concerned constituent informed me about an elderly lady with dementia who required a home visit to get new dentures but who had to wait nearly two months for approval, during which time she was unable to eat. In another case, the dentist of a cancer patient who lost 5 stone and whose dentures no longer fitted decided to cover the cost of the dentures himself rather than wait for permission.
What is the minister doing to ensure that people who are seriously unwell or vulnerable and who require home dental visits receive them and that patients are not being unnecessarily traumatised? Will the minister consider fast-tracking such patients who are seriously ill—
I think we have got the point.
I recognise the concern that the member has raised. I would be concerned if individuals were waiting for unacceptably long periods of time for the practitioner services division to approve particular forms of treatment.
Of course, there can be a number of reasons for a delay in approval, such as insufficient information being submitted. However, if there is no such reason, I expect the practitioner services division to respond to requests timeously. I also expect priority to be given to individuals who have an urgent need for treatment to be agreed.
If the member wishes to furnish me with specific examples, I am more than happy to make sure that the practitioner services division looks into them and provides an explanation for any delay. I am also happy to give him an assurance that I will ask my officials to make sure that the practitioner services division prioritises high-priority cases and has a robust mechanism in place to allow that to happen. If he gives me specific examples, I am more than happy to make sure that they are investigated thoroughly and that he gets a response.
Life Expectancy (Glasgow)
To ask the Scottish Government what action it is taking to address low life-expectancy rates in Glasgow. (S4O-03153)
The Government is pursuing evidence-based health improvement measures on the ground. Last year, NHS Greater Glasgow and Clyde received £30 million of prevention funding to tackle problems involving alcohol, diet, smoking and drugs, for example. We have also made a commitment to take legislative action on plain packaging and minimum pricing, and we have an ambitious physical activity programme to create a lasting legacy from the Commonwealth games.
However, as stated in the recent report of the ministerial task force on health inequalities, the problem cannot be solved with health solutions alone, as other factors, such as entrenched problems of social inequality and poverty, also play a significant role, particularly in health inequalities. We are therefore taking the fight beyond the NHS, with our early years collaborative and the launching of a child poverty strategy to tackle the root causes of poverty, and we are working closely to drive forward improvements in eight transformational regeneration areas in Glasgow.
As the minister is aware, life expectancy for men in Glasgow is about 7.5 years less than for those in East Dunbartonshire, whereas for women there is a difference of some 4.9 years. Those are average figures; for some areas of Glasgow, the gap would be even greater. Can the minister advise what additional help will be given to general practitioners who work in the so-called deep-end practices to ensure that they have the resources to allow them to tackle the elements of this complex issue that are within their remit?
Patricia Ferguson raised the deep-end practices, which are a very good initiative, and the way that they are assisted for the type of demand that they are experiencing. I have met some of the deep-end practice GPs, who are extremely committed to the agenda of tackling inequality in their communities and to using their resources effectively to do that.
We are considering how we can add to their role and augment their staffing levels in order to support the work that they undertake in their more deprived communities. It is a model that can lend itself to helping to undo what are very often intergenerational problems. The additional resource needs to be able to make a real difference on the ground to how those GPs can support individuals more effectively, in order to break the link between what are very often ingrained health and social problems that blight lives and lead to much shorter life expectancy. It is unacceptable that we should tolerate those problems in our society, and we should use every possible lever that we have to break that link, where we can.
NHS Lothian (Meetings)
To ask the Scottish Government when it last met representatives of the NHS Lothian board. (S4O-03154)
Ministers and senior officials meet regularly with the board of NHS Lothian to discuss issues of interest to the people of Lothian.
I very much welcome the fact that reports are being prepared in the light of shocking revelations about general practitioner surgeries being open but full, with patients waiting weeks for an appointment. However, given the importance of swift access to GPs for early diagnosis, which is crucial for so many conditions, the huge pressure that is now on GP services, the time lag for training new GPs and the investment in premises that NHS Lothian, doctors and patients’ groups believe we urgently need, will urgent financial support be made available to increase the supply of GP services?
As Sarah Boyack will be aware, we have been taking forward a range of measures through national policy to model our services in a way that will allow us to shift the balance from the acute sector to the primary care sector, to support individuals more effectively in their own communities and homes. GP services are an important part of that.
