Chamber and committees

While there has been considerable interest in Scotland in the potential adoption of transcatheter aortic valve implantation (TAVI), this is a new technology the introduction of which requires expert opinion. NHSScotland''s National Planning Forum (NPF) has therefore performed a comprehensive review of TAVI, looking at the technology''s efficacy and safety, its cost and service design requirements, and potential future demand.  

The NPF has concluded that there is insufficient evidence, at this point in time, to support a recommendation that a TAVI service should be established in Scotland, on the basis that long term outcomes are unknown, there is only limited evidence of clinical efficacy and no evidence of cost effectiveness. The position is endorsed by the review of the available clinical and cost effectiveness evidence carried out by the Scottish Health Technologies Group.

I have therefore decided to accept this expert advice, but on the clear understanding that the position must be reviewed no later than in one year''s time, or sooner, should further evidence become available. I have asked that relevant clinicians are fully involved in the review of this evidence.

NHS boards will continue to ensure that local arrangements are in place so that people with severe aortic stenosis get access to appropriate clinical treatment. As part of those arrangements, it will still be possible for potential TAVI patients and their doctors to apply, through individual patient treatment request panels, for a consideration of their clinical case.

The most recent advice to NHS boards on transcatheter aortic valve implantation (TAVI) was issued by the Scottish Health Technology Group (SHTG) on 5 August 2010. The SHTG advice statement noted that transcatheter aortic valve implantation (TAVI) is not recommended for use for the treatment of patients with aortic stenosis. The statement can be accessed at:

http://www.nhshealthquality.org/nhsqis/files/TAVI_AdviceStatement_050810.pdf.

The Making Difficult Decisions in NHS Boards in Scotland report, published in March 2010, gives NHS boards outline guidance on managing individual patient decisions in relation to both medicines and technology.

As a result the Scottish Government has not incurred expenditure against the categories on the returning officer''s forms for these elections.

The Scottish Government did, however, contribute approximately £4.8 million to the cost of the electronic counting system for the 2007 elections.

The Scottish Parliament itself also provides public information on the workings of the Parliament and the voting system.

The Minister for Environment, Roseanna Cunningham MSP, met with stakeholders on 6 January 2010 to discuss developments in bee health. The Minister made it clear that the Scottish Government was not in a position to offer financial support for European Foulbrood control or compensation to businesses. The Minister agreed that we would look at spend under the EU Apiculture programme; stated that we had committed additional resources for bee inspectors, and that we would develop and enhance our existing resources while working with the industry on a disease control plan for 2010 and on the issue of antibiotic residues. The Minister also stated, without making firm commitments, that we would consider how to support working groups for the Bee Health Strategy and consider the issues raised in the paper tabled by the Bee Farmers Association at the meeting. The Scottish Government will also continue to develop the Bee Health Strategy within the resources available.

In addition the Scottish Government funded full time apiculture specialist at the Scottish Agricultural College liaises with stakeholders frequently during the provision of training, education and advice.

The UK Transcatheter Aortic Valve Implantation (TAVI) Registry shows that, in 2009, 12 people were referred by NHS boards to a centre in England for transcatheter aortic valve implantation TAVI.