Questions and answers

Question reference: S3W-30654

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 12 January 2010
Current Status: Answered by Shona Robison on 26 January 2010

To ask the Scottish Executive, further to the answer to question S3W-27698 by Nicola Sturgeon on 5 October 2009, when it will publish the final policy framework for the introduction and availability of new medicines in the NHS.

The Scottish Government is in the final stages of the preparation of guidance which sets out the policy framework with regard to the introduction and availability of new medicines in the NHS in Scotland. The draft guidance was circulated to patient groups, stakeholders and NHS boards and will be made available to the Scottish Parliament Public Petitions Committee for comment. The Scottish Government plans to publish the revised guidance by the end of March 2010.

Question reference: S3W-30663

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 12 January 2010
Current Status: Answered by Shona Robison on 21 January 2010

To ask the Scottish Executive what assessment it has made of variations in access to medicines across Scotland.

The Scottish Government is committed to ensuring equitable access to medicines across Scotland, based on clinical need. The Scottish Government expect NHS boards and clinicians to take full account of Scottish Medicines Consortium (SMC) and NHS Quality Improvement Scotland (NHS QIS) recommendations in the planning and provision of NHS services. Where there is evidence that an SMC or NHS QIS accepted medicine (or its equivalent) is not being made available, these will be addressed directly with the NHS board concerned in order that appropriate action is taken where necessary.

Question reference: S3W-30666

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 12 January 2010
Current Status: Answered by Nicola Sturgeon on 20 January 2010

To ask the Scottish Executive for what reason the auditing of cancer standards is performed by those engaged in the clinical practice and not by an independent auditor.

Clinical audit is undertaken by designated audit staff within each managed clinical network. These staff have knowledge of local issues and good links with the relevant clinical leads. It has been demonstrated that the best way to improve clinical standards and care of patients is for the outcomes of the audit process to be reviewed by the clinicians delivering the care, as they are best placed to provide advice and guidance on any changes in practise that may be required. This process is undertaken within the NHS boards'' local clinical governance framework.

Clinical audit data is also used for regional and national purposes and where they exist for UK-wide audits. This allows comparisons across and between regions, across NHS Scotland and in some cases, for example, the LUCADA dataset for lung cancer, the UK.

Question reference: S3W-30665

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Tuesday, 12 January 2010
Current Status: Answered by Nicola Sturgeon on 20 January 2010

To ask the Scottish Executive what the reason is for the time delay since the last publication of an evaluation of performance against clinical standards for cancer.

In 2008, NHS Quality Improvement Scotland (NHS QIS) published the revised and updated cancer standards which were first developed in 2001 and reported on findings in 2002. In line with other reviews of services against standards, NHS QIS allows a period of time before embarking on any assessment. This allows NHS boards the opportunity to introduce the new standards and identify potential areas for improvement in their services as well as start to gather the information on how it is performing against the new standards. This is critical information that has to be submitted to NHS QIS prior to any subsequent review.

The interval between the publication of cancer standards and any subsequent review allows, at both a national and local board level, the amendment of any existing cancer audit data sets (which allow the service to be assessed against the quantitative aspect of the standards). Once any amendment to these data sets have been made, relevant data has to then be collected to enable the service and NHS QIS an opportunity to gain an understanding of current performance against the standards.

Question reference: S3W-29990

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 10 December 2009
Current Status: Answered by Nicola Sturgeon on 13 January 2010

To ask the Scottish Executive, further to the answer to question S3W-28836 by Nicola Sturgeon on 23 November 2009, what the average waiting time was at each accident and emergency department in NHS (a) Greater Glasgow and Clyde and (b) Ayrshire and Arran in each year since 1999.

The national waiting time target for accident and emergency (A&E) department is that 98% of patients wait no longer than four hours between arrival at A&E and admission, discharge or transfer. NHSScotland have consistently delivered this target since it was introduced at the end of December 2007.