It is important that our health boards, including NHS Lothian, have the right type of provision in place in order to meet the needs of their communities. We have increased funding to NHS Lothian and it has had an NHS Scotland resource allocation committee uplift to help it meet the demands that it faces. We expect the board to utilise its resources in a way that allows it to meet those growing demands.
It is also extremely important that services are planned in a way that means that the health service does not operate on its own but works in partnership with the local authority on how it delivers services. I am very much of the view that a key part of the way that primary care services can be planned more effectively is through better joint planning between local authorities and our health services, which should use their resources collectively to meet communities’ needs.
I assure Sarah Boyack that we recognise the importance of primary care. The resources that boards have been given are there to ensure that they plan effectively to meet their communities’ needs. It is important that our local authorities and health boards work together to maximise the resources in their communities to ensure that primary care can be delivered in the most effective way.
Is the minister aware that the population of Lothian is expanding more quickly than that of any other part of Scotland and that Lothian still has a long way to go before it receives the NRAC share to which it is entitled? Given the intense pressure on GP services—on which I am regularly contacted in my constituency—will he at least look at providing additional funding, specifically for primary care services, which I know that in principle he wishes to expand?
It is important that NHS Lothian uses the resources that it already has most effectively to meet the growing demand that it faces.
Mr Chisholm says that we are still some way away from achieving a position through the NRAC formula but, by 2016-17, we expect none of our boards to be more than 1 per cent below funding parity, because we have been accelerating that process. That has resulted in additional funding for NHS Lothian. For example, NHS Lothian received an NRAC parity adjustment of £12.275 million in 2012-13 and a further NRAC parity adjustment of £17.521 million in 2013-14. We have been accelerating that process to ensure that the boards that are looking for parity receive it as quickly as possible. By 2016-17, the difference should be below the 1 per cent figure that I mentioned.
Question 10, in the name of Ken Macintosh, has not been lodged. A less than satisfactory explanation has been provided.
Residential Care
To ask the Scottish Government what its position is on the “Full Report on the Future of Residential Care for Older People in Scotland”. (S4O-03156)
The Scottish Government welcomes the constructive joint working between the Scottish Government and the Convention of Scottish Local Authorities through the high-level task force on residential care for older people. The recommendations in the report will play a vital role in our work with our partners to develop the Scottish residential care sector in the future.
The report calls for further work to be undertaken
“to examine how much additional funding would be required to bring care workers’ pay up to the ‘living wage’ standard.”
Will the Scottish Government commit to investigating that, given the absolute importance of carers, the need to reduce staff turnover and the benefits of a career structure for carers?
The Scottish Government has led the way in implementing the living wage for all staff who are covered by its pay policy and all staff in the national health service in Scotland, and we are working to encourage all other employers to pay the living wage. The Scottish Government has introduced the Procurement Reform (Scotland) Bill, which includes provision for statutory guidance to ensure that, wherever relevant, workforce matters, including pay and benefits, are fully evaluated as part of the public procurement process.
It is extremely important that we ensure that staff who work in the care sector are provided with the right pay for the important work that they undertake. We absolutely recognise the importance of carers and we are already working with partners to address some of the issues that are highlighted in the report, including the issue of the living wage being made available to those in the social care sector.
The report states that
“there is insufficient funding for investment in the care home sector”
and that publicly funded residents are generally being cross-subsidised by self-funding residents, with
“many providers relying on expensive and ... complex debt packages to stay viable.”
What is the Government doing on those two issues?
The member might be aware that, for many years, there has been a marked difference between what a self-funder pays and the funding for someone who is paid for by the local authority. That historical anomaly has long been in the system, and it is highlighted in the report.
In relation to the points that the member raises, she will be aware that the report highlights the need for greater transparency in how care costs are calculated so that people can see that clearly and can consider how to achieve greater consistency in those costs. Given the amount of detail in the report, we will work with COSLA and other partners such as the care sector in Scotland to consider how we can take forward the recommendations to get greater transparency on the issues that the member has highlighted, with the aim of ensuring that there are no hidden costs and that we do not get into a situation in which there is a perception of cross-subsidy taking place between one resident and another.
