Chamber and committees

As part of the Scottish Executive's review of orthodontic services, a new grade of Specialist Salaried General Dental Practitioner and associated feescale were introduced on 9 April 2002 for the salaried general dental service. Such specialist practitioners include orthodontists, with a view to increasing availability of NHS orthodontic treatment. The Executive has already approved, to date, two specialist orthodontist salaried general dental practitioner posts.

The information requested is not held centrally. Waiting time information for treatment for drug and alcohol problems is not held consistently by NHS Trusts. The Executive has, however, obtained information from Drug Action Team Corporate Action Plans which indicates that there are wide variations in waiting times for clients seeking help with drug problems, from a matter of days to several months. Waiting times also vary according to the type of treatment and care required and on the system of prioritisation operating locally. The Effective Interventions Unit's work on integrated care, which will be published in the autumn, will include material about good practice in managing drug treatment services to avoid lengthy waiting times. ISD Scotland and the National Waiting Times Unit are currently involved in identifying how waiting time information in this area might be improved and monitored in the future.

The feasibility study referred to in the answer to question S1W-18320 has concurred that therapist training is feasible within Scotland and has identified the resources required. Potential numbers, location and timing are still being discussed, but it is expected that plans will allow therapist training to start in 2003. The Scottish Advisory Committee for the Dental Workforce (SACDW) will be discussing this issue at their next meeting, prior to making recommendations on the best balance of numbers in training between hygienists and therapists for Scotland. In order to encourage these professional groups to work in all areas of Scotland, we are also reviewing how, in the longer term, educational provision can be supplied in partnership with remote and rural areas of Scotland.

The number of dental hygienists training in Scotland is as follows:

Centre	In Training	To Note
Dundee	10	10 additional starts in September 2002
Edinburgh	8	10 additional starts in September 2002
Glasgow	19	10 replacement course starts in January 2003

I also refer the member to the answer given to question S1W-27548 today, which outlines the current position on training of dental therapists.

I refer the member to the answer given to question S1W-27544.

A caries prevention scheme, which provides the dentist with additional capitation fees, was introduced in October 2001. The scheme is open to all six- and seven-year-olds in Scotland and provides the dentist with an enhanced monthly fee according to the Deprivation Category of the practice postcode. The number of six- and seven-year-olds registered in Deprivation Categories 5, 6 and 7 is set out in the following table:

NHS Board	Deprivation Category	Number of Children Aged 6 and 7 Years
Argyll and Clyde	56	4,2792,694
Ayrshire and Arran	56	3,764446
Borders	Nil	Nil
Dumfries and Galloway	5	667
Fife	5	1,860
Forth Valley	56	7621,929
Grampian	5	1,786
Greater Glasgow	567	4,9709,00712,403
Highland	5	497
Lanarkshire	567	5,7993,890616
Lothian	567	5,44174872
Orkney	Nil	Nil
Tayside	56	2,9551,762
Shetland	Nil	Nil
Western Isles	6	8

I refer the member to the answer given to question S1W-27546 today for an update on the Executive's progress on the delivery of orthodontic treatment. No imminent changes to orthodontic fees are planned. The Executive has already reviewed the narrative and fees for sedation, contained in the Statement of Dental Remuneration, to increase patient safety, and is considering what further changes may be required to the overall framework for the delivery of sedation services in Scotland, following the recent publication of the Scottish Intercollegiate Guidelines Network's guideline on the Safe Sedation of Children Undergoing Diagnostic and Therapeutic Procedures. A working group, which includes representation from the profession, has been set up by the Executive to examine this area.

Under clinical governance NHSScotland is expected to implement evidence-based guidance from bodies such as Scottish Intercollegiate Guidelines Network (SIGN). SIGN Guidelines are an integral part of the development of condition-specific standards by the Clinical Standards Board for Scotland. The board's assessment visits to check compliance with these standards and its clinical governance or "generic" standards will ensure that procedures are in place to implement SIGN and other relevant evidence-based guidance.

I have made clear to NHS Chairs that action must be taken to address this issue. NHS Chief Executives have received the same message from the Head of the Health Department. The Clinical Standards Board for Scotland (CSBS) is currently visiting individual NHS trusts to confirm its assessment of performance against the standard, including planning arrangements.Following up the CSBS interim report was discussed at the recent HAI convention. A detailed action plan based on that discussion will be issued later this year. When the CSBS has completed its detailed assessment of individual trust's performance further action appropriate to local circumstances will be agreed.

Testicular cancer is one of the most curable of cancers, even if it is at an advanced stage at diagnosis, and effective platinum-based chemotherapy has been widely available for nearly 20 years. Although cancer of the testis was one of the most common forms of malignancy in men aged 15-34 between 1989 and 1998, it accounted for less than 2% of all male cancers.Due to improvements in treatment, with dose intensification and the development of new drugs, the outlook should improve for the small proportion of patients with poor prognostic disease, although this will not have a huge effect overall on this disease as the results are already very good.Therefore, although the incidence is rising in most countries in the western world (there are many theories - trauma, vasectomy, infective causes such as mumps, more fat in diet, more oestrogens in agricultural residues) the death rate is low and falling.The projected trends for testicular cancer suggest a continued increase in incidence to a level over 10 per 100,000 by 2010, with a small decrease in mortality.