Chamber and committees

On 2 December 2002, the Scottish Executive launched Choose Life: A National Strategy and Action Plan to Prevent Suicide in Scotland, which aims to tackle the rising rate of suicides in Scotland. It includes a particular focus on a range of vulnerable groups, including young people (especially young men), people with mental health problems, substance misusers and persons in prison. The strategy outlines clear objectives for concerted national and local action. The strategy and action plan are supported by a new investment of £12 million over three years, to be used to help promote improved, co-ordinated planning and the development and implementation of action by local agencies; to support local innovation and training and to encourage the development of interventions and services by local voluntary, community and self-help groups, and for work at national level and the establishment of a national implementation support team.The Scottish Executive also funds the Breathing Space telephone advice line for people, particularly but not exclusively young men, who suffer from low mood and might be at risk of suicide.

Information on the number of specialist rheumatology nurses is not available centrally.Information on the number of consultant rheumatologists working in each NHS board area is available in tables B10 and B11 on the ISD website. The website address is:http://www.show.scot.nhs.uk/isd/NHSiS_resource/Workforce/workforce_statistics.htm.

I have been advised by the Food Standards Agency that the EC Directive 2002/46/EC ensures a high level of protection for consumers as products on the market will comply with agreed safety levels and will bear adequate and appropriate labelling. Implementation of the directive will not immediately outlaw any products already on the UK market. The impact of the directive on the future continued availability of products will depend upon future developments on lists of permitted nutrients and on maximum limits. There are currently no specific limits in UK law on the level or range of vitamins and minerals contained in food supplements. Food supplements are regulated in other member states by differing national rules that may impede their free movement, create unequal conditions for competition and consumers. It is therefore necessary to adopt Community rules on those products marketed as foodstuffs.The directive deals only with the composition of vitamin and mineral supplements and will have no impact on the consumers of herbal remedies. Traditional herbal medicines are a reserved matter, dealt with by the Medicines Control Agency (MCA), the UK Medicines Regulatory Authority.

NHSScotland is expected to implement evidence-based guidelines and recommendations from bodies such as SIGN. As guidelines are an integral part of the development of condition-specific standards by the Clinical Standards Board for Scotland, the board's assessment of compliance with these standards, and with its clinical governance or generic standards, ensures that procedures are in place locally to implement relevant evidence-based guidelines and recommendations. However, NHS boards are responsible for decisions about the level of resource to commit to this work.

The National Waiting Times Centre was purchased by the Scottish Executive for NHSScotland in the course of the current financial year, and it is already making good progress towards the target of undertaking 5,000 procedures in its first full year of operation. As NHS boards had already agreed their financial plans for this year by the time of the purchase of the centre, they would have had to make reductions in other services if they had been required to pay for the extra activity at the centre. Consequently, no charges are being levied against NHS boards for their use of the centre in 2002-03.NHS boards are expected to build their costs for using the National Waiting Times Centre into their plans for future years.

There are no current plans to review this report. It remains a matter for each NHS board or trust to make their own assessment of need for such therapies and provide resources, as appropriate.

The Executive will work with NHS Scotland and professional bodies to ensure that the NHS will have the capacity to meet the additional demands which will be placed on it when the anticipated new Mental Health Act comes into effect. This includes increasing the capacity of psychiatric services to meet the demands associated with the proposed new procedures.

We already have practical examples of managed clinical networks (MCN) at local, regional and national level. There is the cardiac services MCN in Dumfries and Galloway, the diabetes MCN in Tayside, the regional cancer MCNs and national MCNs for cleft lip and palate and home parenteral nutrition. Two demonstration MCNs, one in vascular services and one in neurology with particular reference to stroke, are being evaluated.A wide range of MCN development is being taken forward, covering conditions such as multiple sclerosis, epilepsy, asthma, chronic obstructive pulmonary disorder, hepatitis C and primary immunodeficiency, as well as in areas such as pathology, mental health, learning disabilities and medical receiving in community hospitals.The CHD/Stroke Strategy makes clear that each NHS board should have a cardiac services and a stroke MCN in operation by April 2004. The Scottish Diabetes Framework has a milestone that by September 2004 Managed Clinical Networks for Diabetes will be established in each NHS board area.

The Executive's plans for implementing the recommendations in Fair Shares for All indicated that the aim was for all boards to reach their Arbuthnott share of resources within five or six years.Since the introduction of the Arbuthnott formula in September 2000, all boards have received a minimum increase in unified budget with those boards below their Arbuthnott share receiving additional funding. To date, additional funds totalling £71.2 million have been allocated to boards currently below their Arbuthnott share.

The forecast financial position of the acute NHS trusts as at 30 September 2002 was as follows:

Trust	Forecast Full Year Under/(Over) Spend Against Revenue Resource Limit(£000)
Argyll and Clyde Acute	(3,689)
Ayrshire and Arran Acute	(1,200)
Borders General Hospital	60
Dumfries and Galloway Acute	(300)
Fife Acute Hospitals	(1,490)
Forth Valley Acute	123
Grampian University Hospitals	(4,000)
North Glasgow University Hospitals	2,128
South Glasgow University Hospitals	0
Yorkhill	175
Highland Acute	(1,284)
Lanarkshire Acute	(763)
Lothian University Hospitals	0
West Lothian Healthcare	(1,520)
Tayside University Hospitals	0

The figures in the table are taken from the September 2002 monthly monitoring reports.Those NHS trusts which were forecasting to overspend against their revenue resource limit are working with their local NHS boards, Primary Care NHS Trusts and the Scottish Executive Health Department in order to return to financial balance whilst protecting patient services.