Chamber and committees

The manufacturer’s route to market for Ataluren is through the long standing independent Scottish Medicines Consortium (SMC) process. In April 2016 the SMC decided not to recommend Ataluren for routine use in Scotland because the balance of costs and benefits meant it was not considered to offer value for money. We understand the company will be making a resubmission and would urge them to do so at a fair price to ensure access is as wide as possible. We do think more can be done to build on the progress to date on access to medicines which is why we asked Dr Brian Montgomery to conduct an independent review which will report later in the summer.The initial pilot of the Peer Approved Clinical System for ultra-orphan medicines has been extended to cover all NHS boards. This means that access to licensed ultra-orphan medicines, such as Ataluren, that have not been recommended for use by SMC, can be considered across Scotland through a standard and consistent process. Where such alternative prescribing options are used the Scottish Government’s New Medicines Fund is available to cover the cost.

Tackling the number of delayed discharges is a key priority of this government, and we are working closely with health boards and their local authority partners to address this issue. We are encouraging the continued development of Intermediate Care across Scotland. These services can provide a safe and effective alternative to hospital admission (step-up care), and ensure timely discharge back to the community (step-down care). Providing this type of short-term intensive rehabilitation, or reablement, following a hospital admission can ultimately reduce, or eliminate, the need for longer term packages of care.

Another key solution to delayed discharge is better joint working between health and social care services. To ensure this we have legislated, through the Public Bodies (Joint Working) (Scotland) Act 2014, to bring together local health and social care systems, with the key aim of improving people’s experience of health and care services and the outcomes that services achieve.

We are also providing financial support to all health and social care partnerships in the form of £90 million over three years, specifically to tackle delayed discharge plus an additional £250 million for investment in social care in 2016-17. The funding will help support partnerships achieve the National Integration Indicators, one of which is a commitment to increase the number of people discharged within 72 hours of being ready for discharge.

In answer to enquiries made of NHS boards, as of December 2015 there were a total of 16 hydrotherapy pools across Scotland. All NHS boards provide access to hydrotherapy pools.

The group which met in response to Petition PE1499: ‘Creating Suitable Respite Services for Younger Disabled Adults with Life-Limiting Conditions’ agreed that the immediate focus for this group would be the young adults over the age of 21 who are currently using Children’s Hospice Association Scotland (CHAS) services.

The medium to longer term focus was to generate a range of options that could meet a wider range of needs. To this end the CHAS transition team continues to explore with young disabled adults and others the potential for further collaborative projects which could enable young adults with life limiting conditions to have short breaks outwith a hospice environment.

More recently, as part of the Health and Sport Committee’s inquiry, ‘We need to talk about Palliative Care’ and in the Strategic Framework for Action on Palliative and End of Life Care, I am considering how this area of work can continue to be taken forward.

I will ensure that the relevant interests involved in the stakeholder review group continue to be involved in wider considerations.

Access to specialist respiratory support for people with muscular dystrophy and neuromuscular conditions would form part of an individual care package, agreed with relevant healthcare professionals.

Respiratory Managed Clinical Networks across NHS boards work to improve the respiratory health and quality of life of patients; ensuring that they have equitable access to high quality respiratory services.

The Scottish Government is guided on vaccination policy by the independent expert body, the Joint Committee on Vaccination and Immunisation (JCVI). Following the JCVI's advice, the Scottish Government introduced the Meningitis B (Men B) vaccine on 1 September 2015 with infants aged 2 months (born on or after 1 July 2015) being eligible. The JCVI also advised that there should be one off catch up programme for infants aged 3 and 4 months (infants born between 1 May 2015 - 30 June 2015) who were attending their GP practice for their routine immunisations at that time.

The JCVI recommendation is based on epidemiological evidence that the number of Men B cases in infants peaks at around 5 months of age. After 5 months of age the number of cases decline. It is important therefore to provide protection to infants before they are 5 months old. After administration, the vaccine can take a number of weeks to take effect and for immunity to be established in the host. Therefore, by giving the Men B vaccine at or around 2 months of age, before the peak in incidence of disease at 5 months of age, it allows for infants to be protected when the risk is greatest.

Infants covered by the routine childhood programme are those born from 1 May 2015 onwards. While the routine childhood programme does not extend to older children, there are certain children who should receive the vaccination on clinical grounds due to increased risk of infection and disease. The full list of clinical grounds for those eligible for the Men B vaccination can be found in chapter 22 on the Green Book, which is available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/541186/2905559_Green_Book_Chapter_22.pdf

Infants covered by the routine childhood programme are those born from 1 May 2015 onwards. While the routine childhood programme does not extend to older children, there are certain children who should receive the vaccination on clinical grounds due to increased risk of infection and disease. The full list of clinical grounds for those eligible for the Men B vaccination can be found in chapter 22 of the green book, which is available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/541186/2905559_Green_Book_Chapter_22.pdf

The position is based on independent expert scientific advice from the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI considered all of the available information on epidemiology, vaccine efficacy, strain coverage, duration of protection, and protection against meningococcal carriage, safety, dose-scheduling, vaccine availability, and cost-effectiveness modelling before reaching their recommendation.

The full detail of the JCVI advice in relation to recommending Men B is available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/294245/JCVI_Statement_on_MenB.pdf

Wind farms of more than 50 megawatts are determined by Scottish Ministers through section 36 of the Electricity Act 1989, while those of less than 50 megawatts are determined by planning authorities under the Town and Country Planning (Scotland) Act 1997 (as amended). Planning applications are generally determined by planning authorities in Scotland and the information requested is not held centrally in respect of those sites. In certain circumstances an appeal can be made to Scottish Ministers against the decision by the planning authority. The vast majority of these decisions are made by reporters from Planning and Environmental Appeals Division (DPEA).

It is my understanding that a total of 21 wind farm determinations have been made under the Electricity Act since Scottish Planning Policy 2014 (SPP) (with reference to wild land maps) was published. Of these 21 determinations, 13 were consented. The DPEA have made decisions on 123 proposed wind farm developments for either single or multiple turbines in this period, 67 of which were allowed. In relation to the requested information regarding whether wild land was a determinative factor, this information is not routinely collated. All of the section 36 wind farm decision letters are available from Scottish Government’s Energy and Consents webpage http://www.energyconsents.scot/. Decisions made by DPEA can be searched for at this address: http://www.dpea.scotland.gov.uk/Default.aspx