Chamber and committees

The Scottish Government has discussed in detail with the UK Government the continuing need for the provision of services to and north of Edinburgh and notes that the specification of the InterCity East Coast franchise included within the invitation to tender requires the franchisee to provide services to and from Scotland to, at least, their current levels.

Since the Railways Act 1993, several UK Government administrations have had the opportunity to reverse the decision to privatise the railways but have failed to do so.

The Scottish Government has noted the performance of East Coast Main Line Ltd, a public sector company, in delivering rail services and have made public its views, many times, on the restrictive nature of the Railways Act 1993 which precludes any United Kingdom public sector organisation from bidding to operate a railway service. However, no such barrier applies to state-backed organisations from Europe or elsewhere, a position we believe to be fundamentally unfair and constraining: it discriminates Scottish interests as well as those of the rest of the UK, and it is constraining because it restricts the range of options that are available for the operation of our railway services.

The Scottish Government has been fully consulted by the Department for Transport as part of the InterCity East Coast refranchising process, and has presented its requirements of the new franchise, in partnership with the department, at the Bidders’ Awareness Day, marking the commencement of the franchising process.

Scottish Government officials have also completed discussions with all companies bidding for the InterCity East Coast franchise, and will have further consultation with the Department for Transport on the content of those companies’ bids as they relate to Scotland.

The Scottish Government has not recently been engaged in any specific consultations regarding the East Coast Main Line, although it engages in general industry processes around the management of the line. It notes that Network Rail, who manage and maintain the line as a private sector not-for-dividend company limited by guarantee, will, on 1 September 2014, be part of the UK Government and an arm’s-length body of the Department for Transport.

However, we have engaged fully with the UK Government on the future development of the InterCity East Coast franchise.

New technologies for patients require careful evaluation of the safety, efficacy and clinical and cost-effectiveness prior to use.

The National Institute for Health and Care Excellence (NICE) publishes Multiple Technology Appraisals (MTAs) which are then reviewed in Scotland by Healthcare Improvement Scotland (HIS) who consider the suitability of the NICE MTAs for Scotland. HIS then issues advice to all NHS boards identifying any contextual differences.

NHS boards are expected to follow HIS advice on technologies in the planning and provision of its services, and clinicians are expected to follow their professional judgement, working within the management structure of their boards.

For medicines, the Scottish Medicines Consortium assesses all new medicines and makes recommendations for their use in NHS Scotland.

The Scottish Government is committed to improving survival rates from cancer. The Detect Cancer Early Programme was formally launched in February 2012. The tumour types covered by the programme are breast, colorectal and lung, chosen because these tumours account for over 45% of new cancer cases in Scotland.

Using these three tumour types, which have a large numbers of cases, will demonstrate the impact of the programme more effectively and the learning can then be used to inform initiatives for other tumour types in the future. The Detect Cancer Early Programme board is currently undertaking work to look at the inclusion of additional tumour types into the programme.

The Scottish Cancer Coalition (SCC) is a partnership of 21 voluntary sector organisations which plays a continuing role in the implementation of Better Cancer Care, an Action Plan (2008), providing the Scottish Government with collective views and feedback on what is required in Scotland to support people living with and beyond cancer.

Representatives from the SCC attend the Scottish Cancer Taskforce, the group tasked with overseeing the overall delivery of the action plan. The SCC is also represented by member organisations on the various sub-groups taking forward specific areas of action, such as the National Cancer Quality Steering Group, that has undertaken a programme of work to develop clinical quality performance indicators for all main cancer types, including pancreatic cancer.

The role of the Scottish Government is to provide policies, frameworks and resources to NHS boards in order that they can deliver services that meet the needs of their local population. Within this context, the actual planning and provision of healthcare services is the responsibility of local health boards, taking into account national guidance, local service needs and priorities for investment. This includes deciding how best to utilise funding, facilities and staff.

We expect NHS boards to plan their facilities and workforce to deliver these services and to have robust processes in place to ensure the provision of safe, effective and high quality patient care, which is delivered by the right professional at the right time. NHS boards have fully delegated powers to recruit and deploy their workforce to meet their service provision responsibilities and to deliver high quality, safe and sustainable services to meet the needs of their population.

Whilst recognising that it is NHS boards’ responsibility to plan and deliver services, including specialist nursing services, taking account of national priorities and local need, there is awareness within the Scottish Government of the increasing prominence of the issue of specialist nursing services.

The Chief Nursing Officer therefore wrote to all NHS boards asking Nurse Directors to consider the implications of the recent reports on this issue by our third sector partners in terms of their current approach, future plans for provision and potential solutions to any common challenges identified.

The Scottish Government commissioned NHS Education for Scotland to host three regional workshops to provide opportunities for specialist nurse groups and other stakeholders to explore current provision and the future direction of specialist nursing in Scotland.

Healthcare Improvement Scotland is leading on a review of these Scottish Referral Guidelines for Suspected Cancer. The guidelines for breast, lung and colorectal cancers were published in October 2013. Revised guidelines for suspected oesophagogastric, hepatobiliary and pancreatic cancers, skin, and urological cancers were published in May 2014.

The remaining guidelines are under review and all guidelines will be published by summer 2014. A further sub-group has been convened to support the effective dissemination of the revised guidelines with support from Macmillan Cancer Support.

In addition, following discussions of the referral guidelines at the Cross Party Group on Cancer on 20 May 2014 the Scottish Primary Care Cancer Group will engage with colleagues specialising in pancreatic cancer to facilitate further discussions on referral guidelines and pathways.