Meeting of the Parliament

Meeting date: Thursday, May 17, 2012

Official Report 1184KB pdf

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Scottish Executive Question Time

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Health, Wellbeing and Cities Strategy

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Carers (Mental Health)

1. To ask the Scottish Executive how it will improve access to mental health services for carers with mental health issues. (S4O-01009)

We have—[Interruption.]

Can we get the minister’s microphone on, please?

We have legislation that has, at its heart, fundamental principles to ensure equal access to healthcare for all, including carers. Carers have a legal right to an assessment of their own healthcare needs, and services and support should be put in place to meet those needs.

The new mental health strategy, which is to be published in the summer, will set out our future direction for mental health services and health improvement, including how we can better understand and support the role of families and carers.

Together with the significant resources invested in delivery through “Caring Together: The Carers Strategy” and increased funding for short breaks, we are ensuring that carers are supported to manage their responsibilities with confidence and in good health.

The latest figures show that there are 657,000 carers in Scotland. According to a recent study by the Princess Royal Trust for Carers, six in 10 carers have suffered a mental health illness. A majority of all the carers who took part in the poll had never sought help or support. Should we not ensure that the national health service takes a much more proactive approach to supporting carers, and that information about what help is available and where to find it is prominently displayed in health centres and libraries?

The member raises an important point, and I am aware of the report to which she refers. It is important to recognise the invaluable role that carers play in our society, in supporting cared-for individuals. The Government is doing what it can, through our strategy, to try and assist and support carers in that caring role. I understand the challenge that many carers face in accessing services, and that is why, over the past three years, we have provided £14 million to health boards through the carers information strategy to make sure that information is provided and available to carers on how they can access support and assistance through the health service.

As I mentioned in my earlier response, we intend to publish our mental health strategy in the summer. In that, we will set out ways in which we intend to try to assist carers and their families in addressing the issues around mental health.

Question 2 is in the name of Joan McAlpine. I note that she is not in the chamber to ask the question. This is not the first time, nor is it the second time, that Ms McAlpine has acted in this way. I expect an explanation from her and an apology for the discourtesy to the chamber by the end of the day.

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Health Waiting Times (NHS Grampian)

3. To ask the Scottish Executive what recent discussions ministers have had with NHS Grampian regarding waiting times. (S4O-01011)

Ministers meet regularly with national health service chairs and discuss issues of importance to the NHS, including waiting times. The Minister for Public Health also discussed waiting times at the board’s annual review on 1 November 2011.

I understand from comments reported in The Sunday Times that concerns about social unavailability codes were raised with NHS Grampian as long ago as 2009. Did ministers consider making those concerns known to the public? If so, what action did they take?

The Information Services Division did not make concerns known to ministers. I am not sure whether Lewis Macdonald was in the chamber for the debate earlier today. If he was, or if he was watching it, I am sure that he appreciates the importance that members on all sides of the chamber attach to the issue.

I have received an assurance that NHS Grampian is applying the new ways guidance around social unavailability correctly. As I have stated before, social unavailability should be used only when a patient has advised that they are not going to be able to accept an appointment for a period of time due to work or social reasons. The vast majority of patients who are socially unavailable have a period of unavailability applied for less than three weeks.

The chief executive has confirmed that, in Grampian, social unavailability is applied only after discussion with the patient. However, to ensure that rules are being applied appropriately, NHS boards will, this year, undertake an internal audit of their local waiting times management and processes, including reporting mechanisms. Audit Scotland has also indicated that it will undertake a review of waiting times management across Scotland.

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Clostridium Difficile (Raigmore Hospital)

4. To ask the Scottish Executive whether it will provide an update on the recent outbreak of Clostridium difficile at Raigmore hospital. (S4O-01012)

Two outbreaks of Clostridium difficile in Raigmore hospital have been reported to the Scottish Government in 2012. The first was in January and affected eight patients in wards 4C and 3A. More recently, the Scottish Government was advised of an outbreak in April, which affected three patients in ward 2C. That outbreak was declared over on 23 April. The lessons from debrief meetings that were held by NHS Highland following those outbreaks are currently being taken forward, locally, by the board.

As members are aware, reducing healthcare associated infections is a priority for the Scottish Government and we have put in place a comprehensive programme of actions. The Health Protection Scotland report that was published yesterday shows that good progress has been and is being made by the national health service in reducing outbreaks of C diff.

