Health, Wellbeing and Sport
Good afternoon. The first item of business is portfolio questions. In order to get in as many members as possible, I would, as usual, prefer short and succinct questions and answers, please.
Scottish Medicines Consortium (Decision-making Processes)
To ask the Scottish Government whether it will review the decision-making processes of the Scottish Medicines Consortium following its decision not to reimburse Vimizim for people with Morquio A syndrome. (S4O-04608)
The independence of the Scottish Medicines Consortium’s decisions on individual drugs is well established. In line with what was recommended when the SMC adopted its new approach to orphan, ultra-orphan and end-of-life drugs, there will be a formal review of the new SMC approach in 2015-16, and the Scottish Government is currently working with the SMC on the remit of the review.
I am very grateful to the cabinet secretary for that response. As she knows, when I first became involved with this issue, those who made the case for reimbursement for Vimizim were very complimentary about the SMC process and rather less so about the process south of the border through the National Institute for Health and Care Excellence. However, as time has gone on, that situation has reversed. It is quite clear that the NICE process was highly inclusive in nature and included round-table discussions with clinicians, patients and families, whereas the Scottish process was the very opposite.
Therefore, in drawing up the remit for the 2015-16 review, will the cabinet secretary ensure that the process becomes more inclusive so that those who are most affected are made to feel that they are a valued part of it, rather than being made to feel that they are outside it?
The consultation with stakeholders that will be carried out as part of the review will be wide, and I encourage Alex Fergusson to submit his view on the case that he has cited to the SMC as part of the review.
The review will look at the SMC process, the decision-making process and the issue of inclusivity. Alex Fergusson cites NICE’s process as an example of an inclusive process, but there are many criticisms of the NICE process, too. I think that the new process is better than what we had before, but we always said that we would review the new process within the first year of operation. That is what we will do, and I will certainly ensure that the issue of inclusivity that the member raises forms part of the review and will discuss that with the SMC.
NHS Lanarkshire (Out-of-hours General Practitioner Services)
To ask the Scottish Government what discussion it has had with NHS Lanarkshire since its interim service model for out-of-hours GP services was implemented on 1 July 2015. (S4O-04609)
Discussions with all national health service boards, including NHS Lanarkshire, are on-going as part of the national review of primary care out-of-hours services, which is being led by Professor Lewis Ritchie. The review will report its findings and recommendations in the autumn.
In any discussion and consideration of the matter, will the cabinet secretary recognise that although East Kilbride is the largest population centre in Lanarkshire, it has been without an out-of-hours GP service since NHS Lanarkshire’s interim model was implemented? Does she recognise that that is an anomalous situation that must surely be rectified in any long-term solution?
I certainly expect NHS Lanarkshire to keep the interim service under review. Once we have Professor Lewis Ritchie’s recommendations, I expect NHS Lanarkshire to look at them and to consider whether the interim service is in line with them. It has said publicly that it will undertake a full review, with public involvement, within six months. That will take account of the recommendations, which will be coming soon. I will, of course, consider NHS Lanarkshire’s longer-term plans in the light of all that.
We now have further evidence that NHS Lanarkshire’s so-called interim GP service—out of hours, out of hospital and running out of GPs—is not working. Despite the reduction in the number of centres from five to two, over a recent three-month period one in nine sessions was unfilled. There is often just one GP out-of-hours centre for the whole of Lanarkshire.
I need a question, Mr Pentland.
Does the cabinet secretary agree that that is not the service that the people of Lanarkshire deserve and have the right to expect, as the chief executive promised? For how much longer will she tolerate this worsening position?
With regard to the timeframe, the Ritchie review’s recommendations—as I said in response to Linda Fabiani’s question—are fundamental to the way in which not only NHS Lanarkshire but any other health board operates and organises its out-of-hours services.
John Pentland referred to the interim model. NHS Lanarkshire moved to an interim model because of patient safety concerns, as it made clear that it could not staff its rotas. The board now tells me that it is more able to staff the rotas than it was previously and that the service is safe, so John Pentland should take that on board.
As I have said, I expect that, moving forward, NHS Lanarkshire’s out-of-hours services will be in line with the recommendations that come out of the national review. If the board wants to move to any permanent change in its out-of-hours services, that issue would come to the Scottish Government.
The important point is that we send a message to the people of Lanarkshire that their services are safe; I am sure that even John Pentland would want to do that.
The minister might be aware of reports at the weekend that NHS Lanarkshire is at risk of losing its training status for junior doctors, which is vital for providing out-of-hours services. What is her view on those very worrying reports?
