Chamber and committees

An overarching Detect Cancer Early social marketing campaign 'Survivors' was launched in 2018. The campaign, developed in close consultation with the Scottish Cancer Coalition, aimed to reduce fear around cancer and empower people to take early action, be it visiting their GP practice or attending screening when invited. To coincide with the campaign, a symptom-checker tool was developed on DCE’s website (getcheckedearly.org) to raise awareness of the early signs and symptoms of cancer, including those that are indicative of blood cancer.

A new Early Cancer Diagnosis Programme Board has been formed, Chaired by Dr Catherine Calderwood, National Clinical Director at the Centre for Sustainable Delivery. This group will be responsible for shaping and supporting the delivery of Scotland’s early diagnosis agenda over the coming years, including any additional public awareness campaigns.

The NHS Recovery Plan 2021-2026 – published August 2021 – commits an additional £20m for our Detect Cancer Early Programme, providing greater public awareness of signs and symptoms of cancer and supporting the development of optimal cancer pathways to improve earlier diagnosis rates. Research will be undertaken in the coming months to better understand the possible barriers and levers to early diagnosis that any new awareness campaigns should focus on.

The Scottish Government is committed to finding cancer early. That is why we have established Scotland’s first three Early Cancer Diagnostic Centres in NHS Ayrshire & Arran, NHS Fife and NHS Dumfries & Galloway. These Centres provide primary care with a new referral route for patients with non-specific symptoms suspicious of cancers including blood cancer (such as weight loss, fatigue and nausea), which don’t meet Scottish cancer referral guidelines.

Our £44m Detect Cancer Early Programme adopts a whole-systems approach to diagnosing and treating cancer as early as possible – ranging from screening and public awareness campaigns to diagnostics and data. The NHS Recovery Plan 2021-2026, published August 2021, commits an additional £20m for the Programme.

As outlined in our NHS Recovery Plan, we will also develop and support the delivery of a new early diagnosis vision for Scotland. Stakeholder engagement will be an important part of its development, with Blood Cancer Alliance included in this. Officials recently met with the Blood Cancer Alliance and committed to working together in future to ensure the experiences of those with blood cancers are reflected in national cancer improvement programmes.

The Scottish Medicines Consortium (SMC) previously considered Kuvan ® (the branded version of sapropterin) in August 2018 and the medicine was not recommended for use in NHS Scotland because the submitting company’s justification of the treatment’s cost in relation to its health benefits was not sufficient; in addition, the company did not present a sufficiently robust clinical and economic analysis to gain acceptance by the SMC. The SMC would welcome a resubmission of this medicine, the submitting company (BioMarin).

The first generic version of sapropterin has recently received a Marketing Authorisation from the Medicines and Healthcare products Regulatory Agency (MHRA), and we are currently considering how best to provide advice to Health Boards on whether it should be made available for routine use in NHS Scotland, based on the latest available evidence. Meantime, doctors can request access to medicines that are not generally available on the NHS on an individual case-by-case basis through the Peer Approved Clinical System (PACS) Tier Two process, where the treating clinician considers there would be a clinical benefit for their patient.

The Water Industry Commission for Scotland has responsibility for setting charge caps and otherwise sets out expectations or forecasts including for income as a guide to Scottish Water and stakeholders. Consideration of the economic circumstances of customers encompassed both GDP growth and the GDP level relative to pre-pandemic, wage growth relative to inflation and unemployment levels. Scottish Water’s Independent Customer Group was consulted prior to Scottish Water making its charging decisions for the 2022-23 financial year and its clear preference was to see increases held to around 4%.

Whilst there is no formal requirement to consult the Scottish Government, Ministers were made aware of the outcome of the independent process, including the rationale underpinning the decision by Scottish Water's Board on the scheme of charges for 2022-23.

A seasonal spawning closure in the Firth of Clyde has been in place for over 20 years to provide an area to protect cod during their spawning season (14 February – 30 April). Since its introduction in 2001, the closure has included exemptions to allow Nephrops trawlers, creels and scallop dredgers to continue to fish in the area, due to the low numbers of cod they catch. However, despite the ongoing seasonal closure, the stock has shown little sign of recovery. The Scottish Government has therefore decided to introduce a revised and more targeted closure. The overall size of the closure compared to previous years has been reduced by 28%, while providing increased protection to spawning cod by prohibiting all fishing activity in the closed areas for 11 weeks from 14 th February in both 2022 and 2023.