The median waiting times from arrival to departure for each A&E department in NHS Greater Glasgow and Clyde and NHS Ayrshire and Arran from 1999 to 2008-09 are provided in the following tables.

Prior to 2007, A&E waiting times was collected through an annual census covering three or seven days period in April. The census between 1999 to 2005 only covers the core A&E hospitals. In 2006, the survey was expanded to cover A&E departments, including minor injury units. Only information for core sites have been provided in table A. Information has also been included showing the average daily attendance and the percentage change in attendance from 1999.

Since 2007, detailed data has been collected at all large hospitals containing an A&E department (core sites). Smaller hospitals and minor injury units do not generally collect data at this level and are therefore not included in table B. Information has also been included showing the average daily attendance and the percentage change in attendance since 2007. Due to the nature of the different methods of data collection, the median waiting time information in tables A and B are not directly comparable.

Table A: NHSScotland Median Waiting Times in A&E 1996-2006

A&E Department

1999

2000

2001

2002

2003

2004

2005

2006

Length of survey (days)

7

3

7

NHS Ayrshire and Arran

Ayr Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

88

116

x

82

124

+7

80

93

-20

103

80

-31

77

103

-11

108

71

-39

109

113

-3

121

120

+4

Crosshouse Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

..

82

111

x

89

126

+14

96

167

+50

63

143

+29

107

182

+64

102

161

+45

88

166

+50

NHS Greater Glasgow and Clyde

Glasgow Royal Infirmary

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

100

188

x

86

178

-5

101

172

-9

136

208

+10

120

150

-20

150

160

-15

130

160

-15

155

190

+1

Inverclyde Royal Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

53

87

x

70

82

-6

69

103

+18

85

98

+12

79

84

-4

135

88

-

75

93

+6

103

88

+1

Royal Alexandra Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

74

130

x

70

137

+5

88

140

+7

100

138

+6

101

118

-9

101

127

-2

87

130

-

157

196

+51

Royal Hospital for Sick Children (Yorkhill)

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

107

93

x

131

109

+17

120

97

+4

105

95

+2

93

94

+1

93

105

+13

91

107

+15

80

97

+4

Southern General Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

85

118

x

92

128

+8

120

151

+28

99

128

+9

135

180

+53

127

138

+17

118

139

+18

95

134

+14

Stobhill Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

90

140

x

90

141

+1

100

149

+6

100

137

-2

78

130

-7

98

141

+1

110

125

-11

95

130

-7

Vale of Leven

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

61

54

x

56

51

-6

74

66

+22

72

62

+15

78

55

+2

47

20

-62

70

40

-26

71

50

-8

Victoria Infirmary

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

33

181

x

48

186

+3

48

222

+23

56

199

+10

54

173

-5

73

207

+15

62

86

-53

67

193

+7

Western Infirmary /Gartnavel Hospitals

Median Waits (mins)

Average daily attendance

Change in attendance from 1999 (%)

67

116

x

78

113

-2

96

124

+6

105

122

+5

120

96

-17

130

125

+7

145

86

-26

160

153

+31

Notes:

x - not applicable.

.. - not available.

Table B: NHSScotland Median Waiting Time in A&E for July 2007 to 31 March 2008 and 2008-09

A&E Department

2007-08*

2008-09

NHS Ayrshire and Arran

Ayr Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

103

111

x

109

115

+4

Crosshouse Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

72

175

x

86

177

+1

NHS Greater Glasgow and Clyde

Glasgow Royal Infirmary

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

121

201

x

122

206

+2

Inverclyde Royal Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

87

84

x

88

+5

Royal Alexandra Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

101

181

x

100

189

+4

Royal Hospital for Sick Children (Yorkhill)

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

76

108

x

74

116

+7

Southern General Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

112

129

x

112

134

+4

Stobhill Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

101

111

x

97

115

+4

Vale of Leven Hospital

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

83

40

x

85

41

+3

Victoria Infirmary

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

71

184

x

75

185

+1

Western Infirmary /Gartnavel Hospitals

Median Waits (mins)

Average daily attendance

Change in attendance from 2007-08 (%)

124

164

x

121

169

+3

Source: ISD Scotland.