I am very much aware of the issue of the training status for junior doctors, and my officials and I are having on-going discussions with NHS Lanarkshire about those matters.
NHS Lanarkshire is clear about the improvements that it must put in place in order to resolve those issues, and I am clear that it has to do so. I will keep a close eye on those matters.
NHS Grampian (Recruitment and Retention) (Government Support)
To ask the Scottish Government what support it is providing to NHS Grampian to help recruit and retain staff. (S4O-04610)
NHS Grampian, along with all national health service boards, is required to have in place the correct staff to meet the needs of the service and ensure high-quality patient care.
The Scottish Government has increased NHS Grampian’s resource budget by 6.7 per cent to more than £830 million for 2015-16. That rise is above inflation, and it is the largest increase for any mainland board, with the budget having previously increased by 4.6 per cent in 2014-15. The Scottish Government works closely with all boards to support their staff recruitment efforts.
I know that the cabinet secretary is aware of the particular concern in the north-east regarding general practitioner recruitment, given the closure of the Brimmond medical practice in Aberdeen and the fact that other practices are being affected by staff recruitment issues.
I have raised that issue with the cabinet secretary previously. Can she provide any further details today on what action the Scottish Government is taking to tackle it, given that patients are already being affected and that approximately 20 per cent of GPs in the north-east are due to retire next year?
We have taken a close interest in the issue with regard to Brimmond and other practices in Aberdeen and across the north-east. NHS Grampian is working closely to ensure that there is continuity of service for those patients.
In the medium to longer term, we require new ways of working in primary care. That is why we are discussing with the Royal College of General Practitioners, the British Medical Association and others radically different models of primary care and the need for the new GP contract that will run from 2017 to facilitate those new models of care.
A number of practices in Aberdeen are trailblazing the idea of a federated structure of GP surgeries. Rather than having small—in some cases, single-handed—practices, surgeries would come together in a cluster to provide a greater range of services to their patients. I am happy to keep Richard Baker apprised of progress on that.
In relation to the Brimmond medical group, will the cabinet secretary join me in welcoming the launch, by the Scotstoun medical group, of the new Dyce medical practice, which perhaps conforms to the approach of the federated structure that she has announced and which will ensure continuity for patients of the Brimmond practice who were affected by its withdrawal of general medical services?
I very much welcome the new Dyce medical practice and the new federated structure. As well as the resilience that a federated structure brings to general practice and primary care in the area, the benefit is that it opens up opportunities for specialist services to be delivered to that patient population because of the range of experience and skills within the structure. We believe that the approach has wider application across Scotland, and that is informing our discussions with the profession as we go forward.
Robotic Radical Prostatectomy
To ask the Scottish Government whether robotic radical prostatectomy is available from the national health service. (S4O-04611)
I am pleased to confirm that, two months earlier than planned, robot-assisted surgery for prostate cancer is now available in NHS Scotland. The first robot has been located in Aberdeen royal infirmary and was purchased with the help of a £1 million capital contribution from the Scottish Government, which added to the magnificent fundraising efforts of the people of the north-east through the UCAN charity.
The minister will be aware that such robotic surgery vastly improves outcomes and that recovery times are much quicker. However, she will not be aware that I have three constituents who had to travel to Leipzig and pay for the treatment themselves because Greater Glasgow and Clyde NHS Board refused to fund the procedure. One of those people travelled a mere few weeks ago. Given that treatment was available at the new Queen Elizabeth hospital and should have been offered to my constituent, will she ensure that the money is refunded to him and will she end the postcode lottery of care?
I am happy to discuss with Jackie Baillie, outwith the chamber, the matter that she raises. She will be pleased to know that, this week, it has been confirmed that a robot has been purchased for the west of Scotland to help to deliver minimally invasive radical prostatectomy. An implementation date for that has yet to be confirmed, but we expect that it will be agreed following equipment installation and the completion of staff training.
Homoeopathic Medicine Prescription Withdrawal (Court of Session Decision)
To ask the Scottish Government what its position is on the Court of Session’s recent decision not to overturn NHS Lothian’s withdrawal of prescriptive homoeopathic medicine to a Midlothian resident. (S4O-04612)
The decision was one for the Court of Session to take and is not a matter for the Scottish Government.
Although the scientific benefits of homoeopathy are generally unproven, it is clear that, even as a placebo, many people find it of great help. Will the minister outline some ways in which homoeopathy can be supported in the national health service?
