Chamber and committees

In the year ending 31 March 2003, the median waiting time for a first out-patient appointment with a consultant in the speciality of psychiatry following referral from a GP was 29 days.The £4.5 million investment in the Doing Well by People with Depression will engage service users, carers, clinical leaders and staff in the redesign and improved use of resources to provide better care with improved and timely access to evidence-based intervention including referral to psychiatrists where appropriate.

It is legislation, rather than guidance, under which NHS bodies operate that allow them to enter into contracts to provide medical services. The provision of medical services is arranged through health boards, special health boards and NHS trusts under the powers and duties given to them in legislation, in particular the National Health Service (Scotland) Act 1978 and orders made under that act.

The Executive commissioned a review of patient charges for NHS dental services in Scotland in 2002. The report has been delivered and the options contained therein are currently under consideration. No decision has yet been made on possible publication of the report.The Executive is also committed to reviewing prescription charges for people with chronic health conditions and young people in full-time education or training. We expect the review to commence in the autumn.

An Executive summary of the Analysys report is available in the Parliament's Reference Centre (Bib. number 27702).

The regulation of medicines is a reserved matter and is the responsibility of the Medicines and Healthcare products Regulatory Agency (MHRA).New data from clinical trials of Seroxat in children and adolescents were received by the MHRA at the end of May 2003. These new data have been reviewed by an Expert Working Group on SSRIs and the Committee on Safety of Medicines (CSM), an independent scientific advisory committee. They do not demonstrate efficacy in depressive illness in this age group and show an increase in the risk of suicidal thoughts and behaviour in the Seroxat group compared to placebo. On the basis of these data, CSM has advised that Seroxat should not be used in children and adolescents under the age of 18 years to treat depressive illness.

The three NHS regional planning groups were asked to review provision of joint arrangements for the care and treatment of mothers suffering from post-natal depression and their babies, in the context of the Scottish Intercollegiate Guideline Network (SIGN) guideline on post-natal depression and puerperal psychosis published in June 2002. Each group has now responded. All boards have indicated that they are committed to meeting the guideline. Some boards intend to achieve this within their own facilities and resources. They emphasise the importance of caring for mothers and their babies as close as possible to the communities in which they live, and the use of appropriate care and treatment protocols. Boards in the west of Scotland are undertaking a review of needs and are considering plans for shared services. A short-life working group has been established by the department to produce guidance on appropriate hospital admission arrangements to enable mothers with post-natal depression to be admitted with their child. It is intended to produce guidance by December 2003, reflecting the full range of needs including access to specialist services where appropriate. The department will continue to monitor progress, taking account of the latest available guidance and the steps being taken by the boards.

The Scottish Intercollegiate Guideline Network guideline on post-natal depression and puerperal psychosis (Bib. number 25439) was compiled over the period two years prior to its publication on 20 June 2002 and will be considered for review in 2004. The Scottish Executive guidance on services for women with post-natal depression (Bib. number 24358) was compiled over the five-month period prior to its publication on 18 March 1999. The guidance is kept under review for currency and relevancy. In this case decisions on revisions will be informed by the outcomes of the current audit of best practice funded by NHS Quality Improvement Scotland into primary and secondary care post-natal depression services in Scotland. A short-life working group has been established to produce a template for the best organisation of hospital admission arrangements to allow mothers with a post-natal depression to be admitted with their child. The aim is to produce guidance by December 2003 that reflects the full range of needs including access to specialist services where appropriate. Any issues arising from that consideration will further inform any revision of current guidance.

The Chief Scientist Office, (CSO), is currently funding a research project on the diagnosis of perinatal mental illness in women and their partners and is also funding a research fellowship on the treatment of post-natal depression. These projects are due for completion in July and September 2004 respectively, at which point final reports will be submitted to CSO for review. The Executive summaries from these final reports will be made available on the CSO website, (www.show.scot.nhs.uk/cso), with contact details provided on where to obtain further information.

Prescription data available centrally are not patient-specific but relate to the numbers and cost of prescribed items dispensed in the community by community pharmacists and dispensing doctors.

Prescription data available centrally are not patient-specific, but relate to the numbers and cost of prescribed items dispensed in the community by community pharmacists and dispensing doctors.