Chamber and committees

We published our response to the recommendations of the Grouse Moor Management Group, an independent group tasked by the Scottish Government with assessing the environmental impact of grouse moor management, on 26 November 2020 – Grouse Moor Management Group recommendations: Scottish Government response - gov.scot (www.gov.scot) .

And as we set out in 2021 Programme for Government we will – ‘deliver the recommendations of the Grouse Moor Management Review Group as a matter of urgency, including the licensing of grouse moors. Licensing or further regulation will cover the key areas identified in the review, including muirburn, wildlife control, he use of medicated grit and wildlife crime.’

A full public and stakeholder consultation will be undertaken as part of this process.

The Scottish Government recognises that well-managed grouse moors can produce favourable habitats for certain species such as curlews and that land managers have an important role to play in enhancing biodiversity.

As I set out in my response to question S6W-03211 on 20 October 2021 the Scottish Government commissioned Scotland’s Rural College and the James Hutton Institute to undertake extensive research into the biodiversity and economic Impacts of grouse moors and the findings of this research were taken into account when we developed our response to the Werritty review. The research found that whilst some land management actions undertaken on grouse moors could enhance biodiversity, the findings were clear that there could also be a negative impact resulting in species decline.

Our Statement of Intent on biodiversity notes that Scotland’s land delivers multiple benefits to people, providing homes and water supplies, producing food, timber and space for leisure, as well as supporting biodiversity. We have a distinctively strong connection between people, place and nature which makes Scotland special in terms of landscape and access. All landowners and managers have an important role to play in helping to improve the state of nature.

All of these factors will be taken into account when we publish our new biodiversity strategy in Autumn 2022 followed by an underpinning 5 year delivery plan, including changes in the way we use and manage land and our approach to protecting habitats and ecosystems. We have also announced that we will introduce a Natural Environment Bill in year 3 or the current session, which will include statutory, enforceable targets for nature restoration, and actions to deliver on our ambitious voluntary commitment to protect 30% of Scotland’s land and seas by 2030, with 10% highly protected. We will invest at least £500 million in the natural economy over the course of this Parliament, including £150 Million for forestry, ongoing investment in peatland restoration and multi-year funding for the Nature Restoration Fund.

All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

An analysis of the obtained from the two toxicology providers in Scotland – NHS Grampian which provides approximately 10% of the analysis capability and Glasgow University which provides the rest – is set out in the tables below.

It should be noted however that the extent of toxicological analysis required will depend on the individual circumstances of each case and the extent and nature of substances that are found. Factors such as the need to research the effects of unusual drugs or instruct separate analysis for insulin quantification will result in toxicological reports taking longer to be finalised. 

Additionally, in determining the final cause of death, completion of the toxicological report is only one part of a process which involves a number of separate organisations before a final post mortem report can be issued.

Depending on the circumstances surrounding a death, the pathologist(s) may require a number of further investigations to be completed – including further toxicological analysis as well as input from other experts in the fields of neuropathology or histopathology for example – and the findings of all those enquiries must then be carefully considered by COPFS before a cause of death is confirmed.

GU TOXICOLOGY TURNAROUND TIMES

NHS GRAMPIAN TOXICOLOGY TURNAROUND TIMES

The National Infrastructure Mission includes all capital investment made by the Scottish Government, including that which is aimed at boosting supply chains and promoting private sector investment in our infrastructure and wider economy.

The Capital Spending Review, published on 04 February, sets out the total funding available to support the National Infrastructure Mission: £33,461 million over 5 years. A breakdown of this investment is provided in Table 3 on page 17/18. Table 4 of the Capital Spending Review shows the allocations made to individual portfolios and Annex A shows level 2 and level 3 budget allocations, by portfolio, across the same period.

The Infrastructure Investment Plan (IIP) lists in the Theme Chapters on pages 32 to 43 a breakdown of the main areas of investment by Scottish Government and its agencies and non-departmental public bodies – with a value of around £23.5 billion of capital investment. In addition, a value of £3 billion has been assumed for projects which are expected to be revenue funded. These two figures together are the basis of the £26 billion of investment cited in the Ministerial Foreword of the IIP.

The Infrastructure Investment Plan Pipeline, set out in Annex D, includes only a subset of the projects and programmes from the IIP total. Projects with a capital value of £5 million and Programmes with a £20 million value are included in this subset. As new projects and programmes are developed, they can be added to the pipeline when they are suitably ready, and consequently reported to the Parliament’s Public Audit Committee. This approach is explained on page 29 of the IIP.

National Records of Scotland (NRS) publish deaths by cause in their vital events reference tables, including stroke, available under cerebrovascular disease, table 6.04: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/vital-events-reference-tables

Background information on how NRS record deaths can be found at:

Deaths - Background Information | National Records of Scotland (nrscotland.gov.uk)

Deaths with an underlying cause of stroke (identified as ICD-10 codes I61, I63 and I64), by location of death, showed that in 2018, 698 deaths occurred in a non-hospital setting, in 2019, this figure was 682, and in 2020 it was 847. This includes deaths which are categorised as taking place in a Care Home, Home /non-institution or Other institution.

Scottish Government recognises the important role of prompt defibrillation in improving outcomes from Out-of-Hospital Cardiac Arrest (OHCA).

