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In the course of developing the Hepatitis C Phase 1 Action Plan, Health Protection Scotland estimated the costs of the current and future burden of chronic hepatitis C disease on the NHS in Scotland. This work was completed in February 2007.

Health Protection Scotland estimated that the annual health service costs associated with the monitoring, management and treatment of people with diagnosed chronic hepatitis C disease in Scotland was £11.8 million in 2005. This figure included £2.8 million for antiviral therapy for hepatitis C.

The same work also estimated potential future costs, assuming uptake of hepatitis C antiviral therapy by around 1,000 former injecting drug users a year. In this scenario it was estimated that costs would rise to around £22 million in 2015, comprising around £13 million for the costs associated with the management of chronic hepatitis C disease and around £9 million for the costs of antiviral therapy. (These costs do not take account of inflation and were calculated based on 2005 prices).

These services are not being privatised.

Any shift in service provision from the Public Dental Service to independent contractors providing NHS dental services does not constitute privatisation.

The Scottish Government notes the Mental Welfare Commission’s report on The care and treatment of Mrs CD.

In meeting commitment 19 of the Mental Health Strategy 2012-15 on improving how services respond to distress, a draft report on work to develop and test an approach which focuses on improving responses to distress will be published by NHS Tayside later this year.

Responding to people in distress is one of five themes in the recently published Suicide Prevention Strategy (2013–2016). In addressing commitment 1 under this theme and building on the work in relation to commitment 19 above, we have arranged three stakeholder events, the next one being on 24 June 2014 in Glasgow, to allow colleagues from a range of sectors to work through the challenge of improving responses to the underlying causes of distress in people for whom current practices are ineffective.

Commitment 30 of the Mental Health Strategy: 2012-15 builds on the work at HMP Cornton Vale testing the effectiveness of training prison staff in a 'mentalisation' approach to working with women with borderline personality disorder and women who have experienced trauma. We have provided funding to support a two-year pilot programme at HMP & YOI Cornton Vale and HMP Edinburgh with the aim of improving the care, treatment and support of women with personality disorders through the development of therapeutic relationships and environment. The Scottish Prison Service (SPS) is currently reviewing how best to incorporate the concept of ‘mentalisation’ into the development of the SPS Framework for the Management of Women Offenders in Custody and the Staff Training Strategy.

We have also committed to work with NHS Lothian to test an approach to working with women with borderline personality disorder in the community by extending the Willow Project in Edinburgh. We will use the learning from this to inform service development more widely across Scotland.

Delivering safe and effective care remains a priority for the Scottish Government. SIGN develops guidelines for effective practice, based on current evidence. We expect all health boards to ensure robust systems are in place to support the reliable delivery of high quality care. There are no plans for the Scottish Patient Safety Programme to require boards to incorporate SIGN guidelines into publically available local protocols.

I refer the member to the answer to question S4W-21407 on 11 June 2014. 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/parliamentarybusiness/28877.aspx

There are several reasons why I do not consider that collecting such information as part of the GP contract requirements would be sensible or useful.

At present, much GP training is vocational, and involves practitioners gaining experiences in a variety of care settings in order to gain competencies in managing patients, whether children or adults. I consider it would be unhelpful to assume that a GP who has not completed a formal paediatric or child health post, but has been vocationally trained, is somehow less competent than a GP who did have such experience in a secondary care setting. This is important as our approach to the new GP contract is not to propose changes with current GP training requirements, which is more properly for the General Medical Council (GMC) as regulator of the profession, and the Royal College of General Practitioners.

We are aware of concerns that GP training in paediatric and child health is not as effective as it should be, and it is important that this be addressed. This is one issue highlighted within Professor David Greenaway’s independent review of the future shape of medical training in the United Kingdom, where he has made several recommendations on how improvements might be achieved, including that GP training should be better designed to equip them with more enhanced knowledge and skills based upon broad patient care themes e.g. child health, women’s health, mental health etc. that will enable them to work more seamlessly across primary and secondary care settings. Any restructured medical training will need to be agreed and implemented on a UK basis, with the support of the GMC, health boards, patients, and Royal Colleges etc., and UK-wide discussions on how best to take forward the recommendations are now underway.

The methodology used by and the findings of the University of Dundee’s Fatalities Investigation and Review Studies Team will be considered by the group being set up to develop a national system for reviewing child deaths.

This information is not held centrally.

This information is not held centrally.

Operating costs for health boards are published annually by ISD, and can be found in ISD publication R100T–expenditure and activity figures for the last five years, for Scotland and each health board:

http://www.isdscotland.org/Health-Topics/Finance/Costs/File-Listings-2013.asp

All prisoners receive a health check and can also self-refer to the GP at the health centre in prison, as in the community. A prisoner would not receive any specific assessment, as with the general population.