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Medical device alerts, including those about PIP silicone breast implants, are sent by MHRA directly to Health Facilities Scotland who distribute them to their network of equipment co-ordinators in NHS boards. Those co-ordinators are responsible for cascading alerts to the appropriate areas within their NHS board and the alert specifies what action or actions are to be taken.

Medical device alerts about PIP silicone breast implants were issued by MHRA on 31 March 2010 (MDA/2010/025), 4 October 2010 (MDA/2010/078) and 15 March 2012 (MDA/2010/011).

The first alert, issued in 2010, indicated that further advice about the clinical management of patients implanted with PIP silicone breast implants would be made available, and that advice was provided in the latter two alerts.

My officials work with MHRA in a number of different ways, including regular communication by email and telephone, attending as observers the Committee on the Safety of Devices, as well as other ad hoc meetings to discuss issues of mutual interest.

There have not yet been any meetings between me or my officials and Earl Howe.

My officials have met with Sir Bruce Keogh on three occasions when they attended as observers meetings of the Expert Group led by him on PIP silicone breast implants.

My officials attend as observers the MHRA’s Committee on the Safety of Devices at which PIP silicone breast implants was discussed as part of the agenda at two meetings within the last year.

We have advised SEPA that a map of artificial structures and natural features should be prepared by December 2014, in order to co-ordinate with the start of the consultation period on the draft Flood Risk Management Strategies.

No information is held by Scottish Government on the number of clinicians who have complained to MHRA about PIP silicone breast implants.

I attended the Scottish Terms and Conditions Committee (STAC) on 28 March this year to explain Scottish Government policy on public sector pension reform and set out the parameters within which discussions on future pension arrangements for NHSScotland staff should take place. STAC is a partnership organisation which contains representation from NHS employers, NHS trades unions and professional representative organisations and the Scottish Government. It is STAC’s role to discuss and agree terms and conditions issues specific to NHSScotland staff and, as such, it is for them to take forward any negotiations on the issue of NHS pensions in Scotland.

Since 28 March, STAC have established a Pensions Negotiating Group involving all key stakeholders which met for the first time on 15 May and is due to meet again on 29 June. A smaller Pensions Working Group to examine technical issues in detail and feed into the larger Negotiating Group has also been established and is meeting regularly. Both the design of the NHSScotland Pension Scheme from 2015 onwards and the increases in employee contributions imposed by the UK Government which are being phased in over a three year period from April 2012 are being discussed.

Guidance for the conduct of the industrial action has been agreed between NHSScotland employers and the British Medical Association, and has been issued to all boards and local negotiating committees. This guidance encourages doctors to give advance notice of intended action in order that patient safety is not compromised.

In line with the guidance, doctors fulfilling their contractual duties on 21 June 2012 will receive payment as normal. Employers are entitled to withhold pay where doctors do not fulfil all or any of their contractual commitments. Therefore, doctors undertaking some but not all of their duties will receive appropriate part payment for their work.

We will study the recommendations made in the Office of Fair Trading (OFT) report on Dentistry – an OFT market study where they are applicable to dentistry in Scotland, and consider if any action requires to be taken.

Where there is a change of ownership of a care home, the Care Inspectorate already has the necessary powers to investigate a complaint regarding its operation, even if the same staff are employed by the new service provider.

Under the Public Services Reform (Scotland) Act 2010 and the associated regulations, the new owner of the care home is required to apply to the Care Inspectorate for registration of the service. This is necessary because the registration of the new owner is distinct from the registration held by the previous owner regardless of the similarities between the providers.

These arrangements provide safeguards as the Care Inspectorate can scrutinise the new application and be satisfied that the proposed service meets all the necessary requirements and is able to provide care of the required standard and quality.

Hospital cleanliness is a priority for the Scottish Government and to ensure that the highest standards are maintained we have put in place a comprehensive programme of actions. All hospitals must regularly report compliance with the requirements set out in the NHSScotland National Cleaning Services Specification and independent assurance is provided by the Healthcare Environment Inspectorate (HEI). Additionally, we have made available £5 million of additional resources to boards every year since 2009 to pay for hundreds of additional cleaning staff.

Raigmore Hospital’s cleaning compliance score has remained above 90% and the last HEI unannounced inspection carried out in March 2011 reported that the hospital was clean and the general environment was well maintained. However, following an outbreak of Clostridium difficile in January 2012 the board published a significant event report which found standards of cleanliness were sub-optimal in both the affected wards and that this was primarily due to staffing and infrastructure issues. I have received assurance from NHS Highland that these have been addressed as a matter of urgency as per the recommendations in their report.