On 24 February 2005 the First Ministerannounced that the Executive was establishing a review group to consider the operationalperformance of NHS 24 and to come forward with recommendations for action, includingactions for NHS 24, NHS boards, other partners and the Health Department for improvingthe services provided.

The terms of reference of thereview group include the requirement for the group to come forward with recommendationsfor improving services for patients in remote and rural areas. And I expect bothNHS 24 and the group to consider whether the current three call centre model bestmeets the expected performance standards for the service.

The Scottish Executive supports the effective management of pain for all patients by all clinicians.The Executive recognises that pain management is an integral part of health careand an important part of clinical practice for all health professionals.

Specific training in pain managementis being delivered in a variety of settings, for example for medical and dentalundergraduates and for anaesthetic and intensive care Specialist Registrar trainees,as part of the relevant curriculum; for house officers, in their induction programmes;for surgical and anaesthetic Senior House Officers; for GP registrars and palliativecare Specialist Registrar trainees, and for dentists and professionals complementaryto dentistry, through postgraduate courses. In addition, pain management teams arenow a feature of most hospitals, and junior doctors interface with them during theirextensive period of workplace learning.

A multi-disciplinary PaediatricPain course recently commenced, pump-primed by NHS Education for Scotland andaimed at ensuring that practitioners in Scotland have relevant and appropriately designed educationalprovision to meet the needs of children in pain.

The pilot hadtwo aims - to test the ability of the market to deliver the single survey on a voluntarybasis, and to test the concept itself. It is clear from the low take-up that themarket-led approach has not delivered and that the scheme does not provide enoughincentives for many sellers to participate on a voluntary basis. We believe, however, that the rationale for the singlesurvey remains strong – providing in-depth information on a property to buyer andseller before sale and ending the need for multiple condition surveys. We thereforeconcluded that we should now evaluate the detailed outcomes of the pilot with aview to introducing a mandatory scheme.

The Scottish Executive consultation on fertility treatment will commence in May 2005.

The management of staff fatigue within the Scottish Ambulance Service is an operational matter for that organisation.

The ambulance service is not aware of any occasions when fatigued staff have felt reluctant to sign off work in case urgent ambulance support is required. The organisation actively encourages staff, through its driver fatigue policy, to call in fatigued whenever they feel it would be clinically unsafe for them to continue with their duties.

The management of staff fatigue within the Scottish Ambulance Service is an operational matter for that organisation. Off-duty ambulance crew are recalled to maintain cover during periods of absence caused by staff fatigue only in circumstances where it is assessed that the demand cannot otherwise be adequately covered.

The management of staff fatigue within the Scottish Ambulance Service is an operational matter for that organisation. The Executive would expect the ambulance service to be able to provide safe and appropriate care at all times, in accordance with the clinical needs of patients in the Highlands and elsewhere in Scotland.

The use of on-call by the Scottish Ambulance Service in the Highlands and elsewhere in Scotland is an operational matter for that organisation. The rates of pay, including the on-call payment, are negotiated and agreed each year under the service’s partnership arrangements. The rate applies when staff are providing out-of-hours cover by being available on-call, in most cases at home, to respond to emergency calls. Where they are tasked to respond to a call they receive their full hourly rate of pay for the duration of the incident and for each call-out they receive a minimum of two hours pay. These payments are additional to those made to staff for their contracted in-hours duties.

There are currentlyno separate energy efficiency targets for Scotland. However,the current review of the Scottish Climate Change programme is considering the possibilityof Scottish energy efficiency targets as part of the development of the proposed energy efficiency strategy.

The fees paid to dentists for providing NHS general dental services are increased each year as a result of the recommendations of the Doctors’ and Dentists’ Review Body (DDRB). For 2005-06, the DDRB has recommended an increase of 3.4% in fees and the Government has accepted that recommendation in full and without staging.

We expect to announce in the coming weeks our response to the consultation Modernising NHS Dental Services in Scotland, which will include further measures to support NHS dentistry.