Members will be well aware that C diff can be a serious intestinal disease, particularly for the old, the frail and the vulnerable. Is the cabinet secretary aware of the Roslin institute study that highlighted the risks of C diff for patients who transfer from large to small hospitals, which is a regular occurrence in the Highlands and Islands? Will the cabinet secretary confirm what detailed screening protocols are in place to protect patients who move from one hospital to another, in order to prevent outbreaks of C diff across Scotland?

That is a serious question, and I take the issue extremely seriously. I am aware of the study that the member referred to. As he would expect, as with any such study, the Scottish Government and our HAI task force will carefully consider it and ensure that any lessons that can be learned are applied.

On the details that the member asked about, I am happy to send him some written information about the protocols, practices and procedures that are in place in order to minimise the risk of infection and cross-infection, not only with regard to the specific issues that he referred to but in general.

I am sure that, like me, the member will welcome the fact that, in the past year, C diff cases have reduced by more than a third. As long as there is one case of an avoidable infection in our hospitals, my view is that we still have more work to do. Nevertheless, that reduction, which follows on from similar reductions in recent years, is welcome. As I did this morning, I put on record my thanks to all the staff in the NHS who have worked hard to deliver that improvement.

Although the infection-control measures in hospitals are welcome, we should not ignore the role of antibiotics in cases of C diff. I understand that antibiotics can kill harmless bacteria while allowing C diff bacteria to multiply in greater numbers. Given the two outbreaks at Raigmore this year, has an audit been done of the prescription—or, perhaps, the overprescription—of antibiotics in the area?

I am happy to furnish Mary Scanlon with that information specifically as it applies to NHS Highland and Raigmore. Because she takes a close interest in these matters, I know that she will be aware that antimicrobial prescribing forms a key plank of our efforts to reduce C diff outbreaks. Ensuring that we have appropriate prescribing of antibiotics is an important part of reducing all healthcare associated infections, but it is particularly important in relation to C diff. Indeed, the success in improving the appropriate prescribing of antibiotics—in particular, certain types of antibiotics—has played a significant part in the reductions that I have referred to. Those issues and others must always be kept uppermost in the minds of everyone who is involved in our health boards in order to ensure that reductions of the kind that we have seen continue in the years to come.

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New-build Community Health Facilities

5. To ask the Scottish Executive what the public consultation process is when national health service boards are considering where to locate new-build community health facilities. (S4O-01013)

NHS boards must routinely communicate with and involve the communities and people they serve to keep them informed of their plans and performance. When boards propose to change the way in which local health services are provided, including where services are delivered in the community, it is important that there is robust, visible and effective engagement with the public.

Government guidance was introduced in 2010 to support boards in their statutory duty to inform, engage with and consult their patients and the wider public. The Scottish health council has an important role in advising and supporting NHS boards in meeting that obligation.

In Kilsyth, there are much-welcomed plans for the development of a new community health centre. However, along with existing health centre medical staff, I have concerns that there are accessibility issues relating to the preferred site. What can the cabinet secretary do to continue to assure my constituents that users of the new facility will be fully consulted before a final decision is taken on site selection?

I will ensure that the member’s comments, which I am sure reflect the views of his constituents, are made known to the local health board. The member will appreciate that the matter is one for NHS Lanarkshire. However, it is my understanding—I think the member’s question reflects this—that the board has not yet reached a final decision on the site for the new Kilsyth health centre.

The board must follow the guidance in the Scottish capital investment manual, which sets out the criteria that need to be met when selecting sites for capital projects. Those require engagement with local authority partners to identify potential vacant sites that are publicly or privately available.

I am sure that the health board would be happy to discuss the matter further with the member in order that it can be sure that it is taking account of all relevant views on the matter.

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National Health Service (National Planning Forum)

6. To ask the Scottish Government how it ensures that the work of the national health service’s national planning forum and its sub-groups is widely reported. (S4O-01014)

On completion, national planning forum reports are published via the Scottish Government website. They are also available locally via NHS board chief executives and directors of planning.

