Chamber and committees

Mental Health is a priority for this Government. In 2017-18, for the first time, NHS investment in mental health will exceed £1 billion, and we are working with Boards to deliver sustained improvements.

Under this Government, the number of psychiatric specialists working in NHSScotland have increased by 24.5% to 553.4 Whole Time Equivalent.*

Despite these increases in staff and funding, we recognise that we must adapt to meet the changing needs of the people of Scotland as demand rises in the years ahead.

In June 2017 we published Part 1 of the National Health and Social Care Workforce Plan, which will strengthen and harmonise workforce planning practice, take full account of the future demand for safe and high quality services for Scotland’s people and work to accurately identify gaps in supply, including within the psychiatric workforce.

Parts 2 and 3 of the Plan, to be published later in 2017, will examine how to improve integrated workforce planning in social care and primary care settings. These important steps will enable different health and social care systems to move together towards publication of a second full Health and Social Care Workforce Plan in 2018 and beyond.

*Source: ISD Scotland. Includes Consultant-Grade Directors.

In Scotland the number of people with a diagnosis of dementia and the number of people dying of dementia has risen as our population ages, and the rates of diagnosis have improved, partly due to our former national diagnosis target and a greater awareness of getting a timely diagnosis. The Scottish Government commissioned a report last year which assessed, for the first time, estimated and projected annual diagnosed incidence for dementia rising to 20,000 by 2020. More people who would previously have died from heart disease or cancer but who now live into old age and very old age are now more likely to die from dementia.

Scotland is not alone in experiencing a considerable rise in dementia-related deaths in recent years. In addition, part of the increase is attributable to the introduction by The National Records of Scotland (NRS) of new software to code deaths and adoption of a more recent World Health Organisation (WHO) update to the International Classification of Diseases (ICD). This has resulted in some deaths previously assigned to respiratory causes being allocated to dementia. This development brings Scotland into line with Official National Statistics (ONS), therefore making our mortality figures more comparable with those for England and Wales and further afield.

The Scottish Government published a third three year National Dementia Strategy in June, including an enhanced focus on palliative and end of life care. The strategy builds on our progress over the last ten years in transforming services and improving outcomes for people with dementia, their families and carers. It sets out 21 commitments and provides a framework for further action to ensure the realisation of our shared vision for people with dementia and their carers.

The majority of the funding which the Scottish Government provides to local government is by the means of a block grant. It is the responsibility of individual local authority to allocate the total financial resources available to it on the basis of local needs and priorities, this includes the Scottish Strategy for Autism funding of £1.12m in the financial year 2012-13, having first fulfilled its statutory obligations and the jointly agreed set of national and local priorities.

The Scottish Government intended the award of £35,000 to each local authority to support the development of local autism strategies and associated action plans. The approach to distributing funds was agreed through COSLA and given that it is the responsibility of individual local authorities to allocate resources based on local needs and priorities no analysis has been carried out of the effectiveness of how each council used this.

The Scottish Government have funded a National Co-ordination Team based in Strathclyde University to support the Scottish Autism Strategy and its implementation at a local level. We appreciate that localities are at different stages in developing autism services to meet local need.

When the Scottish Strategy for Autism was published in November 2011, the then Minister for Public Health backed a programme of activity with £13.4 million. This has broadly been committed to a Development Fund which has made between £1m to £1.5m available per annum to a number of local third sector, LAs and NHS Boards who have been funded to develop autism services. Last year we commissioned Inspiring Scotland to work with the third sector projects in the fund and progress reports on the fund can be found at:http://www.autismstrategyscotland.org.uk/strategy/key-documents.html

£1.12m was committed in the financial year 2012/13 of which £35,000 was issued to each local authority to support the development of local autism strategies and associated action plans.

Since 2012 £5.025 has been spent on the development of One Stop shops in six locations throughout Scotland.

A full breakdown of the autism strategy spend will be published when the new outcomes approach is published in the coming months.

We are clear that any death related to substance use is a tragedy and we will continue to do all we can to prevent others from experiencing similar heartbreak.

Evidence supports the view that methadone remains a central component of the treatment for opiate dependency and is just one part of a package of care, treatment and recovery that can be offered to individuals to help them recover from drug addiction. Decisions on the type of treatment to prescribe are for clinicians to make, in discussion with their clients. That view was endorsed in a 2013 report to Scottish Government by an independent expert group on opioid replacement therapies, and is also in line with current UK guidelines.

It is also worth noting that there were only 4 deaths in 2016 where methadone was the only substance present. This highlights the issue of polydrug use which we know is a characteristic of some of Scotland’s problem drug users. We continue to work with our partners to address and better understand these issues.

Each drug related death is a tragedy for the individual, their family and the wider community. Unfortunately, there is a general trend of increasing drug related deaths across the UK and many parts of Europe. This is predominantly being driven by an older cohort of long term, vulnerable drug users who are experiencing multiple health problems.

We remain fully committed to tackling the damaging impact of drugs in Scotland. In response to the changing drug landscape and the rise of drug-related deaths, I recently committed to refreshing our drug strategy. This offers an opportunity to reinvigorate our approach, to respond to emerging challenges and to be more innovative in our response to the wider health and social problems individuals face.

Despite the rise of drug related deaths, the general level of drug use in Scotland is falling, drug taking levels among young people remains low and we’ve achieved significant reductions in treatment times for those needing help with drug problems.

In Scotland the number of people with a diagnosis of dementia - including Alzheimer’s disease - and the number of people dying of dementia has risen as our population ages, and the rates of diagnosis have improved partly due to a greater awareness of getting a timely diagnosis. The Scottish Government commissioned a report last year which assessed, for the first time, estimated and projected annual diagnosed incidence for dementia rising to 20,000 by 2020. Scotland is not alone in experiencing a considerable rise in dementia-related deaths in recent years. In addition, part of the increase is attributable to the introduction by The National Records of Scotland (NRS) of new software to code deaths and adoption of a more recent World Health Organisation (WHO) update to the International Classification of Diseases (ICD). This has resulted in some deaths previously assigned to respiratory causes being allocated to dementia. This development brings Scotland into line with Official National Statistics (ONS), therefore making our mortality figures more comparable with those for England and Wales and further afield.

The Scottish Government published a third three year National Dementia Strategy in June, including an enhanced focus on palliative and end of life care. The strategy builds on our progress over the last ten years in transforming services and improving outcomes for people with dementia, their families and carers. It sets out
21 commitments and provides a framework for further action to ensure the realisation of our shared vision for people with dementia and their carers.