Questions and answers

Question reference: S3W-14692

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Thursday, 26 June 2008
Current Status: Answered by Nicola Sturgeon on 21 July 2008

To ask the Scottish Executive in how many deaths (a) clostridium difficile and (b) MRSA was recorded as a contributory factor in each year since1999, broken down by hospital and expressed also as a proportion of all deaths.

The data in the following tables were provided by the General Register Office of Scotland (GROS). The figures should be noted with caution. Recording of MRSA and clostridium difficile infections on death certificates is based on the clinical judgement of each doctor. Changes in the number of cases year-on-year may therefore be influenced by increased public and professional awareness of these infections and may not be a reliable indicator of the true incidence.

It should also be noted that before 2000 it was not possible to say whether Clostridium difficile was a contributory factor in the deaths. It is only possible to provide information where Clostridium difficile was mentioned in the death certificate. A separate table has therefore been provided for 1999.

Table 1: Deaths where Clostridium Difficile was a Contributory Factor in Deaths in Scotland Between 2000 and 2006

	Year
	2000	2001	2002	2003	2004	2005	2006
Aberdeen Royal Infirmary	2	-	4	2	-	4	4
Annan Hospital	-	1	-	-	-	1	-
Arbroath Infirmary	-	-	-	-	2	1	2
Ashludie Hospital	-	2	-	-	2	1	2
Astley Ainslie Hospital	-	-	-	1	2	3	1
Ayr Hospital	4	2	-	-	-	2	3
Ayrshire Central Hospital	-	-	-	-	-	1	2
Balfour Hospital	-	1	-	-	-	-	-
Bannockburn Hospital	-	1	-	-	-	-	1
Belford Hospital	-	-	-	1	-	-	-
Belhaven Hospital	-	-	1	-	-	-	-
Biggart Hospital	-	-	-	2	1	-	1
Bonnybridge Hospital	-	-	-	-	-	-	1
Borders General Hospital	-	-	-	-	1	4	4
Camerone Hospital	-	-	-	-	-	-	1
Chalmers Hospital	-	-	-	-	-	-	1
Coathill Hospital	1	-	-	-	-	-	2
Community Hospital	-	-	-	-	1	-	-
Corstorphine Hospital	1	-	-	-	-	-	-
Cottage Hospital	-	-	-	-	1	2	-
Crosshouse Hospital	6	9	5	7	5	6	7
Dalrymple Hospital	-	-	-	-	-	1	-
Doctor Gray’s Hospital	-	1	-	1	-	1	-
Drumchapel Hospital	-	1	-	-	-	-	-
Dumfries/Galloway Royal Infirmary	-	5	-	1	2	9	3
Dunoon General Hospital	-	-	-	-	-	-	1
Edington Cottage Hospital	1	-	-	-	-	-	-
Ellen’s Glen House	1	-	1	1	-	1	1
Falkirk & District Royal Infirmary	-	3	3	4	3	1	5
Fraserburgh Hospital	-	-	-	-	1	-	-
Gartnavel General Hospital	4	4	2	-	2	3	11
Glasgow Royal Infirmary	5	3	2	4	10	9	9
Glenrothes Hospital	-	-	-	-	-	-	1
Hairmyres Hospital	2	1	2	2	5	11	12
Holmhead Hospital	-	2	-	-	-	-	-
Inverclyde Royal Hospital	-	1	1	1	2	3	1
Inverurie Hospital	-	-	-	-	-	1	-
Irvine Memorial Hospital	-	-	-	-	-	1	1
Kello Hospital	-	-	-	-	1	-	-
Kildean Hospital	-	-	-	-	-	1	-
Kirkcudbright Hospital	-	-	-	-	-	1	-
Kirklandside Hospital	1	-	-	2	-	1	1
Lady Home Cottage Hospital	-	-	-	-	1	-	-
Leanchoil Hospital	-	-	-	-	1	-	-
Liberton Hospital	4	4	1	10	8	12	6
Lightburn Hospital	2	2	2	2	4	4	3
Loanhead Hospital	-	-	1	-	-	-	-
Lynebank Hospital	-	-	-	-	1	1	2
Memorial Hospital	-	1	-	-	-	-	-
Monklands General Hospital	3	2	-	2	3	2	9
Montrose Royal Infirmary	-	-	-	-	1	-	-
New Royal Infirmary of Edinburgh	-	-	-	4	3	9	14
Newton Stewart Hospital	-	-	-	-	-	1	-
Ninewells Hospital	1	1	3	4	6	5	8
Perth Royal Infirmary	-	3	2	-	1	5	5
Queen Margaret Hospital	3	3	5	8	7	7	17
Raigmore Hospital	-	1	-	1	1	2	1
Roadmeetings Hospital	-	-	-	-	1	-	-
Roodlands General Hospital	1	2	-	1	-	1	4
Rosslynlee Hospital	-	-	1	-	-	-	-
Rothesay Victoria Hospital	-	1	-	-	-	-	-
Roxburghe House	-	-	-	-	1	-	-
Royal Alexandra Hospital	1	3	5	4	7	10	9
Royal Edinburgh Hospital	-	1	-	-	-	-	-
Royal Infirmary of Edinburgh	7	5	7	1	-	-	-
Royal Victoria Hospital, Edinburgh	4	5	5	2	1	14	7
Royal Victoria Hospital, Dundee	-	2	1	2	1	-	3
Sauchie Hospital	-	-	-	1	-	-	-
Southern General Hospital	-	-	1	5	3	3	4
St John’s Hospital	-	1	1	1	1	4	2
St Michael’s Hospital	-	1	-	-	-	-	-
Stirling Royal Infirmary	1	3	1	5	2	5	7
Stobhill Hospital	2	8	6	3	3	8	9
Stonehouse Hospital	-	-	1	-	-	-	-
Stracathro Hospital	1	2	-	-	-	-	-
Strathclyde Hospital	-	-	-	1	-	-	-
Udston Hospital	-	-	-	-	-	1	1
Uist And Barra Hospital	-	-	-	-	-	-	1
Vale of Leven Hospital	-	-	1	-	1	1	1
Victoria Hospital	1	-	3	4	2	1	7
Victoria Infirmary, Helensburgh	-	-	-	1	-	-	-
Victoria Infirmary, Glasgow	7	1	5	1	4	3	9
Victoria Infirmary, Glasgow, Geriatric Unit	2	1	1	1	5	3	10
Wester Moffat Hospital	-	-	-	1	1	-	-
Western General Hospital	1	5	2	7	7	10	10
Western Infirmary	1	6	-	3	3	7	1
Western Infirmary, Beatson Oncology Centre	-	-	-	1	1	1	3
Whyteman’s Brae Hospital	-	-	-	1	-	-	-
Wishaw General Hospital	-	1	10	3	4	4	5
Woodend Hospital	2	-	2	1	2	1	3
Law Hospital	1	4	-	-	-	-	-
Findlay House	-	-	-	-	-	-	1
Roxburghe House	-	-	-	-	1	-	-
Hospital Total	73	106	88	110	129	194	240
Non-hospital	5	7	6	5	12	17	13
Total	78	113	94	115	141	211	253
Proportion of all deaths	0.1%	0.2%	0.2%	0.2%	0.3%	0.4%	0.5%

