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Chamber and committees

Meeting date: Wednesday, June 8, 2016

Meeting of the Parliament 08 June 2016

Agenda: Business Motion, Portfolio Question Time, Queensferry Crossing, Named Person Policy, Business Motion, Parliamentary Bureau Motions, Point of Order, Decision Time, Child Safety Week 2016


Portfolio Question Time

NHS Lanarkshire (Meetings)

1. Elaine Smith (Central Scotland) (Lab)

To ask the Scottish Government when it last met NHS Lanarkshire and what matters were discussed. (S5O-00001)

Ministers and Government officials regularly meet representatives of all health boards, including NHS Lanarkshire, to discuss matters of importance to local people.

The minister will recall that I campaigned to stop the downgrading of Monklands hospital’s accident and emergency department. I was pleased when her Government stepped in to instruct the health board to overturn its decision.

We now face increasing cuts to local health services, which include closure of the dermatology ward at Monklands and the centre for integrative care clinic, as well as another proposal to downgrade A and E, with the removal of orthopaedic trauma. Will she step in to stop those cuts? More specifically, will she instruct the board that downgrading the A and E is as unacceptable now as it was in 2007?

Elaine Smith is right to remember that it was this Government, in 2007, that reversed the Labour plans to close the A and E department at Monklands hospital. Since then, local people have benefited from more than 500,000 attendances at the A and E department.

Local communities can be assured that this Government remains committed to a viable future for Monklands hospital, including the A and E department. That is why we welcomed NHS Lanarkshire’s preparation of a business case for the redevelopment of Monklands hospital, which will be an important investment in the local area.

As Elaine Smith knows, a trauma orthopaedics review is on-going and no decisions have been made. I have been assured that all stakeholders will be fully involved as the process is taken forward.

On dermatology services, Elaine Smith will be aware of the correspondence that I have sent to her. I will be happy to continue to correspond with her if issues arise that have not been answered in the correspondence that I sent to her. I hope that I have been able to assure her that the number of dermatology patients who require hospital admission has dropped and more and more people are being treated as out-patients, which is what lies behind the change.

Kate Forbes, did you press your request-to-speak button because you wanted to intervene now or was it for later?

It was for later.

That is fine. I call Margaret Mitchell.

The most recent delayed discharge figures for NHS Lanarkshire, which were released in May, and excluding code 9 delays, revealed that 123 in-patients were prevented from leaving hospital. That is the highest level for any month so far this year, and the number is almost twice what it was this time last year. Will the cabinet secretary explain what is being done to address that unacceptable increase?

The member is right to highlight the importance of the matter. Discussions are going on with the partnerships that cover North Lanarkshire and South Lanarkshire, and she might be aware that a particular issue in South Lanarkshire lies behind some of the delays. I assure her that officials are engaging closely with the partnership in that regard, to ensure that it takes the action that we know works and that has worked in other partnerships to reduce delayed discharge.

The member will be aware that the Scottish Government is making significant investment in both partnership areas to tackle delayed discharge. I will be happy to keep the member closely informed of South Lanarkshire’s plans to tackle what is an important issue.

May I clarify whether Emma Harper has pressed the button to indicate that she wishes to speak now, or later?


For now. In that case, I call Emma Harper.

To ask the Scottish Government what it is doing to boost GP recruitment.

I am sorry, Miss Harper; I meant to ask whether you were asking a supplementary to the first question. You are down to ask question 6, so I will call you for question 6 at that point.

All right, sorry.

For guidance to members, if you are down in the Business Bulletin for today, wait until your turn comes or press your button at that point. If you press your button during someone else’s question, I will think that you want to ask a supplementary to the question that is being asked there and then. Both Kate Forbes and Emma Harper were, I think, asking to speak later.

I now come to John Lamont and question 2.

National Health Service Boards (Scheduled Operations)

2. John Lamont (Ettrick, Roxburgh and Berwickshire) (Con)

To ask the Scottish Government what it is doing to ensure that operations scheduled by NHS boards go ahead as planned. (S5O-00002)

The Scottish Government continues to work to support health boards to manage their capacity planning to keep cancelled operations to a minimum.

