Chamber and committees

The Scottish Government does not routinely hold information on the number of transfers between hospitals for women to give birth. However we have asked NHS Grampian to provide this information for Dr Gray’s and it has supplied the following. Data in some years has been merged due to low numbers and identifiable data.

Transfers from Dr Gray's for women to give birth in each of the following years.

A number of specific actions are being taken that will contribute towards a more secure and sustainable medical workforce more representative of the communities it serves. These measures have been developed not only to address the more immediate recruitment and retention challenges faced by NHS Scotland Boards, and specifically in primary care services, but in response to strategic requirements to widen access into medical education in Scotland, and respond to demands for enhancing the skills of our GPs within a multi-disciplinary team model.

We are investing £23 million in an undergraduate medical education package comprising the 50 widening access places, a pre-medical entry programme with 40 places, and 55 places for Scotland’s first Graduate Entry Medical programme.

The Scottish Government’s National Health and Social Care Workforce Plan also commits to creating additional undergraduate medical places, and 85 places have been awarded to three of Scotland’s University medical schools.

Regarding selection criterion, the Scottish Government is also collaborating with the Scottish Funding Council which has issued Health related outcomes to University medical schools. The medicine outcomes include a commitment to:

• Retain more graduates of Scottish medical schools in Scotland and working for NHS Scotland throughout their careers.
• Encouraging more of our young doctors to enter GP and other shortage specialities.
• Simplify and clarify the admissions process across all the medical schools in Scotland.
• Increase the number of Scottish domiciled applicants to medicine.

Reach is a national programme which is supported by the Scottish Government via the Scottish Funding Council and focuses on schools with below average progression of pupils into higher education, and pupils from the 40% most deprived communities in Scotland. It aims to increase the number of applications, offers and entrants from students from disadvantaged backgrounds into high demand and competitive areas of study such as medicine.

The Scottish Government has provided Moray Council with long term Resource Planning Assumptions of £25.459 million for the period 2018-19 to 2020-21 to deliver its Affordable Housing Programme. Moray Council’s housing allocations policy offers key workers points to eligible applicants. In determining eligibility for these points, the Council will assess whether the applicant will provide skills that are not available locally. The Council also operate a relocation scheme which provides financial assistance to attract staff who have specialist skills or who are needed to address local skills shortages. The scheme specifically prioritises teaching staff taking up ‘hard to fill’ posts.

In 2014 the Scottish Government requested that Health Boards suspend the use of transvaginal mesh. At the time no such action was taken in England. The recent decision to pause trans-vaginal mesh procedures in England is therefore seen as bringing clinical practice in the two nations into alignment.

Nonetheless, in both Scotland and England it is recognised that for some women with debilitating symptoms, surgery may be the only treatment option. In such circumstances, women must have choices and access to the care they need, delivered with appropriate governance and oversight. In light of this, the Scottish Government has been clear that:

• the protocols in NHS Scotland for care include ensuring that patients receive the information they need to make decisions about their treatment. All options should be considered and treatment can only go forward once a patient gives informed consent; and
• treatment is to be delivered by a multidisciplinary team with appropriate audit, reporting and surveillance.

Furthermore, Healthcare Improvement Scotland has established an Oversight Group which is reviewing trends in procedures and reported adverse events; and the Scottish Government continues to liaise with colleagues in NHS England and the other devolved administrations with a view to establishing a cross-UK registry of mesh procedures.

The Scottish Government's request that Health Boards suspend the use of transvaginal mesh has resulted in a significant reduction in mesh procedures being carried out, with the number of procedures in 2016-17 at 10 per cent of the total number in 2013-14.

The Scottish Government and COSLA Leaders agreed on a multi-year revenue and capital funding package to deliver the expansion in funded Early Learning and Childcare entitlement to 1140 hours by 2020.

As set out in the funding allocation letter that issued to local authorities on 1 May 2018, this funding reflected local authority estimates of the full costs of delivery within their area as set out in their March 2018 finance templates (less adjustments which were agreed with COSLA Leaders to ensure consistency in the source of population projections and in the application of agreed capital funding principles to proposed new build projects).

Local authority finance templates reflected local variations in service delivery costs, including factors such as rurality, deprivation, and estimated trends in the number of children with additional support needs.