Table 2: Deaths that Mention Clostridium Difficile in the Death Certificate in Scotland in 1999

Hospital	Number of Deaths
Airbles Road Hospital	1
Ayr Hospital	1
Ayrshire Central Hospital	1
Bannockburn Hospital	1
Blawarthill Hospital	1
Borders General Hospital	2
Camerone Hospital	1
Crosshouse Hospital	6
Dumfries/Galloway Royal Infirmary	2
Falkirk & District Royal Infirmary	7
Gartnavel General Hospital	1
Glasgow Royal Infirmary	8
Hairmyres Hospital	2
Inverclyde Royal Hospital	2
Liberton Hospital	1
Lightburn Hospital	5
Ninewells Hospital	2
Portree Hospital	1
Queen Margaret Hospital	3
Roodlands General Hospital	1
Royal Alexandra Hospital	1
Royal Infirmary of Edinburgh	4
Royal Victoria Hospital	1
Sauchie Hospital	1
Southern General Hospital	1
St John’s Hospital	2
Stirling Royal Infirmary	5
Stobhill Hospital	6
Stracathro Hospital	1
Victoria Infirmary, Glasgow	2
Victoria Infirmary, Glasgow, Geriatric Unit	1
Western General Hospital	1
Cowglen Hospital	1
Law Hospital	5
Hospital total	81
Non-hospital	5
Total	86
Proportion of all deaths	0.1%

Table 3: Deaths where MRSA was a Contributory Factor in Deaths in Scotland Between 2000 and 2006