Question reference: S3W-29957

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 10 December 2009
Current Status: Answered by Nicola Sturgeon on 13 January 2010

To ask the Scottish Executive what the cost is to (a) the health budget and (b) each NHS board’s budget of the Chancellor of the Exchequer’s decision to increase employers’ national insurance contributions from 2011.

The estimated annual cost to the health budget of the 1% increase in employers'' national insurance contributions from 1 April 2011 is £36.3 million. Details of the estimated costs to each NHS board''s budget are as follows:

	Estimated Additional Cost (£m)
NHS Ayrshire and Arran	2.1
NHS Borders	0.7
NHS Dumfries and Galloway	0.9
NHS Fife	1.8
NHS Forth Valley	1.4
NHS Grampian	3.2
NHS Greater Glasgow and Clyde	9.2
NHS Highland	1.8
NHS Lanarkshire	2.6
NHS Lothian	6.0
NHS Orkney	0.1
NHS Shetland	0.1
NHS Tayside	2.9
NHS Western Isles	0.2
NHS 24	0.3
NHS Education for Scotland	0.1
NHS Health Scotland	0.1
NHS National Services Scotland	0.9
NHS Quality Improvement Scotland	0.1
National Waiting Times Centre	0.3
Scottish Ambulance Service	1.3
The State Hospitals Board for Scotland	0.2

Question reference: S3W-29985

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 10 December 2009
Current Status: Answered by Nicola Sturgeon on 12 January 2010

To ask the Scottish Executive what proportion of total health spending was expended on (a) wages, (b) salaries and (c) pensions in each year since 1999.

The percentage of total health spending expended on salaries and pensions in each year since 1999 is set out in the following table.

	Salaries £	% of Total Expenditure	Pensions £	% of Total Expenditure
2000-01	2,310,087	39.24%	117,068	1.99%
2001-02	2,477,962	38.95%	90,430	1.42%
2002-03	2,722,545	38.03%	132,029	1.84%
2003-04	3,017,766	40.13%	139,972	1.86%
2004-05	3,272,614	38.89%	369,735	4.39%
2005-06	3,582,457	39.29%	398,400	4.37%
2006-07	3,753,362	40.00%	429,370	4.58%
2007-08	3,955,457	39.19%	464,188	4.60%
2008-09	4,150,234	39.42%	493,558	4.69%

Question reference: S3W-29987

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 10 December 2009
Current Status: Answered by Nicola Sturgeon on 12 January 2010

To ask the Scottish Executive how many members of staff were employed by the NHS in each year since 1999, broken down by (a) staff and (b) NHS board.

Question reference: S3W-29986

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 10 December 2009
Current Status: Answered by Nicola Sturgeon on 12 January 2010

To ask the Scottish Executive what proportion of each NHS board’s budget was expended on (a) wages, (b) salaries and (c) pensions in each year since 1999.

The proportion of each NHS board''s budget expended on salaries and pensions in each year since 1999 is set out in the following tables.

