Questions and answers

Question reference: S5W-11988

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Thursday, 12 October 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government what action can be taken if an approved medical practitioner grants a short-term detention certificate after erroneously considering that the requisite conditions to do so have been met.

The Mental Health (Care and Treatment) (Scotland) Act 2003 requires orders such as short-term detention certificates to be kept under review and revoked or varied as appropriate. Where a patient or named person does not think the requisite conditions for a short-term detention certificate have been met, it is open to them to appeal the decision to the Mental Health Tribunal. The Tribunal shall revoke the certificate if not satisfied that the requisite conditions have been met.

An approved medical practitioner can revoke a short-term detention certificate at any point during the maximum 28 day period if detention criteria are no longer met, this will include situations where they originally believed that the conditions had been met.

Mental health law in Scotland is based on rights and principles and offers patients significant safeguards where compulsory treatment is necessary. Safeguards include a right to independent advocacy and an efficient and independent Mental Health Tribunal which grants and reviews orders for compulsory treatment.

Question reference: S5W-11983

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Thursday, 12 October 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government what its position is on whether compulsory mental health treatment can begin prior to the facts concerning the patient being established, and whether it considers that doing so would be consistent with the legislation, which suggests that such treatment should only be allowed in very strict circumstances.

Mental health law in Scotland is based on rights and principles and offers patients significant safeguards where compulsory treatment is necessary. Safeguards include a right to independent advocacy and an efficient and independent Mental Health Tribunal which grants and reviews orders for compulsory treatment.

For example, a short-term detention certificate (STDC) should be the usual route into hospital for someone who needs compulsory treatment. The STDC offers several safeguards for the person. Before granting the certificate, the doctor must consult a mental health officer (MHO) and get her or his agreement. In deciding whether to agree to the certificate, the MHO should speak to the patient in person, unless there is a good reason why they cannot do this.

The patient or the patient’s named person can appeal to the Mental Health Tribunal to have the STDC revoked. Additionally, the patient has a right to support from an independent advocate. The independent body, the Mental Welfare Commission for Scotland monitors the use of Scottish mental health law, including compulsory treatment. The Commission also has the power to intervene in particular cases if there is evidence of improper care, treatment or practices.

Question reference: S5W-11984

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Thursday, 12 October 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government what its response is to concerns that proper enquiries are not always made prior to a mental health officer consenting to the grant of a short-term detention certificate by an approved medical practitioner.

A short-term detention certificate (STDC) should be the usual route into hospital for someone who needs compulsory treatment. The STDC offers several safeguards for the person. Before granting the certificate, the doctor must consult a mental health officer (MHO) and get her or his agreement. In deciding whether to agree to the certificate, the MHO should speak to the patient in person, unless there is a good reason why they cannot do this. Where possible, the doctor should also consult the patient’s named person, and most recent data shows that named persons are consulted in around half of cases where an STDC is made.

Once an STDC is granted, it can be revoked at any time by the patient’s responsible medical officer if they think it is no longer needed. The patient or the patient’s named person can appeal to the Mental Health Tribunal to have the STDC revoked. Additionally, the patient has a right to support from an independent advocate.

It is the responsibility of local authorities to plan their Mental Health Officer (MHO) workforce, ensuring they have the appropriate levels of staff in place to provide services for their residents. The Scottish Government recognises the invaluable contribution made by this workforce to improving the lives of mental health patients and their friends and families.

Question reference: S5W-11985

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Thursday, 12 October 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government, in light of the requirement under the Human Rights Act 1998 that public authorities must take account of the case-law of the European Court of Human Rights (ECHR), what action it has taken to ensure that the NHS is aware of the ECHR case law suggesting that courts should take account of a person raising an action concerning being given non-consensual treatment before having an opportunity to appeal and, in light of this, what its response is to concerns that its mental health legislation permits such treatment to be made in these circumstances.

Scottish mental health and incapacity legislation is based on rights and principles. Our legislation is compliant with the European Convention on Human Rights and has never been found, in part or in whole, by the European Court of Human Rights to be incompatible with the Convention.

