Chamber and committees

The Scottish Government Fiscal Statement (3 September 2024) and accompanying letter to the Finance Committee Scottish Government Pre-Budget Fiscal Update: Letter to Finance Committee - gov.scot (www.gov.scot)set out savings measures taken in the financial year to date, including those generated through the application of emergency spending controls. Alongside specific savings detailed in the statement a further up to £60 million savings are anticipated to be generated through the emergency spending controls over the remainder of the financial year. The controls require greater scrutiny over expenditure and whether it is truly essential or unavoidable, as well as targeting recruitment, overtime, travel and marketing, savings generated that result in revisions to budgets will be reported and published in the Autumn and Spring Budget Revisions, in line with usual in-year financial management processes.

The Scottish Cyber Coordination Centre budget forms a component of existing Cyber Resilience funding, and the future budget for the Scottish Cyber Coordination Centre is still to be determined.

Both Scottish and UK Government Ministers have accepted a South Ayrshire Council proposal that the Prestwick Spaceport is no longer taken forward as part of the Ayrshire Growth Deal. Scottish Ministers look forward to working constructively with AGD partners to agree new projects to be taken forward using funding previously committed to the spaceport project, and are confident that these will focus on and build on South Ayrshire’s clear strengths in aerospace.

Specialist NHS gender identity healthcare in Scotland is delivered by gender identity clinics. There are four NHS gender identity clinics in Scotland providing clinical assessment, treatment and specialist support to adults and a separate service for children and young people.

The role of community pharmacy in relation to gender identity healthcare primarily relates to the dispensing of prescriptions for medication prescribed as part of healthcare support for gender dysphoria.

Scottish Government does not hold information on how many pharmacies have dispensed prescriptions related to gender identity healthcare.

I refer the member to my the answer to question S6W-26340 on 19 April 2024, that clarifies that decisions on clinical pathways are not for the Scottish Government. Decisions on clinical pathways, and prescribing, are for clinicians, based on the best evidence available, through the appropriate clinical governance structures.

The timeline of the Health Boards informing the Scottish Government about their decision:

28 March (pm) - Medical Directors in NHS Lothian and NHS Greater Glasgow and Clyde wrote to the Chief Medical Officer (CMO) advising him that, following a consultation with senior medical staff, both Boards were pausing any new prescriptions for puberty hormone suppressants and cross sex medication for those under 18 years of age. This position followed an interim pause on referrals to paediatric endocrinology, following clinical advice, from mid-March by the Health Boards.

5 April - Ministers were informed of the proposed change in policy, following consideration of the implications of the letter.

9 April - The CMO responded to Medical Directors in NHS Lothian and NHS Greater Glasgow and Clyde confirming that this area is no exception to his expectation that Health Boards make decisions on the delivery of clinical care via agreed local governance processes, considering new and emerging evidence in a clinical field - and conveying his support for the Health Boards’ decision.

All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers.

The Scottish Government welcomes the innovation, continuous improvement and efficiency that Health Board delivery teams have demonstrated to make best use of resources and funding throughout our national vaccination programmes, which remain a key public health intervention.

The Scottish Government provided £80 million on an National Resource Allocation formula (NRAC) basis to cover local Board vaccine delivery costs for the full financial year 2023/24.

These funds were allocated to the following programmes, the largest of which was the winter Seasonal Flu & COVID-19 booster programme:

• Spring 2023 COVID-19 programme
• 6 months – 4 years at risk COVID-19 programme
• changes to the COVID-19 primary rolling offer
• COVID-19 vaccination out-with seasonal programmes for the clinically extremely vulnerable and for travel or visa purposes
• Winter Seasonal Flu & COVID-19 booster programme 2023

Boards also used this funding to deliver across the full range of other vaccine programmes. A breakdown of investment provided to each Health Board is as follows.

As part of the 2023-24 COVID-19 and flu winter vaccination programme NHS Scotland delivered over 3.57 million winter vaccines, including 1,387,766 COVID-19 vaccines, 1,647,596 adult flu vaccines and 538,580 child flu vaccines. Uptake dropped across almost all groups, but remained strong in the highest risk groups, with over 85% of care home residents and almost 85% of those aged over 75 vaccinated for both vaccines, the groups mostly likely to be admitted to hospital with these illnesses. We continued to surpass the World Health Organisation’s flu target of 75% uptake for those aged 65 and over, achieving 79.8%.

The primary aim of the vaccination programme remains the prevention of severe illness and the vaccine offer is to those most likely to directly benefit from vaccination, particularly those with underlying health conditions that increase their risk of hospitalisation. The data from last winter’s programme shows that uptake remained strong within these eligible groups and meets the primary aim of the winter programme.

There were however certain groups where uptake was far lower than expected, for both COVID-19 and flu, notably pregnant women, frontline health and social care workers and those at clinical risk, although uptake in those with a weakened immune system was better than for more general at risk conditions.

The emergence of the new, and theoretically more dangerous variant BA.2.86 in late summer 2023 resulted in us deciding to pull forward the programme to protect those at higher risk. We appointed those at higher risk into all and any spare appointments at the start and middle of the programme, meaning that those at lower risk, who had been prompted to book, found it hard to find spare appointments until November and December. It is difficult to quantify, but we believe that some individuals may have not come forward due to this difficulty.

The Scottish Vaccination and Immunisation Programme (SVIP) has already undertaken various pieces of work to understand why overall uptake has decreased and we have incorporated that learning into our planning for this winter campaign. Communicating why annual revaccination (or bi-annual in the case of COVID for higher risk groups) remains necessary and important is key, as is reiterating the value of these vaccines, and the real health risk to some people in contracting these viruses over the winter period.

We will continue to work closely with Public Health Scotland and the NHS Boards to ensure the successful delivery of Scotland’s vaccination programmes.

The Cabinet Secretary for Health and Social Care met with the Chair of the Scottish Hospice Leadership Group and Hospice UK on 8 August to discuss long-term planning and funding for the commissioning of hospice care as part of an agreed visit.

I am also meeting the Chair of the Scottish Hospice Leadership Group and Hospice UK on 18 September to discuss these matters further.

The Scottish Government continues to work with Integration Joint Boards (IJB) chief officers and independent hospices to support longer term sustainable planning and commissioning for the sector.

However, it is for Integration Joint Boards (IJBs) to govern, plan and resource adult palliative care in their areas, including independent hospice care, using the delegated budgets under their control. We would encourage hospice colleagues to continue to engage with IJBs to help ensure that the needs of the local population are met.

The Strategy Steering Group for Palliative Care (SSG), representing the wide range of partners involved in palliative care, chaired by a National Clinical Lead for Palliative Care, and supported by a Clinical and Professional Advisory Group (CPAG), has been crucial in the development of our new Palliative Care Strategy.

The Strategy Steering Group last met on 20 June 2024, to consider the latest version of the draft Palliative Care Strategy and provide further feedback. We anticipate that the draft Palliative Care Strategy and associated consultation will be published in the coming weeks.

In the last five financial years Scottish Government has provided the following funding to South of Scotland Enterprise:

South of Scotland Enterprise – Budget Allocations 2020-2025