Salaries

Health Board	2000-01	2001-02	2002-03	2003-04	2004-05	2005-06	2006-07	2007-08	2008-09
Argyll and Clyde⁵	44.7%	44.2%	44.6%	45.4%	44.2%	39.9%	n/a	n/a	n/a
Ayrshire and Arran	43.6%	42.9%	43.9%	43.5%	38.6%	39.1%	39.9%	40.5%	40.9%
Borders	47.3%	46.7%	46.4%	46.2%	40.9%	43.9%	42.8%	45.8%	44.6%
Dumfries and Galloway	45.2%	45.2%	44.4%	42.1%	39.6%	39.2%	38.7%	40.1%	41.8%
Fife	42.1%	41.3%	43.0%	41.6%	38.7%	40.1%	39.1%	40.0%	40.6%
Forth Valley	46.0%	44.4%	44.4%	46.9%	41.0%	40.1%	40.2%	40.7%	41.2%
Grampian	50.5%	50.3%	50.1%	51.7%	48.8%	50.3%	50.8%	49.2%	50.5%
Greater Glasgow	54.2%	52.9%	53.7%	56.7%	52.5%	53.2%	52.8%	53.0%	53.2%
Highland	49.9%	49.0%	49.6%	50.0%	44.8%	46.7%	40.1%	38.9%	41.2%
Lanarkshire	40.2%	38.3%	39.5%	41.4%	38.2%	38.1%	36.4%	35.6%	35.9%
Lothian	52.9%	51.5%	53.8%	48.1%	49.2%	51.3%	51.3%	51.6%	52.3%
Orkney	38.5%	38.1%	40.0%	38.4%	38.8%	37.5%	42.8%	43.6%	42.4%
Shetland	34.0%	33.1%	32.3%	33.4%	35.5%	38.1%	38.0%	35.7%	38.2%
Tayside	55.9%	52.0%	54.3%	56.3%	52.1%	52.6%	51.0%	51.6%	51.3%
Western Isles	40.2%	37.2%	39.3%	40.0%	37.2%	38.6%	40.8%	41.0%	38.9%
Health Scotland	14.7%	14.5%	16.2%	23.3%	16.6%	19.5%	18.2%	18.9%	26.0%
Common Services Agency	29.2%	31.5%	33.1%	32.6%	33.6%	32.9%	30.3%	22.0%	22.3%
Scottish Ambulance Service	58.6%	59.7%	59.8%	61.1%	60.9%	62.8%	57.3%	59.6%	60.3%
State Hospital	63.6%	62.4%	62.4%	59.0%	54.5%	52.5%	56.6%	65.6%	63.0%
Mental Welfare Commission	57.3%	53.1%	54.6%	60.8%	44.9%	50.4%	48.8%	51.1%	49.4%
NHS 24¹	n/a	11.2%	36.1%	44.1%	46.7%	53.1%	53.0%	53.1%	52.8%
National Waiting Times Centre²	n/a	n/a	39.7%	41.1%	40.4%	44.1%	43.4%	31.6%	66.0%
NHS Quality Improvement Scotland³	n/a	n/a	26.0%	28.4%	33.9%	39.7%	39.6%	38.5%	38.4%
NHS Education⁴	n/a	n/a	3.9%	4.4%	3.6%	3.8%	4.5%	4.2%	4.5%
Clinical Standards Board	20.9%	31.8%
Health Technology Board	14.1%	29.0%
Scottish Council for Postgraduate Medical and Dental Education	2.5%	3.0%

