Questions and answers

Question reference: S4W-02568

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 09 September 2011
Current Status: Answered by Nicola Sturgeon on 21 September 2011

To ask the Scottish Executive whether it has issued guidelines to NHS boards on the principles and timelines that should govern recommendations by area drugs and therapeutics committees (ADTCs) when reviewing new medicines approved by the Scottish Medicines Consortium and, if so, whether such guidelines deal with the (a) statement in CEL 17 (2010) on the principles determining how new medicines should be measured against other available medicines, (b) relevance of the medicine to approved treatment protocols, (c) basis on which ADTCs reject inclusion in local formularies, (d) resource and (e) service implications.

Question reference: S4O-00230

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Wednesday, 21 September 2011
Current Status: Taken in the Chamber on 29 September 2011

To ask the Scottish Executive whether negotiations have been concluded and a date has been set for the transfer of medical nursing and pharmacy services from the Scottish Prison Service to the NHS.

Question reference: S4W-02253

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Alasdair Allan on 16 September 2011

To ask the Scottish Executive what steps it has taken to evaluate the (a) risks, (b) benefits and (c) consumer acceptability of different types of meal provision by local authorities.

Local authorities have responsibility for the standard and type of meals they provide. In the provision of meals, they must meet their duties as set out in any relevant standards and legislation including National Care Standards and the Schools (Health Promotion and Nutrition) (Scotland) Act 2007. The Scottish Government have published guidance including Nutritional Guidance for Children and Young People in Residential Care Settings, Nutritional Guidance for Early Years, and Healthy Eating in Schools to assist local authorities to meet good standards of meal provision. Adherence to standards and legislation is monitored and evaluated through programmes of inspection by Social Care and Social Work Improvement Scotland (SCSWIS) and Education Scotland. Inspections will assess the nutritional quality of meals and special diet provision, and seek views of consumers of the food.

Question reference: S4W-02260

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Nicola Sturgeon on 15 September 2011

To ask the Scottish Executive how many midwives are there per (a)100 and (b) 1000 births broken down by (i) NHS board and (ii) community health partnership.

The number of midwives as at 30 June 2011 per 100 and 1000 births by NHS board are shown in the following table. Information by community health partnership is not available.

Number of Whole-time Equivalent Midwives¹ per 100 and 1,000 Births² by NHS Board of Treatment

	Per 100 Births	Per 1,000 Births
Scotland	4.1	40.7
NHS Ayrshire and Arran	5.2	51.9
NHS Borders	4.4	43.6
NHS Dumfries and Galloway	6.6	65.7
NHS Fife	4.0	40.3
NHS Forth Valley	3.8	38.5
NHS Grampian	3.8	38.3
NHS Greater Glasgow and Clyde	3.9	38.9
NHS Highland	5.0	49.9
NHS Lanarkshire	3.7	37.5
NHS Lothian	3.2	32.2
NHS Orkney	3.9	38.6
NHS Shetland	4.7	47.5
NHS Tayside	4.8	47.8
NHS Western Isles	7.6	76.0

Sources: GROS, SWISS – ISDScotland.

Notes:

1. Midwives data includes AFC bands 5 to 9, as at 30 June 2011.

2. All live births based on calendar year to 31 December 2010.

Question reference: S4W-02259

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Michael Matheson on 14 September 2011

To ask the Scottish Executive how many cases of verotoxin producing (VTEC) bacterial infection have been identified in Scotland in 2011 and were indentified in (a) 2009 and (b) 2010.

Health Protection Scotland receives laboratory notifications of culture positive cases of VTEC (verotoxigenic Escherichia coli) bacterial infection. These are defined as:

All culture positive cases of Escherichia coli O157, and:

All culture positive cases of verotoxigenic E. coli of non-O157 serogroups (known as non-O157 VTEC).

The figures requested are as follows:

Year reported to HPS	Culture positive E. coli O157 cases*	Culture positive Non-O157 VTEC cases
2009	237	27
2010^±	212	36
2011^± (to end week 33^#)	161	18

Notes:

*Although a very small proportion (less than 3%) of E. coli O157 organisms cultured from humans have no detectable verotoxin-producing genes, national guidance on the Public Health Management of VTEC (see http://www.documents.hps.scot.nhs.uk/about-hps/hpn/vtec.pdf) requires that these cases be managed as VTEC, because organisms may lose VT genes during infection and so this finding cannot be taken to indicate that the original source was non-verotoxigenic.

± Figures for 2010 and 2011 are provisional.

# End week 33 = 18 August 2010.

Question reference: S4W-02252

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Michael Matheson on 13 September 2011

To ask the Scottish Executive what progress it is making toward meeting the World Health Organization's recommendation for reducing the burden of non communicable diseases by replacing all transfats with polyunsaturated fats.

We are committed to working jointly with industry and retailers to make healthy choices easier for everyone. The food industry has successfully taken voluntary steps to reformulate many products and as a result the average intake of trans fats has been significantly reduced to below 1% of dietary intake.

While we will not rule out legislative action where justified on public health grounds; the current public health focus will remain on the more urgent priority of reducing the intake of saturated fat in the Scottish diet as part of a range of wider measures to improve Scotland’s health which is currently at 12.8% of food energy exceeding the maximum recommended intake of 11%.

