This question seems a little late.

To ask the Scottish Executive what action it is taking to reverse the decision to downgrade the accident and emergency department at Monklands hospital. (S3O-154)

There will be no surprise in this answer. Karen Whitefield will be aware that I made a statement to Parliament on the matter yesterday. I have instructed both NHS Ayrshire and Arran and NHS Lanarkshire to re-examine their original service change plans as they relate to A and E services. The boards are to produce revised proposals that will enable A and E services to continue at Monklands, Wishaw and Hairmyres hospitals in Lanarkshire, and at Ayr and Crosshouse hospitals in Ayrshire.

The revised proposals will be subject to robust independent scrutiny to ensure that they are sound, safe, sustainable and evidence based. I also expect the boards to be able to demonstrate that their proposals are patient centred, have taken into account the views of local people and offer value for money.

I again welcome yesterday's announcement that the decision to downgrade Monklands A and E department has been reversed, but I hope that the minister will provide some assurances about the nature of A and E services that will be provided. I will pursue the matter with NHS Lanarkshire, but if it does not give me those assurances I hope that the minister will support me.

Following yesterday's announcement, I ask the minister whether, in the light of her recent comments about the need for improved cancer services in Lanarkshire, she can confirm that the commitment given by the previous Government to build a new cancer centre at Monklands hospital will be fulfilled by the current Administration.

I am sure that Karen Whitefield and I will discuss Monklands hospital and wider health issues in Lanarkshire on many occasions—I look forward to those discussions.

I made my position clear yesterday: I want A and E services to continue at Monklands hospital. It is now for the board to determine how best to achieve that. The proposals will, of course, be subject to independent expert scrutiny, to ensure that they meet the essential requirements of safety and sustainability.

On the other services that were part of NHS Lanarkshire's proposals, including the cancer centre at Monklands, I have made it clear that I want as many of those additional proposals to continue as possible, because they are commendable.

Does the cabinet secretary agree that St John's hospital in Livingston should be a fully functioning acute district general hospital? If so, does she agree to examine any decision or issue that threatens its viability as an acute hospital?

I assure Angela Constance that the Scottish Government is fully committed to the sustainability of St John's hospital as an acute hospital, and we would question closely any proposal to undermine that status.

To overcome, perhaps, some of the imbalance that arose during yesterday's questions on the minister's statement, I call Elaine Smith.

I campaigned against the downgrading of Monklands hospital, primarily on the basis that the decision was based on financial considerations rather than health needs, so I, too, welcome the announcement to retain the A and E unit. However, can the minister advise me whether Monklands will also retain its level 3 status, which will ensure that all of the other services that are required to support A and E, such as intensive care, are retained on site, so that my constituents will be able to access the high-quality health services that they need and deserve? Further, can she confirm that the well-informed and considered views of my constituents, which were ignored by NHS Lanarkshire, will now be listened to?

I thank Elaine Smith and recognise her contribution in relation to yesterday's decision. I assure her that the views of patients in her constituency, which were ignored not only by NHS Lanarkshire but by the former Labour Government, will be listened to by this SNP Government.

In my answer to Karen Whitefield, I made it clear that yesterday I said that A and E services will continue to be provided at Monklands hospital. It is important for the NHS board to determine how best to achieve that outcome. Because the issue is extremely important, I repeat that any revised proposals will be subject to independent expert scrutiny. That is where the assurance comes from that the services will meet the essential requirements of safety and sustainability that Elaine Smith's constituents are entitled to expect.

I begin by welcoming the minister to her role. I did not do that yesterday, and I apologise for the oversight.

The opportunity has arisen on a number of occasions to accept the definition of accident and emergency services that was supplied by David Kerr in his report and by the British Association for Emergency Medicine.

In the minister's letters to and in her discussions with NHS Lanarkshire and NHS Ayrshire and Arran, has she said, "We want A and E services, but they must meet the standards and criteria that were set out by the British Association for Emergency Medicine and David Kerr"? Has she asked the health boards to deliver those services to those standard criteria?

I thank Andy Kerr for his welcoming comments.

I have made it clear to NHS Lanarkshire and NHS Ayrshire and Arran that I expect A and E services to be delivered, to meet certain criteria, to be safe and sustainable, and to meet the needs of patients in those health board areas. I now want the NHS boards to revise the proposals, subject them to independent scrutiny and bring them back to me for a final decision. That is the best, reasonable and responsible way in which to proceed.