Chamber and committees

Women with breast problems are most often referred to specialist breast clinics, where they are normally seen by breast surgeons or general surgeons with a special interest in breast cancer. The term "breast physician" does not refer to any single recognised clinical specialty. There are no specific plans to establish specialist training centres for breast surgery. Cancer in Scotland: Action for Change sets out the Scottish Executive's cancer strategy. Backed up by £60 million additional investment, implementation is progressing through annual investment plans prepared by the three Regional Cancer Advisory Groups and overseen by the Scottish Cancer Group. Cancer in Scotland and the 2001-02 investment plans are available at: www.scotland.gov.uk and www.show.scot.nhs.uk.Copies of the plans are available in the Parliament's Reference Centre (Bib. number 17445).

An examination for oral cancer during the routine dental examination is considered to be part of good practice. Such opportunistic screening has been recommended through reports, such as the Scottish Needs Assessment Programme Oral Cancer Report. There have been no guidelines issued in relation to this issue.

The diagnosis and treatment of patients with breast cancer involves a wide range of highly skilled staff from different medical specialties. We are already taking vigorous action to respond to specialist shortages in this field. In 2001 the numbers of higher specialist training posts available in Scotland were increased for cancer and cancer-related specialties by 29% in medical oncology, 26% in radiotherapy, 15% in histopathology and 16% in radiology. The specialities of general surgery and plastic surgery also saw increases of 9% and 25% respectively.Cancer in Scotland: Action for change was launched last year with a new investment and planning process, to ensure that decisions for cancer services are taken locally, to meet the needs of the people served by healthcare services. Recruitment and retention of specialist staff is central to this strategy. First year Implementation/Investment Plans are available at:www.scotland.gov.uk.

The information requested is not collected centrally.ISD Scotland, however, does collect data on the total numbers of pathologists employed by NHSScotland and the country of qualification of their primary medical degree. This is contained in the following table:Pathologists Employed by NHSScotland by Country of Qualification of Primary Medical Degree¹

Headcount at 30 September
	1995	1996	1997	1998	1999	2000
Total	42	41	44	40	41	39
Primary Degree from Scotland	27	24	27	25	25	23

Note:1. Includes honorary appointments.

It is not possible to identify all the one-stop clinics which provide cancer diagnosis, as many of them cover a wide range of conditions which are treated by general surgeons, dermatologists and urologists.Information from NHSScotland indicates that it is currently operating 300 one-stop clinics, all of which provide a full diagnostic and, where appropriate, treatment service at a single visit. A patient referred to one of these one-stop clinics will typically receive a specialist consultation, undergo the appropriate diagnostic tests, receive results and undergo treatment where necessary. Where immediate treatment is not feasible, the patient should receive a date to attend for treatment.

The information requested is not held centrally, but could be obtained, by the member, from NHSScotland Screening Services.

Section 57(1) of the Scotland Act 1998 has been used to implement European Community obligations 17 times.

None.

The Scottish arm of the UK Colorectal Cancer Screening Pilot targeting people between the ages of 50 and 69 in Tayside, Fife and Grampian NHS Board areas, which commenced in March 2000 is progressing well. One complete round of screening and relevant investigatory work is scheduled to be completed in all three board areas by February 2003.The independent Evaluation Group, which is evaluating the feasibility, practicality and acceptability of the pilot screening programme, is due to report to the National Screening Committee in early spring 2003.

At present the test and treatment for prostate cancer does not meet requirements for an effective screening programme. The Scottish Executive is committed in Cancer in Scotland Action for Change (ISBN:1 84268 915 0) to introducing a population based prostate cancer screening programme, if and when new research leads to screening and treatment techniques being sufficiently developed.