Information from Drug and Alcohol Action Teams (DAAT) for 2002-03 indicates that there are 45 specialist addiction services which are either dedicated solely to under 16s, or which have dedicated workers of facilities for under 16s. Thirty six of these services cover both drugs and alcohol services, while 9 are dedicated to drugs only. A breakdown by NHS board is provided in the following table:-

NHS Board	Total no. services	No for Drugs & Alcohol	No for drugs only
Argyll and Clyde	6	4	2
Ayrshire and Arran	3	0	3
Borders	1	1	0
Dumfries and Galloway	0	-	-
Fife	3	2	1
Forth Valley	2	2	0
Grampian	2	1	1
Greater Glasgow	11	11	0
Highland	10	9	1
Lanarkshire	1	1	0
Lothian	4	3	1
Orkney	0	-	-
Shetland	0	-	-
Tayside	2	2	0
Western Isles	0	-	-
Total	45	36	9

These services provide a range of interventions, including counselling, advice and information, education and training, and aftercare. DAAT returns indicate that 8 services provide detoxification. In addition to the services referred to above, under 16s access mainstream drugs services for treatment, and they can receive assistance through generic health and social services.

In the last five years,there have been no reports of patients under 16 attending the residentialservices which contribute to the Scottish Drug Misuse Database.

Only those private landlordswho are not assessed as fit and proper persons will find that theirregistration applications are rejected or revoked and, in these circumstancesthe tenant will retain his or her protections against eviction under theletting contract and under statute. We do not believe that this will lead to asignificant increase in homelessness and it should help to improve standardswithin the sector.

Depression and anxietydisorders are serious conditions which are known to be associated with anincreased risk of suicidal behaviour. Prescribers and other care providersinvolved with patients taking antidepressants will be aware of the recognisedside effects of treatment. Guidance, available to prescribers, recommends thatpatients with depression should be asked about suicidal thoughts and thoseconsidered to be at risk should be closely monitored.

The safety of the selective serotoninreuptake inhibitors, including any link to an increased risk of suicide, iscurrently undergoing intensive review by an expert working group of theCommittee on Safety of Medicines. The group is expected to finish its worklater this year, at which time it will publish a final report.

Clinicians are also aware of the benefits for patients of talking treatments which can help reduce or removereliance on drug based regimes and put the patient more in control of theircare. An example of this approach is the “Doing Well by People with Depression”programme, funded over three years by the Centre for Change and Innovation.This programme is looking at how we manage mild to moderate depression betterin primary care. The programme is taking a whole systems approach butspecifically it is looking at how we can use interventions such as counselling,self help, psychological interventions such as cognitive behaviour therapy andalso the voluntary sector to help improve the patient’s treatment andexperience as well as attempting to free up GP time and capacity.

In my recent news releaseissued on 7 July, I explained that we are looking at ways to expand the supplyof affordable housing for sale and rent in Scotland through discussionswith Homes for Scotland including ways of expand the supply of starter homesfor sale on larger, planned sites in areas under pressure.

As part of the modernisationof the planning system, we aim to ensure that development plans, which includeallocations for housing, are up to date and that the approval system isstreamlined and speeded up. We are also planning to issue supplementaryguidance later this year on ways in which the planning system can facilitatethe provision of affordable housing, including affordable housing linked to developmentsby private builders. And as part of the Affordable Housing Review, the ScottishExecutive has published research into The Irish Planning System and AffordableHousing, which we shall study with interest.

The Scottish Executive doesnot have robust information on the total number of houses in multipleoccupation which are eligible to be licensed.

The Executive is providing£1 million in this and each of the next two financial years to help localauthorities improve their HMO licensing systems and ensure that all existingHMOs are licensed. As part of the process of setting objectives for the use ofthis funding, each authority was asked to estimate the number of licensableHMOs in their area. The total of these estimates was 18,312, at 30 June 2003.However, this should only be taken as a rough indication of numbers, as therobustness of the estimate for each local authority area depends on the levelof identification activity carried out to date.

The most recent figure forthe number of HMO licences in force is 1922, at 31 March 2003. Statistics forthe year 2003-04 are not yet available.

As with all medicines, thesafety of selective serotonin reuptake inhibitors (SSRIs) and tricyclic andrelated anti-depressants is continuously monitored by the Medicines andHealthcare products Regulatory Agency and the Government’s independent expertadvisory body the Committee on Safety of Medicines.

The choice of treatment fora particular patient depends on the clinical judgement of the doctor concerned,in consultation with the patient and bearing in mind the risks and benefits oftreatment. There are a number of reasons why the SSRIs may be the treatment ofchoice for some patients. For example, the side-effect profile of the SSRIs andthe older tricyclic anti-depressants differ. Also, the SSRIs can be used bypatients with cardiovascular disease. The recognised side-effects for bothcategories of drug are provided in the authorised product information and the BritishNational Formulary www.bnf.org.

Many drugs acting on thecentral nervous system are recognised as having the potential to cause sideeffects in some people. The extent to which these reactions occur may differbetween drugs and between individuals taking the same drug. Guidance, availableto all prescribers from a variety of sources, emphasise the importance ofsupporting and monitoring patients who are discontinuing or reducing treatment.

The information which mustbe provided to a patient about a prescription medicine when it is dispensed,and the form in which the information should be provided, is set out in Title Vof Council Directive 2001/83/EC and in the Medicines for Human Use (MarketingAuthorisations etc) Regulations 1994. In the UK, the Medicines and HealthcareProducts Regulatory Agency is responsible for the policy and regulation ofproduct information and the Agency’s website gives an overview of their work inthis area www.mhra.gov.uk. However, theprovision of good quality patient information is intended to supplement and notreplace the advice given to patients by health professionals.

In Scotland,Psychological Intervention Guidance was published in 2001 and a report by theChief Medical Officer on psychological interventions was issued in 2003. Thesedocuments underline the importance of talking therapies in putting patientsmore in control of their treatment and which can help to remove or reduce areliance on drug treatments.

Depot medication is helpful forpatients who have difficulty complying with oral treatment by simplifying thetreatment process. Guidance, available from a variety of sources, emphasisethat depot medication should be prescribed when appropriate. Importantly, theBritish National Formulary provides national guidance on the prescription ofantipsychotic depot injections. This guidance can be accessed at www.bnf.org.

As with all medicines, thedecision whether or not to prescribe a treatment for a particular patientdepends on the clinical judgement of the doctor concerned, in consultation withthe patient and bearing in mind the risks and benefits of treatment.

Information for patients onhow to use medicines safely and effectively is provided in the PatientInformation Leaflet , which accompanies the medicine. These leaflets areauthorised by the Medicines and Healthcare products Regulatory Agency (MHRA) atthe time of licensing and updated throughout the life of the product as newinformation on risks and benefits emerges.The information required tobe provided to a patient about a prescription medicine when it is dispensed,and the form in which the information should be provided, is set out in Title Vof Council Directive 2001/83/EC and the Medicines for Human Use (MarketingAuthorisations etc) Regulations 1994. In the UK, the MHRA regulates productinformation and their website gives an overview of their work in this area www.mhra.gov.uk

However, the provision ofgood quality patient information is intended to supplement and not replace theadvice given to patients by health professionals.