A decision to cancel a patient’s operation is never taken lightly. Any postponed operation will be rescheduled at the earliest opportunity. The latest figures for cancelled operations, published by ISD Scotland on 7 June, show that, for the month of April 2016, only 1.6 per cent of operations were cancelled by the hospital for capacity or non-clinical reasons. That is a reduction on the month before.

We all agree that cancelled operations are a waste of resources and an inconvenience to patients. In NHS Borders, half of all operations cancelled in the latest month were cancelled for capacity or non-clinical reasons. The figure is regularly twice the national average. Given that NHS Borders has to cancel such a large percentage of operations due to a lack of resources, will the Scottish Government look closely at whether rural health boards are being sufficiently resourced to help with issues such as recruitment?

The member raises a very important point. As I said in my initial answer, progress is being made. The figures show that only a tiny number of operations are cancelled for non-clinical reasons. The vast majority of operations that are cancelled are due to patient choice or for clinical reasons.

However, the member highlights that, within NHS Borders, there is a higher rate of cancellations than we would like. A lot of work is under way to try to improve the level of cancellations by, for example, a weekly review of orthopaedic theatre lists six weeks in advance; planning for staffing, theatre time and equipment; booking on the basis of average time per consultant to carry out procedures for orthopaedics; reviewing admissions per ward, per area and per day and smoothing surgical flow; reviewing data for orthopaedics; and looking at implementing a process to review lists every week to develop a standard operating procedure. I can write to the member with more detail around that, but please be assured that we are working very closely with NHS Borders to make those improvements.

How many procedures have been referred to private hospitals because of a lack of capacity in our NHS and is there a cost for doing that?

The member will be aware that the independent sector is only used at the margins, where it is required because there is no capacity available within the locality. The level of spend in the private sector is reducing, and the elective centres, in which we are investing £200 million over the next few years, are an important way of dramatically reducing that independent sector spend, which is confined to a very small number of boards.

The vast majority of boards hardly use the independent sector at all. There are one or two boards that use it more than others. The elective centres, particularly in the east where two of the centres will be located in the Lothian area, will make a big difference in growing the capacity so that the reliance on the independent sector is reduced further. I am happy to write to the member with further details about that.

Changing Places Toilets Campaign

3. Richard Lyle (Uddingston and Bellshill) (SNP)

To ask the Scottish Government what action it is taking to support the Profound and Multiple Impairment Service campaign, changing places toilets. (S5O-00003)

The Scottish Government actively supports the Profound and Multiple Impairment Service campaign to increase the number of changing places toilets in Scotland. We congratulate PAMIS on its substantial achievements in developing a campaign that has so far resulted in 136 changing places toilets being installed throughout Scotland.

The Scottish Government will continue to work in partnership with PAMIS as it develops a network of changing places toilets and accessible toilets throughout Scotland, enabling those with the most complex needs to have access to their communities.

I was inspired by meeting my constituent Sheila Johnstone, and her son Mason, who opened my eyes to the issue of changing places toilets. What action can the Scottish Government take to support places of interest or tourist attractions to install changing places toilets to help disabled or physically challenged visitors to access their services fully?

I thank Richard Lyle for raising that important issue. We would be pleased to know Sheila and Mason’s thoughts and views, and I invite Richard Lyle to write to me with them.

In 2015, the Scottish Government published its draft delivery plan for 2016 to 2020 in response to the United Nations Convention on the Rights of Persons with Disabilities. That delivery plan sets out our aim to ensure that disabled people in Scotland have the same freedom, dignity, choice and control over their lives as everybody else.

VisitScotland is running an accessible tourism project that aims to work with the tourism industry to boost accessibility for all disabled people. Through that project, tourism businesses are able to showcase their accessibility credentials via access statements, which can be used to feature changing places toilets where those facilities already exist.

