 1.0194, yn y ddechrau Jofus Patrick, wrth ddod, gynnwys, mae gennym i ddweud? 2. Rydw i ddweud i ddweud yr cyllid o'r cwestiwn, Cym fel Rodd Campbell? A gyda'r ddweud o'r Gwyrdegos Cymreig i ddweud yng Nghymru yw'r ddelch yn ddiogelwyd the Mental Welfare Commission for Scotland report, Dignity and Respect Dementia continuing care visits. I welcome the mental welfare commission's report into dementia continuing care words, which shows that the level and quality of care and support is in many cases not meeting the standard that we expect. While we are making significant progress in many areas of dementia care such as diagnostic rates, post diagnostic support and acute hospital care, it is essential that people with dementia receive safe, effective and high quality care at all stages of their illness and in all care settings at home, in hospital or in a residential care setting. The dementia standards published in 2011 are clear that everyone has a human right to this level of care and that we are continuing our national approach to workforce development and education to support services to meet those standards. Nationally, action is under way on a range of areas to address many of the issues highlighted in this report, particularly through national commitments to improve care in specialist NHS care facilities and to reduce the inappropriate prescribing of psychotropic medication for people with dementia. We will work with the Mental Welfare Commission, Algringham of Scotland and others to carefully but rapidly consider other matters highlighted by the report and to develop an action plan. The report reminds us all that dementia is one of our foremost public health and societal challenges now and in the future. The integration of health and social care will enable more people with advanced dementia and more complex care needs to live well in their own homes for longer and lessen their lines on long-term care in specialized and continuing care units. We will work with services across Scotland to support this aim. Scotland's national dementia strategy has commitment to live in dealing with the extension of the quality of care found in general hospitals to other NHS settings. Commitment 13 is about finalising and implementing a national commitment to the prescribing of psychotropic medications. The MWC report raises major concerns about the prescription of psychotropic drugs without a regular review. Can the minister advise what steps will be taken to ensure that both commitments 11 and 13 are being complied with? The member made a particular reference to two of the commitments that are set out in the national dementia strategy, commitment 11 and commitment 13. There is already a body of work being taken forward in relation to commitment 11, which is focusing on improving the way in which the dementia standards have been applied within our acute hospital setting, particularly those NHS wards and units where they have a key function in providing assessment and care and treatment to people with dementia. The intention was that, after that area of work had been completed, it was to roll that out further to such non-acute hospital settings such as continuing care units that are often contained within community hospitals. We are looking to consider how we can speed up that process in order to move that into the continuing care setting that has been highlighted by the mental welfare commission report. We will consider how that can be taken forward as part of the action plan responding to that report. In relation to commitment 13, as the strategy sets out very clearly, there is a need to reduce unnecessary use of medication in all care settings and that medication should also be regularly reviewed and updated. The dementia strategy implementation and monitoring group at their most recent meeting were considering how they can take forward commitment 13 and have agreed on the approach that should be taken forward in order to implement the strategy. What we will now do is work with and laze with the Mental Welfare Commission, Alzheimer's Scotland and others in order to look at how we can make sure that the commitment is implemented as quickly as possible so that we can be assured that individuals who are receiving medication are receiving so in an appropriate way that it is regularly reviewed and that it is also properly recorded. Alongside that, in the action plan I want to look at what further action we can take in order to make sure that there is sufficient work being taken forward to introduce further activities that can reduce the need for medication for individuals in such settings. I hope that reassures the member that there is already work started on taking forward those commitments and we intend to look at how we can press them further ahead in order to speed up the process of their implementation. The review also refers to a disparity in the provision of continuing care beds across Scotland's NHS boards. What can the minister tell us about how the Government proposes to attack that disparity? There will be a difference between different NHS boards on the number of continuing care beds that they have. That can be for a variety of reasons. For example, a particular health board that has a greater focus on supporting in the provision of care within the home setting, within the community setting, might not necessarily have as many continuing care beds as in our health board area that has a greater focus on inpatient or residential beds. There can be a variety of reasons as to why there can be such a disparity. However, the member will be aware that, recently, the Cabinet Secretary for Health and Well-being made a statement to