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The Scottish Government is committed to meeting the costs of delivering the expansion in funded early learning and childcare (ELC) entitlement to 1140 hours by 2020. The expansion must be delivered efficiently whilst ensuring that the outcomes of the expansion are met, particularly that children and their families benefit from a high quality service.

We are in discussions with COSLA with a view to agreeing a multi-year revenue and capital funding package to deliver the expansion.

Our Blueprint Action Plan for 2017-18 sets out the steps we are taking this year to progress the expansion, working in partnership with local authorities and other stakeholders. We have established a multi-disciplinary team to provide delivery support and additional capacity to local authorities in planning for and implementing the expansion.

We asked local authorities to submit ELC expansion plans, which include financial estimates, by 29 September 2017. These expansion plans set out how authorities intend to deliver the expanded entitlement. We are currently reviewing these plans ahead of providing feedback to local authorities by the end of November.

Over the longer-term our new Funding Follows the Child approach, which will be introduced from 2020, will ensure that funding provided for early learning and childcare reaches frontline delivery, directly supporting our young children and their families, as well as enabling financially sustainable provision across all sectors providing the funded entitlement.

The pharmaceutical industry operates in a global market in which the purchase of drugs is traded in dollars and euros. Currency fluctuations have always been part of the normal course of business for both NHSScotland and suppliers.

I have previously highlighted my concerns that some medicines manufacturers will be less attracted to the UK as a market following Brexit in terms of additional costs related to tariffs and other barriers to direct trade. As a consequence, there could be a negative impact for patients, and the UK Government should seriously consider these very real concerns.

We have received representations in relation to primary care prescribing from community pharmacy contractors that the fall in the value of sterling is a factor in increased procurement costs for some generic medicines. However, the Scottish Government regularly monitors the cost of drugs in primary care and manages reimbursement costs through the Scottish Drug Tariff, minimising the impact of price fluctuations.

In relation to prescribing in hospitals, there have been no significant issues to date but we will continue to monitor in line with our normal practices. Our aim is always to ensure that we get the best value for money for taxpayers.

Registers Direct has successfully provided access to information on the public registers maintained by Registers of Scotland since 1999, dealing with 1.4m chargeable searches each year. The Land Registration etc. (Scotland) Act 2012 sets out the action the Keeper must take when satisfied there is a manifest inaccuracy in the land register.

In October 2017, the Keeper of the Registers of Scotland launched ScotLIS (Scotland’s Land Information Service), a new web-based service designed in collaboration with customers that will not only replace Registers Direct but also provides, for the first time, direct citizen access to information from the property registers. ScotLIS has received very positive feedback from both citizens and professional users on ease of use and the better display of information as compared with Registers Direct.

In 2015, the Keeper of the Registers of Scotland consulted on her approach to using the Keeper-induced registration powers provided to her under the Land Registration etc. (Scotland) Act 2012. As part of this consultation, the Keeper sought views on a proposal to change the way that title burdens are shown in land register title sheets, from an abbreviated version of the title deed containing burdens to the whole deed. The responses showed that there was support for this change, including from the Law Society of Scotland. Registers of Scotland is currently working with customers to consider the options for delivering this proposal in a way that would allow conveyancers to complete their work timeously and efficiently without additional cost.

The Keeper of the Registers of Scotland is under a statutory duty to maintain a cadastral map of Scotland. This map shows the legal boundaries of all property registered in the land register. The cadastral map uses the ordnance survey map of Scotland as the base map on which it shows the legal boundaries. That base map is regularly updated by Ordnance Survey in relation to physical changes on the ground. These changes to the base map do not affect owners’ rights or the extent of their property.

The Scottish Government recognises that there are particular challenges around raising awareness amongst clinicians of the many varied rare diseases. These are not issues unique to Scotland and in 2009 the European Union recommended that each EU state have in place a rare diseases plan or strategy by the end of 2013. This led to the four nations of the UK coming together to publish the UK Strategy for Rare Diseases in November 2013. As part of this joint project, Scotland published the Implementation Plan ‘It’s Not Rare to Have a Rare Disease’ in June 2014.

One of the aims of the Scottish plan is to secure rapid and effective translations of advances in the understanding of rare disease into clinical care by creating appropriate infrastructure, care pathways and clinical competences. This will include education and training programmes that enable health and social care professionals to better identify rare diseases in order to help deliver faster diagnosis and access to treatment pathways for patients.

Through this plan, we are working together with partners to improve the outcomes and support for people with rare diseases. The Scottish Government cancer strategy ‘Beating Cancer: Ambition and Action’ complements the actions of the rare disease plan through its focus on early detection, diagnosis and treatment for all forms of cancer, including rare cancers.

Registers of Scotland aim to complete all first registrations within the six month standard, however this is not always possible due to the complex information that is needed to be created when creating a new title. Registers of Scotland has been working over the last few years to improve its speed of service and this is reflected in the increased proportion of applications being completed within 20 days. Registers of Scotland’s new digital services that will be introduced over the next two years will further reduce the time taken to complete first registrations.

On point (a) -

Plans are underway to build a secure adolescent inpatient unit in Scotland. This will benefit the small number of young people who require this specialist level of care and who cannot be treated in the community.

We recognise that there are a small number of young people who require specialist secure care, and we are persuaded that there is a need to build an inpatient facility for the whole of Scotland. This is being taken forward by NHS Ayrshire and Arran.

On point (b) -

Clinical nurse specialists make a valued contribution to delivering services and supporting patients and families who require specialist care. The Scottish Government has invested £2.5 million annually in the Specialist Nursing and Care Fund since 2015. NHS Boards across Scotland have benefited from the investment and have used the funding to enhance specialist nursing and care in ways that reflect local needs. At May 2017, reports from NHS Boards show that specialist nursing capacity had been enhanced through the additional investment by 31.35 whole time equivalents (WTE) and these roles are supporting and caring for patients and families affected by a wide range of conditions, across the life spectrum and across hospital and community settings.

In addition, and as part of this wider effort, the Scottish Government has fulfilled its pledge to double the number of Motor Neurone Disease (MND) clinical nurse specialists and ensure that they are paid from public funds.