As the cabinet secretary will be aware, the national planning forum completed a crucial report on transcatheter aortic valve implantation in November 2010, but the report was not published until 17 months later. It has been suggested to me that the report was kept hidden for fear of fuelling an already hot debate on the issue. However, it would appear that it is not the only report dealing with a controversial issue that has been held back. The health economic evaluation study of Eculizumab—a paper that has been referred to on the Scottish Medicines Consortium website since late 2010—has still not been published.

Does the cabinet secretary agree that in the interests of trust and transparency, reports such as those should be made widely available as soon as possible so that patients and clinicians can be fully informed of the conclusions and so that we avoid the suspicion that is bound to arise in issues that are a focus of debate?

In general terms, I agree with the member. There were two issues in his question, which I will deal with separately, although I appreciate that he is making a more general point.

First, in relation to the national planning forum and the report on TAVI, the status of the report was one of work in progress because the forum was awaiting the availability of further evidence of clinical and cost effectiveness. The report was shared with NHS boards via chief executives and directors of planning. As soon as possible after the National Institute of Health and Clinical Excellence guidance was made available at the end of March, the report was placed on the Scottish Government website, so that it was available as part of the bigger body of evidence on TAVI. As members will be aware, the national planning forum is centrally involved in work that is under way to establish a TAVI service in Scotland as quickly as possible.

On the second part of Duncan McNeil’s question, in relation to the Scottish Medicines Consortium, I know that he will appreciate that the SMC is different from the national planning forum, in that it operates completely independently of ministers. I am happy to pass the detail of his question to the SMC and have it respond, but it would not be appropriate for me to tell the SMC when it should and should not make such information publicly available.

In general terms, however, I believe in the greatest possible transparency around what are often very difficult and complex decisions. I hope that that reassures the member.

Will the cabinet secretary advise when, as a result of the national planning forum’s work, TAVI treatment will be provided in Scotland? Will it be routinely available on the basis of clinical judgment, as it is in the rest of the United Kingdom?

Work is going on just now to make a TAVI service available as quickly as possible. I am happy to keep Parliament advised of progress on that, and as soon as it is possible to do so I will give a definite indication of when the service will go live.

Patient eligibility for TAVI will be decided on the basis of clinical judgment, which will operate as members would expect and—as is the case in all such matters—within clearly defined protocols regarding which patients are suitable for that particular procedure.

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Waiting Times (NHS Greater Glasgow and Clyde)

7. To ask the Scottish Government what steps it is taking to reduce waiting times in NHS Greater Glasgow and Clyde. (S4O-01015)

We continue to support all boards, including NHS Greater Glasgow and Clyde, to ensure that patients get swift access to the services that they require.

Health boards are required to ensure that the minimum length of time from arrival at accident and emergency to admission, discharge or transfer is four hours for 98 per cent of patients. However, none of the A and E departments in Greater Glasgow and Clyde is meeting that standard. What will the Scottish Government do to address that?

As Hanzala Malik and other members will appreciate, the four-hour A and E standard is extremely important, not just for patients who are admitted to accident and emergency, but to ensure that patients move through all parts of the system as quickly as possible.

In recent years, performance has improved. However, some boards consistently struggle to meet that standard. In some cases, that is because of particular circumstances—winter, for example, is more challenging—but there is no doubt that health boards have a duty to meet the standard.

I am happy to write to Hanzala Malik with further information about how the Scottish Government works with all health boards—not only Greater Glasgow and Clyde—to ensure that they have systems in place that allow the target to be met consistently and sustainably.

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Obesity (Schoolchildren)

8. To ask the Scottish Government what it is doing to tackle obesity among schoolchildren. (S4O-01016)

We jointly published with the Convention of Scottish Local Authorities the prevention of obesity route map in February 2010. The route map makes a long-term commitment over 20 years to tackling overweight and obesity issues in order to help to achieve a healthier Scotland and to contribute towards sustainable economic growth.

The route map recognises that obesity is not just a health issue, but a consequence of our culture, society and lifestyle. We need to work across all areas of Government to ensure that local and national policies are directed at supporting people to achieve and maintain a healthy weight. A key element of the work to prevent obesity is aimed at schoolchildren and the early years.

Will the minister consider additional initiatives, which could be rolled out across Scotland, to remove vending machines that contain unhealthy food and drink from schools?