Most people who use mental health services receive treatment without being subject to an order or certificate under mental health legislation For some individuals however, compulsory treatment is used to provide the person with medical treatment to alleviate suffering and for the protection of both the person and others. Compulsory treatment is only allowed under mental health legislation in Scotland in very strict circumstances.

Certain criteria must be met before an order or certificate can be granted. For a
28 day short-term detention certificate (STDC), this includes that an approved medical practitioner considers it likely that the patient has a mental disorder (as defined by the Mental Health (Care and Treatment) (Scotland) Act 2003) and that the patient’s decision making ability is significantly impaired by their disorder and without treatment the patient could be of significant risk to their own health, safety and welfare, or to the safety of others, and that detention in hospital is necessary. Note that a patient can apply to the independent Mental Health Tribunal for the measure which authorises his or her detention in hospital to be revoked or varied.

While detained in hospital, patients may have capacity to consent to treatment and the 2003 Act sets out safeguards around obtaining consent and the strict procedures around giving treatment where consent is not given or is refused. Treatment authorised by the 2003 Act, or the Criminal Procedure (Scotland) Act 1995 may only be given in accordance with the range of safeguards set out in part 16 of the 2003 Act.

Public authorities, including NHS boards, are required by the Human Rights Act 1998 to act in a way that is compatible with the European Convention on Human Rights and will need to satisfy themselves that they do so, taking into account any relevant judgements of the ECHR.

Question reference: S5W-11986

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Thursday, 12 October 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government, in light of the requirement under the Human Rights Act 1998 that public authorities must take account of the case-law of the European Court of Human Rights (ECHR), what action it has taken to ensure that the NHS is aware of the 2012 ECHR judgement in the case of (a) X v Finland, which found that the forced medical intervention had interfered with X's physical integrity and (b) Gorobet v Moldova, which found that forced treatment that had not been shown to be a medical necessity could amount to degrading treatment.

Scottish mental health and incapacity legislation is based on rights and principles. Our legislation is compliant with the European Convention on Human Rights and has never been found, in part or in whole, by the European Court of Human Rights to be incompatible with the Convention.

Public authorities, including NHS boards, are required by the Human Rights Act 1998 to act in a way that is compatible with the European Convention on Human Rights and will need to satisfy themselves that they do so, taking into account any relevant judgements of the ECHR.

Scottish mental health and incapacity legislation sets clear safeguards which apply to ensure that any treatment given to patients subject to compulsory measures is compatible with Convention rights.

Question reference: S5W-11700

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Friday, 29 September 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government what consideration it has given to the possibility that administering medication covertly to an individual might be incompatible with Article 8 of the European Convention on Human Rights, which relates to an individual's right to respect for private life.

I refer the member to the answer to question S5W-11345 on
27 September 2017. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx

Scottish mental health and incapacity legislation is based on rights and principles. We believe that the 2003 Act is fully compliant with the European Convention on Human Rights (ECHR). The 2003 Act has never been found, in part or in whole, by the European Court of Human Rights to be not compliant with ECHR

The most recent reform of mental health legislation was through the Mental Health (Scotland) Act 2015, which was passed by the Scottish Parliament last year. The 2015 Act strengthened measures in the Mental Health (Care and Treatment) (Scotland) Act 2003 that promotes support for decision making, including those for independent advocacy, advance statements and named persons.

Question reference: S5W-11519

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Monday, 25 September 2017
Current Status: Answered by Aileen Campbell on 26 October 2017

To ask the Scottish Government, further to the answer to question S5W-06124 by Shona Robison on 25 January 2017, whether it will provide the uptake rates for 2016-17.

(a) Shingles uptake 2016-17

Further to S5W-06124, vaccination uptake rates for the 2016-17 shingles vaccination programme are not yet available, however provisional uptake rates until the end of March 2017 can be found at: http://www.hps.scot.nhs.uk/immvax/shinglesvaccination.aspx. Publication of the annual report for the 2016-17 programme, including final uptake rates, will be made available in November 2017.