As the member knows, it is for individual NHS boards to decide what complementary and alternative therapies are made available, based on the needs of their resident population and in line with national guidance. We expect boards to ensure that people receive the appropriate clinical care that meets the totality of their needs and that that care is person centred, safe and effective.
Deep-end General Practices (Support)
To ask the Scottish Government what support it provides to so-called deep-end general practitioner practices in the most socioeconomically deprived populations. (S4O-04613)
There is recognition of the additional needs of patients in areas of deprivation in the calculation of Scottish Government funding to GPs for the provision of core services. That is shown in the weighting that is given to reflect deprivation, as a marker for increased morbidity for patients and increased workload for practices, covering the essential element of general medical services.
It has long been recognised that patients who attend such practices often suffer from a range of illnesses, as the cabinet secretary said, which often contribute to premature death. Is she aware that such patients are also likely to suffer some 20 years more of poor health than are those in more affluent areas? Is it not time that the funding formula for GP practices properly recognised that concern and the other challenges that face the deep-end practices and therefore supported the GPs whose patients suffer the most from health inequality, such as those in the Balmore surgery in Possilpark in my area?
I am certainly very well aware of the issues that Patricia Ferguson has raised and I have a lot of sympathy for the points that she has made. There is an opportunity to discuss what the new contract from 2017 onwards—the first Scotland-only one—will look like and how it will facilitate new models of care. Within that, we must have a sharp focus on tackling health inequalities. I am happy to continue the dialogue on the issue with Patricia Ferguson, because what she said is very much in line with my thinking as we take the discussions forward.
I recently met GPs at the deep-end Balmore practice in Possilpark. They have a unique situation and they have made an evidence-led and powerful case for more resources from NHS Greater Glasgow and Clyde. I am in correspondence with the NHS board on the issue and I have written to the cabinet secretary about it.
Will the cabinet secretary consider my suggestion to NHS Greater Glasgow and Clyde that the particular stresses that the Balmore surgery will experience over the winter period need to be mitigated and that the health board could use winter resilience moneys to get the surgery through that period to the spring? An additional resource allocation for the surgery could be considered then, given the unique and powerful case that it has made to NHS Greater Glasgow and Clyde.
I recognise Bob Doris’s interest in the matter and I issued a written reply to him today about it. We all want to ensure that the Balmore practice is able to continue its important work in an area of deprivation. NHS Greater Glasgow and Clyde has been discussing with the practice how to provide support, and that has led to the board providing short-term support.
As for what happens after that, it is important that the board continues to discuss with Balmore how to take the practice forward, because we need to put the practice on a sustainable footing. I certainly encourage Bob Doris to continue to liaise with NHS Greater Glasgow and Clyde on the issue, and I am happy to keep him informed of any discussions and to ensure that the board is aware of his and other members’ representations.
General Practitioner Training Programme
To ask the Scottish Government whether it is experiencing difficulties in recruiting for the four-year general practitioner training programme. (S4O-04614)
It is NHS Education for Scotland, working with the GP National Recruitment Office, that oversees arrangements for selection and recruitment into three-year and four-year GP training programmes. In 2015 national recruitment, 305 GP specialty training posts were advertised in Scotland, and 237 were filled, which is a fill rate of 78 per cent. Of the 305 posts, 172 were for the four-year programme.
We are continuing to work with health boards and the medical profession to make general practice a more attractive career option. The work includes some redesign of the medical training curricula and taking forward recommendations from the shape of training review to provide GPs with enhanced skills as part of their training.
From what the cabinet secretary said, I am not entirely sure whether she recognises the conclusions of, for example, GPs in my area, who include Dr Iain McColl, that what is currently a problem could become a crisis in five years. Will she elaborate on the steps that she is taking to make general practice a more successful and attractive long-term career option? In particular, will she reverse the funding cuts that the Government has made to general practice?
The member can be assured that the issue is a very high priority for me and the Scottish Government, but we must look at a number of interrelated issues. First, in medical schools, general practice is often not seen as the most attractive specialty to go into. There is a range of reasons for that, but we have to change that perception and change the way in which medical students are encouraged or not encouraged to go into general practice.
Secondly, we need to make the training of GPs more attractive. Some of the enhanced training that we are looking at is about bridging the gap between general practice and hospital-based practice and seeing whether there are opportunities for different models that blur more of the boundaries between primary and secondary care.
There is also the requirement to develop and deliver new models of primary care that are based around multidisciplinary teams that allow the general practitioner to work to the top of their skill level and use their clinical skill and training while other health professionals do some of the work that GPs can find frustrating and time consuming. I would be happy to write to Ken Macintosh with further details.