Richard Lyle should also visit the changing places United Kingdom map, which shows the full list of changing places toilets throughout Scotland, including several in his constituency.

Cancer Patients Referral Pathway (Stranraer)

To ask the Scottish Government when it will review the referral pathway that results in cancer patients in Stranraer having to travel to Edinburgh via Dumfries rather than to cancer services in Glasgow. (S5O-00004)

The role of the Scottish Government is to provide policies, frameworks and resources to national health service boards in order that they can deliver services that meet the needs of their local populations. The actual planning and provision of healthcare services is the responsibility of local health boards, taking into account national guidance, local service needs and priorities for investment. However, NHS Dumfries and Galloway has confirmed that it is reviewing its cancer referral pathways to ensure that people with cancer do not have to travel unnecessarily for treatment.

It is my understanding that only patients who require patient transport go via Dumfries to Edinburgh, and that car users can go to Glasgow. Does the minister agree that the Government should ask the health boards and providers to develop the pathways in order to prevent inequalities that affect clinical outcomes, particularly, in this case, travel inequalities?

Wherever they are, I expect health boards to deliver as many of their cancer services as locally as possible. However, it is important to recognise that some complex treatments can be administered only via specialist centres. That involves a clinical decision on where best the person should go, which will be determined in close discussion with the consultant and the clinical team.

I am sure that NHS Dumfries and Galloway is more than aware of the transport issues that Finlay Carson raises. In essence, it is important that people with cancer do not have to travel unnecessarily for treatment, wherever that takes place. It is also important that, when they have to travel, it is to the place that is most appropriate for them.

I am happy to keep in contact with Finlay Carson as NHS Dumfries and Galloway addresses the issues. I am sure that he will feed in his views to the local health board through Jeff Ace, the chief executive. I encourage him to do so.

General Practitioner Surgeries (Waiting Times)

5. Colin Beattie (Midlothian North and Musselburgh) (SNP)

To ask the Scottish Government what measures it is taking to help reduce waiting times at GP surgeries. (S5O-00005)

The Scottish Government is fully committed to reducing waiting times at GP surgeries. We have increased the primary care fund in the draft 2016-17 budget, which will now deliver £85 million of investment over three years. That will include: £20.5 million on the primary care transformation programme, which will be allocated to national health service boards to support work at practice and wider multidisciplinary team level; £6 million to develop digital services, including help for online appointment booking; and £16.2 million to recruit 140 new pharmacists to work directly with practices and support the care of patients with long-term conditions.

We are working closely with the British Medical Association and the Royal College of General Practitioners to reduce GP workload. That includes our pioneering agreement to abolish the bureaucratic system of GP payments in order to free up more time for GPs to spend with patients.

The cabinet secretary may be aware that many surgeries in my constituency of Midlothian North and Musselburgh are closed to new patients, yet housebuilding continues apace. Does the cabinet secretary agree that there is a need to balance infrastructure against development to ensure that constituents’ medical needs can be met?

Colin Beattie makes an important point. Since 2007, the Scottish Government has invested more than £170 million of capital in projects to deliver new or refurbished GP premises across Scotland. In addition, the Government’s hub programme is delivering more than £500 million-worth of community healthcare infrastructure. Planning should take into account current infrastructure capacity and, indeed, future requirements. That applies to all types of infrastructure, including primary healthcare provision.

The delivery of more high-quality homes is a key priority. To that end, we published draft guidance on planning for housing and infrastructure delivery earlier this year, and the recent independent review of the Scottish planning system has made a number of recommendations that aim to strengthen planning for infrastructure, which are currently under consideration.

General Practitioners (Recruitment)

6. Emma Harper (South Scotland) (SNP)

To ask the Scottish Government what it is doing to boost GP recruitment. (S5O-00006)

The number of general practitioners in Scotland has increased by 7 per cent under this Government and we want to go further and faster to boost GP numbers as part of building a strong, multidisciplinary community health service. We are funding support to GP returners, which is provided by NHS Education for Scotland, and we have increased the number of GP training places from 300 to 400. I will soon be in a position to announce the details of the latest package of funding being distributed under the £2.5 million GP recruitment and retention fund, which will include a range of innovative projects to tackle recruitment issues, including those that are faced by rural and remote areas.

