Chamber and committees

There a number of routes into drug and alcohol residential rehabilitation treatment that do not always involve the Alcohol and Drug Partnerships or NHS services.

While the information requested is not currently held centrally, the Scottish Government is working with Public Health Scotland to develop a monitoring system which will include reporting on number of people accessing residential rehabilitation treatment from each Alcohol and Drugs Partnership area.

Getting people into the treatment and recovery that is right for them at the right time is at the core of our national mission to save and improve lives. £100 million of the additional £250 million funding announced as part of the National Mission will support further investment in - and expansion of - residential rehabilitation and associated aftercare over the next five years.

The Scottish Government are committed to improving outcomes for people living with diabetes in Scotland. Our Diabetes Improvement Plan contains specific commitments to raise awareness of the dangers of diabetic ketoacidosis (DKA) and also has a significant focus on equity of access to care and services. This can be found at: https://www.gov.scot/publications/diabetes-improvement-plan-diabetes-care-scotland-commitments-2021-2026/documents/ .

DKA (diabetic ketoacidosis) happens when there is severe lack of insulin in the body. When this happens, chemicals called ketones are released, and can be extremely serious if left untreated. We are working collaboratively with clinical teams, third sector and people living with diabetes to relaunch the national education campaign: Think, Test, Telephone. This campaign is designed to support people living with Type 1 diabetes to better understand the risks of DKA and how to avoid it. We will continue to capture and track data on SCI-Diabetes to assess the impact of this on DKA rates.

Treatments for diabetes are complex and multifaceted. Many treatments require people to go through a formal education programme in order to self-manage their condition from home. This means there are many barriers facing people living with diabetes and in particular, those living in areas of deprivation or people that have English as a second language.

We are committed to understanding these barriers and are working in partnership with Diabetes Scotland and the Alliance to ensure the needs of people living with diabetes are fully understood. We will take targeted action to ensure equity of access across Scotland and share progress of this using data from SCI-diabetes.

We recognise that the opportunities for physical activity, particularly for organised sport, have been significantly affected by the restrictions. Our approach during the pandemic has been to permit as much sport and physical activity as much as possible in a safe way, in particular prioritising under eighteen sport, recognising the importance to both physical and mental health.

Our Programme for Government commits to doubling investment in sport and active living to £100 million a year by the end of this Parliament. That investment will enable us to rebuild capacity and resilience in the sector following the pandemic, and ensure we address inequalities in access to physical activity and sport.

sportscotland works in partnership with all 32 local authorities to invest in and support the Active Schools Network. Over the coming year, we will also work with sportscotland on the next steps to ensure that Active Schools programmes are free for all children and young people by the end of this Parliament, providing them with more opportunities to take part in sport before, during and after school.

We invested over £20m in our Get into Summer Programme across Local Authorities and 18 National Partners to support the wellbeing and mental health of those children and young people most impacted by Covid. This included funding of £1.4m to sportscotland for Active Schools coordinators, Sports Development officers and Community Sport Hub officers to enhance opportunities for all children and young people to participate in activities and experiences over the summer.

Our approach during the pandemic has been to permit as much sport and physical activity as much as possible in a safe way, in particular prioritising under eighteen sport. The Scottish Government is in discussion with key stakeholders involved in the provision of swimming lessons and water safety education. We recognise the importance of swimming lessons in helping to build water confidence and learning to be safe in and around water, as well as the benefits swimming provides to physical and mental health.

When a decision is made on the timing of a Crofting Bill, consideration can be given to what other measures might be useful to support that work.

Scotland did not vote to leave the EU, but the UK’s departure means that there is now a trade border between Scotland and the EU. While our preference remains to have tariff and barrier free trade with the EU, as a responsible Government, the Scottish Government started work to build a Border Control Post (BCP) to apply devolved sanitary and phytosanitary (SPS) controls on EU goods arriving into Scotland through the Loch Ryan ferry routes from Belfast and Larne. Work began to consider our needs in this regard last autumn, including appropriate engagement and liaison with UK Government. Dumfries and Galloway Council and other devolved administration officials to determine the scope, scale and specification of what might be required as a BCP for these Loch Ryan routes. During this time, I have sought assurances from the UK Government regarding the funding for this infrastructure and the effect of its approach to guaranteeing access for Northern Ireland goods to the market in Great Britain (Phase 2 Unfettered Access) on transiting EU goods.

In the absence of any such assurances from the UK Government, and given the enduring uncertainty surrounding the UK Government’s approach to the Northern Ireland Protocol, I have taken the decision to pause the construction of the BCP until there is greater clarity on the long term funding, the need for this infrastructure, and more information about the timescales when controls might come into effect. Once we have greater clarity, work on the BCP can recommence with a view to completion to accommodate Phase 2 Unfettered Access should that be introduced. Contingency plans are also being made to enable SPS checks to take place away from the ports, should that be needed. I will update Parliament of any relevant developments relating to this BCP.

The UK Government’s decision unilaterally to further postpone the introduction of border controls adds to this uncertainty. That decision was made without any prior or meaningful engagement with the Devolved Administrations, which I have continued to push for recently at an Inter-Ministerial Group meeting on 13 September and in a separate call with UK Ministers on 14 September. We have advised Dumfries and Galloway Council and will continue to engage with them regularly.

The information requested is not held centrally. Statistics on patients waiting for pulmonary rehabilitation are not held by Public Health Scotland (PHS). Waiting times statistics relating to specific conditions a patient is waiting to be seen for are not held centrally.

Statistics relating to the waits patients experience for new outpatient appointments and inpatient or day case admission at specialty level are published up to 30 June 2021 using the link https://www.publichealthscotland.scot/publications/nhs-waiting-times-stage-of-treatment/stage-of-treatment-waiting-times-inpatients-day-cases-and-new-outpatients-31-august-2021/ .

Access to pulmonary rehabilitation is a key recommendation in national clinical guidelines which we expect NHS Boards to follow. Improving access to pulmonary rehab is also a key commitment within our Respiratory Care Action Plan (RCAP), which can be found at https://www.gov.scot/publications/respiratory-care-action-plan-scotland-2021-2026/ .

The Plan sets out our vision for driving improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions. As we develop the work plan for the implementation of the RCAP, we will be liaising with key stakeholders within health and social care, including the chief executive.

As part of the work to deliver the Framework for supporting people through Recovery and Rehabilitation during and after the COVID-19 Pandemic, we have undertaken a significant period of scoping and engaging with NHS boards. A recent self-assessment tool was sent to all teams providing rehabilitation services, including health, social and third sector teams providing pulmonary rehabilitation. Results from this are being analysed and recommendations will form the basis of a work plan to improve access and outcomes.

The information requested is not held centrally. Statistics on patients waiting for pulmonary rehabilitation are not held by Public Health Scotland (PHS). Waiting times statistics relating to specific conditions are not held centrally by the PHS Waiting Times Team.

Dental services have not been stopped during the pandemic period. Dental practices were initially closed with urgent and emergency dental care provided through urgent dental care centres. Dental practices reopened following a phased remobilisation programme which culminated on 1 November with dental teams able to provide the full range of NHS care and treatment to patients. While it is the case patient numbers continue to be less than pre-pandemic - as dental teams are required to operate within strict infection, prevention and control guidance - pregnant women and nursing mothers who required urgent or emergency dental care would still be seen during the pandemic period.