Chamber and committees

Scottish Ambulance Service call handlers follow strict protocols to ensure that patients receive the most appropriate response. Their primary focus is to ascertain what the patient''s condition is at the time of the call and to carry out pre-dispatch instructions. This will not routinely include questions about personal care plans for specific conditions.

Decisions about training for call handlers are operational ones for the Scottish Ambulance Service. They can be contacted at:

Scottish Ambulance Service

National Headquarters

Tipperlinn Road

Edinburgh

EH10 UU.

Transport Scotland is leading the project to establish an interchange between rail and tram in the Gogar area. Preliminary consultation with local land owners including the City of Edinburgh Council, Network Rail and TIE Ltd (Edinburgh Tram project) has taken place. As is normal for projects of this nature, a consultation strategy is under development to take the project through its subsequent stages.

Yes. We are operating to the timetable for the construction of the Forth Replacement Crossing set out by the Cabinet Secretary for Finance and Sustainable Growth in December 2007.

The timetable envisages construction commencing in 2011 and an opening date of late 2016.

VisitScotland''s promotion of Scotland and its areas, and the process by which it allocates marketing funds, is based on sophisticated market research, which identifies what visitors are looking for in a trip to Scotland. This allows VisitScotland to focus spending in order to generate the maximum economic value for Scotland, both nationally and area by area. Spend is not allocated on an area basis but spread across a wide variety of promotional activities, many of which cover Fife and its attractions, such as the dedicated www.visitfife.com website.

In addition, VisitScotland works closely with Fife Council, which also provides funding directly to VisitScotland in order to deliver specified marketing activities for the benefit of the area. These activities are agreed through direct discussion with the local authority and form part of an annual partnership agreement that contributes to the effective promotion of Fife.

VisitScotland''s spend on promoting Scotland and its areas in the tourism market is not allocated on a local authority or area basis, but, importantly, according to what VisitScotland know visitors look for in a holiday to Scotland. Because VisitScotland does not market Scotland area by area, no figures specifically for Fife are available. Fife is promoted both domestically and overseas by VisitScotland via a wide variety of channels, some of which focus entirely on Fife, e.g. the Kingdom of Fife Visitor Guide, and some of which feature Fife as part of a wider promotion of Scotland, e.g. through VisitScotland''s golf or other marketing. Funding from Fife Council is spent according to the agreement which VisitScotland has with that local authority. Whichever methods of marketing are used, meeting the needs of the visitor is paramount.

As with all areas of Scotland, Fife is marketed by VisitScotland according to what it has to offer its visitors, and what these visitors are looking for on their visit. Fife''s strengths include: golf, touring, great outdoors, food and drink, walking, nature, local events and festivals, and history and heritage. VisitScotland uses an extensive range of channels in its marketing such as websites, print, direct mail and PR to reach potential visitors “ both leisure and business visitors “ across Scotland and in the UK and international tourism markets.

The purpose of the Adults with Incapacity Act 2000 is to provide for decisions to be made on behalf of adults who lack legal capacity to do so themselves because of mental disorder or inability to communicate. The decisions concerned may be about the adult''s property or financial affairs, or about their personal welfare, including medical treatment.

The act describes incapable as an individual who is incapable of:

(a) acting, or

(b) making decisions, or

(c) communicating decisions, or

(d) understanding decisions, or

(e) retaining the memory of decisions,

by reason of mental disorder or of inability to communicate because of physical disability. It states that incapacity will be construed accordingly.

The definition of incapacity will, on occasions, apply to patients who experience seizures. It should, however, be noted that in the majority of cases normal cognitive functioning returns in a short period of time, often in a matter of minutes. In such cases the important issue for ambulance crews is consent to treatment and the patient''s ability to make decisions independently.

The Scottish Ambulance Service has confirmed that it currently employs 1,229 paramedics and 986 technicians. This is a ratio of around 1.2:1.

In general terms, ambulance service personnel can contact GP practices or out-of-hours services for primary care advice and can make contact with accident and emergency department staff.

How this contact is made at a local level is an operational matter for the Scottish Ambulance Service.

Special arrangements are currently in place whereby paramedics can administer Midazolam¹ to specific named patients under the instruction of that patient''s consultant.

However, the Scottish Ambulance Service is in the process of approving a National Patient Group Direction (PGD)² for the buccal administration of Midazolam to patients in Status Epilepticus³ by registered paramedics. It is anticipated that this will be introduced into practice before the end of the year. This will help ensure that where emergency treatment of Status Epilepticus is required and an ambulance has been called to attend, registered paramedics can treat the patient at the scene. Once treated, the patient will be taken to the nearest appropriate receiving unit .

Notes:

1. Midazolam is a Schedule 3 controlled drug used for the emergency treatment of status epilepticus (unlicensed indication), and can be included in a PGD provided a licensed medicinal product is used. Midazolam is the only Schedule 3 controlled drug that can be included in a PGD.

2. A PGD is a written direction relating to the sale/supply and/or administration of a Prescription Only Medicine (POM), to persons generally, subject to specified exclusions) and is signed by a doctor/dentist, and by a pharmacist.

3. Extract from SIGN clinical guideline no.70. Status Epilepticus has been defined as a condition in which epileptic activity persists for 30 minutes or more, causing a wide spectrum of clinical symptoms. Emergency treatment should be sought or given by carers of people with epilepsy once a seizure has persisted, or there are serial seizures, for more than five minutes. Generalised tonic-clonic status epilepticus is a medical emergency with significant morbidity and mortality, which can often be attributed to inadequate or delayed treatment.