Chamber and committees

Grading for nurses is currently determined according to the guidance laid down in the Nurses and Midwifery Staffs Negotiating Council's Handbook.However, grading is one of the issues being addressed in the national negotiations on Agenda for Change - Modernising the NHS Pay System. A key part of the system will be a new job evaluation system purpose built to covering amongst others, all NHS nursing posts.

I refer the member to the answer given to question S1W-30193 today. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at http://www.scottish.parliament.uk/webapp/search_wa.

I am advised that the Food Standards Agency Board, at a recent open meeting, reviewed progress on pesticide and veterinary medicine residues in food. As part of this discussion, the board endorsed the need to pursue a strategy to encourage ways of improving the use of pesticides so that residues are minimised, with the aim of working towards zero residues. The agency continues to involve stakeholders in this dialogue and is developing an action plan to take forward this commitment to drive down residues in food.

I refer the member to the answer given to question S1W-30193 today. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at: http://www.scottish.parliament.uk/webapp/search.wa.

Figures are not held centrally on the number of people, including children, who have been prescribed methylphenidate hydrochloride (Ritalin) or other drugs for attention-deficit hyperactivity disorder (ADHD). Data collected centrally relate to the number of prescribed items and cost dispensed in the community by community pharmacists and dispensing doctors. The data is not patient-specific.In deciding whether or not to prescribe Ritalin or other drugs for ADHD, clinicians would be expected to take account of advice and guidance about these treatments. This would include the national clinical guideline on Attention Deficit and Hyperkinetic Disorders in Children and Young People issued by the Scottish Intercollegiate Guidelines Network (SIGN) in June 2001, the guidance issued in October 2000 by the National Institute of Clinical Excellence (NICE) on the use of methylphenidate (Ritalin and Equasym) for ADHD in childhood and the Scottish Medicines Consortium advice dated July 2002 about the methylphenidate sustained release OROS formulation Concerta XL. Through the Chief Scientist Office, the Scottish Executive is funding a preliminary study of complementary therapy for children with ADHD. Given that there are well-established mechanisms for assessing clinical research and developing evidence-based guidelines for use within the health service, it would be inappropriate for the Executive to offer assessments of individual research papers.

As described in the consultation document Towards Better Oral Health in Children, issued on 24 September 2002, an expert scientific review, published in 2000, concluded that, aside from a possible increase in the prevalence of dental fluorosis of aesthetic concern, there is no evidence of other adverse effects on health, where fluoride is used at recommended doses.

Cancer in Scotland: Action for change sets out a variety of measures aimed at improving prevention, earlier detection and treatment for all cancers including breast. Investment plans for 2001-02 and 2002-03 include details of additional investment targeted specifically at breast cancer services. Investment plans are published on the Cancer in Scotland website, www.show.scot.nhs.uk/sehd/cancerinscotland. Copies are also available in the Parliament's Reference Centre (Bib. numbers 17445 and 21487).

The daily dose of methadone prescribed is a matter of clinical judgement and should be tailored to meet the needs of the individual. In particular, those who habitually have been taking methadone will be able to tolerate a much higher dose. Those who have never taken the substance, or have not taken it for some time, have much lower tolerance and may experience severe toxicity. Prescribers should take into account advice and evidence about methadone use, for example, the UK Drug Misuse or Dependence - Guidelines on Clinical Management (HMSO 1999), available to all doctors, include a section on the dosage regime for methadone maintenance.

The national target in relation to out-patient waiting, set out in Building a Better Scotland, published on 12 September 2002, is that, by 2006, no patient should wait more than six months for a first out-patient appointment. Information on out-patient waiting times is collected centrally at specialty level only. The median waiting time for a first out-patient appointment with a consultant, following referral by a General Medical/Dental Practitioner, for the six most common specialties and for cardiology, in the year ended 31 March 2002, are given in the table.NHSScotland. Median Waiting Times for a First Out-Patient Appointment with a Consultant, following Referral by a General Medical Practitioner: Year Ended 31 March 2002.

Specialty	Median Wait
Cardiology	42 days
ENT	66 days
General Surgery	40 days
Gynaecology	49 days
Ophthalmology	69 days
Orthopaedics and Trauma	97 days
Urology	68 days
All Specialties	50 days

Source: ISD Scotland.

The provision of individual care therapies and treatments are a matter for clinicians in consultation with the relevant professional staff/multi-disciplinary team. Decisions and appropriate responses in each case should always be based on individually assessed needs. The Scottish Intercollegiate Guidelines Network Guideline on Attention Deficit and Hyperkinetic Disorders in Children and Young People which was published in 2001 to provide good practice guidelines for clinicians covers non-pharmacological therapies as well as pharmacological treatment.