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The Freedom of Information (Scotland) Act sets out the right of any applicant dissatisfied with a response to a request for information to require an authority to review its response. I suggest therefore that Ms Baillie follows the standard processes as set out in the act.

I refer the member to the answer to question S3W-15467 on 5 September 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.

Following the interim reports which I received from NHS Greater Glasgow and Clyde on 13 and 17 June 2008, I announced in Parliament on 18 June 2008 an independent review of the Clostridium difficile outbreak in the Vale of Leven Hospital.

I also asked Kevin Woods, Chief Executive of NHS Scotland to ask Health Protection Scotland (HPS) to collate data from NHS boards on whether there were other unidentified outbreaks and excess deaths associated with CDAD (Clostridium difficile Associated Disease).

Both reports were published on 7 August 2008.

The national response time target for category A calls (life threatening) across mainland Scotland is that, by March 2009, 75% of all incidents should be reached within eight minutes.

The national response time target for category B calls (serious but not life threatening) across mainland Scotland is that, by March 2009, 95% of all incidents should be reached within 14, 19 or 21 minutes depending on population density. For the locations requested, the target is 21 minutes.

The information requested has been provided by the Scottish Ambulance Service for 2007-08 and is set out in the following tables.

Station	Cat A Demand	Cat A Performance	Cat B Demand	Cat B Performance
Arrochar	115	10.4%	144	50.7%
Helensburgh	773	54.6%	1702	92.3%
Vale of Leven	1,396	61.7%	2,488	94.6%

 

Station	Urgent Demand	Urgent Performance
Arrochar	61	88.3%
Helensburgh	986	89.5%
Vale of Leven	1,275	88.9%

Notes:

1. The figures provided are for activity recorded against Arrochar, Helensburgh and Vale of Leven Stations.

2. Urgent performance is measured by the service as the crew being at the patient within 15 minutes of the agreed time in 95% of cases. The time is agreed with the GP or hospital at the time of the call request and is determined by the needs of each patient.

If a medical practitioner knows the cause of death he/she can complete a death certificate. If not, the case should be discussed with the Procurator Fiscal who may decide there is enough information available to sanction the completion of a death certificate, or alternatively instruct further enquiry, which may include a postmortem. The NHS undertakes hospital postmortems with proper authorisation from the deceased person''s relatives, if a clinician wishes to learn more about the cause(s) of death. Postmortems very often reveal that a patient has more than one medical condition, some of which may not have been evident in life. Equally, the cause of death is still on occasion unknown, even following a postmortem. There is no legal requirement for a postmortem in cases of Clostridium difficile, and this condition is diagnosed by microbiological tests on stool samples in life.

Yes. The summary report on the two previous Healthcare Associated Infection (HAI) delivery plans (2002-05 and 2005-08) are available from the HAI Task Force website at:

http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/19529/2005.

It is important to ensure that performance targets are challenging but deliverable. On that basis, the national performance target for responding to category A calls was revised to be achieved across mainland Scotland by March 2009, rather than within each individual NHS board area.

We recognise that achievement at a Scotland-wide level will mean that there may be some communities where this target is not routinely being met. That is why the Scottish Government is looking for the Scottish Ambulance Service (SAS) to demonstrate that across all parts of Scotland it is working to secure continuous improvement, particularly in remote and rural areas.

The Scottish Government and the SAS are committed to ensuring safe, efficient and effective health services across all parts of Scotland, including remote and rural areas. The SAS will continue to work with local partners to achieve this.

The Scottish Ambulance Service (SAS) have advised that they intend to take forward the recruitment of an additional member of staff for the Arrochar station. In addition, this additional crew member will support the elimination of single-rostered crewing in this area.

The Scottish Government is committed to ensuring that the SAS continues to provide sage, efficient and effective services to patients across Scotland, including those in remote and rural area. It is also important that patients have confidence in the SAS''s ability to respond to emergencies.

While this presents particular challenges in remote and rural locations, the service seeks to improve performance for all patients and remains keen to seek local solutions that meet the needs of those communities. In addition, the SAS has appointed a first responder co-ordinator in this area to develop and support first responder schemes.

We are always willing to learn from other countries, and the Scottish Government has done so for many years. Our key stakeholders on the HAI Task Force are in regular contact with their counterparts around the world “ including the Department of Health “ so both they and we can learn from each other on the most effective approaches that are being taken towards tackling Clostridium difficile and other Healthcare Associated Infections (HAIs). It is also the case that both the Chief Scientist Office of the Scottish Government Health Directorate and the Scottish Infection Research Network (SIRN) at Glasgow University encourage and support innovative research and projects into HAI to ensure that our approach continues to evolve.

NHS boards are accountable for the quality and safety of the NHS services they provide including those provided in hospitals. A range of scrutiny and performance management arrangements are in place including annual reviews by Scottish ministers held in public.

The future of scrutiny arrangements in the public sector, including the NHS, is being considered as part of the Scottish Government''s response to the Report of the Independent Review of Regulation, Audit, Inspection and Complaints Handling of Public Services in Scotland (The Crerar Review).