Chamber and committees

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.

I refer the member to the answer to question S4W-21671 on 19 June 2014. 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/parliamentarybusiness/28877.aspx

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.

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 made numerous representations to the UK Government about the unfairness of its rail franchise legislation which prevents UK public sector organisations bidding whilst allowing those from Europe and elsewhere. Those representations have not been heeded.

Following discussion with the UK Government, the invitation to tender for the InterCity East Coast franchise requires the franchisee to provide services to and from Scotland to, at least, their current levels.

The most recent published comparison of cancer survival in the UK is available from the European Cancer Registry Based Study on Survival and Care of Cancer Patients (EUROCARE-5), which relates to the period of diagnosis 2000-07.

According to this study, one year and five year relative survival probabilities for pancreatic cancer in Scotland are not significantly different from the other parts of the UK.

Tables 1a and 1b show the cumulative relative survival (percentage) up to a) one year and b) five years after diagnosis of pancreatic cancer for patients aged 15 years and over in Scotland compared with other parts of the UK.

Table 1a: Survival at one year after diagnosis of pancreatic cancer (2000-07)

United Kingdom; males and females aged 15 and over.

Table 1b: Survival at five years after diagnosis of pancreatic cancer (2000-2007)

United Kingdom; males and females aged 15 and over.

Source: European Cancer Registry Based Study on Survival and Care of Cancer Patients (EUROCARE-5).

Date extracted: 03-06-2014

NHS boards have well-established ‘urgent suspected cancer’ GP referral pathways to facilitate prompt diagnosis of cancer. To support these pathways and support effective referral to secondary care, the Scottish Cancer Taskforce has recently asked NHS boards to confirm what systems are in place to support direct access to imaging modalities for primary care practitioners.

Early diagnosis of pancreatic cancer remains challenging as symptoms are initially often vague and non-specific. The most common presenting feature is obstructive jaundice but may also include weight loss and abdominal pain. Specifically in relation to management of patients who present with jaundice, the General Medical Council approved curriculum for general surgical training details that trainees need to be “competent to manage, including referral for radiological and endoscopic investigation, patients who present with jaundice” and need to be “competent to manage patients who present with malignant disorders including pancreatic cancer … within a multi-disciplinary team with other surgical, medical and clinical oncology colleagues”.

NHS Education for Scotland ensures delivery of these approved curricula through quality managed training programmes and an annual review of competency progression for each trainee.

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 Scottish Government recognises the importance of providing accurate, quality assured information to cancer patients and their carers. This includes pancreatic cancer. In April 2014, we launched the Patient Experience Quality Performance Indicators (QPIs). These QPIs place a responsibility on health boards to provide appropriate information to patients and their carers in order to promote maximum understanding and to assist coping mechanisms. Access to written materials, computerised information and a named nurse should be readily available at all stages of disease management.

The QPIs recommend that healthcare professionals explore the patient’s preferences about the level and type of information they want. Based on this, the patient (and their family members and/or carers if appropriate) should be given clear, consistent, evidence-based, contextualised, and tailored information throughout all stages of their care.

In addition to the QPIs, NHS24 will continue to work to develop the Cancer Zone on NHS inform to provide a trusted source of on-line tailored cancer information that supports the patient at whatever stage they are in their treatment process. This development includes the facility for GPs to produce leaflets for patients which are tailored for their specific needs.