Hospital		Year
Hospital	1999	2000	2001	2002	2003	2004	2005	2006
Aberdeen Royal Infirmary	4	4	3	5	3	6	4	5
Arbroath Infirmary	-	-	-	-	-	1	-	1
Ashludie Hospital	-	-	1	-	1	-	-	2
Astley Ainslie Hospital	-	-	-	-	-	2	1	-
Ayr Hospital	-	2	-	3	1	3	3	-
Ayrshire Central Hospital	-	-	-	1	-	-	-	-
Biggart Hospital	-	-	1	-	1	-	-	-
Borders General Hospital	2	2	5	2	3	-	-	4
Brechin Infirmary	-	-	-	-	1	1	-	-
Caithness General Hospital	-	-	-	-	2	2	1	4
Chalmers Hospital	-	-	-	-	-	-	-	1
Community Hospital	-	-	1	-	1	-	-	-
Cottage Hospital	-	-	1	-	-	-	1	1
Crosshouse Hospital	-	3	2	2	2	2	2	4
Doctor Gray’s Hospital	-	-	1	1	1	-	-	1
Drumchapel Hospital	-	-	-	-	-	-	1	-
Dumbarton Joint Hospital	2	-	-	-	-	-	-	-
Dumfries and Galloway Royal Infirmary	1	2	-	2	4	4	9	3
Falkirk & District Royal Infirmary	1	-	-	3	3	2	-	-
Findlay House	-	-	-	-	-	-	-	2
Fraserburgh Hospital	-	1	1	-	-	-	-	-
Gartnavel General Hospital	2	-	2	3	-	5	4	4
Gilbert Bain Hospital	-	-	1	-	-	-	1	1
Glasgow Royal Infirmary	5	2	5	6	11	8	16	10
Glen O’Dee Hospital	-	-	1	-	-	-	-	1
Glenrothes Hospital	-	-	-	-	-	1	-	-
Hairmyres Hospital	1	-	2	-	2	4	7	5
Haylodge Hospital	-	-	-	-	-	-	-	1
Ian Charles Cottage Hospital	1	-	-	-	-	-	-	-
Inverclyde Royal Hospital	-	-	1	1	1	2	1	-
Inverurie Hospital	-	-	-	1	-	1	-	-
Irvine Memorial Hospital	-	-	-	-	1	-	-	2
Jubilee Hospital	2	-	-	-	-	-	-	1
Kincardine Community Hospital	-	1	-	-	-	-	-	1
King’s Cross Hospital	-	-	2	-	-	-	-	-
Kirkcudbright Hospital	-	1	-	-	-	-	-	-
Kirklandside Hospital	-	-	1	-	-	-	-	1
Lady Margaret Hospital	-	-	-	-	-	-	1	-
Law Hospital	-	2	-	-	-	-	-	-
Liberton Hospital	1	2	1	-	3	4	2	1
Lightburn Hospital	-	2	-	-	-	-	4	-
Little Cairnie Hospital	-	-	-	-	-	1	-	-
Loanhead Hospital	-	-	-	-	-	-	-	1
Lorn & Islands District Hospital	-	-	1	-	1	-	-	-
Lynebank Hospital	-	-	-	-	1	-	-	-
Mid Argyll Hospital	-	-	-	-	-	-	1	-
Monklands General Hospital	1	3	-	6	2	5	1	5
Montfield Hospital	-	-	-	1	-	-	-	-
Montrose Royal Infirmary	-	-	-	-	-	-	2	-
New Royal Infirmary of Edinburgh	-	-	-	-	10	8	13	18
Ninewells Hospital	3	6	5	8	6	9	8	6
Perth Royal Infirmary	2	1	3	1	1	2	4	3
Peterhead Community Hospital	-	-	-	1	1	2	-	-
Portree Hospital	-	-	-	1	-	-	-	-
Queen Margaret Hospital	4	1	8	2	9	10	7	9
Raigmore Hospital	2	-	2	3	2	2	4	-
Randolph Wemyss Memorial Hospital	-	-	-	-	-	-	1	-
Ravenscraig Hospital	-	1	-	-	-	-	-	1
Roodlands General Hospital	-	-	2	-	-	1	-	-
Rosslynlee Hospital	1	-	-	-	-	-	-	-
Roxburghe House	-	-	-	1	-	-	-	-
Royal Alexandra Hospital	-	-	1	3	1	1	2	2
Royal Cornhill Hospital	-	1	-	-	1	-	-	1
Royal Hospital for Sick Children	-	-	-	-	1	-	-	-
Royal Infirmary of Edinburgh	7	9	14	14	4	-	-	-
Royal Northern Infirmary	-	-	-	-	-	-	1	-
Royal Victoria Hospital, Edinburgh	1	1	3	2	1	1	3	2
Royal Victoria Hospital, Dundee	-	1	-	-	-	2	-	1
Sauchie Hospital	-	-	-	-	-	-	1	-
Seafield Hospital	-	1	-	-	-	-	-	-
Southern General Hospital	1	1	-	-	5	5	3	5
St Brendan’s Hospital	-	-	-	-	-	1	-	-
St John’s Hospital	2	1	2	3	-	5	2	-
Stirling Royal Infirmary	-	-	3	1	-	1	3	1
Stobhill Hospital	1	1	2	1	1	2	8	4
Stracathro Hospital	1	-	-	-	-	-	-	-
Stratheden Hospital	-	-	1	-	-	-	-	-
The Orchards	-	-	-	-	-	-	1	-
The Princess Royal Maternity Unit	-	-	1	-	-	-	-	-
Ugie Hospital	-	-	-	-	-	-	-	1
Vale of Leven Hospital	3	-	-	-	3	-	1	1
Victoria Hospital	6	1	1	2	3	6	5	6
Victoria Infirmary, Glasgow	2	-	-	-	-	-	-	-
Victoria Infirmary, Helensburgh	-	-	-	-	-	-	-	1
Western Infirmary	2	1	-	1	5	5	2	2
Western Infirmary, Beatson Oncology Centre	-	1	-	1	-	-	-	1
Wester Moffat Hospital	-	-	-	-	1	-	-	-
Western General Hospital	-	1	5	12	10	5	7	6
Western Infirmary	-	3	4	1	4	4	7	9
Western Infirmary	-	-	-	-	-	-	1	1
Western Isles Hospital	-	-	1	-	1	1	2	3
Whyteman’s Brae Hospital	-	-	-	1	-	-	-	-
Wishaw General Hospital	-	-	1	3	1	3	4	3
Woodend Hospital	2	2	-	-	1	2	1	-
Hospital Total	63	61	92	99	117	132	153	149
Non-hospital	6	13	8	10	13	16	21	13
Total	69	74	100	109	130	148	174	162
Proportion of all deaths	0.1%	0.1%	0.2%	0.2%	0.2%	0.3%	0.3%	0.3%