(b) Flu uptake 2016-17

Further to S5W-06124, influenza vaccine uptake for 2016-17 is provided in table 1.

Table 1: Influenza vaccine uptake in Scotland by eligible group in 2016-17

Eligible group	2016-17
65 years and older	73%
Under 65 at risk	44.9%
2 to under 5 year old children not yet in school	59%
Full primary school implementation	73%

Question reference: S5W-11668

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Friday, 29 September 2017
Current Status: Answered by Maureen Watt on 26 October 2017

To ask the Scottish Government how many people with eating disorders have received NHS support in each year since 1999, broken down by NHS board.

This information has been provided by ISD. ‘NHS support’ has been defined as the number of acute and mental health inpatients with a diagnosis of eating disorder recorded within data returns to ISD. This information is shown in the following table for the financial years 1999-2000 to 2015-2016, broken down by NHS board of treatment. Please note that the figures for the financial year 2016-17 have not yet been published.

Extract Date: October 2017

Number of patients diagnosed with eating disorders¹ by health board of treatment, 1999-00 – 2015-16².

	1999-00	2000-01	2001-02	2002-03	2003-04	2004-05	2005-06	2006-07	2007-08	2008-09	2009-10	2010-11	2011-12	2012-13	2013-14	2014-15	2015-16
Golden Jubilee National Hospital	-	-	-	-	-	-	*	-	*	-	-	*	-	-	*	*	*
NHS Ayrshire & Arran	19	12	15	19	27	9	30	16	38	28	26	51	30	31	34	33	17
NHS Borders	*	*	*	*	*	*	*	*	*	*	5	11	17	13	14	15	10
NHS Dumfries & Galloway	8	12	10	14	21	13	7	*	13	9	12	15	*	6	18	30	22
NHS Fife	26	24	10	9	16	*	8	*	22	23	18	11	18	26	34	38	26
NHS Forth Valley	14	10	17	8	12	8	12	6	*	9	10	7	18	12	18	13	5
NHS Grampian	39	17	15	32	49	39	37	49	66	41	60	63	51	59	77	68	70
NHS Greater Glasgow & Clyde	65	91	67	89	73	70	70	90	92	114	78	81	87	89	100	133	153
NHS Highland	13	25	13	26	16	28	25	22	20	38	36	29	60	67	50	79	86
NHS Lanarkshire	8	10	9	14	16	23	71	35	20	14	19	24	44	32	25	37	32
NHS Lothian	37	56	47	50	65	86	81	82	85	83	102	82	74	84	77	91	84
NHS Orkney	-	-	-	-	*	-	-	*	-	*	*	*	*	6	6	6	*
NHS Shetland	-	*	-	*	-	*	-	-	-	*	*	6	*	*	*	*	*
NHS Tayside	7	*	11	15	11	18	8	22	32	13	21	34	30	38	25	30	45
NHS Western Isles	*	*	*	*	-	*	*	*	-	-	*	*	-	*	-	*	-
Non-NHS Provider	95	104	74	78	75	90	79	75	77	89	89	93	117	124	151	165	170
Annual Total	334	371	296	359	384	390	436	410	473	470	484	511	557	590	633	742	726

Source: SMR01, SMR04

Notes

* - Denotes values which have been suppressed to protect patient confidentiality.

1 - An eating disorder diagnosis is based on current classifications in Chapter V of the ICD-10 Classification of Mental and Behavioural Disorders.

2 - The analyses are based on financial years, e.g. 2015-16 is 1 April 2015 to 31 March 2016.

Question reference: S5O-01375

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Wednesday, 25 October 2017
Current Status: Taken in the Chamber on 2 November 2017

To ask the Scottish Government what action it is taking to reduce waiting times for orthopaedic treatment.

Question reference: S5W-11666

Asked by: Miles Briggs, MSP for Lothian, Scottish Conservative and Unionist Party
Date lodged: Friday, 29 September 2017
Current Status: Answered by Shona Robison on 25 October 2017

To ask the Scottish Government how many receptionists in each NHS board have been trained in phlebotomy (drawing blood and taking blood samples) in each year since 2007

Chamber and committees