Chamber and committees

Patients are not referred under the terms of the European Cross-border Healthcare Directive. They are exercising an EU Treaty right that allows them to travel throughout the European Economic Area (EEA) to receive treatment that is the same as or equivalent to treatment that is provided by the state in their home country, and to be reimbursed on return to that country.

The home healthcare provider has no responsibility for the quality, safety, outcome or governance of the treatment sought in another part of the EEA. In considering reimbursement (which is restricted to the amount the treatment would have cost if it had been provided by the state at home) the home healthcare provider - in Scotland the relevant NHS board - must ensure that the treatment was medically necessary and that prior authorisation has been agreed (if the patient travelled for specialist treatment). The NHS board must also be satisfied with the supporting documentation from the country of treatment, before reimbursement can be paid. Scotland's European Cross-border Healthcare National Contact Point, administered by NHS inform, provides further guidance on the operation of the directive at: http://www.nhsinform.co.uk/rights/europe/.

The directive was transposed in October 2013, although since then Cross-border healthcare activity has been modest. The 14 local NHS boards would be best placed to provide numbers for both outgoing and incoming patients who have used the Directive to travel in the EEA for treatment.

Scottish Government manage and monitor the quality and capacity of trains that ScotRail is required to deliver through the franchise agreement at regular meetings.

Rail services serving Musselburgh and Wallyford station are operated with Class 380 trains which were introduced in 2010 and delivered many passenger benefits such as Wi-Fi, accessible toilets, wheelchair spaces, cycle spaces and power sockets. The on-train facilities are monitored to assess the condition under the Service Quality Incentive Regime, and where standards fail to meet the prescribed level of service, penalties are levied against the franchisee.

With regard to capacity, an investment of £475 million in train improvements is being made resulting in more trains, more seats and more services across Scotland. By early 2018 the new longer, greener, quicker Class 385 trains will serve communities in East Lothian. On peak services when the new six car Class 385 replace Class 380 trains, more than 40% extra seats will be provided. From now until then, ScotRail are committed to ensuring they lay on as much capacity as possible from their current rolling stock to meet passenger demand.

National Health Service (Scotland) Act 1978 already states that Scottish Ministers have a duty to secure improvement in the physical and mental health of the people of Scotland. It does not distinguish between the two, nor does it place a higher importance on one over the other. The 1978 Act also states Scottish Minsters have a duty to secure the prevention, diagnosis and treatment of illness, and for that purpose to provide or secure the effective provision of services in accordance with the provisions of the Act. Illness in the 1978 Act is defined as including mental disorder within the meaning of section 328 of the Mental Health (Care and Treatment) (Scotland) Act 2003.

We will also consider how we further improve the physical health of people with mental health problems to address premature mortality as part of ten year vision for mental health in Scotland due for publication later in 2016.

The Scottish Government is committed to improving the quality of care in Scotland and we meet regularly with COSLA, Scottish Care, Coalition of Care and support Providers in Scotland and other key stakeholders in order to do this.

As part of this partnership approach the Scottish Government is a member of the National Contingency Planning Group, which includes providers and is chaired by COSLA. The group works with stakeholders in identifying potential risks which could lead to the disruption of adult social care provision in Scotland.

We are also working with COSLA and care providers to deliver a major programme of reform to adult social care. These reforms will maintain the continuity, stability and sustainability of residential care provision while embedding greater local flexibility, maximising efficiency, improving quality, enhancing personalisation and promoting innovation.

Each Health and Social Care Partnership is required by the Public Bodies (Joint Working) (Scotland) Act 2014 to put in place a strategic commissioning plan for the integrated functions and budgets that they control.

Before undertaking the strategic commissioning plan, partnerships are required to undertake a strategic needs assessment which considers: needs; population dynamics and projections; service activity; supply and demand; and gaps in provision. This informs their strategic commissioning plan and shapes services and support to deliver better outcomes. It will be for partnerships to determine the need for care home places in their localities and to work collaboratively with others, including providers, to meet that need.

In line with our vision, Scottish Government policies are enabling more people to live longer and more independently in their own homes, which results in fewer people needing residential care. We are providing more than £0.5 billion additional funding over three years to help Health and Social Care Partnerships establish new ways of working, and investing a further £250 million per year to protect and grow social care services.

The consultation document makes it very clear that the proposal relates to cleft surgery only. The consultation document can be accessed at: http://www.nsd.scot.nhs.uk/news/index.html

Clear and categoric assurances that, with the exception of surgery, all other cleft services will continue to be delivered locally have been given throughout this process in correspondence with campaigners and MSPs. These assurances have also been given to the National Specialist Services Committee and NHS board Chief Executives, during their consideration of the proposal. The decision whether to accept the proposal rests with Ministers. I will make my decision in due course.

NHS funded fertility preservation is currently offered to patients diagnosed with cancer on a case-by-case basis. This is for clinical reasons, and referring clinicians should take into account a patient's diagnosis, prognosis of cancer treatment and age.

A Scottish Government led working group is being set up to look at access and draw up protocols for fertility preservation for patients with serious medical conditions, prior to fertility compromising treatment or surgery.

The following table shows the number of laboratory confirmed diagnoses of borrelia infection each year but there will be cases which are not captured by surveillance. This is because current guidance states that if a patient presents to their healthcare professional with a history of a tick bite and erythema migrans (rash), antibiotic treatment should be recommended immediately. This treatment renders subsequent samples non-diagnostic and therefore not recorded by surveillance systems.

The information requested is not held centrally. The Scottish Government funds the Scottish Library and Information Council to provide independent advice to the Scottish Government on library and information services and to act as a leadership body for the sector. Details of library closures for all parts of the UK since 2010 is provided in the following table:

*No return in 2014-15. Libraries across NI operate as single service. Confirmed current figure is 98.

(information provided by SLIC utilising CIPFA data)

SLIC can provide information on the local library landscape in Scotland, and can be contacted using the details below:

Pamela Tulloch

Chief Executive Officer

Scottish Library and Information Council

Suite 2.4

Turnberry House

175 West George Street

Glasgow

G2 2LB

t: 0141 202 2999

e: [email protected]