Pensions

Health Board	2000-01	2001-02	2002-03	2003-04	2004-05	2005-06	2006-07	2007-08	2008-09
Argyll and Clyde⁵	2.0%	1.4%	2.5%	2.0%	4.7%	4.3%	n/a	n/a	n/a
Ayrshire and Arran	2.4%	1.8%	2.1%	2.1%	4.4%	4.4%	4.6%	4.8%	4.9%
Borders	2.6%	1.7%	2.3%	3.3%	4.9%	5.1%	5.3%	5.4%	5.6%
Dumfries and Galloway	2.8%	1.5%	2.4%	2.2%	4.5%	4.6%	4.6%	4.8%	5.0%
Fife	2.3%	1.4%	2.1%	1.9%	4.5%	4.5%	4.7%	4.6%	4.9%
Forth Valley	2.2%	2.2%	2.2%	1.6%	4.6%	4.4%	4.6%	4.8%	4.9%
Grampian	2.8%	1.8%	2.7%	2.6%	5.6%	5.5%	5.5%	5.7%	6.0%
Greater Glasgow	2.8%	1.8%	2.3%	2.5%	5.8%	5.8%	5.6%	5.7%	6.0%
Highland	2.3%	1.9%	2.5%	2.5%	5.2%	5.3%	4.7%	5.7%	5.0%
Lanarkshire	1.7%	1.3%	1.8%	1.8%	4.3%	4.2%	4.2%	4.2%	4.2%
Lothian	2.8%	1.8%	2.5%	3.4%	5.6%	5.7%	6.0%	6.1%	6.2%
Orkney	1.3%	1.3%	1.8%	1.8%	4.4%	4.2%	5.1%	5.2%	5.0%
Shetland	2.5%	1.1%	1.6%	1.6%	3.8%	4.3%	4.3%	5.0%	4.6%
Tayside	2.5%	1.8%	2.5%	2.5%	6.0%	6.0%	6.3%	6.3%	6.6%
Western Isles	1.3%	1.3%	1.8%	1.8%	4.1%	4.5%	4.7%	5.0%	4.5%
Health Scotland	0.9%	0.5%	0.8%	1.0%	2.2%	2.4%	2.8%	3.2%	3.4%
Common Services Agency	1.6%	2.1%	2.2%	1.8%	4.1%	3.7%	3.7%	3.2%	3.1%
Scottish Ambulance Service	3.2%	2.0%	2.7%	2.9%	6.6%	6.6%	8.2%	7.3%	7.2%
State Hospital	2.1%	2.0%	2.9%	2.7%	6.2%	6.3%	6.9%	7.7%	8.1%
Mental Welfare Commission	6.2%	5.6%	6.0%	4.8%	5.2%	7.9%	6.5%	7.1%	5.3%
NHS 24¹		0.5%	1.7%	5.1%	5.5%	6.3%	6.1%	6.1%	6.1%
National Waiting Times Centre²		n/a	3.0%	1.8%	3.9%	4.4%	4.5%	3.4%	7.3%
NHS Quality Improvement Scotland³		n/a	1.2%	1.3%	3.4%	4.3%	4.7%	4.7%	4.7%
NHS Education⁴		n/a	0.2%	0.3%	0.5%	0.5%	0.6%	0.6%	0.6%
Clinical Standards Board	0.8%	1.1%
Health Technology Board	0.3%	1.0%
Scottish Council for Postgraduate Medical and Dental Education	0.14%	0.1%

Notes:

1. NHS24 was created in 2002-03.

2. The National Waiting Times Centre was created in 2003-04.

3. NHS Quality Improvement Scotland was created in 2003-04 and took over the activities of the Clinical Standards Board and Health Technology Board for Scotland.

4. NHS Education was created in 2003-04 and took over the activities of the Scottish Council for Postgraduate Medical and Dental Education.

5. Argyll and Clyde health board was dissolved after 2005-06 and its activities transferred to Greater Glasgow and Highland health boards.

6. The rate of employer''s pension contribution rose from 6% to 14% in 2004-05, which was funded on a UK level.

Question reference: S3W-29988

Asked by: Jackson Carlaw, MSP for West of Scotland, Scottish Conservative and Unionist Party
Date lodged: Thursday, 10 December 2009
Current Status: Answered by Nicola Sturgeon on 22 December 2009

To ask the Scottish Executive whether it will publish survival rates for each type of cancer for each year since 1999, also broken down by NHS board.

This information is not collected centrally, however, data on cancer survival in Scotland are summarised in the document Trends in Cancer Survival in Scotland, 1980-2004, which is available at http://www.isdscotland.org/isd/files/Survival_summary_8004.pdf.

It is not possible to calculate survival rates on each type of cancer for each year because for some rarer cancers, small numbers render statistical analysis unreliable. Survival rates are usually calculated on five year pooled diagnosis years, and for types of cancer with sufficient patient numbers to enable statistical analysis.

Chamber and committees