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NHS standard management of CIN2 in Scotland remains treatment, except in situations where treatment is not appropriate, for example during pregnancy. There are two treatment types that currently meet the gold standard for management of CIN2. The Scottish Cervical Screening Programme continues to consider emerging evidence about more conservative management for individual cases and welcomes the Jo’s Cervical Cancer Trust report.

Information on cervical screening results and what happens after treatment is standardised in the Scottish Cervical Screening Programme. The cervical screening information needs of women are being reviewed for the implementation of HPV primary screening next year and Jo’s Cervical Cancer Trust is represented on the communications group. The cervical screening programme will therefore be able to take account of the findings in the research on the impact of cell changes for women in the development of new information materials.

On 13 March 2018, in answer to S5W-14655, the Scottish Government indicated that no adverse events had been reported to NHS Scotland’s Incident Reporting and Investigation Centre (IRIC).

Although this answer was given in good faith, IRIC now advises that incorrect advice was given to the Scottish Government and, in fact, a small number of adverse events relating to Essure had been reported. Whilst for confidentiality reasons a precise number cannot be stated, IRIC confirms that it was fewer than five.

IRIC intends to treat the provision of incorrect information as an adverse event, will carry out and investigation into the cause, and will consider any corrective actions as necessary. The answer given to S5W-14655 will be amended accordingly.

IRIC further advises that, to the present date, it remains the case that fewer than five adverse events have been reported in relation to Essure.

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

Scotland is part of the United Kingdom Oak Processionary Moth (OPM) protected zone. On the 16 July 2019, following the introduction of OPM infested trees into England, the Scottish Government further strengthened protection by introducing emergency measures which has restricted the movement of larger oak trees deemed the highest risk of OPM. Similar legislation was introduced throughout the UK.

Scottish Government officials are working with other parts of the UK to share intelligence on scale and distribution of trees imported into the UK and our inspectors are investigating all Scottish sites where suspect trees have been planted since September 2018.

As of 14 August 2019, Scotland has had 5 positive findings. The trees infested have been destroyed. Scottish Government inspectors have visited 127 sites in total to inspect for OPM.

The MHRA is responsible for monitoring adverse events associated with any medical device. Any patient who has experienced a complication from her Essure device is able to report this through the MHRA’s Yellow Card scheme .

Following withdrawal of the device from the European market, the MHRA advised that there is no evidence to suggest any increased risk to patient safety. This is clearly set out in the statement the Agency issued on 21 September 2017. Health Boards would, of course, be fully expected to take appropriate action were the MHRA to change its advice in the future, including contacting patients if necessary. Any individual patient who has concerns should not hesitate to speak to her GP.

The Scottish Government is committed to providing the right support at the right time, and creating equity of access to service provision, particularly for those most vulnerable in our society. We want to engage in an open discussion to ensure that any concerns relating to particular aspects of accessing programme provision are properly considered and discussed.

Where contraception is provided, provision should be made through local sexual health services to ensure that informed consent is sought and provided.

The Scottish Government direct funding allocation to Integration Authority’s for Alcohol and Drug Partnerships (ADPs) is included in NHS Board allocations. Letters were issued on 12 December 2018 to advise Board allocations. The allocations for ADPs within each NHS Board are published on our webpage and is available here: https://www.gov.scot/publications/alcohol-and-drug-partnerships-funding-allocations/

2019-20 allocations through our Programme for Government, Local Improvement Fund are being finalised and we will be writing to Integration Authorities in the coming weeks.

This information is not collated centrally. We reported to the Health and Sport Committee on Alcohol and Drug spend for 2016-17 and agreed to provide a similar update on 2018-19 spend following the end of the financial year. We will provide this information to the Committee when this becomes available.

We invested £53.8 million to NHS Boards for onward allocation to Integration Authorities to support Alcohol and Drug Partnership (ADPs) projects in 2018-19. This information is available here: https://www.gov.scot/publications/alcohol-and-drug-partnerships-funding-allocations/

Our Rights, Respect and Recovery Strategy is being supported by further investment of £20m per year for the remainder of this parliament, to help improve the quality and provision of drug and alcohol services. £17 million of this was allocated to Integration Authorities and ADPs in 2018-19, through our Local Improvement Fund to support work in improvement and innovation in the way alcohol and drug services are developed and delivered. This information is available here: https://www.gov.scot/publications/local-improvement-fund-allocations/

The total financial resource available in any given year is higher than the direct contribution provided from the Scottish Government budget and includes contributions from the NHS and other statutory partners.

As part of the response to the Health and Sport Committee Governance Report of July 2018, I asked Healthcare Improvement Scotland (HIS) to carry out a review of its role and approach to the adverse events process.

As a first step, HIS has been working to establish a baseline to determine where there is uniformity and divergence in the way that NHS Boards approach significant adverse event reporting and to gain a greater understanding of the contributing factors to this variation. The baseline report has involved detailed engagement with individual NHS Boards and I understand that it will be published in the next few weeks.

I have been clear that health and social care providers throughout Scotland must use learning from all reporting systems to support a culture of openness and learning. I have asked HIS to look further than the existing National Adverse Events Framework, which while essential, is only part of the solution to developing a reporting and learning system which drives continuously improving services and outcomes for patients, carers and staff.

I have instructed my officials to work closely with HIS, NHS Education for Scotland and other stakeholders to ensure that now that the baseline review is concluded, actions can be identified and implemented, as quickly as possible.

The regulation of medical devices is a matter that is reserved to Westminster and, as such, medical devices are approved for use on a cross-UK basis. Essure model ESS305, the version of the device made available in the UK, received a CE mark in 2006 and was therefore available for use in the UK from that date. Four Health Boards previously offered the Essure device in Scotland and, with the exception of a small number of procedures that went ahead as outlined in answer to S5W-14658 all stopped fitting the device following withdrawal of its CE mark in August 2017.