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Chamber and committees

Meeting date: Thursday, June 20, 2019

Meeting of the Parliament 20 June 2019

Agenda: Business Motion, General Question Time, First Minister’s Question Time, Glasgow School of Art Fire, Planning (Scotland) Bill: Stage 3 (Day 3), Portfolio Question Time, Provisional Outturn 2018-19, Gender Recognition Act 2004 Review, Planning (Scotland) Bill, Business Motion, Decision Time


Portfolio Question Time

NHS Scotland (Ownership)

To ask the Scottish Government what steps it is taking to ensure that NHS Scotland stays in public ownership. (S5O-03413)

The Scottish Government remains absolutely committed to the founding principles of a publicly owned, funded and operated national health service that is free at the point of need. We will oppose any attempt, in post-Brexit or other trade talks, to impinge on that in any way. Our NHS in Scotland will not be on the table in any trade deal.

I thank the cabinet secretary for her assurance. I am sure that the people of Scotland will be very happy to hear that.

How is the continued integration of health and social care in Scotland assisting the Government in protecting and managing the precious resources of the NHS? What discussions is the Scottish Government having with local health boards to ensure that our NHS is safeguarded against any future proposal by the Tory United Kingdom Government?

As Mr Lyle will know from the budget that was agreed in this chamber, the aim of our additional investment in health and social care, which exceeds £700 million, is to shift the balance of care that people need to their local communities except where it is clinically necessary for them to be in acute settings. The health and social care medium-term financial framework sets out that approach.

I assure Mr Lyle that we will not do what the Warrington and Halton Hospitals NHS Foundation in England is doing. As has been revealed in the Nursing Times, it is now producing a price list for procedures that should be provided free at the point where they are needed. For example, cataract surgery is priced at £1,700 and hip replacement surgery at more than £7,000. Those prices cover only one pre-op consultation, one attendance as a day case and one follow-up attendance. That is what is happening to the health service in England—they are getting it ready to trade off. That will not happen to the NHS in Scotland.

I ask all members to ensure that, if supplementary questions are allowed, they are asked quickly.

In 2017, NHS Scotland signed a contract worth £400 million with a private company for locum staff. Last year, a further contract worth £30 million was signed with six private companies. Does that not illustrate the increasing use of the private sector that is happening under the Scottish National Party?

No, it absolutely is not. [Interruption.] I will explain to Mr Briggs—and his amused colleagues—why that is the case.

I think that the first contract to which Mr Briggs referred is one with IHI, which is a not-for-profit organisation. The other contracts that he mentioned may, indeed, represent interim use of the private sector to reduce long waiting times for patients, as I set out in the waiting times plan. However, I say to Mr Briggs that that is not selling off sections of our health service to Virgin Health or allowing any of our boards to produce price lists for hip replacement, cataract or knee replacement surgery, which is precisely what his colleagues in England are doing. The day and hour that Mr Briggs defends that practice in this chamber is the time when he and I might have a proper conversation.

Has the cabinet secretary investigated the worrying implications of investor-state dispute settlement being invoked as part of a trade deal? That would give foreign companies the right to sue the Scottish Government for devolved health decisions.

Mr Stewart makes an important point that came up previously when deals were being looked at. It is about the vulnerability of the UK being seen as a single state when trade deals are negotiated, and whether that places our NHS in a vulnerable position. We looked at the issue and took up-to-date advice at that time. We are looking at it again to ensure that we are as prepared as possible. I am absolutely certain that, with colleagues in Labour and elsewhere in the Parliament, if not the Conservatives, and with the people of Scotland, we will defend our health service.

Beauty Industry (Regulation)

To ask the Scottish Government when beauticians, hairdressers and others who provide aesthetic procedures will be regulated in the same way as medically qualified practitioners. (S5O-03414)

Independent clinics were brought within the regulation of Healthcare Improvement Scotland on 1 April 2016. The policy was to ensure that certain healthcare professionals who are working independently of the NHS do so in a clinic that is registered with Healthcare Improvement Scotland. That work puts Scotland at the forefront of regulating independent private healthcare, mainly in the cosmetic area but also in dentistry, midwifery and slimming clinics, to name but a few areas.

Until 2016, there was no regulation of cosmetic procedures. It is crucial that aesthetic procedures that are currently provided by non-healthcare professionals are subject to a similar level of inspection and scrutiny as those that are provided by medically qualified practitioners. We plan to bring forward a consultation later this year, to inform our legislative amendments.

Will the minister clarify what action can be taken in the meantime to highlight to consumers the risks they face when they submit to procedures such as Botox and lip-filling injections that are carried out by unqualified practitioners who might have no training or insurance and who might not be regulated?

