The range of treatments available for opiate misusers includes different forms of prescribing, for example substitute drugs, counselling and other psychosocial interventions, detoxification and alternative therapies. The various treatment options are described in Drug Misuse and Dependence - Guidelines on Clinical Management, and are also examined in the Effective Intervention Unit's research publication, A survey of NHS services for opiate dependents in Scotland, which can be found at http://www.drugmisuse.isdscotland.org/eiu/pdfs/eiu_nhs_opi.pdf.As indicated in the clinical guidelines, a key aim of treatment for opiate users is to "assist the patient to remain healthy, until, with appropriate care and support, he or she can achieve a drug-free life." The nature and duration of the treatment are determined by health professionals in accordance with the needs of the individual patients concerned.

There have been some trials outwith the UK, focussing upon chronic heroin users, which suggest that diamorphine maintenance may be beneficial for this population of drug users. In practice, it is rare for diamorphine to be prescribed in Scotland for opiate addiction as an alternative to methadone, given the strong evidence base which exists for the effectiveness of methadone maintenance. The treatment plan is based on the clinical judgement of the medical practitioner, with regard to the needs and circumstances of the individual patient. The National Treatment Agency (England and Wales) is developing new guidelines on the prescribing of diamorphine, and we are already in touch with the agency so that we can consider possible application in Scotland.

I have asked Tony Cameron, Chief Executive of the Scottish Prison Service (SPS) to respond. His response is as follows:The SPS accredits intervention programmes and sites where programmes are delivered. The standards are contained within the accreditation manual. Information from individual site accreditation is published in the Annual Report of the SPS Accreditation Panel. The annual report for 2001-02 is available in the Parliament's Reference Centre.

The staffing of the Scottish Heart Transplant Unit has been strengthened, in particular by the inclusion within the multi-disciplinary team of four consultant surgeons capable of performing heart transplants. The basis on which the unit was allowed to resume heart transplant operations in September 2001 was that its performance would be reviewed after two years.

The Executive welcomes the Heartstart UK Scottish schools initiative and the development of emergency life support skills within the community.

We very much support the teaching of emergency life support skills, but these do not have a specific role in reinforcing the Executive's healthy eating and physical activity policies.

Health boards were allocated non-recurring spend of £19 million in 2000-01. Local authorities were allocated £10 million in GAE from 2001-02. New expenditure of £20 million was allocated to local authority and health partnerships from 2002-03 to support the Delayed Discharge Action Plan, announced on 5 March 2002. This sum rises to £30 million from 2003-04. All these allocations supplement existing budgets. Partnerships have been encouraged to take a whole systems approach to tackling delayed discharge, looking at how to make best use of all the resources available to them and to more effectively link together existing services, as well as developing new ones. The Executive has set a target to provide 1,000 extra places in the community in the current financial year. Partnerships are implementing Local Joint Action Plans to achieve their targets and performance will be measured at the point of the April 2003 census. It is not possible to extract from total discharge numbers those discharges funded directly from the above sums.

Guidance was issued to NHS boards and local authorities in March on the interests that Alcohol Action Teams (AATs, formerly Alcohol Misuse Co-ordinating Committees) should bring together. This includes the voluntary sector, alcohol industry, the community and service users. AATs are due to submit local alcohol action plans by April 2003 which will detail how all interests are involved in the work of the team.

The review identified gaps in young people, service user and prison interests and we have appointed representatives from Young Scot, Alcoholics Anonymous and the Scottish Prison Service to the committee to fill these gaps.

I have asked Tony Cameron, Chief Executive of the Scottish Prison Service to respond. His response is as follows:In line with our drug strategy, we have invested in services designed to bring substance misusing prisoners into an effective treatment process, to hold them there, and to manage effective transition to the community around release.