The Nutritional Requirements for Food and Drink in Schools (Scotland) Regulations 2008, which we introduced, explicitly proscribe the sale of unhealthy food and drinks in all schools, including from vending machines. The impact of those regulations is evident in the results in the World Health Organization study that was published earlier this month, which showed that the consumption of fizzy drinks by 11 to 15-year-old schoolchildren has halved in the past decade.

There are some excellent local initiatives to promote healthy eating in schools. When the Cabinet Secretary for Education and Lifelong Learning visited Dunoon grammar school in January to see the British Heart Foundation’s latest food for thought campaign, he was very impressed with the piloting of healthy products in vending machines. However, we can always do more in that regard.

Does the minister agree that our efforts to tackle obesity must start long before school? Given that research suggests an increased probability of formula-fed infants being obese by the age of three, what action is the Scottish Government taking to encourage and support breastfeeding as part of the measures to tackle obesity among children?

I thank Elaine Smith for her question, and for her long-standing efforts in that area. She is right: the evidence is clear that the earlier the intervention, the better, and that—as we set out in our route map—breastfeeding is an important part of preventing obesity.

Health professionals provide much of the support for new mothers, but more innovative work includes peer support groups in which women work with young women in particular to help them to see the benefits of breastfeeding their babies. We would like more of that to happen.

The Government will be delighted to hear that, at the European Union congress in Lyon last week, Scotland was recognised as being a world leader in an evidence-based weight programme. I refer to the counterweight programme. Is the Government as dismayed as I am to learn that, despite the cabinet secretary’s answer to my previous question on the issue, all six staff in the national counterweight programme were declared redundant at the end of April and the programme has therefore effectively been abandoned as a national programme?

Not for the first time, the member is being very economical with the truth. It has not been abandoned at all; in fact, it has been mainstreamed into the work of health boards. As the member knows as well as I do, not every health board used counterweight. We have allowed allow health boards to choose how they take forward this important work. I hope that that will correct the member’s misinterpretation of the facts.

Question 9, in the name of Patricia Ferguson, was not lodged. The member provided me with an explanation and an apology.

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Ambulance Cover (Shetland Islands)

10. To ask the Scottish Government what the outcome is of the trial of using retained staff to provide ambulance cover in the Shetland Islands. (S4O-01018)

A proposal for a retained ambulance scheme was approved by the Scottish Ambulance Service board in spring 2009. The operation of the scheme was formally evaluated during the first six months of operation and it is now the subject of on-going clinical audit and governance arrangements.

The retained staff in Shetland have received a range of training to allow them to be crewed with a paramedic as part of an emergency response crew, and they are providing an enhanced and more resilient service for patients. The transition to the new Ambulance Service academy has had an impact on the further development of the scheme, but I have been advised that, over the next 12 to 24 months, the retained staff in Shetland will be trained to ambulance technician level.

I hope that that type of retained scheme and other innovative service models will be developed in other remote and rural areas to support local communities.

I thank the cabinet secretary for her reply. It has, in fact, covered my supplementary, which was going to be about that model being used in other rural areas of Scotland.

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Lung Cancer (Early Symptoms)

11. To ask the Scottish Executive what it is doing to raise awareness of the early symptoms of lung cancer in risk groups. (S4O-01019)

Earlier this year I launched the final implementation plan for the detect cancer early initiative. Lung cancer is one of the three cancer types that the initiative will focus on in the first instance. A social marketing and fieldwork campaign has already been run to help to address fears and negative attitudes to cancer and its treatment. The campaign is designed to encourage people to present earlier with any suspicious signs or symptoms. As a follow up, cancer-specific symptoms and signs campaigns will be run from the summer and continue over the winter period. Those will start with a campaign on breast cancer, followed by one on colorectal cancer and then one on lung cancer.

Evidence shows that people living in deprived areas are more likely to develop lung cancer, so the lung-specific campaign will concentrate on reaching people aged 45 and over in those areas, with a particular focus on females in recognition of the increased incidence of lung cancer among women.

I thank the minister for her very comprehensive answer. I apologise for the fact that only since I lodged the question last week have I become aware of a national television campaign, which is doing exactly what we want to be done. I must apologise for the Conservative Party in general. We will take the lesson from today that we should read the papers and watch the television more.

I call the cabinet secretary.

Nicola Sturgeon rose—

However—[Laughter.]

