Chamber and committees

Local authorities are required by the Social Work (Scotland) Act 1968 (Choice of Accommodation) Directions 1993 to take measures to ensure that people have a genuine choice over where they receive residential care. In conjunction, the Accounts Commission's, Commissioning Community Care Services for Older People: Applying a Best Value Framework, provides councils with a framework for commissioning to secure best value care for older people, regardless of whether this is in council or private residential care homes.

Taxol and Taxotere are recommended for hospital use only. Centrally collected data relates to items dispensed in the community by community pharmacists and dispensing doctors. Information about the number of women prescribed Taxol and Taxotere as part of their treatment is not therefore available centrally.

As stated in Our National Health: A plan for action, a plan for change the Executive proposes a wide-ranging consultation on children's oral health, which will seek views on a range of measures, including ways in which the benefit of fluoride can be made available, for example through the fluoridation of public water supplies or by means of fluoridated drinks or tablets. A draft consultation paper and arrangements for the consultation are currently being developed and will be announced in due course.

Addiction to benzodiazepines is part of the wider drug misuse problem. Help is, therefore, available from the wide range of services which cater for people with misuse problems. Depending on the locality, these measures include general medical services and primary healthcare teams, psychiatric services, community psychiatric nurses, mental health nurses, psychological services and counselling. Also accessible to most drug misusers are drug problem centres, voluntary agencies and self-help groups and counselling services. This list is not definitive.Treatment and rehabilitation funding forms an important part of the £100 million package which the Executive has made available for tackling drug misuse. We are determined to break the cycle of misuse which leads to the many other problems associated with drugs. That is why we have committed an extra £10 million for treatment services and £21 million for rehabilitation over the next three years.

Information on the number of people with an addiction to valium or other benzodiazepines who have committed suicide in each of the three years is not held centrally. However, the number of suicides where a benzodiazepine was recorded as being present at the time of death is as follows:1997 321998 381999 26

These figures, it should be noted, include deaths where it is undetermined whether the injury was purposely or accidentally inflicted. This is normal practice when collecting information on suicides. Also, in many instances other drugs were recorded, for example, methadone and heroin.

Of the above deaths the following numbers were known to be dependent drug misusers, though the drug of abuse may not have been a benzodiazepine:

1997 91998 111999 10

The dangers of long-term addiction to benzodiazepines are well recognised and information about the prescribing of these medicines is available to GPs from a number of sources. Importantly, the British National Formulary (BNF), issued free to doctors and pharmacists, provides key information for health professionals on how to use medicines safely and effectively. In addition, in 1988, the Committee on Safety of Medicines issued guidelines to doctors on the use of benzodiazepines. These guidelines remain extant.General practitioners take responsibility for their own learning needs as part of the process of lifelong learning and maintenance of clinical skills. The Scottish Executive supports this through payment of an annual Post Graduate Education Allowance to GPs. In addition we would expect all GPs to keep up-to-date with current practice and clinical guidelines in all relevant clinical areas as part of their continuing professional development.

Health boards and NHS Trusts are responsible for the training and continuing development of their staff, other than those aspects managed centrally by bodies such as the Scottish Council for Postgraduate Medical and Dental Education. It is for boards and Trusts to budget so that sufficient priority is given to providing resources for this vital activity. They will have been assisted in this by my announcement on 21 September last year of a 6.5% increase in health board funding. The policy framework for learning in NHSScotland is provided by Learning Together, the Education, Training and Lifelong Learning Strategy, and through guidance on Clinical Governance. In addition, the Scottish Executive Health Department is providing £6 million of central funding over three years to support the development of good practice in learning and the use of learning resources. Our National Health: A plan for action, a plan for change introduces a new Staff Governance Standard and makes the commitment of NHS bodies to implementing Learning Together a core element of their performance against that standard.

Our National Health: A plan for action, a plan for change stated that: "we will review existing financial systems to ensure that resources flow and are managed in a way that is effective, efficient and accountable. The review will provide initial propsals for change by March 2001"This includes a review of Trust financial targets. The review will take into account the requirement to maintain high standards of financial management and control.

Information on drug costs is provided routinely in a number of reports including Scottish Prescribing Analysis (SPA) and financial schedules. These relate to British National Formulary chapters and sub-sections. Information relating to the last two financial years is given in the table "Information on Prescribing Cost and Items" published by the Common Services Agency, a copy of which is available in the Parliament's Reference Centre (Bib. no. 12055).However, there are relatively few drugs that link specifically to an illness or disease. Therefore such information is not available.

Scottish Prescribing Analysis reports are normally provided quarterly to individual prescribers and Primary Care Trusts. The provision of this information is currently two quarters behind normal schedules. This is due to a delay in the processing of prescriptions. Production of the first of the outstanding reports is planned for the end of March.The routine issue of good practice guidance, which is not affected by the delay in prescription processing, should continue to influence prescriber behaviour.