The Scottish Government notes the finding of the report 'Five Years On; Royal College of Nursing (RCN) Scotland Review of the Transfer of Prison Health Care from the Scottish Prison Service to NHS Scotland'.

The report highlights a number of important areas of improvement and innovation in health care for the prison population and welcomes the improvement in access to wider clinical expertise and clearly demonstrates the commitment of nursing staff working with people in prison. However, it is only right and proper to acknowledge that it also details a number of challenges facing Health Boards in the delivery of service for this vulnerable group.

While it remains the responsibility of individual Health Boards to provide appropriate healthcare for its population, including prisons, the Scottish Government will support Health Boards, the Prison Service and their partners, to fully implement the aspirations to reduce health inequalities, integrate prison health care into the wider NHS system without discrimination, increase continuity of care and improve sustainability.

The safety and efficacy of medicines in the UK is a reserved matter and is the responsibility of the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA also has responsibility for investigating any suggestions of poor manufacturing practice by pharmaceutical companies.

Tackling and reducing antimicrobial resistance remains a key priority for NHS Boards in Scotland.

NHS Boards are working with the Scottish Antimicrobial Prescribing Group and National Services Scotland to reduce inappropriate use of antibiotics and ensure that antibiotic use follows national and local evidence-based polices to combat the emergence of resistant organisms.

NHS Boards are required to implement surveillance of antimicrobial use as described by the Scottish Antimicrobial Prescribing Group Local Surveillance of Antimicrobial Use guidance for both Primary and Secondary Care. In addition, NHS Boards are required to adopt and implement mandatory healthcare associated infection and antimicrobial resistance policy requirements as set out in the recent Scottish Government Director’s Letter (2015) 19 issued to all Chief Executives and distributed to the infection prevention and control disciplines within NHS Boards. The Scottish Government also funds Antimicrobial Team Pharmacists within NHS Boards who play a key role ensuring prudent prescribing and active stewardship of antibiotics.

The Controlling Antimicrobial Resistance in Scotland (CARS) expert group, chaired by Scotland's Chief Medical Officer continues to oversee Scotland's antimicrobial resistance strategy and supports delivery of the UK 5 Year AMR Strategy.

I have asked Colin McConnell, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

The previous response to question S4W-22551 clearly stated SPS’s recognition that LDD was a significant issue within the prison population. The reference within current question S5W-05324 stating that “SPS does not recognise that LDDs are a significant issue” is a typographical error.

It is still the case that there is no routine screening for learning difficulties/disabilities (LDD) for those entering custody or who are part of the Scottish prison population. However, SPS has now concluded an LDD screening pilot project initiated at three prisons in partnership with Forth Valley NHS, New College Lanarkshire and Fife College.

An evaluation of the project was subsequently undertaken and the key findings of this will be considered in 2017, which will determine the way forward for SPS in this area of intervention.

The Mental Welfare Commission for Scotland submitted a final version of its review report to the Scottish Government in November 2016. The report includes a review of the existing process of investigation of homicides by people who are users of mental health services, as well as a proposal for changes to the existing system. Ministers are currently considering the report and it will be published in early 2017 as part of a consultation exercise on the proposal for changes to the current system.

I have asked Colin McConnell, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

SPS does not find acceptable the late arrival of any prisoner at, or cancellation of, any appointment, and is very conscious of the potential impact on both the prisoner and partners. The contract has in place a rigorous contract monitoring regime undertaken by a team of Escort Monitors whose role it is to keep the services under review, and challenge the contractor when a failure in meeting performance measure has arisen. Where relevant, contractual remedies such as improvement plans or direct monetary reductions are applied to failures to provide the required level of service.

The escort contract contains a varied specification and there are a number of different service requirements, with an escort to a hospital appointment, being classed as a non-core service movement. In 2016, to 31 October, 29 out of 14,603 non-core movements (which include 7,884 hospital appointments) have had a performance measure applied because of the late arrival to scheduled appointments, and 40 appointments have been cancelled. There has however been a service improvement from the period referred to and this level of service is currently being sustained.

The escort contract is currently due for renewal and SPS and partners will ensure that any lessons learned are considered and reflected in the drafting of any new contract.

ISD publish a quarterly report on the number of people who have started treatment for Psychological Therapies as well as Child and Adolescent Mental Health Services, this data is provided by the NHS in Scotland and is published online at: http://www.isdscotland.org/Publications/. This information has been published quarterly since August 2013 and includes a breakdown by boards as well as Scotland wide figure. Latest published figures for the quarter ending September 2016 show that a total of 11,138 people started treatment for Psychological Therapies in Scotland in Quarter 3 of 2016.

The health care of prisoners transferred to the NHS as of November 2011. The national HEAT standard (now an LDP standard) for psychological therapies waiting times was approved in November 2010 for inclusion in HEAT from April 2011, before the NHS was responsible for the Scottish Prison Service.

I refer the member to the answer to question S5W-04352 on 9 November 2016 and also S5W-04700 on 23 November 2016.

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 Mental Health Tribunal Scotland is an independent organisation and was established by the Mental Health (Care and Treatment) (Scotland) Act 2003 to make decisions on the care and treatment of people who are subject to the Act. The aim of the Tribunal is to provide a responsive, accessible, independent and impartial service when making decisions on the compulsory care and treatment of people with mental disorders.

The rules under which the Tribunal operates are set out in the Mental Health Tribunal for Scotland (Practice and Procedure) Rules 2005.

There is a right under the Mental Health (Care and Treatment) (Scotland) Act 2003 to appeal to the Sheriff Principal (with a further appeal right to the Court of Session). Sections 320 - 322 make such provisions and detail the time limits for bringing in an appeal and the grounds on which an appeal may be brought. The majority of appeals against decisions of the Tribunal are made to the Sheriff Principal under section 320(2). However complex cases, where an appeal is made under section 320(2), may be remitted by the sheriff principal, or on the motion of any party to the appeal, to the Court of Session.

It would be for the sheriff principal and then the Court of Session to review a decision made by the Tribunal. The Court may set aside the decision of the Tribunal and can also substitute its own decision.