Chamber and committees

The Scottish Government has a framework agreement for the provision of Interpreting, Translation and Transcription Services used by Central Government bodies only and does not contract directly with individual interpreters. Conditions of employment are a matter between the interpreter and the framework supplier. However during the procurement process for the framework agreement, suppliers were asked to describe how their organisations would support Scottish Ministers' policies on fair work practices, sustainability and community benefits and suppliers responded positively.

The Scottish Futures Trust (SFT) led hub programme is comprised of five hubCos that have delivered 41 revenue funded projects since they were established. Details relating to both the public and private sector investors in the hubCos and the revenue funded projects can be found on the SFT website by way of the following link SFTi Portfolio Investor Information - February 2020 .

In addition to the revenue funded hub projects, Scottish Futures Trust Investments Limited (SFTi) is a member of 28 Limited Liability Partnerships (LLPs) which aim to increase the supply of affordable housing across Scotland in conjunction with Local Authority and private sector partners.

Details relating to SFTi’s investments are provided in their published annual accounts, which can be found on the SFT website by way of the following link SFTi Annual Accounts .

Details of the investors supporting the 10 NPD projects included within the SFT led NPD programme, can be found on the SFT website by way of the following link NPD Investor Information - February 2020 .

Between August 2019 and January 2020, staff costs for the new Royal Hospital for Children and Young People in Edinburgh were £350,000.

I remain committed to providing as up to date information as possible, however as cost data needs to be reviewed, checked and validated before it is confirmed, it is not possible to provide costs in real time.

Social media advertising is a cost effective way to reach key audiences with relevant messaging. All Scottish Government spend is aligned to key government priorities, supporting social change, conveying public information and raising the profile of Scotland internationally.

2015/16 - Key government campaigns including road safety and home energy campaigns.

In 2018 the Scottish Government published the Polypharmacy Guidance and Quality Prescribing in Chronic Pain strategies, which promote a systematic holistic review of all patients on potentially high risk medicines. These aim to identify whether the risks outweigh potential benefits, and understand from the patient what matters to them. Furthermore, NHS Boards are also provided with their comparative use of a number of classes of drugs which have the potential to cause addiction. Work is ongoing on both an antidepressant paper and further specific guidance for opioid prescribing.

On reducing the number of people on illicit opioids, there are clinical guidelines, drafted by and for clinicians, which clearly define the options available to individuals who wish to stop using opioids, and the treatment options available to them. These guidelines can be found here - https://www.gov.uk/government/publications/drug-misuse-and-dependence-uk-guidelines-on-clinical-management .

Further to this, and as part of the work of the Drug Deaths Taskforce, a set of standards are being developed which will define what a national standard of care for the delivery of Opioid Substitute Therapy in Scotland should look like, and to help partners across Scotland to achieve it. These standards are being discussed with clinicians, nurses and drug treatment service providers at the moment and will be published following this consultation exercise.

Antidepressants are effective evidence based treatments for neuropathic pain, depression and other mental illnesses. These conditions can be chronic and therefore require long term treatment. This is no different from many chronic physical conditions such as rheumatoid arthritis or diabetes. The long term pharmacological treatment for these would not be challenged, despite the fact that patients with these conditions could equally be described as ‘reliant’ on them. Concepts of illness and treatment are the same whether mental or physical.

All long term medications require monitoring and clinical review to check on effectiveness, potential side effects and to ensure they are prescribed no longer than is needed. This requires a listening dialogue between prescriber and patient.

The Scottish Government will shortly be publishing prescribing strategy best practice on use of opioids and a paper on antidepressants which will contain key information and advice on prescribing. Both will complement existing strategies, which are derived from evidence based research.

The Scottish Government has worked hard to reduce the stigma faced by people with mental health problems. As this stigma declines we would expect more patients to seek help from their GPs for problems such as depression. People with mental illness should expect the same standard of care as people with physical illness and should receive medication if they need it. We are also committed to improving access to alternatives, such as psychological therapies, that increase choice and best accommodate patient preference. However, medicine and psychological therapy are commonly used together to achieve better outcomes.

Where medication is prescribed, this is a clinical decision, which should be discussed within the context of an individual’s long term recovery, and all prescribing should be in line with clinical guidelines and evidence-based practice. Medication should be reviewed regularly to achieve the best possible health outcomes and on-going support should be provided to patients who are prescribed medicines.

The Chief Medical Officer for Scotland has convened a Short Life Working Group to examine the prescribing landscape in Scotland, looking at five classes of prescribed drugs which have the potential to cause addiction and withdrawal symptoms. This includes opioids and antidepressants. The group is examining prescribing data, and patient submissions from patients with lived experience, on the impact of the use of these medicines.

The group is currently holding regular meetings, including a patient sub-group, to ensure that the voices of those with lived experience are heard.

While the use of opioid medications can be highly effective for a number of purposes, including managing severe pain, we are becoming increasingly aware that these type of drugs can be highly addictive, both through legitimate and illicit use. We are also supportive of the findings of the UK MHRA Opioid Expert Working Group, which has recommended addiction warning labels.

Antidepressants remain effective treatment for many patients with neuropathic pain as well as depression, alongside non-pharmacological approaches. They can be vital to some people’s treatment when they suffer from depression and can be life-saving in the most severe illnesses. However, some patients have reported withdrawal effects when stopping antidepressants.

The Chief Medical Officer for Scotland has convened a Short Life Working Group to examine the prescribing landscape in Scotland. The group is considering, among other things, improving information for patients and carers on prescribed medicines at point of prescribing, increasing informed choice and shared decision making between clinicians and patients, as well as supporting patients who wish to stop taking these medications.

The matter of licensing of medicines is reserved to the UK government. Should any new medicine receive a marketing authorisation (or license) then, in Scotland, we have a clear and consistent route for these licenced medicines to be appraised through the Scottish Medicines Consortium (SMC). These would then be considered by Health Boards’ Area Drug and Therapeutics Committees for use locally.