Question reference: S3W-14693

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Thursday, 26 June 2008
Current Status: Answered by Nicola Sturgeon on 21 July 2008

To ask the Scottish Executive how many deaths have been caused by clostridium difficile in each year since 1997, broken down by NHS board.

The data in the following table were provided by the General Register Office of Scotland (GROS). It should be noted that it is unusual for clostridium difficile to be the sole cause of death as a range of contributory factors are normally involved, and it should be noted that changes in the number of cases year on year may be influenced by increased public and professional awareness of clostridium difficile and may not be a reliable indicator of the true incidence.

Between 1997 and 1999, it was also not possible to state whether clostridium difficile was the underlying cause of the death as death certificates were not recorded in this way. It is therefore only possible to provide the member with data on deaths where clostridium difficile was the underlying cause of death between 2000 and 2006. Figures for 2007 and 2008 are also not yet available from GROS.

The death certificates that have recorded clostridium difficile as the underlying cause of death between 2000 and 2006 are as follows:

NHS Board of Residence	Year
NHS Board of Residence	2000	2001	2002	2003	2004	2005	2006
Scotland	38	57	70	73	98	102	164
Ayrshire and Arran	2	7	9	5	12	3	5
Borders	2	-	1	2	-	-	3
Dumfries and Galloway	-	5	1	2	2	8	6
Fife	1	4	3	4	14	13	11
Forth Valley	6	2	3	1	4	8	8
Grampian	2	1	3	6	7	6	9
Greater Glasgow and Clyde	9	15	21	18	26	22	41
Highland	-	1	1	2	1	-	4
Lanarkshire	10	4	9	7	6	13	24
Lothian	6	11	13	20	22	22	40
Orkney	-	-	-	-	-	-	-
Shetland	-	-	-	-	-	-	-
Tayside	-	7	6	6	4	7	13
Western Isles	-	-	-	-	-	-	-

Question reference: S3W-14682

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Thursday, 26 June 2008
Current Status: Answered by Nicola Sturgeon on 21 July 2008

To ask the Scottish Executive when Health Protection Scotland met the Health Protection Agency to discuss guidance on clostridium difficile.

Health Protection Scotland (HPS) has not formally met with the Health Protection Agency (HPA) to discuss their new draft guidance on clostridium difficile, although I am advised that a member of HPS attended a conference hosted by the Health Protection Agency on 14 February at which the draft guidance was discussed.