Question reference: S4W-02256

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Tuesday, 23 August 2011
Current Status: Answered by Michael Matheson on 7 September 2011

To ask the Scottish Executive whether it will publish the full risk assessment which led NHS Scotland to decide not to run a catch-up campaign to immunise teenagers who are unprotected from the risk of measles, in light of the Health Protection Agency in England deciding to run such a campaign.

The English MMR catch-up campaign, which was launched in 2008, was targeted at all young people aged three years and seven months to under 18, and those over 18 going to higher/further education. The campaign was phased, with the youngest age groups being the first priority. The catch-up was driven in part by the low levels of vaccine uptake across England, but particularly the very low levels of uptake of MMR vaccine in London. In 2008-09 uptake of MMR at 24 months in London was as low as 76.3%.

By comparison, uptake of vaccine in Scotland has never fallen as low. Indeed, although there has been an increase in MMR uptake in England, uptake remains lower than in Scotland, where quarterly uptake at 24 months is consistently around the 93%. By comparison, in 2009-10 uptake in England at the same point was 88.2%. It is also unclear how much of this improvement in England was down to the catch-up itself as, at the same time as the catch-up data improvement activity was taking place, with previously given doses being updated onto child health systems.

In Scotland, following a 2005 risk assessment by Health Protection Scotland (HPS) carried, the agreed priority was to focus MMR immunisation efforts on pre-school children to ensure that a high proportion of children were immunised with first dose of MMR (MMR1) by the age of two years. This activity was augmented with action to immunise as many children as possible who had not taken up their first routine dose with MMR1 before the age of six, and by a HEAT target of 95% uptake of at least one dose of MMR by age five (i.e. before starting school).

In 2008, when the Department of Health launched its catch-up campaign, the uptake of MMR1 was very good in Scotland (94.9% of children had received MMR1 by the age of five, and 89.2% had received both doses) and there was no evidence of measles circulating in the Scottish population. The risk assessment was not repeated at that time, as the findings from the previous work in 2005 were still considered valid. In addition, action had been taken in 2004 in response to the emergence of mumps in teenagers and young adults to bolster immunisation levels in those aged 13 to 25, by asking GPs to opportunistically offer MMR to all those in this age range.

Earlier this year it became clear that there was significant transmission of measles in Western Europe among young adults. As a result a further assessment of the risk of measles in this group was undertaken by HPS. The Minister for Public Health has considered this assessment and has discussed it with HPS.

HPS are currently exploring options for the publication of this risk assessment. Meantime the risk assessment (and its companion paper on the options for management of measles susceptibility in Scotland), will be placed into SPICE, once they have been finalised through the HPS document approval process. This is expected to be completed by the end of September.

Question reference: S4W-02257

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Nicola Sturgeon on 6 September 2011

To ask the Scottish Executive what percentage of hip fractures are operated on within 24 hours.

The information requested is not available centrally.

NHS Scotland delivered the hip fracture standard in December 2007 and maintained it throughout 2008. Due to the excellent performance by NHS Scotland it was decided to stop the Scottish Hip fracture Audit and re-invest the funding into a service where there was a need for significant improvement in access to treatment.

From 2009, NHS boards should be monitoring performance against this waiting time standard locally to ensure continuing delivery.

Question reference: S4W-02249

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Michael Matheson on 5 September 2011

To ask the Scottish Executive, in light of the case of Helen McGlone against Greater Glasgow Health Board, in which the board admitted negligence on its part on two occasions in failing to identify pre-cancerous cells from smear tests in December 2005 and March 2006 leading to the subsequent progression to cervical cancer, what steps has the board taken to carry out an independent review of all tests it carried out from 2005 until the date it admitted negligence in 2010 to confirm whether other similar errors have occurred.

Following Ms McGlone’s legal case in 2008, NHS Greater Glasgow and Clyde reviewed the performance of individual laboratory staff and of laboratory systems and processes. This review found that the sensitivity rates of screeners were within the national performance guidelines limits.

In addition, NHS Greater Glasgow and Clyde has undertaken a number of reviews through the invasive cervical cancer audit. These reviews have identified no other case similar to that of Ms McGlone.

Due to the nature of invasive cervical cancer NHS Greater Glasgow and Clyde would now be aware, through regular audit of cervical cancer, of any woman who had had one or more false negative smear results in 2005-06 and who had since developed cervical cancer. No such cases have been identified.

Question reference: S4W-02250

Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
Date lodged: Friday, 19 August 2011
Current Status: Answered by Michael Matheson on 5 September 2011

To ask the Scottish Executive, in light of an audit carried out in 2010 suggesting that four out of its 128 cytoscreeners were not performing to the required standard, what steps has NHS Scotland taken to rectify errors that might have arisen as a result.

The information referred to within the question relates to the 2009-10 External Quality Assurance (EQA) scheme. The EQA scheme uses interpretive assessment utilising anonymised slides which have already been reported and are no longer required for clinical management. The results of the EQA scheme therefore do not affect women’s cervical screening results or management.

Every member of laboratory staff in Scotland responsible for reporting smears participates in interpretive assessment. If an individual has a substandard performance in two of three consecutive circulations, the individual and consultant in charge of the laboratory are informed and a professional development plan agreed.

Within the 2009-10 EQA scheme no individual had a substandard performance in two of three consecutive circulations and therefore no intervention was required.

Chamber and committees