In the longer term, we are committed to delivering a national workforce plan that will set out how we will address workload and capacity by building those multidisciplinary teams, including boosting GP numbers and of course our £3 million commitment to train 500 more advanced nurse practitioners.

Does the cabinet secretary agree that the Scottish Government’s measures to boost GP recruitment will bring enormous benefits to the healthcare provision in rural parts of Scotland, including in my area of Dumfries and Galloway?

Yes, I do. We are taking a number of actions but there is more to be done. One of the key components of transforming primary care is the new models that we are testing along the lines of the community health hubs and multidisciplinary working. The new GP contract that will take place from 2017 onwards will underpin that. That is being negotiated with the British Medical Association as we speak, and discussions are going well. It has to be a contract that will help to deliver a radically different model of primary care, which will benefit remote and rural Scotland as well as urban Scotland.

As the cabinet secretary will be aware, it can be difficult for an increasingly ageing and scattered population to get to GP appointments in the rural Highlands. What progress is the Scottish Government making towards increasing home-based options such as telecare, which is currently used by more than 2,000 people in NHS Highland, without replacing contact time with healthcare workers?

As part of the Scottish Government’s technology-enabled care programme, more than £1 million is being made available to NHS Highland and its partners over the next two years. The funding is to drive forward the uptake of technology-enabled care services, including telecare, across the NHS Highland and NHS Argyll and Bute partnership areas. That is in addition to the £973,000 that was awarded to Highland and Argyll and Bute during 2015-16, as well as the significant funding provided to both areas over the past few years to develop as part of their local strategy to raise public awareness of the benefits of technology-enabled care.

Given that clinics are closing now due to the immediate crisis, that hospitals such as Lockhart hospital in Lanark are not taking new patients, and that it takes several years to train a GP, what action is being taken to deal with the immediate short-term crisis?

The member may be aware that a few weeks ago, just before the election, I announced a £20 million package for this financial year, which covered many of the workload issues that GPs said could help to relieve some of the pressures. That was very well received by the profession and it was intended to address some of the short-term issues.

Without doubt, it is in the medium to long term that the biggest transformation will be made. Although that resource and investment are important in tackling workload issues, the new contract and the new model of primary care are fundamental to changing primary care and making it a more attractive proposition for medical undergraduates, not enough of whom are choosing it as their specialist option once they qualify. That is an issue that has to be changed. We are working very closely with the profession to deliver that.

Scotland is excellent at training doctors but that means that other countries, such as Canada, Australia and New Zealand, often try to poach newly trained doctors. What can we do to mitigate that, given that those people are perhaps offering a different lifestyle than folk who are born, educated and trained here would enjoy if they stayed in Scotland?

Our recruitment campaign for junior doctors has had a very positive response across a number of specialties—certainly, the numbers are well up on last year. We need that to translate through to appointments but the indications are that junior doctors see Scotland as an attractive place in which to train.

However, there is still an issue in general practice—and that is mirrored across these islands. We are in an international competitive environment. Part of the solution is to make sure that our training environment is internationally recognised as somewhere where junior doctors want to come and train—and there is evidence of some success in that. We also want to grow more of our own doctors, which is why we are taking forward the first graduate entry programme for medicine in Scotland. I hope to be in a position to say something more about that over the next few weeks.

In this session of Parliament we have already heard much about the crisis in GP staffing. What plans does the Scottish Government have to boost recruitment, in particular by reducing stress levels and the workload of GPs?

As I said in my earlier answer, the £20 million for this financial year that I announced a few months ago was new money that was intended to help with some of those short-term workload issues. The profession had called for such measures to help to reduce the workload.

Getting rid of the quality and outcomes framework was a major step forward. The QOF was seen as a bureaucratic tick-box system that took up a lot of GP time, and our decision to get rid of it was warmly welcomed.

