The safety of medicines is a reserved matter and is the responsibility of the Medicines Control Agency (MCA) and the Committee on Safety of Medicines (CSM).The MCA has advised that various data sources are used for monitoring drug safety. This includes the Yellow Card Scheme, where health professionals' report suspected adverse drug reactions to the MCA/CSM. The value of spontaneous reporting schemes such as the Yellow Card Scheme is in the early identification of possible drug hazards. The other data sources used regularly in the monitoring of drug safety in the UK include formal safety studies, published medical literature, information from pharmaceutical companies and other regulatory authorities throughout the world. When a new safety issue is confirmed, regulatory action is taken to minimise risk. This may include strengthened product warnings or restricting the terms of the marketing authorisation. Rarely, if there is evidence that the balance of risks and benefits is no longer favourable, it may be necessary to remove the medicine from the market.The MCA/CSM monitor the safety of all new medicines under the "black triangle scheme" where any of the following circumstances apply: if the medicine contains a new active substance or a combination of active substances; if the medicine is administered via a new route or drug delivery system; if the medicine is going to be used in a new population of patients.

It is not possible to estimate the quantity and cost of unused medicines which are not handed in to community pharmacies for safe disposal.We set out in The Right Medicine - A Strategy for Pharmaceutical Care in Scotland (Bib. number 18835) the actions we will be taking to help patients understand how to use their medicines to best effect. This will help reduce wastage through non-compliance.

All LHCCs have an important role in developing population-wide approaches to health improvement and disease prevention, for all those in the communities they serve.

Under the National Health Service (General Medical Services) (Scotland) Regulations 1995, an Islands NHS Board or a Primary Care Trust is required to keep an up-to-date list of patients for each of its general practitioners. Where the board or trust is satisfied that a person no longer resides in the area where the general practitioner provides services or that the whereabouts of the person are no longer known to it, it should remove that person's name from the patient list. Students are entitled to have their names included in the patient list of a general practitioner in the area where they reside during their course of study. Registration of students is subject to the same controls as other patients. When a patient dies their name is to be deleted from the patient list as from the date on which notification of death is received by the board or trust. A general practitioner is obliged to send the medical records of a patient who has died to the board or trust in a case where he or she learned of the death other than by notification from that body.Temporary residents are not included in a general practitioner's list. The board or trust for the area of their normal place of residence should remove them from the list of their own general practitioner once their stay in the place of temporary residence exceeds 90 days and they have not returned to their own area.

The Executive issued NHS HDL (Health Department Letter) (2002)20 to NHSScotland on 28 March 2002. This outlines guidance on payment verification arrangements for family health services. Chapter 4 of the payments verification procedures document at Annex B of the HDL lists the verification checks undertaken by the Common Services Agency on payments claimed by GPs under general medical services, including item of service fees. In addition, the Executive issued HDL(2002)23 on 5 April 2002 which provides guidance to NHSScotland on procedures to be followed where there is cause to suspect that a criminal offence, including fraud, has been committed involving public funds or property. There is a requirement to report the case to the Procurator Fiscal where there is prima facie evidence of fraud. The HDLs are available on the SHOW website at:http://www.show.scot.nhs.uk/sehd/publications.aspIn addition to having their case referred to the Procurator Fiscal, GPs who are suspected of claiming payments falsely will be investigated by the Fraud Investigation Unit of the Common Services Agency and may be referred to one or more of the following bodies, depending on the gravity of the alleged offence - an NHS Discipline Committee, the NHS Tribunal, the General Medical Council.

All claims for payment from general practitioners are subject to pre-payment verification checks ranging from a scrutiny of claim forms to contacting the patient to confirm details. Guidance on pre- and post- payment verification procedures was issued to NHS Scotland on 28 March 2002. The guidance issued under cover of circular NHS HDL (2002) 20, a copy of which can be obtained from the Scottish Health on the Web (SHOW) website at:http://www.show.scot.nhs.uk/publicationsindex.htm.

I have asked Tony Cameron, Chief Executive of the Scottish Prison Service (SPS) to respond. His response is as follows:About 2,100 prisoner places are currently available to prisoners who wish to have nothing to do with drugs. This figure represents 36% of available capacity. The SPS Drug Strategy (Partnership and Co-ordination, published in March 2000) looked for around 40% of capacity to be available to such prisoners by April 2002.

The Scottish Executive Health Department is funding the evaluation of two demonstration Managed Clinical Networks, one in vascular services in Lanarkshire, the other in neurology with particular reference to stroke which is being taken forward jointly between Wishaw Hospital and the Institute of Neurological Sciences at the Southern General Hospital, Glasgow. A wide range of other Managed Clinical Networks are being developed.

According to the community health index, 5,350,424 patients are currently registered with general practitioners in Scotland.

This funding is not targeted at any particular group of patients, but at increasing recruitment to relevant clinical trials for all cancers. The availability of suitable trials, patient eligibility and consent to participate will determine appropriate action areas.