Chamber and committees

It is for the judge in eachcase to decide the response to a request that jurisdiction should be declined.Ministers cannot intervene in matters which are for the courts to determine.

Each of the four neurosurgicalcentres in Scotland provides this service.

Jean Dunlop and Roy Hayter attendthe Disabled Persons Transport Advisory Committee (DPTAC) meetings. They were nominatedby the Scottish Executive for membership. The Mobility and Access Committee forScotland (MACS) has a complementary work programme to DPTAC who are the UKGovernment statutory advisers on transport issues for disabled people relatingto devolved transport issues. The Taxi Working Group is a sub-committee ofDPTAC and DPTAC members are assigned to its membership. The Scottish Executiveremains committed to improving transport for disabled people in Scotland.

Employers and serviceproviders must meet accessibility obligations under the DisabilityDiscrimination Act 1995 (DDA) including, from October 2004, a duty to makereasonable adjustments to physical features of premises. The DDA is reserved UKlegislation.

The Scottish Executive has taken many steps to improve accessibility for disabled people,including adjustments to physical features. These include:

Access audits of core Scottish Executive buildings across the estate.

Support for over £500 millionof local authority housing capital investment in the current year, throughgrant and support for borrowing. This is an increase of 40% on 2000-01. Councilsestablish their own capital investment priorities and should take into accounttheir responsibilities under the DDA.

The Scottish Executive Health Department has established a Disability Steering Group to assistthe NHS in compliance with the DDA. The steering group has cross-sectoralrepresentation including the Disability Rights Commission, the ScottishDisability Equality Forum, Capability Scotland and the NHS.

The Scottish Executive has recently agreed to fund an umbrella body which will support localaccess panels in improving disabled peoples' access to the built environment.

For schools the DDA does not cover physical alterations.However, the Education (Disability Strategies and Pupils’ Educational Records)(Scotland) Act 2002 requires that positive steps be taken to improve access toschool premises, to the curriculum and to school information. The firstaccessibility strategies were to be prepared by April 2003 and the Scottish Executive is providing £9 million/£17 million/£17 million in 2003-06 to helpeducation authorities implement their strategies. This additional funding canbe further supplemented by use of the school refurbishment and improvementbudget, by school estate public and private partnership projects, and by theNational Priorities Action Fund Inclusion Programme (£20 million/£25 million/£25million).

Further and Higher education were brought within the scope of the DDA through theSpecial Educational Needs and Disability Act 2001 at Westminster.

An additional £26 million infunding was announced for 2002-03 to help ensure equal access to further andhigher education opportunities to all members of society.

£10 million for the highereducation sector to improve disability infrastructure.

£16 million for furthereducation institutions primarily to strengthen their financial position,contribute to legislative compliance and other local priorities.

The funds helps both sectorsmeet the requirements of the Special Educational Needs and Disability Act 2001,which requires educational institutions to remove physical barriers and alterpremises that could prevent disabled access. Institutions must comply with thelegislation by September 2005.

Rehabilitation services forthose who are registered blind are not provided nationally. The following tableshows the employment of qualified rehabilitation workers in each localauthority area in Scotland. In addition, nine rehabilitation workers areemployed by the Guide Dogs for the Blind Association and are allocated to localareas on a project basis.

Employment of Qualified Workers

Local Authority	Total
City of Glasgow	6
City of Edinburgh	4
Fife	4
North Lanarkshire	3
South Lanarkshire	2
Aberdeenshire	1
City of Aberdeen	1
Highland	3
Renfrewshire	3
City of Dundee	2
Dumfries and Galloway	1
West Lothian	1
Falkirk	1
North Ayrshire	2
Perth and Kinross	1
East Ayrshire	2
South Ayrshire	1
Angus	1
East Dunbartonshire	0
Scottish Borders	1
West Dumbarton	1.5
Inverclyde	1
Argyll and Bute	0
East Renfrewshire	1
Moray	0
East Lothian	1
Stirling	0
Midlothian	1
Clackmannan	0
Western Isles	0
Shetland	0
Orkney	1

Source: Guide Dogs for theBlind Association.

For many women, the symptomsthat occur at menopause adversely affect their quality of life. Followingcareful assessment of findings from a number of studies that provide importantinformation on the safety of hormone replacement therapy (HRT), the UK Committeeon Safety of Medicines (CSM) and its expert working group on HRT have reviewedthe use of HRT in its licensed indications and issued clear safety advice tohealth professionals and women.

The CSM’s advice regarding theshort-term treatment of these symptoms is unchanged and HRT remains the firstchoice of treatment. However, in these women, the lowest effective dose shouldbe used for the shortest possible duration, each decision to start HRT shouldbe made on an individual basis with a fully informed woman and treatment shouldbe re-evaluated at least annually in light of new knowledge and any changes inthe woman’s risk factors.

The CSM has further advisedthat HRT should no longer be considered as the first choice treatment for theprevention of osteoporosis in women who are at increased risk of fractures, asthe risks are considered to outweigh the benefits. However, HRT may still beused in women who are intolerant of, or unresponsive to, other osteoporosistherapies.

The UK Committee on Safetyof Medicines (CSM) and its expert working group on hormone replacement therapy(HRT) have kept the safety of HRT under constant review and have providedadvice to health professionals and women in response to important new evidenceas it emerged. The latest advice was cascaded to health professionals and womenin December 2003.

At that time, the CSMadvised that, for women of all ages, the benefits of short-term use of HRT forthe relief of menopausal symptoms outweigh the risks for most women.

For women who are over 50years of age, HRT should no longer be considered as a first-line therapy forthe long-term prevention of osteoporosis. In women who are under 50 years andhave experienced a premature menopause, HRT may be used until the age of 50years.

Prescribers are advised thateach decision to initiate treatment with HRT should be made on an individualbasis and that women should be made aware of the increased risk of adverseeffects. Each treatment decision should take into consideration the known risksand benefits of HRT, the contraindications for use and each woman’s individualcircumstances. Importantly, the treatment should be re-evaluated at leastannually in light of any new knowledge and any changes in the woman’s riskfactors.

Product information providedwith each pack of HRT reflects safety information. In addition, the Medicinesand Healthcare products Regulatory Agency (MHRA) and CSM website www.mhra.gov.uk contains comprehensiveinformation about the known risks associated with HRT use.

As with all licensedmedicines, the CSM keeps the safety of HRT under close review, and would takeappropriate action if further evidence relating to its safe use becameavailable.

At present women under 50are not offered routine breast screening due to the density of their breasttissue which makes it difficult to detect small breast cancers by mammography.The findings of a UK trial looking at the benefits of screening womenfrom the age of 40 are expected in 2005 and will be considered in due course.

Scottish MedicinesConsortium (SMC) advice is issued direct to NHS boards by the SMC. Informationabout products recommended by the SMC for use within NHSScotland can be foundon their website www.htbs.co.uk/smc ,or by contacting the SMC secretariat at Delta House, 50 West Nile Street,Glasgow, G1 2NP (0141 225 6997).

During 2003, the SMCreviewed 3 contraceptive products Yasmin, Evra and Cerazette.

Currently all new buildingwork, including alterations and extensions, which is covered by the buildingregulations, must comply with the Technical Standards for compliance with theBuilding Standards (Scotland) Regulations 1990. Access for disabled people to,and throughout, a building is an integral part of these requirements.

My officials will consider thescope for disability audits as we take forward work on modernising the planningsystem.