Chamber and committees

The Scottish Government, through HPS is committed to working with experts to keep evidence and guidance relating to the diagnosis and treatment of Lyme disease under constant review to ensure patients in Scotland receive care tailored to their individual needs and circumstances.

The Scottish Lyme Disease and Tick-borne Infections Laboratory at Raigmore Hospital in Inverness has recently been granted Reference Laboratory status which will provide additional funding for research and development into new tests for tick borne diseases and will help improve our understanding of this complex infection.

The Scottish Lyme Disease and Tick-borne Infections Laboratory will continue to work with experts at Public Health England and elsewhere to ensure that patients in Scotland have access to the most robust and scientifically justified testing regime available.

With regard to testing, it is acknowledged that there are gaps in the effectiveness of the tests which are currently available and work is underway to address the lack of sensitivity surrounding testing for the early stages of Lyme disease infection.

On 14 June 2019 the Chief Medical Officer wrote to all NHS Health Boards and GP practices highlighting the availability of a series of resources to staff. The letter shares current sources of public facing advice and information about Lyme disease as well as links to current guidance on diagnosis and management.

SEPA is responsible for regulation of the site and enforcement of the conditions of the operator's permit. Healthcare Environmental Services Limited entered into liquidation on 25 April 2019; BDO LLP was appointed as Liquidator and is now responsible for the management of the site. SEPA is in ongoing discussions with BDO LLP with respect to securing compliance with permit conditions, including the appropriate disposal of all waste held at the Shotts site. We understand that BDO LLP is currently exploring options to remove waste from the site.

Details of the waste categories and volumes held at the site are matters that relate to the statutory regulatory functions of SEPA and they may be able to assist with the specific information requested.

Nitrates and nitrites are found naturally in the food we eat. Most come from vegetables and only around 5% come from processed food. Nitrates and nitrites are permitted food additives.

Nitrates and nitrites are permitted food additives. Potassium and sodium nitrates and nitrites are used to cure and preserve meats such as bacon, ham, hot dogs, salami, and pepperoni (this doesn’t include fresh burgers or mince). They to help reduce the growth of micro-organisms including those which can cause food poisoning, and also preserve colour and enhance flavour.

Nitrates can be converted to nitrites in the body, where, under certain conditions, they can form compounds called nitrosamines. Some nitrosamines have been found to be carcinogenic (cancer-causing). The formation of nitrosamines is affected by other factors in the diet, for example, vitamin C can help to prevent its formation.

There are already strict regulations imposed on the use of Nitrate/nitrite preservatives in certain meat products which are regulated under EU food additives legislation. This legislation covers the usage of the preservatives and is reviewed regularly to ensure regulatory limits are at the lowest possible level to perform their required function.

In 2017 the European Food Safety Authority published two opinions on its re-evaluation of the safety of nitrates and nitrites as food preservatives which concluded that existing safe levels for meat and other foods are sufficiently protective for consumers.

Food Standards Scotland (FSS) have advised that they consider the limits prescribed in the legislation supports the safety of processed meats that contain the regulatory levels of nitrates and nitrites. Based on the findings of expert risk assessment, and taking account of Scottish Government recommendations on processed meat provision in schools and consumption in the wider population, the risks to health are low.

Taking this into account along with the routine sampling undertaken by Scottish Local Authorities, we will not at this time be looking to take any action on meat processors. However FSS stand ready to assist any producers who have any questions or require any assistance with any aspect of the regulations covering the use of the preservatives.

We are currently investigating the availability and cost of nitrite-free preserved/cured products, such as bacon. We would be happy to discuss the outcome of our findings with the Member in due course.

I am scheduled to meet with the RCGP in August to discuss the report’s findings in more detail.

No public health campaign is planned. I have already clarified the Scottish Government's position on nitrates and nitrites, based on the evidence, in answer to recent PQs from Ms Lennon (see S5W-22368 on 18 April 2019 and S5W-23537 on 12 May 2019).

The Scottish dietary goal for red and processed meat sets limits for the consumption of all red and processed meat for the purpose of reducing the risk to the population of colorectal cancer. See https://www2.gov.scot/Topics/Health/Healthy-Living/Food-Health/DietaryGoalsScot for more information on the Scottish dietary goals.

Public information and advice on the recommended consumption of red and red processed meat can be found at: https://www.foodstandards.gov.scot/consumers/healthy-eating/health-wellbeing/managing-health-issues

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 undertaken a scoping exercise with Boards to determine Board’s current position and establish how many students could be available to begin the school nursing programme in the academic year 2019-20.

Distribution of school nurses will be determined based on Health Board need established following analysis of the scoping exercise with Boards and in consultation with Scotland’s Executive Nurse Directors.

It is for Health Boards and Education Leads to determine the geographic locations of staff given the demands in their local areas.

All boards have a legal obligation to comply with food safety legislation. The Food Safety Act 1990 requires that any food preparation environment must prioritise hygiene and cleanliness, as well as safe storage environments for food, e.g. correct refrigeration temperatures, or stock rotation times.

The boards must develop robust Hazard Analysis and Critical Control Point (HACCP) plans based on the guidance contained within the National Food Safety Manual tailored to meet their service needs to ensure that all possible Food Safety risks to patients and staff across NHSScotland are reduced. These HACCP plans are regularly audited and verified by each Board’s Local Authority during their food hygiene inspections.

Suppliers must demonstrate compliance with food safety legislation and provide documentation of quality assurance as part of the NHSScotland National Contract tendering process. Following award of a contract, suppliers are subject to periodic independent audits to ensure continued compliance for the duration of the contract.

Health Protection Scotland has received no Hospital Infection Incident Assessment Tool (HIIAT) submissions or reports of Healthcare Associated Infection connected to food products from any NHS Scotland board from 2014 to date. On ObSurv, the surveillance system used for general outbreaks of Infectious Intestinal disease, there have been no hospital-related foodborne outbreaks recorded in the past five years (2014-2018), nor to date in 2019.