Chamber and committees

The Committee on Safety of Medicines (CSM) has advised that botox met appropriate standards of quality, safety and efficacy to justify its licence for use in the relief of muscle spasms and the management of excessive sweating of the armpits.Since licensing, the safety of botox has been closely monitored by the Medicines Control Agency (MCA) and the CSM. The balance of risks and benefits remains favourable in the licensed indications.

A full and formal assessment of product safety, quality and efficacy occurs in response to an application, by a pharmaceutical company, to the UK licensing authority for a marketing authorisation (product license). Marketing authorisations (product licenses) have been granted for single measles vaccine and these licenses are extant. The Medicines Control Agency is given more basic information about plans to import unlicensed medicinal products, such as unlicensed single measles vaccine. That notification is the subject of professional negative vetting for any evidence of quality or safety issues and whether there are any licensed equivalent products available on the market in the UK. The agency may object to importation if negative vetting raises any concerns.

The Scottish Executive welcomes this report, however this falls within the Food Standards Agency's area of responsibility and I am advised by them that they are currently reviewing its conclusions and recommendations. The report is a most welcome addition to the information the agency already holds and will be useful in helping to develop food safety policy as well as informing future research requirements.

There is general guidance in Drug Misuse and Dependence - Guidelines on Clinical Management on the procedures which doctors should go through before prescribing methadone. In light of the patient's motivation and expectations, the doctor will set mutually agreed and realistic goals covering what methadone treatment will mean for the individual concerned.Many doctors provide new patients starting on methadone with a copy of The Methadone Handbook, which sets out for those undergoing this treatment the effects of the drug, and the penalties for unlawful possession and supply.

Naloxone is a very effective drug and can be life saving when used to reverse the effects of any opiate-induced respiratory depression, or overdose with opiates. Naloxone should only be given where an overdose is suspected, and is usually administered initially by intravenous injection (0.8-2 mgs) which can be repeated at intervals of two to three minutes to a maximum of 10 mgs. If at that stage there is no response, then the problem is unlikely to be related to opiate overdose. If the patient responds, then naloxone can continue to be given for as long as required to allow the effects of the opiate to wear off.The effectiveness and limits of naloxone treatment should be well known to all doctors, in particular those in Accident and Emergency Departments and other doctors dealing with emergency situations. I understand that paramedics are allowed to carry and administer naloxone, subject to protocols developed by the Scottish Ambulance Service.

The Food Standards Agency has advised that label clarity is currently being addressed as part of the agency's Food Labelling Action Plan. Recommendations in the Scottish Consumer Council's report Young People and Food Safety will be carefully considered along with the views of many other stakeholders, including industry, consumer representatives and members of the public, who have been included in the consultation process.

Guidance has been issued to NHSScotland underlining the important role of Local Health Care Co-operatives (LHCC's) in developing and delivering a broader range of community based services and initiatives, including health improvement and health promotion. This is underpinned by a locality based approach to assessing the needs of local people and working with a range of agencies to provide appropriate services which focus on improving health and reducing inequalities. This role is underlined by the appointment of public health practitioners to each LHCC.

Single-use equipment for tonsil and adenoid surgery has been widely available to NHSScotland since August 2001.Following concerns about patient health and safety, an embargo on undertaking routine tonsil and adenoid surgery was introduced on 21 December 2001, whilst an audit of all such procedures, performed with single-use instruments was undertaken. Routine tonsil and adenoid surgery recommenced with effect from Monday 11 March 2002.Information on the number of patients waiting for in-patient and day case treatment is collected centrally at specialty level only. The Information and Statistics Division of the Common Services Agency has now put arrangements in place, so that the number of patients on the in-patient/daycase waiting list, awaiting routine tonsil and adenoid surgery on 31 March 2002, can be accurately identified.

NHSScotland should take account of advice and evidence from the Health Technology Board for Scotland, and ensure that recommended drugs or treatments are made available to meet clinical need. Likewise, individual clinicians should take account of evidence-based guidance, when exercising their clinical judgement. Centrally, the Clinical Standards Board for Scotland includes all relevant guidance when developing its standards and, subsequently, checks for compliance during its visits programme.

There are no plans to provide assistance with the housing debt of those authorities who do not transfer their housing stock.