Local authorities have already received additional funding in 2017-18 and 2018-19 to support capacity building required for the expansion to 1140 hours by 2020. This has been allocated as grant specific funding and, as set out in the revenue funding allocation letter which issued to local authorities on 22 February 2018, one of the uses to which the funding is to be applied is for enhanced provision for children with additional support needs.

In addition, an Early Learning and Childcare Inclusion Fund has been set up to help cover one-off costs associated with delivering ELC to a child with ASN. Individual settings will be able to bid into the fund to help cover the costs associated with staff training, as well as resources, equipment and adaptations. The fund will distribute up to £500,000 in total per annum over four years to ELC settings delivering the funded hours.

The Scottish Government and COSLA Leaders agreed on a multi-year revenue and capital funding package to deliver the expansion in funded Early Learning and Childcare entitlement to 1140 hours by 2020.

As set out in the funding allocation letter that issued to local authorities on 1 May 2018, this funding reflected local authority estimates of the full costs of delivery within their area as set out in their March 2018 finance templates (less adjustments which were agreed with COSLA Leaders to ensure consistency in the source of population projections and in the application of agreed capital funding principles to proposed new build projects).

Local authority finance templates reflected local variations in service delivery costs, including factors such as rurality, deprivation, and estimated trends in the number of children with additional support needs.

Local authorities have already received additional funding in 2017-18 and 2018-19 to support capacity building required for the expansion to 1140 hours by 2020. The methodology for allocating this funding, the pre-school education Grant Aided Expenditure distribution methodology, has been agreed by local authorities and Scottish Government and includes an adjustment for rurality.

The Rural General Practice Short Life Working Group, which is chaired by Professor Sir Lewis Ritchie and includes representation from rural GPs, had its first meeting on 12 June. The group will work with clinicians and healthcare providers from a range of remote and rural communities to help implement the new GP Contract. My officials are in dialogue with its members to identify issues for the group to discuss at the next meeting, expected to be held in September.

This is a question for the Keeper of the Registers of Scotland. She advises me that, in the last financial year, more than 70% of land register applications to Registers of Scotland were dealt with inside 5 days, with the majority of first registration applications being completed within 20 days. Some applications, in particular more complex first registrations, are taking longer than anticipated. Registers of Scotland are working closely with their customers to improve the processes and technology that support land registration; in particular focussing on how new mapping technology can be used to speed up the first registration process.

The Mortuary Review Group made 13 recommendations in its report published in January 2018 which were grouped into the following categories - Roles and Responsibilities, Mortuary Provision, Contracts, Facilities and Quality Improvements. Responsibility for implementing the majority of the recommendations rests with Health Boards, Local Authorities, Police Scotland and the Crown Office and Procurator Fiscal Service, so it is necessary to create a framework and reporting mechanism that allows progress to be visible to the Scottish Government.

We are therefore working with Healthcare Improvement Scotland (HIS), who will follow their recently established Quality of Care Approach, to deliver quality assurance activity that drives improvement in mortuary services. HIS are testing the new methodology to deliver quality assurance activity this year with a phased roll out in secondary healthcare settings and independent hospitals. This framework will allow us to demonstrate quality improvement and best practice in mortuary services.

In addition, Health Facilities Scotland published Scottish Health Planning Note 16-01 in November 2017 which provides facility guidance for mortuary and post mortem services’ premises in Scotland, to support public bodies to design new buildings, adapt or extend existing buildings and assess the standards of existing facilities consistently.

I want to express my thanks to Eric Fraser for his outstanding work over the past four years. He has achieved a great deal and his work has informed future priorities for this government. I have very much appreciated his great dedication to promoting veterans as assets to both employers and society.

I am pleased to announce that I have appointed Charles (Charlie) Wallace as a very able successor to Eric Fraser.

Colonel Charlie Wallace has had an exemplary 35 year career in the Army and is currently the Deputy Commander, 51st Infantry Brigade and HQ Scotland. Colonel Wallace will succeed Mr Fraser when his tenure ends in the Autumn. Details of Colonel Wallace’s appointment are currently being finalised, and I look forward to working with him when he commences this vital role.