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I appreciate how difficult postponement of treatment has been for people with chronic pain. This includes those who may have had their normal treatment paused, including injections to manage acute pain, owing to clinical concerns related to an increased risk of COVID-19 infection or severity during the pandemic. We have taken a number of steps to provide advice and support to people with chronic pain during the pandemic, and remain committed to ensuring that Health Boards resume a full range of specialist pain services as quickly as it is safe to do so.

Last summer we published a national resource for people with chronic pain to provide information which was developed in partnership with a range of stakeholders including clinical advisors and third sector partners and is regularly reviewed. This guidance referenced advice on the safety of steroid injections from the Faculty for Pain Medicine (FPM) which clearly highlighted the potential risk to providing these interventions during the pandemic and states: ‘As with all pain management procedures a risk benefit balance has to be reached in discussion with the patient. Each case is unique and no guidance will cover all eventualities.’

It is important to understand that it is not appropriate, nor is it the case, that Scottish Government officials or Ministers make or influence treatment or prescribing decisions, such as those related to the provision of pain procedures, as these are entirely for clinicians in charge of a patient’s care to make. When taking these decisions we expect clinicians to be aware of relevant guidance and to take into account the impact of pain on people’s quality of life and any safety considerations.

In order to ensure Health Boards prioritised remobilisation of their pain services, in September 2020 we published the COVID-19 Recovery Framework for NHS Pain Management Services to support them in this process. As set out in the Framework, we recognise that pain has a significant impact on people’s quality of life, and Health Boards are expected to triage cases locally based on clinical need and in line with advice from organisations, including the FPM and the British Pain Society. The Framework also stated the Government’s expectation that people awaiting treatment should be contacted to advise them about their support options should the services they attend be disrupted.

Evidence-based caution is at the forefront of our decision-making, and we will continue to work with Health Boards to remobilise the NHS in the safest possible way, while also supporting Boards to prioritise elective activity on the basis of clinical urgency. As set out in the Framework for Clinical Prioritisation, people awaiting treatment who are experiencing worsening or existing pain should be considered for prioritisation in line with the principles of active waiting list management. However, the number of patients who can be seen, diagnosed and treated may be reduced by the continuing and necessary infection prevention and control measures. Any decisions to scale back elective activity will be taken on an evidence basis and where the need to support COVID-19 patients exceeds capacity for elective care.

The Scottish Government takes seriously the impact of the pandemic on the mental health of all individuals, including those experiencing chronic pain. That is why we have published the Mental Health Transition and Recovery Plan which outlines our response to the mental health impacts of COVID-19.

The Scottish Government has made a commitment within the Transition and Recovery Plan to ensure that those who need mental health support as a result of delayed treatment of their physical health services are identified and directed to the appropriate support and care. This is part of our wider approach to ensure that people with a long term condition are also given support for their mental health and wellbeing and are involved in decisions affecting all aspects of their care.

I appreciate how difficult postponement of treatment has been for people with chronic pain. We want to ensure people with chronic pain can access appropriate support, however we are aware of the challenges facing specialist pain services as they continue to remobilise during the pandemic.

We remain committed to ensuring that Health Boards resume a full range of specialist pain services as quickly as it is safe to do so and in September 2020 we published the COVID-19 Recovery Framework for NHS Pain Management Services to support Boards in this process. As set out in the Framework, we recognise that pain has a significant impact on people’s quality of life, and Health Boards are expected to triage cases locally based on clinical need and in line with advice from expert clinical organisations, including the Faculty of Pain Medicine and the British Pain Society. Furthermore, the Framework for Clinical Prioritisation published in November 2020 outlines that people awaiting treatment who are experiencing worsening or existing pain should be considered for prioritisation in line with the principles of active waiting list management.

The National Advisory Committee for Chronic Pain (NACCP) meets quarterly, with the most recent meeting taking place on the 26 May, and outputs from its discussions are used to update Ministers as required and inform the ongoing development of the new Framework for Chronic Pain Service Delivery which is intended for public consultation later this year.

