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The Scottish Government are determined to tackle poverty and reduce health inequalities in Scotland - continuing to take wide ranging action to deliver improved outcomes for families and individuals across the country and to address the root causes of inequality.

The and the both provide Scottish Government with evidence to support the monitoring of inequalities and outcomes across Scotland, including rural areas.

The Scottish Government has committed to publish a plan setting out how all parts of the Scottish Government are delivering for Scotland’s rural mainland communities, by the end of the current Parliament. This is underpinned by the evidence compiled on Rural Scotland, which was published on 21 December 2023. In addition, the was published on 5 December 2023.

The Plan will cover a range of key areas, including health and social care.

Officials engage with Health Boards and HSCPs on a regular basis to review health outcomes.

Routinely collected data on the waiting time for a diagnosis of endometriosis are not available.

However, in 2024 Endometriosis UK published a report based on a survey of 4,371 people who received a diagnosis of endometriosis from a medical practitioner or following a diagnostic intervention. The report suggested that the current average waiting time for a endometriosis diagnosis in Scotland is now 8 years and 10 months.

Endometriosis has two stages of diagnosis, a working diagnosis at primary care level and a confirmed diagnosis via laparoscopy at secondary care. Not everyone with endometriosis will want to have a laparoscopy to confirm their diagnosis, particularly if their symptoms can be well managed.

We know that excessively long waits for laparoscopy are not acceptable and we apologise to all patients waiting too long. We are determined to drive improvements in this area and continue to work with NHS boards on a number of actions which will see patients treated as quickly as possible.

We want people to achieve a working diagnosis as soon as possible to enable swift access to appropriate care and treatment.

There are several treatment options to manage the symptoms of endometriosis. These include pain management options and hormonal contraception as well as surgical interventions including laparoscopy. There is no cure for endometriosis. More information can be found on .

As set out in the for NHS Scotland clinicians should consider women’s individual needs in order to determine treatment for example symptoms, aspects of daily living and desire for fertility.

Through the actions set out in our Women’s Health Plan we have taken steps to support both women and health professionals to learn more about endometriosis, the symptoms and treatment options.

Further information about the progress to date against each of the priorities in the Women’s Health Plan can be found in the .

Public Health Scotland publishes annual data on NHS eye examination on their website at: .

Figure 5b of that report provides data on referrals from community optometry to the hospital eye service.

There is presently no national community audiology service. We are sponsoring the RNID ‘Near You’ scheme in partnership with the NHS in five Health Board areas. Benefits include locally-recruited staff, trained volunteers, savings of circa 500 clinical hours and 4,600 patient miles per year, and provision of domiciliary care.

Remote consultations are now part of free universal NHS funded eye examinations. The Government is also in the process of rolling out new enhanced services including the Community Glaucoma Service. No specific assessment has been made of the impact this has had on rural areas, but these commitments support patients being treated closer to home.

In order to provide high quality services to all patients NHS Scotland plans and delivers some services on a national or regional basis. This is particularly the case for highly specialist treatments and those with low numbers of cases.

We have convened an NHS Board-led working group which is working to develop a framework for delivery of health services in rural and island areas and considering how best to deliver the right care in the right place

The group will develop a model with services provided as local as possible and specialised as necessary in order to ensure equity of outcomes. As part of the work, the group will seek to define what the "core services" are that should be provided locally, balancing these with the need for specialised care which may be provided outside the local area where clinically appropriate.

The Scottish Government's Transport to Health delivery plan aims to ensure access to healthcare facilities is fully considered within regional and local planning, including planning for our rural communities.

Funding is provided to Network Rail, ScotRail Trains Limited, Scottish Rail Holdings Limited and Caledonian Sleeper to facilitate their ongoing operations. Investment in security measures is determined by the aforementioned parties, using their existing funding streams. British Transport Police operates in these remote areas as part of its responsibilities.

There have been no official complaints logged regarding the overall condition of the A90 in the last five years. However, there has been a total of 171 individual complaints with resulting reports:

There are a total 4,552 road traffic signs on the A90 trunk road network. Of these, a total of 185 signs do not meet the current standards for visibility and effectiveness and are on a works programme for future replacement. Where regulatory signage and warning signage are noted as defective they are categorised as Category 1 defects. These are required to be made safe when identified, following which a temporary or permanent repair must be undertaken as soon as possible and no later than 24 hours following first identification. Where possible, Category 2 sign replacement is coordinated with other works on the network to mitigate disruption to road users.

Transport Scotland conducts machine-based surveys using specialist vehicles each year to gather information on the surface integrity of the road; the friction characteristics of the surface; and the structural capacity (strength) of the underlying road construction. The data obtained provides an annual snapshot of the road condition across the network and is used to determine a Road Condition Index for each section of road. The Index values can then be used to identify where detailed engineering investigations should be focused in order to determine maintenance requirements.

The proportion of the A90 that has been assessed as requiring further preliminary investigation to determine whether structural maintenance is required is currently 18%. This compares with 17% across the whole of the trunk road network.

A breakdown of fleet additions and disposals since 2019-20, broken down by vehicle and fuel type, is provided in the following tables.

2019-20