As I have said to members in the chamber, I believe that, while those short-term measures are important, the new models of primary care and the new contract will make the biggest difference in enabling us to recruit and retain doctors, and—importantly—to get young doctors to choose general practice as their specialism. We are undertaking work with the profession in that regard, and if we get the new contract right, we will be able to do those things.

Minor Ailment Service (Extension)

7. Jamie Greene (West Scotland) (Con)

To ask the Scottish Government what timetable it is working to in its pledge to examine extending the minor ailment service. (S5O-00007)

As I am sure that Jamie Greene will appreciate, considerations about extending the minor ailment service are at an early stage, following the First Minister’s statement on 25 May on taking Scotland forward. Detailed scoping work must be undertaken first-—taking into account, for example, the costs of an extended service, the capacity in community pharmacies, the wider primary care transformation agenda and consideration of how we can better support self-care as a core part of the service as we move forward.

Over the coming weeks, we will engage with national health service boards, Community Pharmacy Scotland and other stakeholders on the options and the associated timeframes. I am happy to keep the member informed of the progress that is made.

I welcome the cabinet secretary’s commitment to extending the minor ailment service, as was set out in our manifesto. What extra funding will be allocated to that in the first instance?

We invest a significant amount of resource in community pharmacy. The community pharmacy remuneration global sum is just over £178 million, which is £1 million more than the previous year’s figure. In addition, community pharmacy contractors will earn a minimum of £93.5 million in reimbursement for the purchase of drugs on behalf of NHS Scotland, as part of the overall funding settlement.

Jamie Greene will appreciate that negotiations with Community Pharmacy Scotland about extending the minor ailment service will have a resource component. It would be more appropriate to have those discussions than to put out arbitrary figures in the chamber. Community Pharmacy Scotland appreciates that resource will be part of the discussions.

What we are doing with community pharmacy is in stark contrast to the situation south of the border. Pharmacies in England face a potential reduction of up to 6 per cent—of up to £170 million. Pharmacies there say that, if that reduction happens, it will have far-reaching consequences. Many say that pharmacies in many areas could close. I hope that the member is reassured that we are not taking such action in Scotland.

NHS Forth Valley (Child and Adolescent Mental Health Services)

To ask the Scottish Government what the average wait in weeks was for child and adolescent mental health services in NHS Forth Valley for patients who started their treatment in the last quarter of 2015. (S5O-00008)

In NHS Forth Valley, the average waiting time for the quarter that ended in December 2015 was 22 weeks. I am disappointed that the board has still to achieve the waiting time standard for CAMHS. However, the average waiting time decreased month on month throughout the quarter and was down by seven weeks by December 2015.

In the most recent Scotland-wide data for the quarter that ended in March 2016, which was published yesterday, the percentage of children and young people who were seen within the waiting time standard had increased on the previous quarter, and half of patients were seen within eight weeks. NHS Forth Valley’s performance against the standard increased by 10 per cent. I welcome that progress, but the position is still far from good enough, and I expect the board to increase its efforts to meet the waiting time standard. I will pay close attention to ensure that all boards meet the waiting time standard sustainably.

We, too, welcome the recent small improvements in performance, but we highlight the fact that further progress is required in NHS Forth Valley’s performance. It is unacceptable that our youngest and most vulnerable people in that area must wait approximately four or five months for treatment for mental health issues, especially given that early diagnosis and early treatment are critical to successful outcomes.

Given the disappointing overall figures and particularly those for NHS Forth Valley, will the minister and the Government follow the advice that the Scottish children’s services coalition published yesterday by putting in place an urgent action plan for not only NHS Forth Valley but all of Scotland that will increase investment in mental health services and provide additional resources?

The member will be aware that the Scottish Government is putting in £150 million in extra resources. The mental health strategy will take into account the requirements of those not only in Forth Valley but throughout Scotland.