NHS Greater Glasgow and Clyde Chief Executive (Meetings)
To ask the Scottish Government when it last met the chief executive of NHS Greater Glasgow and Clyde. (S4O-04615)
Ministers and Government officials regularly meet representatives of all health boards, including NHS Greater Glasgow and Clyde.
The cabinet secretary will be aware of correspondence that I have sent to her about smoking in hospital grounds ceasing from 1 October. That will have an impact on Ravenscraig hospital in Greenock, which provides continuing care and in-patient services for adult and elderly psychiatric patients along with rehabilitation and alcohol addiction in-patient services.
I would be grateful to know about any discussions that the cabinet secretary has had with NHS Greater Glasgow and Clyde to consider introducing contingency measures to assist staff with the smoking ban when it comes into force. How will patients who have limited mobility be able to leave the grounds to smoke? Have any hospitals in Scotland been given an exemption from the policy?
I confirm to Stuart McMillan that a letter will be on its way shortly in response to the issues that he has raised. It is a matter for NHS boards to decide whether it is appropriate and in the interests of patients to designate the grounds of their mental health facilities as smoke-free.
In line with the view of the mental welfare commissioner, the Scottish Government recognises that people with mental ill-health face some of the greatest health inequalities. As such, we support action by health boards to protect the health of that population group.
Where health boards have decided to create no-smoking outdoor areas, I expect them to ensure that patients have swift access to smoking cessation support. We are providing more than £10 million to health boards for tobacco control activity, including the provision of specialist cessation services.
During the cabinet secretary’s discussions with the chief executive of NHS Greater Glasgow and Clyde, did she have time to discuss the staggering £44 million maintenance backlog at Inverclyde royal hospital? Reported in 2013, that figure is almost double the figure that was reported in 2011. As I understand it, rather than it being diminished, that figure is increasing and placing a huge question mark over the future of our local hospital. Can the cabinet secretary assure us that the issue will be addressed urgently to ensure that there is a viable future for Inverclyde royal hospital?
I can confirm and reassure Duncan McNeil that Inverclyde royal hospital has a viable future.
On the maintenance backlog, we expect all health boards to have in their capital plans a clear plan for maintenance, particularly if there is a backlog. We will continue to discuss issues with the health boards, including NHS Greater Glasgow and Clyde.
Polypropylene Mesh Implants
To ask the Scottish Government when it expects to receive the interim conclusions of the independent review into polypropylene mesh implants and what progress the expert group has made in developing pathways of care for women experiencing complications. (S4O-04616)
The Scottish Government expects the independent review of transvaginal mesh implants to publish its interim report at the end of this month or the beginning of October.
The expert group suspended its activities during the period of the independent review’s main work programme and reconvened at the end of August. The new pathways of care for women who are experiencing complications can now be progressed. Evidence that has been gathered by the independent review will inform the configuration of this service.
I am grateful to the cabinet secretary for her reply and for her continued focus on the issue. I know that she will give evidence to the Public Petitions Committee on 6 October, and I look forward to engaging with her on the detail of the report.
Will the cabinet secretary confirm that there is not one surgeon on the expert group who is not a proponent of polypropylene mesh, and whether that might yet prove to be a cause for concern? Meanwhile, will the cabinet secretary update members positively on the helpline that was launched on 3 August?
The make-up of the expert group and the work that has been undertaken should be respected and should give us confidence. Indeed, the women who have been directly affected by the issue to whom I have spoken have been supportive of the work of the expert group. We need to enable it and leave it to draw its work to its conclusion.
I will write to Jackson Carlaw with an update on the use of the helpline. The helpline was well received by the women concerned. Their input into the development of the helpline and the recruitment to the service has been valuable.
I want to put on record again my thanks to the women concerned. They have had a terrible experience and have been badly affected by the issue. Their intention to support other women who are affected deserves all our praise.
We are not progressing very far today. Questions and answers will need to be briefer.
What progress is being made to reduce the use of the implants? Can the cabinet secretary guarantee that any woman using them is fully apprised of the risks that are involved?
As I have said, most health boards have suspended mesh implant procedures for stress urinary incontinence and pelvic organ prolapse. Women affected and health boards are eagerly awaiting the findings of the review, as am I.