The Committee provides advice to the Scottish Government to inform national policy. As set out in its Terms of Reference, the NACCP is an advisory group which seeks to achieve consensus based on the shared knowledge and experience of the members on an equal basis. The membership of the Committee comprises representatives from the Scottish Government, NHS services, clinical, third-sector and research sectors, and following a review last year, an increased number of people with lived experience of chronic pain.

In addition to the individual people with lived experience who provide input as members of the NACCP, officials have also consulted the wider Chronic Pain Patient Reference Group which is supported by the Health and Social Care Alliance. In advance of the Framework being finalised officials will work with the Alliance to identify opportunities to consult with people with lived experience of chronic pain.

I refer the member to the answer to question S6W-00914 on 5 July 2021. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers.

The numbers of babies reported in the Scottish Birth Record (SBR) as having a diagnosis of ‘foetus and newborn affected by maternal use of drugs of addiction’ or ‘neonatal withdrawal symptoms from maternal use of drug addiction’ in Scotland during the period 2006-07 to 2016-17 are provided in the following table. The figures presented cover three year aggregates to avoid disclosing small numbers in each individual year. Further suppression of small numbers has been applied as per ISD’s Statistical Disclosure Control policy in order to protect patient confidentiality.

Number of babies affected by maternal use of drugs, financial three year aggregates, 2006-07-2008-09 to 2014-15-2016-17 1,2,3

Marine Scotland has spent £115,176 since 2016 on monitoring and supporting science of seabed marine plastics, floating surface microplastics and also beach litter citizen science data collected by the Marine Conservation Society volunteers. These costs do not include the vessel costs associated with monitoring marine plastics at sea as this monitoring is carried out using existing surveys.

Marine Scotland has also spent £213,437 since 2018 on monitoring and maintenance of the marine litter sink case study area of Arrochar to better understand the problem and inform future policies.

In addition, Marine Scotland also funded the Scrapbook project, a partnership between Moray Firth Partnership, Civil Air Support and the Marine Conservation Society, spending £123,000 in 2018/19. This aerial photography project identified marine litter sink hot spots around our coastline, providing a baseline for future monitoring and enabling effective, focused clean-up operations. Marine Scotland has taken the outputs of this project and added this data to the National Marine Plan Interactive (NMPi), which is free to access.

The historical deaths reported in the Scottish Sun were shocking in their alleged nature. However, enforcement of the Zoo Licencing Act 1981 is a matter for Local Authorities. In addition, I am aware that Blair Drummond Safari and Adventure Park is a member of the British and Irish Association of Zoo's and Aquaria, and that these incidents are currently the subject of an investigation by BIAZA. It would therefore be inappropriate for me to comment further, or indeed launch a further investigation, at this time.

No discussions have taken place about having a dedicated vessel to monitor marine plastic pollution as this is already carried out by multi-purpose research vessels.

Additional funding of £1.08 billion has been confirmed through the Scottish Budget for health and care for 2021-22 to support the response to the pandemic.

From this, the Scottish Government is providing an initial £380 million to NHS Boards in 2021-22 to meet ongoing costs associated with Covid-19. This includes funding for PPE, Test and Protect and delivery of Covid-19 vaccinations.

The Scottish Government will continue to ensure that our health and care services have the funding that they require to respond to this pandemic, and will make available further additional support following our detailed Quarter One financial review.

Details of funding allocations to NHS Boards are set out in the following table:

At the start of 2021, the Scottish Government held several discussions with the UK Government and the other Devolved Administrations regarding a joint approach to encourage participation in Horizon Europe by UK organisations. As part of these, UK Government officials were made aware of the plans of the Scottish Government to dedicate funding to support European research collaboration before the launch of the Saltire Research Awards. Scottish and UK Ministers communicate on strategic research policy issues regularly.