Chamber and committees

The Scottish Government is committed to taking forward the recommendations from Dr Brian Montgomery’s Review of Access to New Medicines.

I wrote to the Health and Sport Committee on 16 November 2017 to provide an update on the Scottish Government’s progress on implementing the recommendations and I plan to provide the Committee with a further update in Spring 2018 as we continue to take this work forward at pace in collaboration with our stakeholders.

The National Code of Practice for GP Premises sets out the measures the Scottish Government will provide to assist GPs who own their premises. These measures include interest-free secured loans to be resourced through the new GP Premises Sustainability Fund.

The secured loans will be for an amount of up to 20% of the Existing-Use Value of the premises.

All GPs who own their premises will be eligible to receive a GP Sustainability Loan by 31 March 2023.

As the estimated Existing-Use Value of the GP owned estate is around £200 million, the fund is likely to require £8 million a year (£200 million divided by 5 years multiplied by 20%) to ensure loans are available to all GPs who own their premises by 31 March 2023.

£30 million over the next three years represents substantial progress towards the commitment that the Scottish Government will support a shift, over 25 years, to a new model in which GPs will no longer be expected to provide their own premises.

Influenza viruses change all the time, and each season more than one strain of flu virus will circulate. Different flu strains may have a different impact on population groups within Scotland, and this in turn can lead to variation in the impact on health services from year to year. This year, to date, influenza A(H3N2) has been the dominant strain, and this more severely impacts the elderly.

The annual variation in circulating viruses presents a significant challenge. We do not know which flu viruses will be circulating but we do have a robust surveillance programme in place, monitored by Health Protection Scotland to provide early intelligence.

At the end of each flu season an annual review is undertaken across the UK with a combined annual report produced by Public Health England with contribution from Health Protection Scotland and each of the other Devolved Administrations. This work informs activities and planning for the following season. This year’s annual report will be published in the summer.

Our cancer strategy, ‘Beating Cancer: Ambition and Action’ and the accompanying £100 million investment over the coming years serves as a blueprint for the future of cancer services in Scotland, improving the prevention, detection, diagnosis, treatment and aftercare for all people with cancer, including those with less survivable cancers.

Two of the overarching aims of the cancer strategy are for more people to survive cancer for 1, 5 and 10 years, and to close the gap in survival between Scotland and the best countries in Europe; and we are determined to make this happen.

Our tax plans for 2018-19 were announced as part of the Budget and were formulated to protect and promote the level of public services the people of Scotland expect; to ensure the lowest earning taxpayers are protected and don’t see their taxes increase; to make the tax system more progressive and reduce inequality: and, together with our corresponding decisions on spending, to support the economy.

If the Scottish Government were to match the UK government plans for tax in devolved areas in 2018-19, this would result in a reduction in available public spending of £501 million, which is the equivalent of around 12,000 nurses.

Clinical nurse specialists make a valued contribution to delivering services and supporting patients and families who require specialist care. The Scottish Government has invested £2.5 million annually in the Specialist Nursing and Care Fund since 2015. The majority of this funding (£2.2m) has been transferred to NHS Boards' baseline funding.

As of May 2017, reports from NHS Boards show that specialist nursing capacity had been enhanced through the additional investment from the fund by 31.35 WTE and these roles are supporting and caring for patients and families affected by a wide range of conditions, across the life spectrum and across hospital and community settings.

In addition, and as part of the wider effort, the Scottish Government has fulfilled its pledge to double the number of Motor Neurone Disease (MND) clinical nurse specialists and ensure that they are paid from public funds.

A report of how NHS Boards used the additional funding (as at May 2017) can be found in the 'Report on the Specialist Nursing and Care Fund' published in September 2017 which can be accessed via this link http://www.gov.scot/Publications/2017/09/7753

NHS Lothian have taken a number of steps over the years to maintain and control parking to ensure that available spaces at St John's are used by legitimate users (patients, visitors and staff) while deterring the use of the car park by non hospital users, but there is a balance between deterring non-hospital users and creating unnecessary congestion. In the longer term, the Board, as part of a possible expansion of clinical services at the site, will look at additional car parking options and any schemes brought forward by them will be considered by the Scottish Government.

NHS Lothian advise that since the publication of the Royal College of Paediatrics and Child Health Report in 2016, the Board has undertaken six rounds of consultant recruitment, which has resulted in six consultants being in post. The Board continue to advertise for consultants on a planned regular basis.

It has been confirmed by NHS Lothian that in 2017 it recruited for two International Medical Fellowship Trainees without success. The Board intends to recruit through this scheme in 2018. Given that no trainees were recruited in 2017, NHS Lothian intends to use a different approach which is to advertise for fellowship posts linked to academic departments within the Board.

To support the Children's Ward at St John's, NHS Lothian advise that it is committed to strengthening its Advanced Nurse Practioner (ANP) workforce, with two internal members of staff currently being trained to undertake this role within the Children’s Ward. These members of staff are scheduled to be fully qualified during the winter of 2018. The Board's intention is to run an advertising campaign in 2018 for qualified ANPs whilst continuing to offer staff internally the opportunity to train as ANPs. These posts would support the Children's Ward at St John's Hospital.

Civil servants abide by the Civil Service Code, which expects them to act with integrity, honesty, objectivity and impartiality. In particular, civil servants are asked to set out relevant issues truthfully, and must not mislead Ministers or be influenced by improper pressures. Civil servants must provide information and advice on the basis of evidence, and accurately present opinions and facts.

The Civil Service Code can be viewed here: https://beta.gov.scot/publications/civil-service-code/

Any Minister who has concerns about advice given by Scottish Government officials should raise the issue with the relevant senior official at the time the advice is offered.

The Scottish Government does not hold information on the structured diabetes education offered by individual NHS Boards. NHS Boards are responsible for delivering structured education tailored to suit local circumstances.

The Scottish Diabetes Survey includes the "Percentage of people with diabetes who have ever attended Level 3 structured education - presented in defined age ranges".

The Scottish Intercollegiate Guidelines Network (SIGN) evaluated the evidence relating to its effectiveness in helping to prevent other serious diabetes-related conditions prior to its inclusion in their national clinical guidance on diabetes, SIGN 116.

In Scotland, the Diabetes Education Advisory Group provides support to NHS Boards, for example, accreditation of local courses to ensure a consistent high standard.