Chamber and committees

The Scottish Executive currently has no plans to reform procedures for dealing with clinical negligence claims. However, we are aware of recent developments to assess the potential benefits of mediation for such claims and intend to explore the matter with the British Medical Association.

The Dentists Act 1984 gives power to the General Dental Council (GDC) to make regulations governing dental therapists, among other dental auxiliaries. That power is restricted so that, without an Order in Council, dental therapists cannot undertake the filling of teeth or the extraction of deciduous teeth in general dental practice. In addition, regulations made by the GDC prevent therapists from carrying out other activities in general practice. Whether these restrictions should be altered is a regulatory matter falling within a reserved area. The desirability of lifting or modifying these restrictions, in order to increase patient access while assuring the quality and safety of treatment, is the subject of discussion with the UK Government.

Training on drug and alcohol addiction is provided by each of the five medical schools in Scotland. It is also included in pre-registration nursing courses, and within the Diploma in Social Work qualification.

Information on the total cost of drug and alcohol treatment and rehabilitation for Scottish patients outwith Scotland is not available centrally.Health boards received an additional £2 million for drug treatment services this year, giving a total of £14.352 million. Local authorities have been allocated an additional £6.8 million for drug rehabilitation services. This additional funding will enable Drug Action Teams to plan an integrated approach to the provision of services locally.

Neither the Scottish Intercollegiate Guidelines Network (SIGN) nor the Health Technology Board for Scotland (HTBS) have this topic in their current work programme. The Executive currently has no plans to ask them to consider it.However, anyone may propose a topic to either body by using the topic proposal forms available on their website (www.sign.ac.uk and www.htbs.org.uk). This would then be considered according to the organisation's published process for the selection of topics.

Towards a Safer Healthier Workplace, the occupational health and safety service strategy for NHSScotland staff, requires all NHSScotland organisations to offer a comprehensive, competent and confidential occupational health and safety service to all staff as an integral part of their Human Resources Strategy. The proposal adopted by the Yorkhill NHS Trust is to provide its employees with the opportunity to have a lifestyle fitness assessment and forms part of the criteria for the Scotland's Health at Work Silver Award. This is in line with current policy for NHSScotland employers to achieve the Scotland's Health at Work Award and for staff to be encouraged to improve and manage their own personal health.

Heroin and methadone are opioids that act in the same way on receptors in the brain. Opioid dependence is a well-established and clearly defined phenomenon. It is characterised by physical and psychological dependence, which becomes more likely as the dose and duration of use increase.Users of heroin experience a euphoria, but addicts become tolerant to the pleasurable effects of the drug quite rapidly. Methadone does not produce euphoria.Street heroin varies in purity and heroin requires more frequent "hits" than methadone.Heroin is generally thought to be more addictive than methadone. However, because methadone is long acting and the withdrawal effects, though less severe, can last much longer, drug users often claim that methadone is "harder to come off" than heroin.

Our objective for every discharge or transfer from hospital care is for the continuing care arrangements to fit the assessed needs of the individual. This is particularly true for those with a mental illness where needs can be complex and require co-operation and planning among a number of agencies. The aim always is to provide care, support and in some cases accommodation that matches needs and is both sustainable and responsive to changing needs.The Care Programme Approach (CPA) has been designed specifically for people with more severe and enduring mental illnesses. The objective is to ensure that properly designed and managed packages of health and social care are arranged for such people in appropriate accommodation in the community. No-one is included in the CPA without the agreement of a consultant psychiatrist and informed consent is sought wherever possible.

Following a commitment in Our National Health, the Chief Medical Officer has asked Professor David Lawson to lead work with the Health Technology Board for Scotland and with local area drug and therapeutic committees on removing inequities in prescribing practice across Scotland. As a result of this, a seminar was held on 16 May at which the concept of a Scotland-wide consortium of Area Drug and Therapeutic Committees - a Scottish Medicines Consortium - was launched. This would provide a single source of Scottish advice to clinicians as close to the time of marketing of a new drug as possible. The Health Technology Board for Scotland has agreed to provide administrative and methodological support to the consortium. Discussions are ongoing with local area drug and therapeutic committees and health boards across Scotland and it is hoped that the consortium could begin operating in the autumn.

On 30 September 2001, the number of patients waiting for Adult Cardiac Surgery, which includes patients waiting for heart bypass operations, was 620.