Chamber and committees

The National Strategic Programme for Information Management & Technology 2001 - 2005 states that we will "establish with active co-operation of patients first versions of electronic health records based on GP summary information. First pilots to be in place 2003."We are on course to deliver that target and will establish time scales for the national roll out in the course of the pilot.

I refer the member to the answer given to question S1O-5652 on 26 September 2002, which is available on the Parliament's website, the search facility for which can be found at http://www.scottish.parliament.uk/search.htm.

The regulation and safety of medicines is reserved and is the responsibility of the Medicines Control Agency (MCA).The MCA has advised that Ritalin (methylphenidate hydrochloride) was assessed for quality, safety and efficacy at the time of licensing. As with all medicines, the safety of Ritalin is continually monitored by the agency and the independent expert advisory body, the Committee on Safety of Medicines. The authorised product information contains comprehensive information on the recognised side effects of treatment.There is the potential for abuse of Ritalin due to the nature of the drug. Ritalin has controlled drug status, which imposes restrictions on prescribing and handling. Caution is advised in patients who are emotionally unstable, such as those with a history of drug or alcohol abuse. The available clinical evidence indicates that treatment with Ritalin during childhood does not increase the likelihood of addiction in later life.The Committee on Safety of Medicines considered the issue of possible misuse of Ritalin in June 1999 and concluded that the product information contained adequate warnings and advice on prescribing.The clinical use of Ritalin for the treatment of Attention Deficiency Hyperactivity Disorder (ADHD) was reviewed by the National Institute for Clinical Excellence (NICE) in 2000-01 who recommended that treatment with methylphenidate should only be initiated by child and adolescent psychiatrists or paediatricians with expertise in ADHD and that children on methylphenidate therapy should receive regular monitoring. When improvement has occurred treatment should be discontinued at intervals under careful specialist supervision, in order to assess both the child's progress and the need for continuation of therapy.In deciding whether to prescribe Ritalin for the treatment of ADHD, clinicians would be expected to take account of advice and guidance about the drug including the Scottish Intercollegiate Guidelines Network (SIGN) Guideline 52 on ADHD and the advice issued by NICE.

It is thought that patient-held smart cards have the potential to put the patient in control of access to their records and that this might be especially beneficial when their health care providers span a number of health care organisations. For example, the card could contain a personal electronic signature which could unlock the information when used in conjunction with a card held by a clinician containing his/her electronic signature. This may contribute to the secure access infrastructure required for electronic health records.

The Scottish Executive Health and Education Departments are conducting a joint review of speech and language therapy, occupational therapy and physiotherapy services for children, and speech and language therapy services for adults with learning disabilities and/or autistic spectrum disorders. The review is being taken forward by a steering group comprising representatives from the professional therapy bodies and local authority, health and parents' interests. The working group is supported by a consultancy team from Queen Margaret University College and expects to send its report to the Executive by the end of the year.

Since the beginning of 2002, nine patients have received a heart transplant at the Scottish Heart Transplant Unit in Glasgow.

As with all medicines, the safety of Seroxat (paroxetine) is continually monitored by the Medicines Control Agency (MCA) and the independent expert advisory body, the Committee on Safety of Medicines (CSM).The CSM reviewed the issue of withdrawal reactions and possible dependence with Seroxat and the other Selective Serotonin Re-uptake Inhibitors (SSRIs) in 1998-99 and concluded that all SSRIs may be associated with withdrawal reactions on stopping, but they are not drugs of dependence. As a result of the review product information was updated.Similarly, in 2000, the European scientific advisory committee, the Committee on Proprietary Medicinal Products carried out a detailed review of withdrawal reactions and possible dependence with the SSRIs. The available evidence did not suggest that the SSRIs caused dependence. The results of the review can be found on the European Medicines Evaluation Agency website at: www.emea.eu.int.Also in 2000, the MCA/CSM reminded prescribers about withdrawal reactions associated with the SSRIs in an article in the drug safety bulletin Current Problems in Pharmacovigilance. This bulletin can be accessed on the MCA/CSM website at: www.mca.gov.uk.The MCA and the CSM will continue to assess any new data that emerge on these important issues.

I have asked Tony Cameron, Chief Executive of the Scottish Prison Service to respond. His response is as follows:Prisoners with mental illness or a tendency to self-harm are cared for by a multidisciplinary team including medical, nursing, psychology and social care staff.

The framework referred to in the question was promulgated by the National Osteoporosis Society, not by the Executive. The Executive acknowledges the role of the voluntary sector in offering advice to NHS boards on service issues, but does not monitor the implementation of such advice.

All NHS boards have adopted and are expected to operate by the principles set out in The Scottish Compact. In addition, Voluntary Health Scotland have been funded to employ development staff to ensure that NHSScotland is aware of, and makes use of the potential of their local voluntary organisations.