Mr Torrance brings an important point to the chamber. Anyone who is considering undergoing such a treatment should always use a regulated provider, details of which are available on the Healthcare Improvement Scotland website. Unregulated providers will not appear on that list, nor will they have any HIS-accredited literature to prove their competence. We also urge consumers to carry out due diligence checks on the provider.

Child and Adolescent Mental Health Services Waiting Times (Lothian)

To ask the Scottish Government what steps it is taking to reduce excessive waiting times for young people in Lothian to access mental health support. (S5O-03415)

Through the mental health access improvement support programme, between 2016-17 and 2019-20, NHS Lothian is scheduled to receive an additional £4.7 million from the Scottish Government to support mental health workforce development and capacity building.

The director for mental health has written to NHS Lothian, seeking reassurance about the approach that is being taken to address long waits and confirmation that patients are kept informed of their situation and provided with support and advice while they are waiting for on-going treatment.

I thank the minister for her answer, but the fact remains that, in the most recent quarter, 85 young people in NHS Lothian waited for more than a year, and 118 young people waited for more than a year across all NHS health boards. Does the minister agree with me and the Scottish children’s services coalition that there must be a radical transformation of our mental health services?

Long waits for child and adolescent mental health services and support are unacceptable; I have said that on more than one occasion in this chamber. The Scottish Government expects all health boards to meet and sustain performance against mental health waiting time targets. To help to achieve that ambition, our 2018-19 programme for government outlines a package of measures that are supported by £0.25 billion of additional investment. That is in addition to the £54 million that has already been invested to help boards to improve their performance against waiting time targets.

Looking at the broader picture of access to CAMHS across Scotland, the latest figures show that more than a quarter of referred children are not seen within the 18-week target waiting time. When does the minister expect to reach the 90 per cent target for children and young people accessing CAMHS within 18 weeks?

All boards now have in place improvement plans for CAMHS and psychological therapies, supported by the mental health access improvement team, with milestones to meet over the next two years. The Scottish Government is working with health boards, including in Lothian and Fife, to agree their annual operating plans, which include how they will meet those standards.

Mesh Implants

To ask the Scottish Government what work it has done to plan for the lifting of the ban on mesh implants. (S5O-03416)

I have been consistently clear that the complete halt to transvaginal mesh procedures, which I announced last September, will be lifted only if a high-vigilance restricted use protocol is developed to my satisfaction. I have not instructed any planning to consider the lifting of that halt and the Scottish Government has undertaken no work to that effect.

I warmly welcome the news that US surgeon Dr Veronikis might come to Scotland to help mesh-injured women. I thank the Scottish mesh survivors, the Sunday Post and the parliamentarians who have kept up the pressure on the issue.

In the interests of transparency, can the cabinet secretary ensure that all the minutes of the accountable officer short-life working group and the short-life working group on mesh complications are published today, so that we can clearly see what has been discussed at the groups and whether they are planning for the return of mesh?

As I have made clear to Mr Findlay, whether mesh ever returns will be my decision as cabinet secretary. I have been clear in the chamber that I have not instructed any work to plan for it to return and I have not had any work undertaken by the Scottish Government to plan for it to return. It is vitally important that, in the chamber and elsewhere, we are crystal clear on that and that we do not cause further distress to those who would be affected by incorrect information.

Neil Findlay referred to the minutes of the two groups. The short-life working group that I established following a meeting in March with some of the women who are affected by mesh complications published the minutes of its first meeting today. Subsequent minutes will be published when the group approves the minutes. That also applies to the one meeting of the other group, which was set up following my statement in September to look at the high-vigilance protocol and the work in relation to the audit that I committed to have undertaken. That group also has to approve its minutes before they are published. When all that is done, it will all—including declarations of interest—be published on the Government’s website.

Fife Hospitals (Safety)

To ask the Scottish Government what action it is taking to tackle safety concerns in Fife hospitals. (S5O-03417)

The safety of NHS Scotland’s patients and staff is a key priority for the Scottish Government. The Scottish Government introduced a range of measures to protect and improve patient safety, including the Scottish patient safety programme, which was launched in 2008. The Scottish patient safety programme has contributed to the effectiveness of NHS Fife, with, for example, a fall of 9.8 per cent in hospital standardised mortality ratios, a fall in cardiac arrests and a reduction in falls over a period of six years.

I thank the cabinet secretary for that response. However, during a recent unannounced inspection visit to Glenrothes hospital, Healthcare Improvement Scotland uncovered a number of concerning issues, including contaminated equipment, used waste and sharps being stored in accessible areas and inappropriate monitoring of water safety associated with legionella. What action will the Scottish Government take to restore patient trust in that hospital?

