Chamber and committees

The information requested is not held centrally.Temporary closures of this nature are usually of very short duration, and when they occur, arrangements are put in place to ensure that patients requiring urgent treatment are diverted to another hospital and that elective admissions which have to be cancelled are re-scheduled as soon as possible.

The information requested is not available centrally.The majority of temporary closures to new admissions occur when a hospital is under particularly severe pressure, for example due to a substantial increase in emergency admissions during the winter months. Such closures are invariably of very short duration, and when they occur, arrangements are put in place to ensure that urgent cases are diverted to another hospital and that elective admissions which have to be cancelled are re-scheduled as soon as possible.

The information requested is not available centrally.The majority of temporary closures to new admissions occur when a hospital is under particularly severe pressure, for example due to a substantial increase in emergency admissions during the winter months. Such closures are invariably of very short duration, and when they occur, arrangements are put in place to ensure that patients requiring urgent treatment are diverted to another hospital.

The number of women for whom a diagnosis of endometriosis was recorded, discharged from general acute NHS hospitals in Scotland, in each of the financial years 1999-2000, 2000-01, and, provisionally, 2001-02 is recorded, by NHS board and NHS trust, as follows:Year end 31 March

NHS Board	NHS Trust	2000	2001	2002 (provisional)
Argyll and Clyde (A and C)	A and C Acute Hospital NHS Trust	275	245	203
Ayrshire and Arran (A and A)	A and A Acute Hospital NHS Trust	218	210	193
	A and A Primary Care Trust	0	1	0
Borders	Borders General Hospital NHS Trust	25	19	13
Dumfries and Galloway (D and G)	D and G Acute and Maternity Hospitals NHS Trust	81	63	59
Fife	Fife Acute Hospitals NHS Trust	226	281	226
	Fife Primary Care NHS Trust	2	0	0
Forth Valley	Forth Valley Acute Hospitals NHS Trust	100	94	115
Glasgow	North Glasgow University Hospitals Trust	286	268	230
	South Glasgow University Hospitals Trust	244	284	263
	Yorkhill NHS Trust	0	0	1
Grampian	Grampian University Hospitals NHS Trust	333	273	312
Highland	Highland Acute Hospitals Trust	137	138	119
Lanarkshire	Lanarkshire Acute Hospitals NHS Trust	151	181	165
Lothian	Lothian Primary Care NHS Trust	12	9	6
	Lothian University Hospitals NHS Trust	210	196	144
	West Lothian Healthcare NHS Trust	154	160	129
	Fairmile Marie Cure Centre	1	1	0
Orkney	Orkney Health Board Unit	1	4	3
Shetland	Shetland Hospitals and Community Services Unit	0	3	5
Tayside	Tayside University Hospitals NHS Trust	152	152	86
Western Isles	Western Isles Health Board Unit	3	0	1
Total		2,611	2,582	2,273

In NHS Scotland consultant gynaecologists deal with most cases of endometriosis. Consultants in acute general hospitals may refer severe cases to university or tertiary centres. In cases in which endometriosis is associated with infertility, women will usually be referred to one of the four tertiary centres for infertility treatment in Edinburgh, Aberdeen, Glasgow or Dundee. These arrangements ensure access to clinical expertise. It is the responsibility of each NHS board to deploy the resources available to it to address the health care needs of its local population.For details of Executive funding for research into endometriosis please refer to the response to S2W-1558 on .

Over the ten years 1992-2001 there was an average (mean) of 1,240 new admissions per annum, to acute general NHS hospitals, in which a principal diagnosis of endometriosis was recorded. The crude rate per 1,000 female population aged 15 to 64 (which accounts for 99% of hospital in-patient and day case admissions) averaged (mean) 0.73 over this period.

It is the responsibility of each NHS board to deploy the resources available to it to address the health care needs of its local population. In 2003-04 every NHS board received an above inflation increase in unified budgets of between 7.4 and 8.9%.

