Chamber and committees

The pharmaceutical industry operates in a global market in which the purchase of drugs is traded in dollars and euros. Currency fluctuations have always been part of the normal course of business for both NHSScotland and suppliers.

I have previously highlighted my concerns that some medicines manufacturers will be less attracted to the UK as a market following Brexit in terms of additional costs related to tariffs and other barriers to direct trade. As a consequence, there could be a negative impact for patients, and the UK Government should seriously consider these very real concerns.

We have received representations in relation to primary care prescribing from community pharmacy contractors that the fall in the value of sterling is a factor in increased procurement costs for some generic medicines. However, the Scottish Government regularly monitors the cost of drugs in primary care and manages reimbursement costs through the Scottish Drug Tariff, minimising the impact of price fluctuations.

In relation to prescribing in hospitals, there have been no significant issues to date but we will continue to monitor in line with our normal practices. Our aim is always to ensure that we get the best value for money for taxpayers.

The Keeper of the Registers of Scotland is under a statutory duty to maintain a cadastral map of Scotland. This map shows the legal boundaries of all property registered in the land register. The cadastral map uses the ordnance survey map of Scotland as the base map on which it shows the legal boundaries. That base map is regularly updated by Ordnance Survey in relation to physical changes on the ground. These changes to the base map do not affect owners’ rights or the extent of their property.

Registers Direct has successfully provided access to information on the public registers maintained by Registers of Scotland since 1999, dealing with 1.4m chargeable searches each year. The Land Registration etc. (Scotland) Act 2012 sets out the action the Keeper must take when satisfied there is a manifest inaccuracy in the land register.

In October 2017, the Keeper of the Registers of Scotland launched ScotLIS (Scotland’s Land Information Service), a new web-based service designed in collaboration with customers that will not only replace Registers Direct but also provides, for the first time, direct citizen access to information from the property registers. ScotLIS has received very positive feedback from both citizens and professional users on ease of use and the better display of information as compared with Registers Direct.

The Scottish Government recognises that there are particular challenges around raising awareness amongst clinicians of the many varied rare diseases. These are not issues unique to Scotland and in 2009 the European Union recommended that each EU state have in place a rare diseases plan or strategy by the end of 2013. This led to the four nations of the UK coming together to publish the UK Strategy for Rare Diseases in November 2013. As part of this joint project, Scotland published the Implementation Plan ‘It’s Not Rare to Have a Rare Disease’ in June 2014.

One of the aims of the Scottish plan is to secure rapid and effective translations of advances in the understanding of rare disease into clinical care by creating appropriate infrastructure, care pathways and clinical competences. This will include education and training programmes that enable health and social care professionals to better identify rare diseases in order to help deliver faster diagnosis and access to treatment pathways for patients.

Through this plan, we are working together with partners to improve the outcomes and support for people with rare diseases. The Scottish Government cancer strategy ‘Beating Cancer: Ambition and Action’ complements the actions of the rare disease plan through its focus on early detection, diagnosis and treatment for all forms of cancer, including rare cancers.

On 10 November, we were pleased to publish a comprehensive Inpatient Needs Assessment Report which sets out the need for a specialist inpatient service for those with learning disability and/or autism and mental health conditions:

http://www.gov.scot/Publications/2017/11/2477

We are happy to accept, in principle, the report’s main recommendation that a national LD CAMHS inpatient unit for Scotland should be established, subject to initial feasibility and planning processes. This is a significant step forward in ensuring that children and young people with learning disabilities are able to access appropriate highly specialist inpatient support in Scotland

We will now work closely with NHS National Services Scotland on developing the proposal further.

On point (a) -

Plans are underway to build a secure adolescent inpatient unit in Scotland. This will benefit the small number of young people who require this specialist level of care and who cannot be treated in the community.

We recognise that there are a small number of young people who require specialist secure care, and we are persuaded that there is a need to build an inpatient facility for the whole of Scotland. This is being taken forward by NHS Ayrshire and Arran.

On point (b) -

Clinical nurse specialists make a valued contribution to delivering services and supporting patients and families who require specialist care. The Scottish Government has invested £2.5 million annually in the Specialist Nursing and Care Fund since 2015. NHS Boards across Scotland have benefited from the investment and have used the funding to enhance specialist nursing and care in ways that reflect local needs. At May 2017, reports from NHS Boards show that specialist nursing capacity had been enhanced through the additional investment by 31.35 whole time equivalents (WTE) and these roles are supporting and caring for patients and families affected by a wide range of conditions, across the life spectrum and across hospital and community settings.

In addition, and as part of this wider effort, the Scottish Government has fulfilled its pledge to double the number of Motor Neurone Disease (MND) clinical nurse specialists and ensure that they are paid from public funds.

Antenatal Results and Choices (ARC) Awards from the Scottish Government in the last 10 years

The funding provided to ARC by the Scottish Government in this period was through the Section 16b grants scheme and was to assist ARC in their aims, including their specialised support services.

The organisation ceased to be named Support After Termination for Abnormality in 1993.

The latest figures show that there were (a) 58,232 3 year olds and (b) 59,741 4 year olds in Scotland as at 30 June 2016. Table 1 shows the number in each local authority.

Table 1; Number of 3 and 4 year olds by council area, Scotland, Mid-2016.

Source; Mid-year population estimates 2016

Our consultation paper 'A Healthier Future - Action and Ambitions on Diet, Activity and Healthy Weight' published on 26 Ocotber makes clear that we strongly support this.

Following on from the publication the UK Government ‘ Childhood Obesity: A Plan for Action’ in summer 2016, I wrote on 19 August to the UK Government on this matter, but they made no commitment to reconsider their earlier decision

I have, therefore, written again seeking a discussion and offering our collaboration in going forward. The recent remarks from the Secretary of State for Health Jeremy Hunt MP informing the House of Commons Health Select Committee that the prohibition of advertising of unhealthy foods before 9 p.m. is now under active consideration is welcome. However, as broadcast advertising is currently reserved, I am urging the UK Government to prioritise such action which would have significant benefits for Scotland and the rest of the UK. Alternatively, I am requesting that these powers are devolved to the Scottish Parliament.