Chamber and committees

I was very disappointed to read the statistics that came out recently on the stroke bundles. I agree that improvement has to be made.

Just last week, I chaired a round table of all the stroke leads from the health boards across Scotland, at which we talked specifically about door-to-needle time as a major concern. We have considered how health board staff are configured and we have helped boards to introduce nurses who will specifically support people who could be presenting with stroke symptoms. I think that I am right in saying that NHS Lanarkshire has made really good improvements there. At the meeting last week, it was great to hear about what NHS Lanarkshire has been able to do. The other health boards heard about that and they can consider the changes that they could make. The Scottish Government has provided some funding to allow additional training for nurses across the health boards.

As you will know, the Scottish Government provides funding to health boards directly. The total health budget is about £21 billion. Of that, about £15 billion goes directly to health boards, and it is for them to make their decisions on how to allocate that among the various conditions that they have to support.

Having met the Bundy family and representatives of the Stroke Association and Chest Heart & Stroke Scotland, I felt very strongly that it was important for each health board to have a stroke lead and for me to meet them regularly. We also have a stroke specialist in the Scottish Government, who is part of the chief medical officer’s team. He engages regularly with the stroke leads to ensure that we can improve, because that is what we have to do. You are absolutely right that we have to improve the statistics.

I would just like to say thank you. I appreciate the evidence that you gathered in your previous evidence session.

As you know, the Cabinet Secretary for Health and Social Care and I have written to the UK NCS, which is an independent body, and we understand that, over the next three years, it will be reviewing evidence. The evidence must be robust and peer reviewed, so we are pleased that that is part of the screening committee’s work programme.

We are already considering what we can do once the UK NCS makes a decision. It was clear, when Kym Kestell answered a question on screening, that it is not just about screening; we need to ensure that we have the pathways in the various health boards to ensure that they can support people who are screened and might have a condition. We do that work regularly with health boards.

With regard to data, I touched on the Public Health Scotland Scottish cardiac audit, which was released yesterday. There is an iterative process to ensure that we are collecting the right data, and the scope has been extended, as this is the first year in which the audit has contained additional information on congenital, if I can use that word—

When the First Minister and I met the Hill family, one of the outcomes concerned the need to understand clearly what sportscotland is doing. Sportscotland has some guidelines, and Scottish Rugby and the Scottish Football Association have clear pathways to ensure that people who are participating in sport have the right healthcare monitoring that they need. In that meeting, I was struck by the work that the Hills have been doing on monitoring young children who have been playing sport. We have been looking at that in preparation for any change in the UK NSC guidelines.

I understand the concerns that you have raised, Mr Ewing. That response prompted us to start thinking about, if that decision was changed, what we need to do in Scotland to work with clinicians to ensure that we have the right processes. Those questions prompted us to review whether we would change what we do if the UK NSC’s decision changes in three years.

Yes, and I was, too. That is why it is important that Public Health Scotland is now gathering the inherited cardiac conditions information to allow us to shift, and is also gathering information from sportscotland about what is done through sport. As I said earlier, the information that the Hill family gave us at the meeting with the First Minister was very compelling and we are looking at that.

I am content to take that away and have a conversation with the Cabinet Secretary for Education and Skills about it. You are right that, in different areas of Scotland, different training is given. I have highlighted that people from the Royal National Lifeboat Institution may be going into schools, and I know that the St John Ambulance service has a very good plan to go into schools to provide support with that. I completely understand where you are coming from.

I would be happy to have that engagement. From a public health perspective, we have very good relationships with Scottish Women’s Football, which has supported us with an anti-vaping campaign as well.

I will hand over to Professor Bauld to answer that.

That is a good question. We were talking about that earlier. The LCM will allow us to include digital ways of getting identification, but it will not stop the use of paper identification. We will not be repealing provisions on the use of paper forms of identification from the Tobacco and Primary Medical Services (Scotland) Act 2010 until we have new regulations in place.

We will do some consultation on the regulations to ensure that we get them right, but it is through the important conversations that we have with trading standards and the regulatory review group representing businesses that we will understand the best way of implementing them if the decision is made to do so.

As I highlighted earlier, we also have the updated register, which will allow us to push out information to retailers, so that they are kept informed of any changes.