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We are aware of the concerns that have been raised by patients and their families relating to some PACS Tier Two applications. Scottish Government health officials are actively working to investigate and resolve any issues.

We have been advised that a number of applications were returned to clinicians requesting additional clinical evidence relevant to individual patients. This is a valid request for local Boards to ask of applicants.

We are currently undertaking a 6-month review of PACS Tier Two, and the concerns expressed by patients and their families are feeding into that process.

The Scottish Government’s Chief Medical Officer met with a number of cystic fibrosis clinicians on 27 November 2018, following concerns being raised, to talk through the PACS Tier Two process and to reaffirm that the cost of medicines should not be a decision-making criterion. On 7 January 2019, the Principal Pharmaceutical Officer wrote to all NHS Scotland Medical Directors and Directors of Pharmacy to advise that applications through PACS Tier Two could be accepted for all licensed indications of Orkambi with immediate effect, and that Vertex had agreed to offer a confidential discount to support any such applications.

We strongly encourage clinicians to make use of this system where they judge a medicine, such as Orkambi, to be appropriate for their individual patient’s needs and we expect NHS Boards to process applications appropriately as is set out in the national guidance.

This response is related to the answer to question S5W-21488 on 27 February 2019. The response is copied here:

An update on progress in preparation of the public sectors accounts was provided to PAPLS at the meeting on 29 November 2018 https://www.parliament.scot/S5_Public_Audit/Meeting%20Papers/PAPLS_Meeting_papers_PUBLIC_29_Nov_2018.pdf .

The committee was advised that, as Audit Scotland acknowledges, the Scottish Government delivers on all its financial reporting requirements and has delivered a range of new financial publications as a result of the Scotland Acts. We are progressing a plan to achieve audit and publication of a 2017-18 product, as explained in the letter from the Permanent Secretary to the Convener on 23 November, and included in these committee papers.

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 .

The Scottish Government has not had any discussions or correspondence with the leader of West Dunbartonshire Council or members of the council's SNP group regarding the 2019-20 Budget. However, as per my answer to question S5W-21178, negotiations on the annual local government settlement are officially conducted between the Scottish Government and COSLA on behalf of all 32 local authorities, including West Dunbartonshire Council.

An update on progress in preparation of the public sectors accounts was provided to PAPLS at the meeting on 29 November 2018 https://www.parliament.scot/S5_Public_Audit/Meeting%20Papers/PAPLS_Meeting_papers_PUBLIC_29_Nov_2018.pdf .

The committee was advised that, as Audit Scotland acknowledges, the Scottish Government delivers on all its financial reporting requirements and has delivered a range of new financial publications as a result of the Scotland Acts. We are progressing a plan to achieve audit and publication of a 2017-18 product, as explained in the letter from the Permanent Secretary to the Convener on 23 November, and included in these committee papers.

Scottish Water invests around £650m pa to improve all aspects of its service to customers across Scotland and also enable growth to support new housing. This involves thousands of projects ranging from major capital projects such as the Shieldhall Tunnel to small value capital jobs on its asset base. As with all large utilities, much of this work can be intrusive in nature such as building new water and sewer pipelines, new treatment works and pumping stations and maintaining 60,000 miles of water mains and sewers. This often results in Scottish Water having an obligation to make payment to customers, landowners and occupiers to ensure that they are recompensed appropriately whilst it delivers its extensive investment programme.

In addition to the figures previously listed, Scottish Water has paid the following over the last 4 years, which represents less than 0.5% of the cost of delivering its investment programmes:

The Scottish Government considers that Age Concern would have an interest in any potential changes to the available household discounts. We will engage with them as part of any further consultations on this matter.

My officials will respond to the member's FoI request on this matter.

The Scottish Government will further develop the Principles of Charging in discussion with Scottish Water, the Water Industry Commission for Scotland, Citizens Advice Scotland, the Scottish Environment Protection Agency, the Drinking Water Quality Regulator and the Customer Forum. In examining existing discounts we shall engage with relevant interests including COSLA and organisations such as Age Concern. Customers will be able to contribute as part of any further consultation.

The regular members of the group are as follows:

• Bob Irvine, Scottish Government
• Jon Rathjen, Scottish Government
• Douglas Millican, Scottish Water
• Simon Parsons, Scottish Water
• Tom Harvie-Clark, Scottish Water
• Alan Sutherland, Water Industry Commission for Scotland (WICS)
• Ian Tait, WICS
• Sue Petch, Drinking Water Quality Regulator
• Jennifer Leonard, Scottish Environment Protection Agency
• Sam Ghibaldan, Citizens Advice Scotland (CAS)
• Gail Walker, CAS
• Peter Peacock, Customer Forum