Let us have the “However”, then.

My specific follow-up question relates to an issue that the cabinet secretary touched on. The TV campaign that is running features a middle-aged man. As the incidence of the disease gradually drops, the balance shifts towards more women being affected as a proportion. Will she undertake to ensure that there is monitoring of the performance of any campaign in raising awareness among women, to ensure that they do not miss the symptoms?

I say, in the spirit of consensus, that no member should apologise for raising the important issue of cancer awareness and detection in the chamber. I am happy that the member has done so.

I am not sure which particular campaign the member is referring to. The Scottish Government’s detect cancer early campaign that has been running recently has a woman as the key character in the advert. I absolutely take the member’s point, and in my original answer I made the point that there are two particular issues that we have to make sure are addressed by any campaign on lung cancer. The first is the fact that more people in deprived areas get lung cancer, and the second is that the incidence of lung cancer among women is growing. I assure the member that both those aspects will be taken into account as we develop the detect cancer early programme for all three of the tumour types on which it focuses.

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Day-case Targets (NHS Tayside)

12. To ask the Scottish Executive what steps it has taken to ensure that NHS Tayside meets the nationally agreed targets for day cases. (S4O-01020)

As part of the delivery of the nationally agreed target for day cases, NHS Tayside was set a board target of 75.2 per cent, to be met by the end of March 2011. The latest published data for the end of March 2011 shows that that target was delivered by NHS Tayside when it reached a performance level of 76.7 per cent.

As the cabinet secretary knows, day cases are a cost-effective way of treating patients. They are much cheaper than overnight stays in hospital. However, cost-effective day cases in Tayside have been reduced by almost one third since Labour left office in 2007. What is the cabinet secretary doing to ensure that national targets are being met and that the number of day cases climbs back up to the levels that existed under the previous Labour Administration?

I am not going to turn the question into some kind of party-political ping-pong because I agree with Jenny Marra about the importance of increasing and promoting day-case surgery. That is not just because it is cheaper and more cost effective for the national health service, although it undoubtedly is, but because it is also more convenient for patients. Most patients would prefer to have any procedure done on a day-case basis than be admitted to hospital as an in-patient.

Across the country, day-case rates have been rising in the past few years, and that is a good thing. However, as in so many other areas, there is still work to do and I hope that all members will accept and agree that pushing up day-case rates even further is an important priority that will deliver benefits for the health service and for patients.

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Health and Social Care Integration

13. To ask the Scottish Government whether it will provide an update on the integration of health and social care. (S4O-01021)

On 8 May I launched the consultation on the integration of adult health and social care. During the three-month consultation period, a thorough engagement process will take place with a wide range of stakeholders in the national health service, local government and the third and independent sectors. The analysis of the consultation will take place in the autumn, and it will inform and develop the policy and legislative proposals that will follow.

I thank the cabinet secretary for her answer, which partially answered my supplementary. I am sure that she was aware of the concerns that were raised last year by the Royal College of Nursing and Audit Scotland about the proposed model for the integration of health and social care that was being pursued by NHS Highland and Highland Council. Is she able, at this point, to say whether those concerns have been addressed as the integration of those services has proceeded?

As the member knows, NHS Highland has been pursuing a particular model of integration—the lead commissioning model—and I support the health board in doing that. Any process of change, whether in health and social care or in any other walk of life, leads to anxieties, and it is important that health boards and local authorities work with staff and others to make sure that their views are taken into account as the process develops.

One of the reasons why we have taken a deliberate approach to the wider consultation on health and social care and are doing the three-month consultation to which I referred in my first answer is to make sure that we get the expert views of all the stakeholders who are involved and the staff who work on the front line in those services. There is no doubt in my mind that our direction of travel is the right one and that it will deliver real benefits to patients and service users across the country.

I have spoken to many interested parties about the Social Care (Self-directed Support) (Scotland) Bill that is going through the parliamentary process. Does the cabinet secretary agree that, to be effective, the development of SDS must go hand in hand with the further integration of health and social care? I would also be interested to know whether she can give us a timetable for the proposed legislation.

