Regulation for the Licensing and Safety of Medicines is currently a reserved area for the UK Government.

The Scottish Government meets regularly with the MHRA to discuss medicine safety issues. This includes discussion on Primodos. Furthermore, I wrote to the UK Government urging them to conduct a thorough examination of all materials in the Review and also to ensure that families in Scotland were given the opportunity to engage with the independent Review.

The Scottish Government has arranged to meet with the Chair of the Association for Children Damaged by Hormone Pregnancy Tests to hear first hand their experience and learning from observing the Expert Working Group Review.

A core principle of the Vaccination Transformation Programme is that services will continue to be delivered to patients in a safe, sustainable and acceptable way. It will be a matter for Boards locally to determine whether or not any change in service provision will warrant consultation with the public, for example if there is a meaningful change in how patients access services, but in many cases this is not likely to be necessary.

In some parts of the country NHS Boards have already taken over responsibility for delivering vaccinations previously delivered by GPs, and all NHS Boards currently deliver school-based vaccinations.

The Programme is using Managing Successful Programmes (MSP) methodology which includes requirements around risk. A key role of the Vaccination Transformation Programme governance will be to identify and manage risk, undertake equality impact assessments, and establish quality metrics for monitoring the impact of the new delivery model. Local risk assessments will also be carried out as plans progress.

At the heart of any change must be the core principle of patient safety. That is why our planned approach is of a three year transition with changes to services only taking place when it is safe to do so.

The Vaccination Transformation Programme will support Health Boards to design local solutions to vaccination delivery. Health Boards will be able to make different arrangements in their areas to suit local circumstances. In some areas GPs may continue to deliver vaccination programmes through local agreements.

The Vaccination Transformation Programme will not mandate how Health Boards will deliver vaccinations in their area. Rather the programme will support Health Boards in implementing local delivery solutions that best suit them, their patients, and their geography. The solutions developed may involve establishing immunisation teams, contracting local GPs, or a combination thereof. As service providers, the local Health Board will ensure that the service they design provides best value for money.

One of the key principles of the Vaccination Transformation Programme will be to implement new models of delivery that do not adversely impact on uptake rates. While GPs will no longer be responsible for the delivery of vaccinations, it is likely that general practice premises will still be used to deliver vaccinations allowing opportunistic immunisation to continue. Different delivery options and a changing NHS and public health landscape may also provide opportunities and benefits which are not possible within current arrangements. At present local variation in uptake of the flu vaccine across GP practices is monitored closely and appropriate interventions applied to improve uptake. New Primary Care clusters will work closely with HSCPs and make use of intelligence and data to continue monitoring uptake in their areas and provide support as necessary.

NHS Territorial Boards continue to make limited use of the independent and private sector for health care services. Total spend decreased from £78.5 million in 2015-16 to £72.0 million in 2016-17.

Spend by each Board for 2016-17 is set out in the following table. Figures for
2006-07 to 2015-16 were provided in response to question S5W-05822.

Hepatitis C (HCV) prevention remains a priority for the Scottish Government as set out in our Sexual Health and Bloodborne Virus Strategy. All NHS Boards and partners continue to work to prevent new infections, promoting best practice in relation to HCV prevention, diagnosis and treatment.

Monitoring the impact of our investment in prevention and treatment strategies on the incidence of infection remains a challenge as new infection incidents are difficult to measure directly, given that the infection can be asymptomatic and undiagnosed. However, there is evidence to suggest that the prevalence of injecting drug use in Scotland has decreased in recent years, which indicates that the overall number of HCV infections in people who inject drugs is likely to have decreased. In Scotland, HCV is mainly transmitted among injecting drug users.

Despite advertising internationally there were no suitable candidates for the locum surgical post.

National Services Division has advised that the two surgeons will still provide the current service and ensure that patients are being managed within clinical protocols. NHS GG&C has confirmed that the surgeons are content with this position and are now supported by a full team of specialist nursing and administrative staff.

The current service will continue to be monitored by NHS GG&C to ensure patients are being managed appropriately and that the impact on the surgeons is being assessed accordingly. This approach is ensuring that all patients receive time appropriate surgery.

This information will not be available until after the publication of the Scottish Local Government Finance Statistics 2016-17 in February 2018.