Chamber and committees

We are not aware of any specific issues which are causing delays in finalising the ratification of job evaluation outcomes for paramedic and ambulance staff.

In common with NHSScotland generally, Agenda for Change is being implemented in the Scottish Ambulance Service in partnership with trades unions and professional organisations. The majority of staff have now been job matched, with progress being made with those staff who require local evaluation. The National Monitoring Group are currently monitoring job matching outcomes.

The process of notifying staff of job matching outcomes commenced on 17 February 2006.

The Joint Committee on Vaccination and Immunisation (JCVI) has not recommended the vaccination of children under two years of age against influenza. At their meeting on the 19 October 2005, JCVI agreed that more work was required before influenza immunisation in children could be considered. As such, the ingredients of any proposed vaccine to improve the child’s immune response have not been determined.

Crown immunity applied to all NHS bodies from the date of the creation of the NHS, 5 July 1948, until its removal by means of the NHS and Community Care Act 1990 which came into force on 1 April 1991. Immunity therefore applied to all NHS premises during this period. In 1986, however, the NHS (Amendment) Act 1986 removed Crown immunity from the NHS in respect of food hygiene and health and safety legislation.

The Scottish Teachers’ Superannuation Scheme provides a specific pension scheme designed for the teaching profession. The Local Government Pension Scheme in Scotland provides a pension scheme for a variety of local government (and similar) employees where they are not entitled to be members of another statutory public service pension scheme. It is therefore common for employees working in the same establishment to belong to different public pension schemes.

Following the introduction of testing in 1991, considerable work was carried out to trace any links between blood donors infected with hepatitis C and patients who had received infected blood. A lookback exercise was undertaken by UK blood services from 1995 and completed in 1997.

The look back exercise was based on tracing the past donations of blood donors found to be infected with hepatitis C. Where this was the case, a thorough search of records was carried out with the aim of identifying recipients of the blood and offering them counselling and testing for the virus.

Where currently SNBTS is informed of any patient who is discovered to be infected with hepatitis C - and transfusion may have been the route of infection - a full investigation is carried out.

Where returning blood donors from pre-1991 test positive for hepatitis C, or where patients present with hepatitis C infection which may be linked to blood transfusion, Scottish National Blood Transfusion Service (SNBTS) will investigate thoroughly the background and circumstances to these cases and will initiate lookback procedures so that any patients potentially affected can be offered counselling and testing.

All blood products carry a risk of infection from blood-borne viruses, however small. It is estimated that about 200,000 women in Scotland will have been treated with anti-D immunoglobulin since its introducion in 1968. Anti-D immunoglobulin, which is administered to women who are rhesus D negative, is generally considered safe from blood-borne viruses when prepared by a method recommended by the World Health Organization (WHO). The Scottish National Blood Transfusion Service (SNBTS) has always prepared anti-D immunoglobulin in accordance with WHO advice and its product has therefore always been considered safe from transmission of blood-born viruses. The SNBTS have confirmed there have been no cases of blood-borne virus transmission by anti-D, and there has been no evidence of any hepatitis C transmission.

I refer the member to the answer to question S2W-22853 on 23 February 2006. 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/webapp/wa.search.

The Scottish Executive, and previous governments, have consistently remained open to learning any lessons which would improve donor and patient safety. Current procedures demonstrate that lessons have been learned.

Where returning blood donors from pre-1991 test positive for hepatitis C, or where patients present with hepatitis C infection which may be linked to blood transfusion, Scottish National Blood Transfusion Service (SNBTS) investigates thoroughly the background and circumstances and initiates lookback procedures so that patients potentially affected can be offered counselling and testing. This allows SNBTS to trace archived specimens of blood from the original donations which can be tested and, if it is confirmed that those were the cause of the hepatitis C transmission, the patient’s doctor is informed. Other donations from the implicated donor are then traced, tested and any positive results found lead to a search for the recipient of those positive donations so that those individuals can be informed. Since the introduction of testing for hepatitis C, traceability is closely monitored.

During the period 1998-2004, SNBTS investigated 32 potential transfusion-transmitted infections related to hepatitis C and the results indicted that the number of cases arising from blood transfusions before 1991 is very small. SNBTS therefore have effective arrangements in place for tracing donors and recipients where there is a suspected link between hepatitis C and blood transfusions.

The NHS is committed to becoming a better learning organisation, to using experiences and views of patients and staff to learn and build a culture of continuous quality improvement. A key element of this is developing a patient-centred approach which involves the sharing of information and decisions about treatment with patients in line with best professional practice. We are also aware that GMC guidance issued in October 1997 addresses the issues raised.

Council of Europe recommendation R (83) 8 makes a number of recommendations in relation to AIDS. The recommendations dealt with the use of coagulation factor products prepared from large plasma pools; informing patients and recipients of the risks of blood products, and providing blood donors with information. Policy in Scotland in relation to blood products fully reflected these principles and recommendations. The risks of large plasma pools were recognised and appropriate warnings were provided on products. Clear warnings were also provided to blood donors by Scottish National Blood Transfusion Service (SNBTS) in 1983, specifically in relation to AIDS.

An earlier Council of Europe Recommendation No. R (80) 5, concerning blood products for the treatment of haemophiliacs, was discussed with Scottish Haemophilia Directors and Directors of The Scottish National Blood Transfusion Service at a meeting organised by the Scottish Health Department in 1981, at which it was agreed that “policy and practice in Scotland were consistent with this document, subject to further consideration of the recommendation on the setting up of a haemophilia register”. It is believed that policy and practice in Scotland were also consistent with the subsequent Recommendation No. R (83) 8 concerning AIDS.

This was the subject of a Freedom of Information Review request from the member. A copy of this response has been placed in the Scottish Parliament Information Centre  (Bib. number 38917).