Scottish guidance on surveillance of clostridium difficile associated disease (CDAD) has been available since the start of the mandatory CDAD surveillance programme in September 2006 and this was updated in October 2007. New guidance on CDAD in Scotland is being prepared by HPS and will be discussed at the next HAI Task Force meeting in September.

Question reference: S3W-14803

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Wednesday, 02 July 2008
Current Status: Answered by Bruce Crawford on 17 July 2008

To ask the Scottish Executive whether it will publish the criteria on which the First Minister will refer any allegations of breach of the ministerial code to the independent advisers.

Question reference: S3W-14804

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Wednesday, 02 July 2008
Current Status: Answered by Bruce Crawford on 17 July 2008

To ask the Scottish Executive what criteria will apply to the referral of allegations of breach of the ministerial code to the independent advisers by the First Minister.

Question reference: S3W-14797

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Tuesday, 01 July 2008
Current Status: Answered by John Swinney on 16 July 2008

Question reference: S3W-14337

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Wednesday, 18 June 2008
Current Status: Answered by Nicola Sturgeon on 15 July 2008

To ask the Scottish Executive, further to the statement by the Cabinet Secretary for Health and Wellbeing on the BBC's Politics Show on 15 June 2008 that she was told on Tuesday 10 June 2008 about the clostridium difficile issue at the Vale of Leven Hospital, and, in light of evidence to the contrary, whether she will withdraw her statement.

No. I clearly set out the timeline of events in my statement to the Parliament on 18 June 2008. I made clear in the BBC interview that I was first aware of the cases of clostridium difficile (C. diff) at the Vale of Leven in late May. I advised that on 6 June 2008, a local Dumbarton newspaper informed me that it intended to report a possible five deaths from C. diff at the Vale of Leven Hospital.

On 10 June 2008, the Scottish Government was advised by NHS Greater Glasgow and Clyde that, in addition to a range of other actions being taken, a full look-back review had been conducted. That review has now identified a total of 55 cases of C. diff infection from December 2007, including nine deaths where C. diff was the main cause of death and another nine cases where it was a secondary cause.

The infection control team met on 10 June 2008 and NHS Greater Glasgow and Clyde updated issued a press release on 11 June 2008. I received an interim report on the situation from NHS Greater Glasgow and Clyde on 13 June 2008 and a further report on 17 June 2008.

Question reference: S3W-14339

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Wednesday, 18 June 2008
Current Status: Answered by Nicola Sturgeon on 15 July 2008

To ask the Scottish Executive when the Vale of Leven Hospital was last deep cleaned.

I am advised by NHS Greater Glasgow and Clyde that the Vale of Leven Hospital is cleaned in accordance with The National Cleaning Specification and monitored in accordance with the National Monitoring Tool. Returns for the standard of cleanliness are submitted to Health Facilities Scotland on a monthly basis in accordance with national reporting arrangements for cleaning services.

Terminal and Isolation cleans are completed in line with NHS Greater Glasgow and Clyde Infection Control Policy Standard Operating Procedures when they are required. Terminal cleans involve domestic services and nursing staff thoroughly cleaning all surfaces and equipment within the clinical environment. This includes the removal of curtains and bed screens for laundering, beds, lockers and drip stands etc. In the majority of cases a hypochlorite based cleaning solution is used but this may vary according to any advice provided by the Infection Control Team on specific precautions to be taken.

In addition, when a patient is being treated in isolation for an infection, specific “Isolation Cleans” are carried out twice a day in the area in which the patient is being nursed. Isolation Cleans are thorough cleans of all the patient and nurse contact areas which minimise the risk of contamination.

Wards at the Vale of Leven Hospital undergo terminal cleans for a variety of reasons and I have been advised by NHS Greater Glasgow and Clyde that 13 terminal cleans have taken place in various wards at the hospital since December 2007. I am also advised that a rolling programme of terminal cleans of all wards at the Vale of Leven began on 13th June and that this was completed on 28 June 2008.

Question reference: S3W-14795

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Tuesday, 01 July 2008
Current Status: Answered by Kenny MacAskill on 15 July 2008

To ask the Scottish Executive whether it intends to provide any additional funding to police boards to cover the extra police pensions costs for 2009-10.

Question reference: S3W-14798

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Tuesday, 01 July 2008
Current Status: Answered by Kenny MacAskill on 15 July 2008

To ask the Scottish Executive whether it will provide Strathclyde Police Joint Board with additional funding to cover the cost of policing Faslane 365 protests at HMNB Clyde.

Chamber and committees