I agree with the member that we should see our integration of health and social care agenda and the Social Care (Self-directed Support) (Scotland) Bill as two sides of the same coin. They will work best if they develop in tandem. The Minister for Public Health, Michael Matheson, is leading for the Government on the Social Care (Self-directed Support) (Scotland) Bill, and I know that he welcomes views from members of all parties on how we can ensure that it delivers what we want it to. As always, there will be adequate opportunity for members to scrutinise the bill as it goes through Parliament and to propose amendments, when they think that that is appropriate. I know that Michael Matheson would be happy to have further discussions with the member if she would find that helpful.

The cabinet secretary will be aware of the significant underspend that occurred in the first year of the change fund. According to the Scottish Council for Voluntary Organisations, that was a result of pressure caused by

“draconian procurement processes for working with the third sector.”—[Official Report, Health and Sport Committee, 13 March 2012; c 1130.]

Will the cabinet secretary outline how the Government plans to work with local authorities to amend the procurement procedure to address that issue?

We need to get all such issues right and to work in a collaborative way to deal with them. A number of comments have been made about the procurement process—bodies such as Audit Scotland have had things to say about it. As we take forward the consultation on the integration of health and social care, it is important that we see the process as an opportunity not just to bring the structures together, but to deal with any other barriers to the effective and fair commissioning of services. I would welcome submissions to the on-going consultation on how we might do that better from members of all parties, all of which will be treated in the spirit that members would expect. If good suggestions are made, we will take them forward.

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National Health Service Dentists (Orkney)

14. To ask the Scottish Executive how the rate of adult registrations with an NHS dentist in Orkney compares with the national average and what plans the Scottish Government has to improve the situation for patients in the islands. (S4O-01022)

As at 30 September 2011, 55.6 per cent of adults in Orkney were registered with a dentist under NHS general dental services, whereas the figure for Scotland as a whole was 73 per cent.

Responsibility for the overall provision of NHS general dental services in the area rests with NHS Orkney. It is taking measures that are aimed at improving access. The Scottish Government has provided significant financial incentives, grants and allowances that are aimed at encouraging dentists to join NHS boards’ dental lists and to continue to provide NHS treatment.

I thank the minister for his response and, indeed, for his correspondence with me over recent months. I acknowledge that progress is being made, but the figures for Orkney on adult registrations with an NHS dentist and participation rates remain far below the national average. I discuss that concern regularly with the chief executive of NHS Orkney, and I know that meetings have been held recently to consider how improvements might be accelerated.

Given that the minister has accepted that NHS Orkney faces particular challenges and that current improvements appear to be failing to close the gap between the figures for Orkney and the national average, will he agree to look at how progress can be accelerated and whether that could be done through a lump-sum funding arrangement, so that adult patients in Orkney can look forward to the same access to an NHS dentist that their counterparts elsewhere in Scotland enjoy?

The member is correct to say that we have been in correspondence on the issue. Although it is disappointing that the registration level in Orkney is below the national average, since 2007 there has been a 21.4 per cent increase in the number of adults in Orkney who are registered with an NHS dentist. Significant progress has been made, but it is clear that there is more to be done.

I know that NHS Orkney is looking at extending the amount of chair time that is available through NHS dental services and that it is considering the recruitment of additional staff to provide that increased capacity. I understand that it is in dialogue with a practice in Orkney to establish whether it would consider applying for some grant funding to allow it to extend the service that it provides, thereby increasing capacity in the islands.

The chief dental officer will contact NHS Orkney in October, when it expects to be able to highlight the progress that it has made in increasing the levels of registration. At that point, we will consider whether there are further measures with which it requires assistance.

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General Practitioners (Remote and Rural Areas)

15. To ask the Scottish Government what support is available for general practitioners in remote and rural areas. (S4O-01023)

A range of financial, educational and practical support is available to GPs who work in remote and rural areas.

The Acharacle medical practice in Ardnamurchan in my constituency is to lose its two doctors and its practice manager on 31 August. It appears that provision of out-of-hours cover, 24/7 working and the need for more established support from NHS Highland have been major factors in the decisions of the doctors and the practice manager to resign. Will the cabinet secretary—who I know is well aware of the issues in Ardnamurchan—give me an assurance that she will look into that serious situation as a matter of urgency?

