Chamber and committees

The MHRA is responsible for monitoring adverse events associated with any medical device. Any patient who has experienced a complication from her Essure device is able to report this through the MHRA’s Yellow Card scheme .

Following withdrawal of the device from the European market, the MHRA advised that there is no evidence to suggest any increased risk to patient safety. This is clearly set out in the statement the Agency issued on 21 September 2017. Health Boards would, of course, be fully expected to take appropriate action were the MHRA to change its advice in the future, including contacting patients if necessary. Any individual patient who has concerns should not hesitate to speak to her GP.

The Scottish Government is committed to providing the right support at the right time, and creating equity of access to service provision, particularly for those most vulnerable in our society. We want to engage in an open discussion to ensure that any concerns relating to particular aspects of accessing programme provision are properly considered and discussed.

Where contraception is provided, provision should be made through local sexual health services to ensure that informed consent is sought and provided.

This information is not collated centrally. We reported to the Health and Sport Committee on Alcohol and Drug spend for 2016-17 and agreed to provide a similar update on 2018-19 spend following the end of the financial year. We will provide this information to the Committee when this becomes available.

We invested £53.8 million to NHS Boards for onward allocation to Integration Authorities to support Alcohol and Drug Partnership (ADPs) projects in 2018-19. This information is available here: https://www.gov.scot/publications/alcohol-and-drug-partnerships-funding-allocations/

Our Rights, Respect and Recovery Strategy is being supported by further investment of £20m per year for the remainder of this parliament, to help improve the quality and provision of drug and alcohol services. £17 million of this was allocated to Integration Authorities and ADPs in 2018-19, through our Local Improvement Fund to support work in improvement and innovation in the way alcohol and drug services are developed and delivered. This information is available here: https://www.gov.scot/publications/local-improvement-fund-allocations/

The total financial resource available in any given year is higher than the direct contribution provided from the Scottish Government budget and includes contributions from the NHS and other statutory partners.

The Scottish Government direct funding allocation to Integration Authority’s for Alcohol and Drug Partnerships (ADPs) is included in NHS Board allocations. Letters were issued on 12 December 2018 to advise Board allocations. The allocations for ADPs within each NHS Board are published on our webpage and is available here: https://www.gov.scot/publications/alcohol-and-drug-partnerships-funding-allocations/

2019-20 allocations through our Programme for Government, Local Improvement Fund are being finalised and we will be writing to Integration Authorities in the coming weeks.

As part of the response to the Health and Sport Committee Governance Report of July 2018, I asked Healthcare Improvement Scotland (HIS) to carry out a review of its role and approach to the adverse events process.

As a first step, HIS has been working to establish a baseline to determine where there is uniformity and divergence in the way that NHS Boards approach significant adverse event reporting and to gain a greater understanding of the contributing factors to this variation. The baseline report has involved detailed engagement with individual NHS Boards and I understand that it will be published in the next few weeks.

I have been clear that health and social care providers throughout Scotland must use learning from all reporting systems to support a culture of openness and learning. I have asked HIS to look further than the existing National Adverse Events Framework, which while essential, is only part of the solution to developing a reporting and learning system which drives continuously improving services and outcomes for patients, carers and staff.

I have instructed my officials to work closely with HIS, NHS Education for Scotland and other stakeholders to ensure that now that the baseline review is concluded, actions can be identified and implemented, as quickly as possible.

The regulation of medical devices is a matter that is reserved to Westminster and, as such, medical devices are approved for use on a cross-UK basis. Essure model ESS305, the version of the device made available in the UK, received a CE mark in 2006 and was therefore available for use in the UK from that date. Four Health Boards previously offered the Essure device in Scotland and, with the exception of a small number of procedures that went ahead as outlined in answer to S5W-14658 all stopped fitting the device following withdrawal of its CE mark in August 2017.

The Scottish Government believes clinical research should be rigorous, be of high quality, and should be considered by relevant professional groups. The research in question is considered by the clinical community in NHS Scotland to be of a reasonable quality.

The manufacturer of Essure, the device that was used in the hysteroscopic sterilisation procedure, voluntarily withdrew it from the European market in 2017. Information on withdrawal can be found on the Medicines and Healthcare products Regulatory Agency’s website here and advice given by the manufacturer to healthcare professionals and patients can be viewed here .

No Health Board in Scotland presently offers any form of hysteroscopic sterilisation.

Mental health is priority for the Scottish Government and it is committed to improving the provision of perinatal mental health services. Women who experience post-traumatic stress disorder (PTSD) following childbirth are currently able to access support from their midwife, GP, health visitor, from psychological services in primary care and, in some areas, from specialist perinatal mental health services.

The 'Delivering Effective Services' report from the national Perinatal Mental Health Managed Clinical Network sets out a range of recommendations which will improve access to care for postnatal women with PTSD. These include increasing the provision of psychological therapies at primary care level, developing maternity and neonatal psychological interventions services based in maternity units, which will include midwives with additional specialist skills in detecting and managing mental health problems, and the roll-out of specialist community perinatal mental health teams across Scotland.

The Scottish Government has supported these recommendations by committing £50 million over the next four years to perinatal and infant mental health. The recently established Perinatal and Infant Mental Health Programme Board will drive forward this improvement at pace and ensure the delivery of improved perinatal mental health services.

During 2018-19, £27,000 was made available under the Waiting Times Improvement Plan for Chronic pain services.

I also refer the member to the answer to question S5W-24078 on 18 July 2019. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx .

The next phase of funding under the Waiting Times Improvement Plan was announced on 28 April. An additional investment of £70 million will be allocated to NHS Boards to target long waits during the financial year 2019-20.

An announcement will be made later this month which will provide detail around the allocation of funding and which specialities it covers.