Chamber and committees

Telehealth has great potential to help patients and NHS staff. New telehealth products require the same evaluation as any other health technology, i.e. a Health Technology Assessment*. Implementation in the NHS would be driven by the same policy considerations as guide the implementation of any other new technology.

In developing and proving a telehealth application, a number of steps are required in order to show that the application is ethical, legal, feasible, acceptable to the users, safe, and finally clinically and cost effective. The early stages are normally carried out in the laboratory, pilot trials are then done which involve patients or volunteers, and then clinical trials with patients are carried out to assess the costs and benefits.

Note: *Health Technology Assessments apply to all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care including:

Drugs: such as antidepressants, contraceptives, antibiotics;

Devices: such as pacemakers, dialysis machines, hearing aids;

Procedures: such as surgical techniques, acupuncture, counselling;

Settings of care: such as general practice, hospitals, care homes, and

Screening: for cancer, sexually transmitted diseases, stroke.

As part of the Single Outcome Agreement (SOA) approach, Councils (for the 2008-09 SOA) and Community Planning Partnerships (for subsequent SOAs) will be expected to report to the Scottish Government and their local communities each year. Reports for 2008-09 will be due in September 2009. These reports will describe progress made towards local outcomes, including those outcomes relating to health and physical activity, and show how this progress contributes to the Scottish Government''s National Outcomes. The Scottish Government will ensure that the reports are made available for scrutiny by Parliament.

I have asked Mike Ewart, Chief Executive of the Scottish Prison Service to respond. His response is as follows:

Before the proposed HMP Highland opens, the Scottish Prison Service needs to select and acquire a suitable site, obtain planning permission for the proposed development, conduct a procurement process for the design and construction of the prison and then prepare the prison for operation. These steps will take a number of years, with the date of opening being largely dependent on the time required to acquire a site and secure planning permission. A target date for HMP Highland opening will be set following completion of these key stages.

The provision of NHS services including podiatry services, is a matter for NHS boards. NHS boards have a responsibility for allocating resources for NHS services in line with local and national priorities.

The following table shows the number of patients admitted to Scottish NHS hospitals for weight loss surgery for the calendar years 1998-2007:

Year	Number
1998	54
1999	36
2000	44
2001	58
2002	49
2003	65
2004	73
2005	105
2006	146
2007	185

Source ISD.

This question was answered in the Chamber. The answer can be viewed in the Official Report using the following link:

http://www.scottish.parliament.uk/business/officialReports/meetingsParliament/or-09/sor0305-01.htm

Health for All Children (Hall 4) guidance recommends that BMI be recorded in primary 7 children every three years for public health monitoring purposes from 2007-08. There is no requirement for this to be monitored by the Scottish Government and these are not official statistics and are not routinely released for publication.

Information on body mass index (BMI), derived from height and weight measurements recorded in primary seven, is available for NHS boards which use the Child Health School system (CHSP-S) and routinely collect BMI measurement. Data for school years 2007-08 are shown in the following table.

Table 1: Recording of Height and Weight in Primary Seven

Total (all NHS Boards participating in CHSP - School)1,2,	2007-08
Population estimate of 11-year-olds	40,339
Number of children who had their height and weight recorded3	9,883
Estimated percentage of children who had their height and weight recorded4	24.5%

Source: ISD Scotland, CHSP-S Nov 2008 and General Register Office for Scotland (GROS) Ref: IR2009-00320.

Notes:

1. Data are not available for the following NHS boards: NHS Grampian, former NHS Greater Glasgow, NHS Highland, NHS Orkney and NHS Shetland.

2. For the period shown, the school system was not implemented in all areas of former NHS Argyll and Clyde.

3. A proportion of the height and weight measurements recorded on CHSP-School may be invalid.

4. The GRO mid-year population estimate of 11-year-olds has been used to approximate the number of children in primary seven in the NHS boards participating in CHSP “ School.

BMI statistics were recorded for primary 7 children and published until 2004-05. This information is available from the following link. http://www.isdscotland.org/isd/3640.html.

The information requested is shown in the following table:

Cause of death	2003	2004	2005	2006	2007
Coronary thrombosis - all cases are due to it (1)	6,962	6,311	6,046	5,494	5,340
Coronary thrombosis - most cases are due to it (2)	4,346	4,340	4,123	3,782	3,767
Cerebral thrombosis (venous and arterial) - all cases are due to it (3)	44	33	31	20	21
Cerebral thrombosis (venous and arterial) - most cases are due to cerebral or pre-cerebral thrombosis (4)	3,365	3,258	2,922	2,834	2,732
Peripheral arterial thrombosis - most cases are due to it (5)	248	245	265	302	278
Venous thrombosis at various sites - all cases are due to it (6)	2	6	4	1	3
Venous thrombosis at various sites - most cases are due to it (7)	170	161	142	137	128
Other conditions caused by thrombosis - all cases are due to it (8)	0	0	0	0	0
Other conditions caused by thrombosis - most cases are due to it (9)	17	21	15	10	20

Source: General Register Office for Scotland.

As the figures demonstrate, the vast majority of these deaths are caused by clots in the coronary arteries, which result in certain types of heart attack, and clots in the brain, which result in certain types of stroke.

In view of the responses generated by the answer given to the question S3W-12541 on 9 May 2008, it should be emphasised that of the 12,289 deaths in 2007, 257 were related to pulmonary embolism and there were also 112 deaths in which Deep Vein Thrombosis was recorded as the underlying cause of death.

All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

I have asked Mike Ewart, Chief Executive of the Scottish Prison Service to respond. His response is as follows:

The Scottish Prison Service, working in conjunction with Highland Council, has identified possible sites for the proposed HMP Highland and further work is now being carried out to evaluate the suitability of these sites.

Services for people with eating disorders are planned and delivered on a regional and local basis by NHS, local authority and independent and voluntary sector providers reflecting the level of specialisation required to meet individual''s clinical needs.