Chamber and committees

Scottish and UK Government Officials are currently working in partnership with Network Rail and HS2 Ltd to identify options that could be implemented between 2019 and 2029 to improve journey times, capacity, resilience and reliability on routes between England and Scotland. The Scottish Government's ambitions for high speed rail services in Scotland are being pursued as part of that North of HS2 to Scotland Working Group.

The Queensferry Crossing is expected to be fully open to traffic in May 2017, ahead of its June contractual completion date and is being delivered £245 million under budget since construction started in June 2011.

I requested that the ScotRail Alliance to put together an improvement plan. This plan was published on 29 November 2016 and can be accessed from the following link:https://www.scotrail.co.uk/about-scotrail/how-were-performing

Both myself and officials at Transport Scotland continue to work with ScotRail as it progresses the various elements of the improvement plan.

The Scottish Government’s investment in Prestwick Airport is on a commercial basis, in the form of loan funding. Scotland's Budget: Draft Budget 2017-18 allocates loan support of £9.4 million for the airport in 2017-18.

Pricing of telecoms services is a reserved matter which falls within the remit of Ofcom, the UK telecoms regulator. Whilst telecoms providers in the UK do not differentiate pricing on a geographic basis, we accept that there is generally less competition in rural areas, which can adversely affect consumers.

We have asked Ofcom to assess telecoms markets at a more granular level to uncover differences in the way they operate across the UK, and to consider regulatory remedies to take account of, and address, market failure in any areas where there is limited competition at both the infrastructure or services layers.

The Draft Budget 2017/18, announced in Parliament on 15 December 2016, indicated that the baseline allocation for NHS Ayrshire and Arran will increase to a total of £682.1 million. Subject to parliamentary approval, the Budget (Scotland) Bill 2017/18 will confirm the baseline budget for boards; including each board’s share of NRAC parity funding.

NHS boards are expected to remain within their financial resource limits, ensuring they are spent in a way that improves the health and wellbeing of the community whilst delivering best value for taxpayers.

The Government remains in close contact with all Health Boards, including NHS Ayrshire & Arran, to scrutinise and support their performance, in line with the commitments to national standards set out in Local Delivery Plans and reiterated at Annual Reviews.

In terms of the financial resources provided under this Government, NHS Ayrshire & Arran’s resource budget has increased by £172.1 million from £496.9 million to £669.0 million; a cumulative cash increase of 34.6%, and a cumulative real terms increase of £82.2m (14.0%). In 2016-17, the Board’s annual resource budget increased by 5.3% to £669.0 million; an above inflation increase, having previously increased by 2.7% in 2015-16. As announced in the Draft Budget for 2017-18 in Parliament on 15 December 2016, the baseline allocation for NHS Ayrshire and Arran will increase to a total of £682.1 million. In addition to this increase, the Board can also expect to receive an additional £1.5 million of recurring NRAC parity funding. NHS Ayrshire and Arran are currently projecting a deficit of £13.3 million for 2016-17. The Board has prepared plans for transformational change with the intention of returning to recurring financial balance over the coming three years. The additional funding announced in the draft budget will contribute towards the Board's planned recovery. The Scottish Government will continue to support and assist NHS Ayrshire and Arran in returning to financial balance.

On staffing, it should also be recognised that, under this Government, the number of all staff in NHS Ayrshire & Arran has risen 6.3% or 507.3 WTE (from 8,114.1 to 8,621.4); with medical and dental consultants up 59.5% or 107.7 WTE (from 180.9 to 288.6), and emergency medicine consultants up 143.0% or 9.0 WTE (from 7.0 to 17.0).

As relates to the BBC investigation, I have been clear that the safety of expectant mothers and their babies is of paramount importance; I want to ensure that Scotland is as safe a place as possible for mothers to give birth. That is why I have asked Healthcare improvement Scotland (HIS) to review the quality of care and processes for managing adverse events within maternity services in NHS Ayrshire and Arran. The terms of reference for the review are published on the HIS website. HIS will report back in March 2017, after which I have offered to discuss those findings with the families concerned. Our national Maternity and Neonatal Services Review will also be published in the New Year; it will make recommendations on how services can be further improved, ensuring models of care that continue to deliver high quality, safe services.

In terms of waiting times I have been consistently clear that this Government remains wholly committed to ensuring all patients have swift and safe access to the full range of services from NHS Scotland; long waits for any patient are completely unacceptable. In the current year the Government has made available £3.7 million to address waiting times in Ayrshire and Arran; this includes £2.2 million from the additional £10 million announced on 21 November to address outpatient waiting times. On 29 November I announced a plan to deliver a major shift in the way outpatient care is delivered, giving patients faster and more local access to care. The Modern Outpatient: A Collaborative Approach 2017-2020 sets out a new strategy for responding to rising demand and aims to free up 400,000 hospital outpatient appointments by 2020. The strategy proposes that some patients, particularly those who are waiting for a routine check-up or test results, would be seen closer to home by a team of community healthcare professionals with close links to hospital departments. The NHS will also make better use of e-consultations and action will be taken to reduce the number of unnecessary referrals. Furthermore, I have also announced that the Scottish Government is providing an additional £10 million to address outpatient waiting times; this includes £2.2 million to help NHS Ayrshire & Arran reduce long waits over the coming months.

Turning to Accident and Emergency performance in NHS Ayrshire & Arran, whilst there has been some improvements – with performance against the 4-hour standard for the year to October 2016 (91.7%) more than three percentage points better than the equivalent period last year and the number of long delays of more than eight and twelve hours reducing by around 20% and 11% respectively over the same period – there is still too much variability. Performance is generally better at University Hospital Crosshouse which has benefited from the opening of the new Combined Assessment Unit in April. Performance at University Hospital Ayr has been more challenging. The national Unscheduled Care Team will continue to work closely with the Board to support implementation of the six Essential Actions across both sites; to monitor progress; and to offer on-going assistance and support.

Whilst it is right to challenge Boards in areas where performance is not what we would expect, it is also important to recognise where significant local progress has been made. By way of an example in NHS Ayrshire & Arran, I would suggest looking at infection control: with an 85.4% fall in cases of C Difficile in those aged 65 and over since March 2007; an 84.6% fall in levels of MRSAsince March 2007 (compared to June 2016); and in Hospital Standardised Mortality Ratios (HSMR), a fall of 15.6% for University Hospital Ayr and 7.1% for University Hospital Crosshouse, between the quarter ending March 2014 and the quarter ending June 2016.

I refer the member to the answer to question S5W-05561 on 11 January 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

I refer the member to the answer to question S5W-05692 on 12 January 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

As announced in the Draft Budget for 2017-18 in Parliament on 15 December 2016, the baseline allocation for NHS Ayrshire and Arran will increase to a total of £682.1 million. In addition to this increase, the Board can also expect to receive an additional £1.5 million of recurring NRAC parity funding.

In the current year the Scottish Government has made available £3.7 million to address waiting times in Ayrshire and Arran, This includes £2.2 million from the additional £10 million announced on 21 November to address outpatient waiting times.

You will also be aware that on 29 November the Scottish Government announced a plan to deliver a major shift in the way outpatient care is delivered, giving patients faster and more local access to care, has been published The Modern Outpatient: A Collaborative Approach 2017-2020 sets out a new strategy for responding to rising demand and aims to free up 400,000 hospital outpatient appointments by 2020. The strategy proposes that some patients, particularly those who are waiting for a routine check-up or test results, would be seen closer to home by a team of community healthcare professionals with close links to hospital departments. The NHS will also make better use of e-consultations and action will be taken to reduce the number of unnecessary referrals.