General Practitioners (Shortage)
To ask the Scottish Government what measures it is taking to address the shortage of GPs. (S4O-04617)
Under this Government, the number of general practitioners employed in Scotland has risen by 7 per cent to nearly 5,000—the highest ever on record. We have also increased investment in primary medical services by more than £88 million, and there are more GPs per head of population in Scotland than in England. However, I recognise that demand is increasing, which is why I have recently announced that, over the next three years, an additional £60 million will be invested to address immediate workload and recruitment issues.
I welcome the investment in general practice. The reason for the shortage of GPs is complex and, of course, not confined to Scotland. However, I have been told by national health service insiders that the high rates that are being paid to locum doctors, including GPs, can exacerbate the shortage, as some doctors choose to pull out of the NHS and return as part-time locums.
Given that trend, would the Scottish Government support health boards that choose to cap the rates that are paid to locums?
Joan McAlpine raises an important point. Our long-standing agency locum contract already caps the rate at which locums can be paid at the national NHS rates, and the doctors and dentists terms and conditions of service again ensure a capped rate for locum staff who are engaged through local supplementary staffing services such as the medical staff bank.
Health boards have been advised to use only agencies that are on the nationally agreed contract and to ensure that any local locums are paid at the contracted rates.
I welcome the recent statements in support of federated practices or clusters, which were proposed by the Royal College of General Practitioners eight years ago. Will the minister now examine Labour’s consultation paper. “Fit for the Future”, which I have sent to her and Maureen Watt? It is based on GP responses. Will the cabinet secretary or Maureen Watt come to the chamber with a statement on the developing crisis in GP recruitment and retention? In the meantime, will the cabinet secretary ensure that, where advanced nurse practitioners are being deployed instead of or alongside GPs, they are fully qualified?
To be fair to Richard Simpson, at least he is trying to develop some Labour health policies. I have looked at his paper and I can tell him three things: every element of the paper either has already happened, is already happening or is already under active consideration. There is nothing in the paper that we were not already doing, looking to do or planning to do. I thank him anyway for his thoughts on the matter.
General Practitioners (North-east Vacancies)
To ask the Scottish Government whether it will provide an update on progress in filling GP vacancies across the north-east. (S4O-04618)
Senior managers and GP clinical leads within Aberdeen health and social care partnership are working closely with practices offering support and assistance where required with advertising and recruitment.
The minister will know that the acute shortage of GPs is impacting daily and directly on local communities throughout the north-east, with surgeries at Gamrie, Cuminestown and Brimmond particularly affected and thousands of patients being displaced to other already busy practices in a fairly ad hoc way. What patient safety risk assessments does the cabinet secretary expect health boards to carry out in such circumstances and what safeguards have been put in place to ensure that patients with long-term and complex conditions do not experience any potentially critical disruption to their medical care?
Two practices in the north-east are under what is described as special measures, which is when the board steps in to support them: one is Brimmond and the other is Gamrie. In the case of Gamrie, it was due to a GP being injured and, therefore, on sick leave, so some of the situations are difficult to predict. Obviously, the board has taken swift action. We guarantee patient continuity either through other practices taking on patients or through a salaried service as required. Boards are expected to respond rapidly to such cases, whether in Aberdeen, Aberdeenshire or anywhere else in Scotland.
I thank the cabinet secretary for attending a recent constructive meeting with GPs, NHS Grampian and colleagues.
Mr Stewart, I really need a question.
At the meeting, it was said that United Kingdom pension changes were having an effect and GPs were retiring early. Will the cabinet secretary comment on that? Is it a real problem?
The organisations that represent general practitioners have raised the issue that those changes have facilitated more rapid retirement in some cases. It is not the only backdrop to the challenges with GPs and primary care, but it is an issue.
Primary Care (Aberdeen) (Support)
To ask the Scottish Government how it is supporting primary care in Aberdeen. (S4O-04619)
The Scottish Government continues to support NHS boards in this work through investments and initiatives that have been set up to test at scale new ways of working in primary care. Within Aberdeen, we have supported the development of a cluster model as the basis for improving patient care. That involves six practices across three community health partnerships with practices in Aberdeen, Aberdeenshire and Moray with a combined patient population of around 60,000 working together to ensure a fully integrated approach to patient care.
The cabinet secretary might be aware that part of the work that is being done to modernise primary care in Aberdeen is being carried out in the Danestone medical practice in my constituency. In light of the First Minister’s announcement in the programme for government about the Scottish Government looking to remodel primary care, how will that work feed into the national agenda?
Danestone medical practice is one of the six practices in NHS Grampian that are taking part in the work, which is exploring how we can develop a new model of delivery in primary care to address current and future patient demand. The Government looks forward to hearing more about the findings from that work, and the lessons learned will play an important part in informing the work on the future delivery of primary care.
