Chamber and committees

The New Model of Neonatal Care is aimed at the most premature and sickest of babies and is based on a review of evidence carried out by Dr Anna Gavine, Dr Steve MacGillivray and Prof Mary Renfrew of the University of Dundee and a summary of the evidence review is published within The Best Start ( Appendix H ).

The evidence showed that outcomes for very low birth weight babies (VLBW) are better when they are delivered and treated in Neonatal Intensive Care Units with full support services, experienced staff and a critical mass of activity (expert recommendation defines this as care for a minimum of 100 VLBW babies a year).

This evidence has since strengthened with the publication in 2021 of the British Association for Perinatal Medicine (BAPM) Framework for Practice , which sets out optimal arrangements for neonatal intensive care.

As set out in the Programme for Government, we are committed to prioritising capital spending to achieve net zero and maintain high quality public infrastructure across Scotland. We have been consistently open about the challenges facing our capital investment plans and tough decisions will need to be taken at the 2024-25 Budget to ensure we remain fiscally sustainable.

The challenging economic conditions of the last few years resulting from Brexit and high inflation as well as the real terms fall in the capital grant allocation from the UK Government has significantly impacted our ability to deliver on all capital infrastructure commitments. Given the economic challenges we face, we have committed to refreshing the multi-year capital spending envelopes and resetting the infrastructure project pipeline, including road projects, alongside the 2024-25 Budget.

This Government understands the critical role of rehabilitation in supporting people affected by chest, heart, and stroke conditions, long COVID and other long-term health conditions. We are committed to ensuring that all adults who require rehabilitation have timely access to the right information and services by the end of 2025 through our Once for Scotland Rehabilitation Approach.

The Scottish Government expects that where Health Boards are aware of any patient who has been adversely affected by any poor-quality infant auditory brainstem response (ABR) assessment, the relevant Health Board follows up with the patient and their family to provide appropriate support, reassurance and advice on next steps.

The Scottish Government published Quality Standards for Adult Hearing Rehabilitation Services in 2009 which sets out a standard for the repair being carried out within 2 days of the repair service receiving the hearing aid.

It is for NHS Boards to ensure appropriate provision of a service for the timely repair of hearing aids for patients.

Health Boards are responsible for planning services to best meet the needs of their patients.

Service planning and design should take place at a local level and be informed by an assessment of the type, and level, of support required by patients who need to access those services.

The Scottish Government published Quality Standards for Paediatric Audiology Services (2009) and Quality Standards for Adult Hearing Rehabilitation Services (2009) which both state that patients (and their families in the case of children) should be given a copy of their ‘Individual Management Plan’ following visits to services.

It is for Health Boards to ensure that this takes place in line with the quality standards set out.

The range of experts that have been involved in the Best Start and the Options Appraisal Process represent the leading expertise on this issue and are fully competent to reach an objective decision. I have no doubt that the process of determining where the final three units should be located was independent and robust, and can see no reason to commission a further review.

The Early Interventions for Children and Young People working group are currently developing recommendations of what good quality early intervention support services should be available across Scotland for young people with emerging problematic drug and alcohol use.

In Spring 2023, the working group began engaging with young people, using a co-design approach, to gather their views of what good support should look like. These findings, along with existing international evidence of good practice will be used by the working group to develop standards of support for children and young people.

The co-design work will conclude in January 2024.

The working group will then outline the minimum principles of support that is required by local areas to meet the needs of children and young people, providing early intervention support in a way young people want.

Scottish Government has outlined the importance of a person-centred approach to treatment in it’s alcohol and drug treatment strategy, Rights, Respect, Recovery . By developing recovery oriented systems of care and creating services that are trauma informed, the root causes of problematic alcohol and/or drug use can be identified and supported.

We recognise the many drivers behind problematic use of drugs and alcohol, and the importance of working together to address the underlying causes, providing support to those affected to live full and healthy lives.

We are tackling this by ensuring a holistic approach and strengthening links between work on poverty, structural inequality, education, children and young people and work on alcohol and drug policy.