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Health Protection Scotland is part of National Services Scotland, and NHS Quality Improvement Scotland is a special health board. National Services Scotland and NHS Quality Improvement Scotland are accountable to Scottish ministers who hold annual reviews in public.

The principal measurements of the levels of healthcare associated infection (HAI) in Scotland have been the long-standing national mandatory and voluntary HAI surveillance schemes, most recently mandated by HDL(2006)38 and the National HAI Point Prevalence Survey carried out by Health Protection Scotland. The mandatory elements of surveillance currently include MRSA bacteraemias, Clostridium difficile and selected surgical site infections. I am pleased to note that MRSA bacteraemias in Scotland have shown a significant decrease since April 2006, and that orthopaedic surgery (hip and knee replacement) and caesarean section infection rates have also declined “ see http://www.documents.hps.scot.nhs.uk/hai/sshaip/publications/ssi/ssi-2007.pdf.

On 11 July 2007, I announced the publication of the Scottish Point Prevalence Survey which, for the first time, provides us with a comprehensive picture of the rate of HAI in every acute Scottish hospital and in a representative sample of community hospitals. The publication of the survey led to the preparation of a three year HAI Task Force Delivery Plan, which came into affect on 1 April 2008. The Delivery Plan is being backed with £54 million of Scottish Government funding over the next three years and a second Point Prevalence Survey is scheduled for 2011. The delivery plan is available from http://www.scotland.gov.uk/Publications/2008/03/07110818/0.

Mandatory reporting on compliance with hand hygiene and cleaning performance are regularly monitored and reviewed by the HAI Task Force so they remain fit for purpose. I am pleased to note that both these schemes have shown substantial improvements in hand hygiene and cleaning since their implementation, and these are both key areas in the prevention of Clostridium difficile as well as other HAIs.

Another key document relevant to Clostridium difficile is the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP), which I launched in March. ScotMARAP outlines the national programme for Scotland in tackling antimicrobial resistance and prudent prescribing over the next five years. The expert Scottish Antimicrobial Prescribing Group (SAPG) has been established to take this forward, and is now starting a programme of work which all the evidence suggests will have a significant effect in prevention of Clostridium difficile infections.

The HAI Task Force has also commissioned extensive staff training resources from NHS Education for Scotland, notably the Cleanliness Champions programme. This programme continues to expand, and has been used in postgraduate and undergraduate training for health professionals here and in other UK countries. In addition, the recently revised NHS Quality Improvement Scotland (NHS QIS) HAI Standards is a key document against which all NHS boards are assessed, both in terms of their organisational structures and practical compliance with HAI policies.

In relation to Clostridium difficile specifically, I refer the member to the announcement I made on 7 August about the publication of both our new National HAI Action Plan and the HAI Action Plan specific to NHS Greater Glasgow and Clyde. Both Action Plans are available from the HAI Task Force website at http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/19529/2005/actionplans.

These additional plans will be fully integrated into our existing national HAI Task Force programme.

NHS Greater Glasgow and Clyde have been given a formula capital allocation of £97.417 million in 2008-09 and notified of indicative capital allocations of £98.92 million and £100.423 million in 2009-10 and 2010-11 respectively. Future years capital allocations will be determined by the outcome of the next Spending Review.

Yes.

I am advised by NHS Quality Improvement Scotland that it''s predecessor body, the Clinical Standards Board for Scotland, visited NHS Argyll and Clyde in 2004-05 as part of the Healthcare Associated Infection (HAI) standards peer review programme. The methodology used at that time meant that the board carried out a local self-assessment at board level rather than individual hospital site level. The external peer review team then assessed performance by considering the board''s self-assessment data and visited the board to validate and discuss the data provided.

Revised and updated HAI standards were published in March 2008 and NHS boards are now carrying out local self assessments against them.

Guidance to NHS boards is provided in the Standard Infection Control Precautions model policies produced by Health Protection Scotland (HPS). HPS is currently drafting new overarching national guidance on Clostridium Difficile Associated Disease (CDAD) which will set out the containment measures that should be used for patients with Clostridium difficile. As advised in previous answers, the Scottish Government''s HAI Task Force has been informed by HPS that the draft CDAD guidance will be provided to them in September 2008.

No. The Rapid Review Panel assesses equipment, materials and other products that may be of value to the NHS as a whole, including NHS Scotland.

Investigations by NHS Greater Glasgow and Clyde into cases of Clostridium difficile were on-going in late May 2008 and I was being kept regularly informed of the situation that was emerging. As evidence was still being gathered, and as the situation was being actively managed by the board public health professional team with specialist advice from Health Protection Scotland, it would not have been appropriate for me to intervene in that process by instructing a look back exercise any earlier than June.

I refer the member to the answer to question S3W-15205 on 18 August 2008. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/webapp/wa.search.

There are different types of public inquiry, but under the Inquiries Act 2005 a Minister (including the Scottish Ministers) may cause an inquiry to be held where it appears that (a) particular events have caused, or are capable of causing, public concern, or (b) there is public concern that particular events may have occurred.

Ministers therefore have the power to instigate inquiries themselves, rather than simply calling for them to be held. The Scottish Ministers can do so if the subject-matter is concerned wholly or primarily with a matter that relates to Scotland and is not a reserved matter within the meaning of the Scotland Act 1998.