The child and adolescent mental health service in NHS Forth Valley has gone through significant redesign in the past year. Investment has gone into the service to create new nursing and psychology posts, and a new management structure has been established, with clear lines of responsibility and accountability. The service now has a dedicated manager, and lead roles have been established for each specialty. A new CAMHS website also went live on 1 June with a range of self-help material. However, NHS Forth Valley will have to do more to meet the standards.

National Health Service Boards and Integration Joint Boards (Budgets)

9. Johann Lamont (Glasgow) (Lab)

To ask the Scottish Government when it will announce the final 2016-17 budgets for NHS boards and integration joint boards. (S5O-00009)

On 26 February, the Scottish Government announced 2016-17 budgets for NHS boards, taking health spending to a record level of almost £13 billion. Additional funding of more than £500 million for health boards enables the investment of the additional £250 million to support the integration of health and social care and build the capacity of community-based services.

The Scottish Government does not set the budgets for integration joint boards. Rather, budgets are delegated to them by health boards and councils. Budgets for integration joint boards were agreed by 1 April as planned, subject in some areas to final decisions regarding health efficiencies, as part of NHS boards’ local delivery plans. The Scottish Government is working to 30 June as the date for conclusion of local delivery plans and is providing support for that process.

To what extent do those budgets reflect the needs and disproportionate levels of social and health challenges in Glasgow? Is the process for defining needs and budgets under review? What work is being done to address the inverse care law, which means that general practices that are dealing with patients with the most complex needs, many of which are in Glasgow, are also the most poorly funded? That perhaps creates the levels of stress and pressure that have been discussed in the chamber today.

Johann Lamont makes an important point. On a number of occasions in the chamber, I have made it clear that, particularly when it comes to the resourcing of primary care, the Scottish resource allocation formula needs to have more of a direct correlation between deprivation and need and the budget that follows.

I have been very clear, in the on-going new GP contract negotiations, that the issue must be addressed. I am very happy to keep Johann Lamont informed as those discussions continue, although she will understand that they are quite sensitive and there is a lot of detail to go through. I assure her that it is very important for me, as cabinet secretary, to ensure that the resources that go to deprived communities, particularly through primary care moneys, better reflect the levels of need in those areas.

NHS Fife announced that it must make a £30 million cut in its budget, and the health and social care partnership in Fife has said that it has a deficit of £11 million. Will the cabinet secretary agree to meet me to discuss those massive challenges faced by the NHS and social care in Fife?

It is important to reiterate the fact that half of the additional funding of more than £500 million is going to support the integration of health and social care, as I said in my earlier answer. Where efficiency savings are required within territorial boards—as they are for all the public sector—all savings are retained locally by those boards for reinvestment in front-line services.

I am very happy to meet Alex Rowley. I met David Ross, the leader of Fife Council, and I met health board representatives recently. What is important in NHS Fife and Fife Council is as much the building up of the relationships and ways of working that are needed to change the way that things are done.

If Alex Rowley looked at partnerships across Scotland, he would see that many of them are making very good progress in tackling delayed discharge and changing the way that services are delivered, to the benefit of service users and patients. All areas need to do that, and more progress needs to be made in a number of areas, including Fife. I am very happy to work with Alex Rowley, if he thinks that by working together we can encourage both parties to get on with the job of improving those local services.

New Medicines Fund (Access to Ivacaftor)

To ask the Scottish Government what consideration it has given to using the new medicines fund to ensure access to the cystic fibrosis medicine, Ivacaftor, for two to five-year-olds with the G551D gene. (S5O-00010)

The new medicines fund can be used by NHS boards to support the cost of that treatment. The peer-approved clinical system pilot provides a route for clinicians who want to prescribe the treatment. I will be happy to meet the member to discuss the issue further.

Although the Scottish Government has taken action to improve access to new medicines, including our new medicines fund investment, pharmaceutical companies also need to take action on their prices. It would be in the best interests of the people of Scotland for the manufacturer of the drug to make a resubmission to the Scottish Medicines Consortium at a reduced price.