Environmental Health Workforce (Capacity)
To ask the Scottish Government what its position is on the Royal Environmental Health Institute of Scotland’s reported concerns regarding the capacity of the environmental health workforce in local authorities. (S4O-04620)
The environmental health staff who are employed by local authorities contribute significantly to environmental and public health in Scotland. I know how important it is that we have an effective and experienced workforce. Ministers have met the Royal Environmental Health Institute of Scotland in the past to discuss these matters, and I would be happy to do so again to understand the work that has been undertaken in recent years to address some of the challenges.
In 2009, local authorities in Scotland employed 556 environmental health officers and 105.6 food safety officers. By September 2014, that had dropped to 470.74 EHOs and 77.6 FSOs, a reduction of 85.26 EHOs and 20 FSOs. Given the vital front-line role that EHOs and FSOs play in safeguarding Scotland’s public health and the very important educational and, therefore, preventative role that they carry out with the producers in Scotland, does the minister share my concerns about the threat posed to public health by the drop in the number of EHOs local authorities employ? What can the Scottish Government do to ensure that we have enough EHOs and FSOs in Scotland to safeguard our excellent public health standards?
The figures described certainly show a decline in numbers. In 2010, the then Minister for Public Health, Shona Robison, received a report from a short-life working group that ministers established to look at these issues. That group made a number of recommendations and the Royal Environmental Health Institute agreed to take forward some work, in particular on the training and education of environmental health staff and on the establishment of a Scottish environmental health advisory group to strengthen local environmental health.
I intend to meet that group to understand what work it has been doing in recent years but, again, I would be happy to meet REHIS and the Society of Chief Officers of Environmental Health in Scotland to explore what more can be done to support and promote environmental health provision.
General Practitioners (Recruitment Problems)
To ask the Scottish Government what it is doing to alleviate the problems in recruiting GPs across the country. (S4O-04621)
Scotland continues to have the most general practitioners per head of population and spends the second highest amount per head in the United Kingdom on primary care. However, we recognise that increasing attendances and recruitment challenges are putting additional pressure on GPs and that is why, last month, I announced that an additional £60 million would be invested in primary care over the next three years.
That is a drop in the ocean. With huge numbers of GPs retiring, vacancies impossible to fill, highly paid locums having their pick of where to work, doctors leaving for Australia, patient lists closing down, general practice as we know it is under threat—[Interruption.]
Order, please.
—and that is what the doctors say. This Government has been in power for nine years.
Come to your question, Ms Marra.
Where is its prescription to rescue GP services in Scotland?
Again, I thank Richard Simpson for his ideas on the matter. They are most welcome. However, as I said earlier, we are already doing them, have already done them—[Interruption.]
Order, please.
—or are already considering doing them. Be assured that Labour’s suggestions are things that we have already done or are doing. [Interruption.]
Order.
I say to Jenny Marra that £60 million is not a drop in the ocean; it is a substantial investment over the next three years. However, working with the Royal College of General Practitioners, the British Medical Association and others, the most critical thing for us to do is to devise and look at new models of care. Of course we will ensure that those new models of care are properly funded and that we have the workforce that is required to deliver those new models of care. I hope that, instead of carping from the sidelines, Labour will support that. [Interruption.]
Order, please.
Orthopaedic Specialisms (Patient Needs)
To ask the Scottish Government what evidence it has that orthopaedic specialisms are meeting the needs of patients. (S4O-04622)
The Scottish Government works closely with the Scottish Committee for Orthopaedics and Trauma to ensure that each orthopaedic sub-specialty is providing high-quality care for patients as well as monitoring clinical outcomes. However, it is for individual health boards to plan services, including orthopaedics, to meet the needs of their local population.
My health board has had rather a long waiting list for some of those things. Is the availability of consultants in rural areas keeping pace with demand as the population ages? Operating on knees and hips keeps people active and mobile for longer.
Rob Gibson raises an important issue about the recruitment of consultants to our remote and rural areas. NHS Grampian and NHS Highland have been quite innovative in looking at how to recruit consultants on to networks, which would involve consultants working in a large hospital but spending some of their time in the rural general hospitals as well. Those are exactly the type of developments that we need to ensure that our rural and remote populations get access to the services that they require.
Rob Gibson will also be aware that we are looking at elective capacity and ensuring that we have enough elective capacity to meet the needs of patients, particularly in the area of hip, knee and eye operations.
That concludes portfolio questions.