That is precisely why those inspections are so important and why they are undertaken. In fairness to Glenrothes hospital, the inspection report also found a number of areas in which the hospital was satisfactory—it is only fair that we note that in the chamber. Following the report, the board is required to produce an action plan of the specific actions that it will undertake. It has done that, and I am happy to ensure that Mr Stewart sees a copy of it. HIS will go back and report again on the actions. My officials will keep the situation under constant review. If there are matters that require my intervention, I hope that Mr Stewart is assured that I will intervene.

Alcohol and Drug Treatment Strategy

To ask the Scottish Government how it will evaluate the delivery of the alcohol and drug treatment strategy, “Rights, Respect and Recovery”. (S5O-03418)

NHS Health Scotland is leading on the development of a monitoring and evaluation plan that involves the Scottish Government as well as other key stakeholders. The plan will enable the Scottish Government to measure progress and assess the impact of the strategy.

The landscape for treatment and recovery services can be complex, and the process of how funding is allocated for early intervention and recovery work as opposed to core clinical services is a little opaque. How will the Scottish Government address that? Audit Scotland’s report of May 2019 highlights that making performance-related reporting public could help with accountability. Does the minister agree?

We welcome Audit Scotland’s report, and our national alcohol and drug strategy, which was published last year, set out a number of actions that will address issues that were identified in the report.

In the coming weeks, the Scottish Government and the Convention of Scottish Local Authorities intend to publish a partnership delivery framework to support local planning arrangements to address alcohol and drug harms. As I mentioned, we are working with NHS Health Scotland to develop a monitoring and evaluation framework for the new strategy. The introduction later this year of the new drug and alcohol information system, or DAISy, will provide clear links between spending and outcomes and will demonstrate how investment in drug and alcohol services contributes to improving health outcomes.

Drumwealth Games (Health Impact)

To ask the Scottish Government what its response is to the health impact of the 2019 Drumwealth games, which took place on 14 June and saw over 500 primary 5 to secondary 1 pupils participate in sport activities. (S5O-03419)

First, I would like to congratulate everyone who is involved in the Drumwealth games, now in their seventh year, which are a great legacy of the Commonwealth games in 2014.

Being physically active is one of the very best things that we can do for our physical and mental health. The Drumwealth games are testament to what can be achieved through partnerships between schools and clubs, with Drumchapel sport—the Drumchapel community sport hub—active schools and Glasgow Sport working together in partnership. Sport at an early age makes a fun and sustainable contribution to physical activity, which we hope will lead to longer, happier lives.

The Drumwealth games encourage children of all capabilities to try out new sports. Does the minister agree that it is important for all children in Scotland to be introduced to a wide variety of sports and to have the opportunity to pursue those that they find a passion for?

Yes, I do. That is why programmes such as the active schools programme offer more than 100 different activities, ranging from football to dance and movement, which gives children the opportunity to be active and take part in the activities that they enjoy. While I was deputy convener of the Health and Sport Committee, I was fortunate enough to visit the Drumchapel community sport hub. I was very impressed by the facility, which provides an opportunity to improve the health and wellbeing of all members of the local community.

Chronic Pain Treatment Waiting Times (NHS Forth Valley)

To ask the Scottish Government what support it is giving to NHS Forth Valley to reduce waiting times for chronic pain treatment. (S5O-03420)

As Mr Lockhart will recall, in its initial work, the waiting times improvement plan specifically targets those people who have been waiting the longest and those with a clinical priority. In 2018-19, NHS Forth Valley received an additional £4 million, which it focused on support for general surgery, ear, nose and throat, trauma and orthopaedics.

In this financial year, NHS Forth Valley plans to utilise the additional funding for waiting times improvement to recruit new staff to the chronic pain service so that it can increase capacity by running a pain management programme with extended scope physiotherapists. That programme, which will run in parallel with consultant-led services, will contribute to and complement the national work that we are doing to improve the development of the chronic pain service across the national health service.

I thank the cabinet secretary for that response, but recent figures show that more than a quarter of patients in NHS Forth Valley have waited more than 18 weeks for treatment for chronic pain. Only 73 per cent were seen within 18 weeks of referral, which is below the target of 90 per cent. That made NHS Forth Valley the second-worst-performing health board in Scotland on that measure.

The cabinet secretary mentioned the provision of additional funding, but what real measures will she take to provide additional support to NHS Forth Valley to improve the situation?

I think that the provision of additional funding is one of the real measures that we are taking. It is precisely because of the situation that Mr Lockhart has outlined that, as all boards are required to do, NHS Forth Valley targets those areas with the longest waits and where there is a clinical priority. That is why it is targeting its chronic pain service in this financial year. We will see the effectiveness of that when the figures come out in due course.