I thank the minister for her answer, but I also want to put on the record my thanks to Duncan McNeil, the convener of the Health and Sport Committee in the previous session, who worked very collaboratively with the Scottish Government, as we all did as members of that committee in relation to developing new models for access to medicines.

Access to medicines improved dramatically right across Scotland as a result of the work. However, the case I am talking about raises further issues about access and I would be delighted to meet the minister to discuss that further.

Will the minister ensure that the new independent Montgomery review of access to new medicines takes account of how SMC structures handle submissions such as Ivacaftor and when access to the new medicines fund would be triggered?

I thank the member for raising the issue. I also record my thanks for the work that Duncan McNeil did during the previous parliamentary session. The member knows that the cabinet secretary has asked Dr Brian Montgomery to lead an independent review on access to new medicines. The review will report to the cabinet secretary later this year.

The First Minister and the cabinet secretary have been very clear that progress has been made to improve access but that more can and should be done. To reiterate the point that I made in my first answer to Bob Doris, we do not always get a pharmaceutical company’s best offer on price early enough, or at all. There is therefore clearly a lot more that we want to do, which is why the independent review has been taking place. Again, I will be happy to meet the member to discuss that and other interests that he may have on the issue.

Vale of Leven Hospital (Retention of Services)

11. Maurice Corry (West Scotland) (Con)

To ask the Scottish Government whether it will retain the current level of services at the Vale of Leven hospital. (S5O-00011)

This Government ended a decade of damaging uncertainty for the hospital by approving the vision for the Vale in 2009. Local people can be assured that we remain committed to maintaining and improving services at the Vale of Leven hospital, which include sustaining emergency services.

Will the Scottish Government work to reintroduce full accident and emergency services so that the West Dunbartonshire area has such services on the north side of the River Clyde, especially in view of the fact that the Royal Navy will be increasing its personnel at Faslane by 2,000?

The member will be aware that there has not been a full accident and emergency department at the Vale since 2002, when it was closed under the previous Administration. We cannot just stick an accident and emergency department at a hospital; what lies behind that department is crucial. The Royal College of Emergency Medicine specifies that a full 24/7 accident and emergency service has to be supported by on-site, 24/7 anaesthetic, surgical and critical care cover, and they are not available at the Vale of Leven hospital.

We need to ensure the sustainability of the services at the Vale of Leven hospital. That is why we fully supported putting the minor injury unit at the Vale, which is open from 8 o’clock in the morning until 9 pm every day, dealing with up to 70 per cent of local unscheduled care—so 70 per cent of people who need unscheduled care get their care at the Vale of Leven hospital. I assure the member that the unit is doing well. It experienced a 4 per cent increase in attendance between November 2014 and November 2015.

I want to make sure that the vision for the Vale is delivered because it brought a hospital that was on its knees to a position where it is doing very well indeed. I hope that the local member will support us in our efforts to do so.

Disabled Access (Health Facilities)

12. Gordon Lindhurst (Lothian) (Con)

To ask the Scottish Government what discussions it has had or plans to have with NHS boards and local authorities regarding disabled access in and around hospitals and other health facilities. (S5O-00012)

Scottish Government officials regularly meet NHS boards to discuss a range of issues involving finance, performance and the management of healthcare facilities.

Does the Scottish Government agree that specific steps should be taken to require local authorities to ensure the state of repair and suitability of pavements for disabled people, particularly those who use wheelchairs, near hospitals such as the Edinburgh royal infirmary where the Royal hospital for sick children is due to be relocated?

We take access to healthcare facilities very seriously, as do the NHS boards across the country. Given the time we have left, I am happy to follow up in more depth any particular issues that the member wants to raise.

I know that there is an access audit checklist that uses inclusive design to ensure that new buildings are accessible; a whole host of different vulnerabilities are taken into consideration when designing new facilities. That also goes for older buildings, which the NHS has a number of, to ensure that they are as accessible as they can be. Not everything is perfect, but there are a range of tools in place to ensure that new buildings and the existing infrastructure are as accessible as possible.