This decision is underpinned by analysis of sediment distribution in the Clyde, as well as by scientific research which suggests that any fishing activity within 10m of the seabed (which would include trawling, dredging and creeling) has the potential to impact on cod spawning activity. Given the vulnerability of cod to any disturbance during the spawning season, we believe that it is appropriate not to continue the exemptions in order to provide a higher chance of stock recovery and contribute to a more sustainable fishery in the West of Scotland in the medium-longer term. We will be increasing monitoring in the area during the period of the closure. We will also arrange a review meeting with stakeholders at the end of the closure to assess its effectiveness and practicality.

The Sea Fish (Prohibition on Fishing) (Firth of Clyde) (No. 2) Order 2022 introduces a closure for 11 weeks from 14 February in both 2022 and 2023. Both the timing of the closure and the statutory approach are consistent with the approach the Scottish Government has taken to this closure since 2001. There are no plans at this time to amend the statutory instrument cited above.

In line with Scottish Government policy, we will not provide financial compensation to fishermen for areas closed in order to protect fish spawning, such as those in the Firth of Clyde. This approach is consistent with that take in respect of similar management measures, including the National Cod Avoidance Plan and MPAs.

Whilst we fully understand that the non-continuation of the exemptions may come with short term costs, this seasonal closure covers a short period of 11 weeks, during which vessels may fish in alternative locations, which the vast majority regularly do. This is a more targeted closure than in previous years; the overall size of the closure compared to previous years has been reduced by 28%. The closure will not affect quota and should not affect the overall volume of fish that fishers are able to catch over the year. Moreover, cod and potentially other stocks, should benefit from the closure period, allowing greater fishing opportunities on the reopening of the seasonal closure.

The area of the revised closure is based on sediment distribution in the Firth of Clyde, with greater protection for those sediment types known to be favoured by spawning cod. Full details and coordinates are available at: Fishing closures: Firth of Clyde - 2022 and 2023 - gov.scot (www.gov.scot) and https://www.gov.scot/publications/cod-spawning-areas-research/

The non-continuation of the exemptions is based on scientific evidence that, while spawning, cod are extremely vulnerable to disturbance . They are focussed on mating, and the males are unwilling to leave their hard-won leks, so both sexes are less likely to try and evade oncoming fishing gear which means that mating adults are at risk of being caught. In addition, physical disturbance within the relevant areas of the Firth of Clyde during the mating period will disrupt the mating activity and potentially destroy the lek areas, and cod so disturbed may not return (and therefore may not spawn that year). Removal of all fishing activity in the closure areas should significantly mitigate this risk. If the stronger males are caught or disrupted leaving the weaker males, those males that remain may not be able to attract females. Moreover, stressed males are less likely to initiate mating. Noise may also disrupt mating, with females potentially unable to hear mating calls (Slabbekoorn et al 2010).

Although we carried out a consultation on this issue in autumn 2021, we acknowledged the strong reaction from the fishing industry around this change of policy in January 2022 and engaged further with them and other stakeholders to refine the policy. We have worked at pace to develop revised closure areas which minimise disruption to fishers (through a reduction in size of the overall closure areas) while increasing protection for cod in the areas where they are spawning.

In light of the pressures of the COVID-19 pandemic, the wellbeing of our health workforce, wherever they work, remains a key priority. The 2021/22 pay uplift saw staff receive an average 4% pay rise, the highest in the UK. The Scottish Government is committed to ensure that NHS Scotland nursing staff continue to benefit from the best pay and conditions in the UK.

In 2021-22, the Scottish Government made £12 million available to support the wellbeing of the workforce. This includes £8 million from the NHS Recovery Plan to provide ongoing wellbeing support for the workforce alongside an additional £4 million to provide further support to address winter pressures.

To complement this at a local level, we also have a range of resources including the National Wellbeing Hub, a 24/7 National Wellbeing Helpline, confidential mental health treatment the Workforce Specialist Service and funding for additional local psychological support. We are also providing further support for practical measures to aid rest and recuperation alongside additional resources such as Coaching for Wellbeing and grief and bereavement support.

Nursing and midwifery staffing is also at a record high, up by 13.1% since September 2006.