I recognise the close interest that Dave Thompson has taken in the issue and in other issues that affect Ardnamurchan. I am well aware of the circumstances surrounding the medical practice in Acharacle. All members will appreciate that service provision in some geographical locations is challenging, but that does not take away from the fact that people who live in such areas deserve the same quality healthcare as people who live elsewhere in Scotland receive. I expect the health board to work closely with the local community to ensure that adequate service provision is put in place. I am happy to give Dave Thompson an assurance that I will keep a close eye on developments. I would be happy to discuss the issue with him or his constituents at any time.

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Selective Dorsal Rhizotomy

16. To ask the Scottish Government what its position is on providing selective dorsal rhizotomy on the national health service. (S4O-01024)

Decisions on the use of the treatment for individual patients who might benefit are a matter for national health service boards, following the advice of clinicians in collaboration with their patient in each case.

NHS Tayside has approved referral pathways and criteria for the use of SDR. My constituent Brooke Ramsay has been advised that, as she meets the criteria, her operation will be funded by the NHS. Will the same or similar pathways and criteria be adopted in other parts of the country and, if so, will the detail of the pathways and criteria be made available to parents of young cerebral palsy sufferers so that they can determine whether their child is likely to benefit from the procedure?

I am glad that Graeme Dey’s constituent has had her treatment approved and I hope that he passes my good wishes to her and her family. In my initial answer, I made it clear that the decisions are a matter for individual health boards, based on the circumstances of individual patients.

However, as Graeme Dey rightly said, a national clinical pathway and referral protocol for the treatment has now been agreed and NHS Tayside has adopted that process for referrals. The member is right that there should not be simply a Tayside referral pathway. It is, and should be, a national referral pathway, so that the decisions, which are often difficult, are made that bit easier.

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Commonwealth Games 2014 (Edinburgh)

17. To ask the Scottish Government what benefits will be seen in Edinburgh from the 2014 Commonwealth games. (S4O-01025)

The Scottish Government is committed to creating a lasting legacy and maximising the benefits for the whole of Scotland from Glasgow hosting the 2014 Commonwealth games. Edinburgh’s refurbished Royal Commonwealth pool reopened on 20 March 2012. It will host the diving events for the Commonwealth games and is now available for the local community to enjoy. More than 100,000 visits have been made since it reopened.

In addition, four community sports hubs are now operating and delivering services to their local communities. Local businesses are benefiting, with nine Edinburgh-based companies to date having won Commonwealth games related contracts. Six young people from Edinburgh are part of Young Scot’s youth legacy ambassador programme, through which they will develop new skills by engaging in a wide range of legacy activity and championing that among their peers and local communities.

Does the minister agree that the Commonwealth pool, which is already a legacy of a previous Commonwealth games, provides a fine example of how to ensure a lasting and effective legacy from an event such as the Commonwealth games?

I was fortunate enough to visit the pool just before it reopened. It is a fantastic state-of-the-art facility of international quality. I look forward to the Commonwealth pool playing an extremely important role in the Commonwealth games in two years. I am sure that it will also attract a number of international events, which of course will benefit the local economy in Edinburgh.

Question number 18, by Liz Smith, has been withdrawn. The member provided an explanation.

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Air Ambulance Helicopters (Faults)

19. To ask the Scottish Government what the implications are of the discovery of faults in Scottish Ambulance Service air ambulance helicopters. (S4O-01027)

The safety of patients, air crew and paramedic air ambulance teams are of paramount importance. When a fault was discovered at the beginning of April in a component part of the rotor hub on one of the service’s EC135 helicopters, a replacement part was fitted and the aircraft returned to operational service. Subsequently, and as a result of a similar fault being discovered in two EC135s in service elsewhere in Europe, an enhanced regime of safety checks has been introduced.

Will the new air ambulance contracts provide any guarantees that the kinds of faults that were discovered last week in the EC135 helicopters that are used by Bond Air Services and other operators can be avoided in the future?

The contract is yet to be awarded and announced, so Rob Gibson will understand that I am limited in what I can say about the detail of that contract. Suffice it to say that it is incumbent on the Scottish Ambulance Service and those it contracts with to ensure that everything possible is done to minimise any faults occurring in any of its air ambulance aircraft. Clearly, there can never be an absolute guarantee that faults will not develop. That makes it all the more important that robust safety checks are in place, that safety checks are carried out, and that appropriate action is taken at all times to secure and ensure the safety of those who fly in them.