Chamber and committees

We are building a sustainable medical workforce for the future. We welcome students from Scotland, the rest of the UK and EU who want to study and work in NHS Scotland and are taking a number of actions to encourage this. To increase supply and widen access we are investing £23 million in an education package which includes an increase of 50 medical undergraduate places from 2016-17, the establishment of Scotland’s first graduate medical entry programme and a pre-medical entry programme.

The State of Nature 2016 Scotland Report has highlighted the challenges which lie ahead in conserving Scotland’s wonderful nature. We are committed to driving forward Scotland’s Biodiversity Strategy - the ‘2020 Challenge for Scotland’s Biodiversity’ published in 2013, which sets out the major steps needed to improve the state of nature in Scotland - and the accompanying ‘Scotland’s Biodiversity - a Route Map to 2020’ published in 2015. The Route Map helps direct priorities for action and sets out six Big Steps for Nature and a number of priority projects associated with them.

The planning and implementation of the Route Map takes a cooperative approach between the Scottish Government, its agencies, environmental non-governmental organisations (NGOs) and others with a key role or interest in looking after Scotland’s biodiversity. The work is being led and coordinated by Scottish Natural Heritage (SNH). Implementation of the Route Map will contribute to Scotland meeting our international commitments on biodiversity. Many of the Route Map Priority Projects will help to protect plant and animal species, for example, Priority Project 9 on the conservation of priority species is particularly focussed on delivering this. Work is ongoing to protect species and enhance habitats, including freshwater pearl mussel, breeding seabirds on the Shiant Islands and red squirrels.

Progress under the National Peatland Plan has already exceeded the Route Map target and restored more than 5,000 hectares of peatland. The Peatland Action project, led by SNH, was recently awarded the Best Practice - Large Scale Conservation Award for 2016 by the Chartered Institute of Ecology and Environmental Management. We have also achieved and surpassed our action to ensure that at least 18% of land and freshwater is under conservation designation. Indeed Scotland is leading globally with protection of 23% of our land and freshwaters and 16% of our marine waters. The main headline from the recent IUCN World Conservation Congress, which closed last week, highlights that the terrestrial and inland waters figure globally has reached 15%.

As part of its role on reporting regularly on progress with the Scottish Biodiversity Strategy and the Route Map to 2020, SNH published a six month progress report in November 2015. It reported on progress on the Route Map’s 12 Priority Projects and 64 route map actions undertaken through partnerships and collaborative working across the public, private and third sectors. The Route Map to 2020 first year report will be published shortly. Preliminary outcomes of this report suggest that nearly 80% of the actions included in the Route Map are on track to achieve or exceed their target. A report of progress towards the international ‘Aichi’ biodiversity targets will also be published shortly.

Sport Scotland, the national agency for sport, invests both Scottish Government and National Lottery monies into Scottish governing bodies of sport. The Camanachd Association (CA) is the governing body for the sport in Scotland and is responsible for the promotion of its activities.

Between 2007 and 2015 sportscotland invested £991,770 in the Camanachd Association. sportscotland’s investment into the governing body for the 2015-18 investment cycle is up to £546,000. Investment beyond 2017-18 has not yet been confirmed.

*15 month investment due to sportscotland investment realignment

We know that the earlier cancer can be diagnosed, the better the chance of a positive outcome. Scottish Government initiatives such as the Detect Cancer Early programme aim to raise awareness of all cancers amongst the public and health care practitioners, so as to lead to earlier diagnosis and treatment.

Our ‘Beating Cancer: Ambition and Action’ strategy and the accompanying
£100 million investment over 5 years serves as a blueprint for the future of cancer services in Scotland, improving the prevention, detection, diagnosis, treatment and aftercare for people who may be suspected to have/or who have a confirmed diagnosis of cancer of any type.

The manufacturers route to market for Kadcyla is through the long standing independent Scottish Medicines Consortium (SMC) process. In October 2014 the SMC decided not to recommend Kadcyla for routine use in Scotland because the balance of costs and benefits meant it was not considered to offer value for money. We understand the company will be making a resubmission to SMC this autumn and we would encourage them to do so at a fairer price so that patients across Scotland can have the opportunity to benefit from more treatment options which could give them precious extra time with their families and loved ones.

In recent years the Scottish Government have made significant reforms and investment to improve access to newly licensed medicines. As a result Scotland is now one of the top nations in the world for accessing new medicines for cancer. However, we do think that more can be done to build on the progress made to date which is why we asked Dr Brian Montgomery to conduct an independent review which will report soon.

Following an SMC decision not to recommend a medicine, NHS boards do have systems in place which can provide access to newly licensed medicines on an individual patient basis and where the patient’s clinician considers this to be appropriate. Where such alternative prescribing options are used the Scottish Government’s New Medicines Fund is available to support the cost of Kadcyla.

Exact plans for where, when and the range of disciplines that will make up this figure will depend on radiotherapy demand and capacity plans and delivery over the next five years as part of the implementation of the Scottish cancer strategy. Our Radiotherapy Sub-Group is now up and running and will make investment recommendations across the Scottish radiotherapy service.

The descriptions of the Wild Land Areas identified on the Scottish Natural Heritage 2014 map are currently in preparation. The descriptions are detailed and require technical input. We expect that these descriptions will be published later in 2016.

It is right that all NHS boards keep services under review to ensure they remain safe, sustainable and of the highest quality. The planning and provision of local healthcare services are for NHS boards and their planning partners, in line with national policies, guidelines and frameworks.

The legal basis used to underpin the current authorisation regime and guidance on service change is founded in NHS boards’ statutory duties of participation, i.e. the public involvement duties given to them in the NHS Reform (Scotland) Act 2004. The Scottish Health Council (part of Healthcare Improvement Scotland) was established in statute to support and advise NHS boards’ practice and to quality assure the public involvement process.

Within this context, NHS boards adhere to national guidance (CEL (2010) 4) which can be accessed at: http://www.sehd.scot.nhs.uk/mels/CEL2010_04.pdf. This guidance details expectations around appropriate public engagement in potential service change. Such potential changes are designated either major or non-major. Cases designated as major must be informed by formal public consultation (usually no less than three months) and are ultimately subject to ministerial approval.