The safety of medicines is reserved and is the responsibility of the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA has advised that research into the risks associated with synthetic progestins is conducted in the UK and worldwide on a continuous basis by a variety of research bodies, including pharmaceutical companies, hospitals, universities and other independent researchers.The National Research Register (NRR), a UK wide database of all publicly funded research of relevance to the NHS, records that there are currently seven projects on-going in the UK on the effects of synthetic progestins.Details of these projects are available from the NRR, a copy of which is in the Parliament's Reference Centre (Bib. number 17404).In the UK, a study (The Million Women Study) involving around one million UK women aged 50 and over is on-going and aims to answer many outstanding questions about the factors affecting womens' health in this age group. In particular, the study is looking at how hormone replacement therapy (HRT) affects a woman's health. This study was set up in 1996 by Cancer Research UK, the National Health Service Breast Screening Programme and the Medical Research Council. Over one in four women in the UK in the target age group are now participating in the study which means that the Million Women Study is the largest study of its kind in the world.In 2001, a European-wide review of all the available evidence regarding HRT use was initiated in order to produce consistent information for health professionals and women throughout Europe. The UK has had significant involvement in these discussions and has provided advice from the Committee on Safety of Medicines (CSM) Expert Working Group (EWG) on HRT. In July 2002, the combined (oestrogen and progestogen) HRT arm of the Women's Health Initiative (WHI) trial, a study that was set up to investigate the long-term effects of HRT in healthy post-menopausal women in the USA, was prematurely stopped because a pre-defined threshold of harm was reached. In the UK, the WISDOM trial, which was similarly designed to assess the balance of risks and benefits of long term HRT, was subsequently stopped as it was considered unlikely to provide substantial evidence to influence clinical practice in the next ten years. When the findings of the WHI trial were published, they were immediately considered by the CSM. Preliminary urgent advice was issued to all UK health professionals later that same day, together with a fact-sheet to help advise women who may have been concerned about the implications of these findings.The EWG on HRT has met three times since July 2002 to examine in detail these trial findings together with other recent data on the long-term risks associated with HRT and their implications for the safety of HRT in the UK. Their conclusion was that these data confirm what is already known about the small increase in risk of breast cancer and venous thromboembolism (VTE) and the lack of protection from coronary heart disease. Importantly, they also confirm protection against hip fracture and reduced incidence of colorectal cancer but provide new evidence for a small increase in the risk of stroke and ovarian cancer.In light of these data, the CSM advises that the benefits of taking HRT in the short-term outweigh the risks for the majority of women who use it. However, the risks of HRT increase with long-term use and so treatment should only continue as long as the benefit in alleviating symptoms continue to outweigh the possible risk. For women with osteoporosis, the risks and benefits of HRT should be considered alongside those of alternative treatment options and each patient's treatment should be reviewed at least yearly.The CSM advises that HRT continues to have a useful role in alleviating menopausal symptoms and helping prevent osteoporosis. However, in an effort to maximise the safe and judicious use of HRT, women are encouraged to make the decision to take HRT jointly with their doctor, taking into consideration her personal and family history, their general health, concomitant medication and personal preferences and, importantly, to review the need for continuing therapy at least annually.The new advice has recently been published in the MHRA's safety bulletin, "Current Problems in Pharmacovigilance", which is distributed to all GPs, pharmacists, dentists and coroners in the UK. This information, together with an article specifically for women, has been posted on the MHRA/CSM website (www.mhra.gov.uk).These important messages have also been included in the British National Formulary (BNF) and are being added to the information for prescribers and the patient information leaflet that should be included with each pack of HRT.

The constitution and proceedings of fatal accident inquiries are governed by the Fatal Accidents and Sudden Deaths Inquiry (Scotland) Act 1976. The findings of the sheriff at the conclusion of a fatal accident inquiry have the same status in law as findings of fact in any other civil proceedings. The sheriff does not determine legal liability for the death, either in the criminal or civil sense, and the determination cannot be founded upon in any other judicial proceedings.The purpose of a fatal accident inquiry is to determine certain specific matters relating to the death with which it is concerned, and certain of the circumstances surrounding that death. These matters include the time, place and causes of the death and of any accident resulting in the death, any reasonable precautions which might have prevented the death, and any defects in any system of working which contributed to the death or the accident which caused it. The findings of the inquiry should inform changes to working practices or safety procedures, where defects in these have contributed to the death. The responsibility for learning any lessons which come out of the inquiry, and for implementing its findings by remedying any defects in practices or procedures which the sheriff identifies, lie with those who have responsibility for managing the systems in question. Examples would include employers, in the case of a death at work, or hospital managers in the case of a death due to medical mishap. The Executive looks to the responsible bodies to have regard to, and to apply as appropriate, any recommendations for change which emerge from a fatal accident enquiry.

I refer the member to the answer given to question S2W-1236 today. All answers to written parliamentary questions are available on the Parliament's website, the search facility for which can be found at http://www.scottish.parliament.uk/webapp/search_wa.