Chamber and committees

The Scottish Court Service consultation Shaping Scotland’s Court Services represents a very thorough assessment of the context and the challenge of providing services and facilities across Scotland which are consistent with the standards of a modern court system within the financial constraints imposed by the Westminster Government. The existing network of courts reflects more the social and economic needs of the Victorian age, but in the modern world it is more appropriate to devote the available reduced budget to a smaller number of courts, supplemented by new technology such as video links.

I have deliberated very carefully on the options presented, particularly in view of the representations made in relation to particular courts, and the Cabinet has given its consent to the proposals. We think that the proposals strike the correct balance in the current economic climate.

We realise that a court can be regarded as an important element in communities such as Arbroath and Stonehaven, but this needs to be balanced against the fact that many similar and larger communities function without a local court. We believe that the economic and community impact will be localised and short term.

No specific meetings have taken place between the Health and Social Care Directorate and NHS Health Scotland to discuss the introduction of a new meningococcal B vaccine into the routine childhood immunisation schedule.

The Scottish Immunisation Programme Co-ordination Group, co-ordinated by NHS Health Protection Scotland, and with representation from the Scottish Government, NHS Health Scotland and other NHS stakeholders, keeps abreast of all recommendations made by the Joint Committee on Vaccination and Immunisation (JCVI), the independent scientific expert committee that considers matters in relation to all immunisation programmes.

The Scottish Government currently has no plans to introduce a new meningococcal B vaccine into the routine childhood immunisation schedule before winter 2013.

The Scottish Government will consider any future recommendations made by the Joint Committee on Vaccination and Immunisation (JCVI) in relation to the meningococcal B vaccine.

The health reforms in England will have no bearing in relation to timescales for the introduction of new vaccines in Scotland, including a meningococcal B vaccine.

The Scottish Government considers all recommendations made by the Joint Committee on Vaccination and Immunisation (JCVI).

Once a JCVI recommendation is received and a decision is taken to introduce a programme, the Scottish Government works with colleagues in NHS Health Protection Scotland, and the Scottish Immunisation Programme (SIP) Co-ordination Group to identify and undertake the work required for implementation of the routine programme and any catch up programme.

The SIP Co-ordination Group has a number of sub groups established within its structure to take forward work required in relation to service delivery, communications, workforce, vaccine supply and epidemiology issues.

The Scottish Government awaits recommendations on the possible introduction of a meningococcal B vaccine from the Joint Committee on Vaccination and Immunisation (JCVI).

The Scottish Government would always be guided by the JCVI in relation to timescales for the introduction of any vaccination programme, as well as the need to consider issues around the practicalities involved in the introduction a new vaccination programme.

There have been no formal discussions with the UK Government regarding the introduction of a meningococcal B vaccination programme. Informal discussions take place from time to time between officials in Scotland, England, Wales and Northern Ireland looking at a range of issues including horizon scanning.

NHS boards have the responsibility for publicising screening within their local area and working closely within their communities to increase screening uptake. GPs also play a pivotal role in highlighting the benefits and risks of cervical screening to their patients.

In 2009 the Breast and Cervical National Advisory Group commissioned NHS Health Scotland to undertake research with women into the reasons for non-uptake of the cervical screening invitation. The results of this work were used to develop an engagement and communications strategy to support the Scottish Cervical Screening Programme. This strategy considered a series of recommendations to improve uptake of cervical screening and to make screening a more consistently positive experience for all eligible women. To help address low uptake a new suite of information leaflets was developed in August 2010. Nationally, the information we provide is key to allowing women to make an informed choice. Women are involved in the design of the information leaflets, which are promoted in healthcare and community settings, including GP surgeries.

The Scottish Cervical Screening Programme invites all women aged 20 – 60 for screening every three years. Screening has been shown to be the best way to prevent cervical cancer. The Scottish Government is supporting NHS Boards to increase uptake of the screening programme through informed consent.

All young women are now offered the HPV vaccination which protects them against 70% of all high risk types of HPV. Vaccine uptake is high with 82.8% of girls in S2 in school year 2011-12 completing the three dose course of HPV immunisations by the end of the school year. 91.7% had received two doses and 93.1% had received one dose.

Although the Detect Cancer Early Programme, which aims to increase the number of cancers detected at an early stage of the disease, will initially concentrate on lung, bowel and breast cancer, it is fully expected to raise awareness of all cancers amongst the public, health practitioners and crucially save more lives each year. Whilst not directed at cervical cancer specifically, we anticipate benefits to other groups of people as general awareness raising initiatives result in earlier presentation, referral and assessment for all those with a possibility of cancer.

In addition, the Scottish Government will continue to work with GPs to promote earlier referral or investigation of patients who might have cancer. To support GPs in Scotland to refer patients with suspected cancer, including cervical, as early as possible, the Scottish Government published referral guidance in 2007 called the “Scottish Executive health Department Letter (2007) 9: Scottish Referral Guidelines for Suspected Cancer”. In early 2009, the guidelines were shortened into a user friendly version for quick reference. All GPs across NHS Scotland were sent a copy of this guidance, which is available on the Scottish Government website:

www.scotland.gov.uk/quickreferenceguide/suspectedcancer.

The Scottish Cervical Screening Programme is a whole population screening programme and there are no plans to change this.

NHS boards have responsibility for publicising screening within their local area and working closely within their communities to increase screening uptake. NHS boards do currently monitor uptake within their populations and put in place measure to address low uptake. Targeted communications to specific groups of the population have been developed nationally and are promoted in healthcare and community settings, including GP surgeries.

GPs also play a pivotal role in highlighting the benefits and potential risks of cervical screening to their patients and are incentivised, under the Quality and Outcomes Framework, to do so.