Chamber and committees

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.

Information on the number of children diagnosed with attention-deficit hyperactivity disorder is not available centrally. However, information from a sample of GP records in practices across Scotland whose population is nationally representative suggests the following numbers of patients with attention deficiency disorder/attention deficit hyperactivity disorder were seen by GPs over the last four years. It is not possible to provide information prior to 1998-99 because of code differences prior to that date.

Year	Estimated Number of Patients Seen by GPs
1998-99	1,600
1999-2000	1,800
2000-01	1,800
2001-02	1,700

These data refer to diagnoses known to the patients' GP. There may be other patients whose condition is managed by specialist services, such as child psychiatry, who may not see their GP for these conditions and will therefore not be included in the data.

Complementary and alternative medicine treatments, such as homeopathy and osteopathy can feature within NHS services, and this is a matter for local decision.During the financial year ending 31 March 2002, the Prescription Cost Analysis system records that 38,157 homeopathic items were dispensed in the community with a gross ingredient cost of £109,132. Data on homeopathic medicines dispensed by hospitals or hospital based clinics are not available centrally.Data on other non-conventional medicines, for example herbal medicines, are not separately identified because of the small numbers of prescription items.Data on non-conventional therapies provided by the NHS such as acupuncture are also not held centrally.

Successful implementation of the agreement A Teaching Profession for the 21st Century will provide greater flexibility, autonomy and diversity to deliver local solutions, helping to modernise school education throughout Scotland. The agreement recognises and rewards the professionalism teachers bring to the classroom and, by improving administrative practices and providing increased numbers of support staff, ensures they have more time to teach. The implementation of the agreement is on track and making good progress towards full implementation in 2006.

All the care and treatment required to secure and maintain the oral health of a patient is available and remunerated under NHS general dental service arrangements. For children, dentists receive a capitation fee for each child registered with them under NHS arrangements. This fee covers preventive treatment, advice and attention required by the child. In addition, dentists receive an enhancement of the capitation fee for each child aged zero to two years, each child aged three to five years in Depcat 6 and 7 areas, and each child aged six to seven years, registered with them under NHS arrangements. This enhancement is for the provision of a preventive programme including dietary advice. For those aged six and seven the enhanced fee includes the application of fissure sealants. For adults this includes payment for preventive treatments such as instruction in the prevention of dental disease, scaling and polishing, application of fissure sealant and the application of topical fluoride in certain circumstances.

The information available is shown in the following table:Number of Patients in Scotland Diagnosed with Obesity who have had Surgery to Aid Weight Reduction: Years Ending 31 March

Year	Number of Patients
1996-97	38
1997-98	58
1998-99	49
1999-2000	30
2000-01	51

Source: ISD Scotland SMR1/01 linked data set.

The information requested is not held centrally. However, clinicians report that at present the numbers are very low but are expected to rise. Type 2 diabetes in children is usually a consequence of obesity.

SIGN (Scottish Intercollegiate Guidelines Network) Guidelines on the management of obesity are due to be published in winter 2002. "Obesity - children and young people" will focus on weight management and risk factor reduction as well as the role of the patient and family.Two of the key risk factors in obesity are poor diet and lack of physical activity. The implementation of the Scottish Diet Action Plan, which prioritises children's diet, is being pursued in a renewed and focused effort to meet the dietary targets set for 2005. The Expert Panel on School Meals published draft National Guidelines for School Meals in July 2002. The report, Hungry for Success, sets nutritional standards for school meals as well as measures to improve the appeal and uptake of school meals. As part of our wider approach to health improvement, Building a Better Scotland has committed additional investment to improving the nutritional content and uptake of school meals.Increasing the level of physical activity is fundamental to achieving a healthy lifestyle for children and we are determined that every step should be taken to increase participation. The Physical Activity Task Force, which was set up in June 2001, has brought together key agencies in sport and leisure, education, health, fitness, exercise and play in a joint action to help people of all ages enjoy the benefits of physical activity. As part of our wider approach to health improvement, Building a Better Scotland has committed additional investment to expand the Active Primary School programme.

It is for local authorities to choose care provision which best suits the needs of those people requiring care. It is also for authorities to set the level of fees for their own care homes, in line with the requirement in the National Assistance Act 1948 that the fee represents the full cost to the authority of providing the care home place.