Given that the report calls for the living wage for all those who are employed in the care sector and that the European Union has confirmed that there is no barrier in European law to prevent the Scottish Government from implementing a living wage, will the Government now back Labour’s proposals for the Procurement Reform (Scotland) Bill and ensure that a living wage is paid in relation to all public service contracts?
Rhoda Grant should be in no doubt about the Government’s commitment to the living wage, which we—unlike the previous Labour Government at Westminster—have proven through the measures that we have taken.
The detailed recommendations in the report require not just a quick reaction or response; they concern complex issues that we must work through to ensure that our care sector—and the care home sector in particular—is fit for purpose and that we have in place the right level of support for future years. We will work with our colleagues in local government and in the independent and third sectors to ensure that we progress the recommendations in a measured way so that we have a sustainable social care sector in the future.
Scottish Ambulance Service (Remote Communities)
To ask the Scottish Government when it last met the Scottish Ambulance Service to discuss crewing in remote communities. (S4O-03157)
The Scottish Government is in regular contact with the Scottish Ambulance Service on a range of issues, including the mix of skills that ambulance crews require to support the delivery of high-quality patient care throughout Scotland, both at present and as we strive to deliver the 2020 vision for healthcare.
The minister will be aware of the positive contribution that ambulance service personnel can make when they are recruited from and living in small communities, where a full roster can avoid single crewing and the consequent delays for patients. Will he ensure that Kinlochbervie gets a full-time ambulance team? The nearest neighbouring community of Lochinver, which has a similar geography and population, already has one.
Rob Gibson will be aware that there are at times challenges in ensuring that we have the right ambulance service cover in all rural areas. He highlights the particular issue that Kinlochbervie is presently experiencing, and I expect the Scottish Ambulance Service to try to ensure that it has the right crewing levels in the local area to meet local need.
It is extremely important to ensure that there is the right training for the staff who are crewing those particular ambulances, because they will often have to travel considerable distances with individuals before they are able to get medical cover.
I am happy to assure Rob Gibson that I will ask the chief executive of the Scottish Ambulance Service to look into the issues that he raises and to consider what can be done to address the concerns of the residents of Kinlochbervie in the member’s constituency about the way in which the Scottish Ambulance Service operates in their community.
National Health Service Pharmaceutical Services
To ask the Scottish Government when it will publish the findings of its consultation on the control of entry arrangements and dispensing general practitioner practices. (S4O-03158)
The independent analysis of the consultation responses is now complete and a report has been submitted to the Scottish Government. It has highlighted complex and competing views, and issues have been expressed across the range of respondents that are extremely helpful in informing how we move forward.
We will announce very shortly how we intend to take forward an amended framework for control of entry that we believe will best meet the service needs of communities throughout Scotland. It will build on the themes, and the responses to those themes, that were tested in the consultation exercise.
Is the minister aware that in my constituency of Stirling, applications to open new pharmacies were recently approved for Drymen and Aberfoyle by the pharmacy practices committee for Forth Valley? There is no doubt that, in both those areas, the services that local GP practices provide will suffer.
The approval that was given on 20 March for a pharmacy in Aberfoyle was greeted by shock and anger by me and my constituents, given that application’s significant weaknesses. It is now potentially the subject of an appeal.
Given that situation, can the minister be much more precise on exactly when the Scottish Government will introduce the necessary changes to the regulations? How long does he estimate that it will be before amended regulations will be enacted?
I am sure that Bruce Crawford recognises that it would not be appropriate for me to comment on the individual cases, given that they are going to appeal. However, I acknowledge the concerns that he has expressed, and I am aware of similar concerns that his constituents have raised in correspondence directly with the Scottish Government.
I assure the member that GP practices that are affected by the opening of a community pharmacy in their area remain eligible for funding for the primary medical services that they are contracted to provide. I would expect national health service boards—in this instance, NHS Forth Valley—to work constructively with those GP practices and their patients to continue to meet their reasonable needs.
Key aspects of the control of entry framework will, as we move forward, be underpinned by amended regulations, which we aim to lay before Parliament—and which should come into force—before summer recess this year.
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