We are a key partner in Save a Life for Scotland (SALFS). The partnership published an updated OHCA strategy in March 2021. This sets out actions to improve outcomes from OHCA, including actions to improve the accessibility of defibrillators and increase defibrillation rates across Scotland. SALFS work in collaboration with local community groups, including those in rural and island communities, to ensure the implementation of the strategy addresses local needs.

The purchasing and placement of defibrillators is the responsibility of individual businesses, local authorities, organisations or community groups. For any groups or organisations interested in providing access to a defibrillator, the Scottish Ambulance Service (SAS) have details of providers and organisations that may offer funding towards the purchase of a defibrillator.

We are working closely as part of the SALFS partnership to build the evidence base required to make strategic decisions about the placement of defibrillators, to encourage their registration with Scottish Ambulance Service and to increase public confidence and knowledge around defibrillation. We believe that these actions will help us to increase bystander usage of defibrillators from 8 to 20% over the lifetime of the strategy.

Scottish Water is working in partnership with the Scottish Environment Protection Agency (SEPA) in the Chemical Investigation Programme (Scotland). Through environmental investigation this project identified chemicals of concern, their sources and concentrations leaving the sewerage system and how they should be addressed in the most sustainable way. The CIP 2 (Scotland) has provided a clear decision making framework for how compliance with the Environment Quality Standards Directive (2008/105/EC) and the subsequent revision (2013/39/EU) is to be addressed. To support this, an extensive monitoring programme of Priority Substances, substances with Environmental Quality Standards set by UK Technical Advisory Group on the Water Framework Directive (UKTAG)/Scottish Government (referred to as UKTAG Substances), substances of interest to SEPA (referred to as Watch List Substances), additional pharmaceuticals and sanitary determinands was conducted at 20 Wastewater Treatment Works (WwTW) within Scotland. At each site, sampling took place at the inlet to the WwTW, the final effluent discharge, and within the receiving watercourse upstream and downstream of the WwTW. The sampling programme took place between 2015 and 2020.

Pharmaceuticals are considered ‘contaminants of emerging concern’ and monitoring and assessing the risk to the water environment for many of these substances is still in the development phase. 23 pharmaceuticals were investigated during CIP2 Scotland. Following analysis with the PNEC (Predicted no effect concentration) the agreed approach with SEPA for 14 pharmaceutical was no further action. The agreed approach with SEPA for the 9 pharmaceuticals that were identified as substances of concern was to carry out a process optimisation study and to control them through source control. The next stage of this research, CIP3 Scotland, aims to carry out further sampling in relation to emerging pharmaceuticals and process optimisation trials at the WwTW in order to understand whether better treatment can be achieved at existing assets.

Scottish Water is also a member of the One Health Breakthrough Partnership ( www.ohbp.org ) which aims to reduce levels of pharmaceutical substances in the environment.

The Scottish Government encourages essential workers, along with the wider adult population and secondary school-aged pupils, to participate in regular asymptomatic testing irrespective of their vaccination status.

The Scottish Government’s asymptomatic workplace testing programmes provide free test kits to a wide range of public, private and third-sector businesses and organisations. Different testing regimens are employed as appropriate to the setting. Most workplaces offering regular asymptomatic testing use twice-weekly testing with lateral flow devices. Weekly polymerase chain reaction (PCR) testing is offered to specific cohorts of staff, including Scottish Prison Service staff and health and social care staff working with clinically vulnerable patients.

Scottish Government officials are in regular contact with NHS Highland to support the service management team with the delivery of orthopaedic elective procedures within the Health Board.

In response to the pressures on NHS services caused by the pandemic, which we are still firmly in the midst of, the First Minster launched the NHS Recovery Plan, on the 25 August. The Plan sets out the Scottish Governments key headline ambitions and actions to be developed and delivered now and over the next 5 years, including an increase in both inpatient and outpatient capacity across the Country. The plan is backed by more than £1 billion of investment over the next five years.

As part of this, we are investing over £400 million in a network of National Treatment Centres, one of which will be located in NHS Highland. When fully operational, the National Treatment Centres will provide increased capacity for surgeries and procedures across 14 specialties, including hip and knee surgery.

GP practices have remained open, accessible and at the forefront of our community services to deal with non-COVID-19 medical care throughout the pandemic. As outlined in the NHS Recovery Plan, a key aim is to work with our GPs to continue to restore face-to-face practice consultations as quickly and safely as possible, while ensuring everyone can continue to make use of eHealth services if that is their preference.

Public Health Scotland have published guidance on social distancing and infection control measure in health settings, changing the 2 metre social distancing rule to 1 metre, enabling more patients in waiting rooms, while continuing to ensure that vulnerable patients and staff are kept safe. In addition, specific guidance to general practices has been published making it clear that there is no longer a need to triage every patient, although they should continue to screen patients for Covid before seeing them face-to-face. We will continue to take advice from public health experts and clinicians when reviewing these measures.

With these recently announced changes I would expect the number of face-to-face appointments to increase.

While high quality data from across the health system is collected, we are working with stakeholders to improve the quality of data we can collect from GP practices to ensure it is robust.

We have continued to meet routinely with GPs and their representatives, and hear regularly from patients, to help build intelligence around appointments and pressures in GP practices throughout the pandemic, and are currently working together with NSS and PHS on a more advanced digital solution for capturing this information moving forward.