out future plans for care provision in Scotland. Part of that also includes looking at the level of continuing care beds that we have in Scotland and the policy for the provision of continuing care beds in Scotland. Work is presently on developing the guidance in that area and looking at the specific amounts of continuing care beds that we have in Scotland. Once that process is being completed, we will then be able to set out the national approach to the provision of continuing care beds in NHS boards across the country. I welcome the detail that the minister has given on a number of aspects of this very worrying report from the Mental Welfare Commission, which is indeed almost as bad as the Bridgend report in Wales, which led to significant action by the Welsh Assembly. He has given detail on a couple of issues, but there are so many other issues in the report. Can I press him to accept that the Government should provide time for a full debate so that we can look at the things that are not going right, given that Scotland is ahead? I acknowledge that in terms of dementia standards, early diagnosis and early support, but clearly in terms of the most severe cases, we have very severe problems as are illustrated by the report. We need to have a full debate on that. One last point is that my reading of the report, minister, is that the care inspectorate would frankly have closed some of those units if it had been the care inspectorate doing this report, and others would have said that there should be no further admissions until the situation has been approved. We do not yet have an adequate, on-going inspection system for years between the reviews by the Mental Welfare Commission are not enough. I recognise and acknowledge that Scotland is ahead on the way in which it delivers dementia care broadly, but the report highlights an area in which there is a significant area for improvement and further action. As I mentioned in my response to Roderick Campbell, I have asked officials to develop an action plan specific to the recommendations that have been set out in the report. Of the 20 recommendations, there are three specific to the Scottish Government. We accept all of those recommendations. However, what I also want to do is not only have an action plan but also a monitoring and implementation approach to taking it forward, to ensure that this work is driven forward at a local level where delivery bodies have a responsibility to do that. I hope to have that action plan by the end of this month, and it may be at that point that it would be an appropriate opportunity to consider a full debate on that matter. I am more than happy to take away the member's reference to that. I also say that, in this issue about the inspection regime in this issue, one of the things that I think that the report highlights is that many of the carers who were interviewed—a vast majority of the carers who were interviewed—were satisfied with the care that was being provided to their relatives. That, to me, sends out a signal that there are issues about the expectations that relatives actually have about the care that is being provided to their relatives. I want to give consideration as to how we can address that type of issue, because it is clear that a number of the units were not providing care of an adequate standard, and their carers should have been aware of that. If so, able to lay alert the appropriate agencies to consider those matters. I think that we have to consider it in the round about how we can make sure that carers are better informed about what they should expect for their relatives and the care that is provided to them as well. Thank you, Presiding Officer. When the Scottish Government published its national dementia strategy in 2010, it promised to adopt the principles of the Charter of Rights produced by the cross-party group on dementia. Does the minister agree with me that the report demonstrates a failure to adhere to the charter, particularly with regard to the accountability and empowerment principles, and the fact that most dementia sufferers are going for longer than a month without getting fresh air is a disgrace, of course, and that simply not enough staff are receiving enough dementia-specific training? The report clearly highlights a number of areas where the level of care and the way in which the care has been delivered to individuals with dementia has been unacceptable, and there have been some basic standards of care that are not to be tolerated. The 2010 strategy set out the broad areas where we wanted to see improvements, including signing up to the rights-based approach. As I mentioned in my open response, I believe that this is an issue of human rights for the individuals concerned, particularly in areas where they are being prescribed medication that may be inappropriate. That is an issue of human rights that has to be addressed, and the updated strategy that we published last year looks to drive that whole agenda further forward. We recognise that there has been a broad improvement in the way in which services are delivered in Scotland for individuals with dementia. As Richard Simpson correctly said, Scotland has seen a world leading in a range of areas around how it delivers dementia care. However, in those areas where there have been deficiencies identified, what we now need to do is make sure that we take appropriate action to deal with it robustly and to deal with it as swiftly as we can. The action plan that I have requested that officials bring forward is intended to drive that forward and to monitor how that is then effectively implemented across the country. Thank you. That ends the topical questions.