Chamber and committees

I have asked Dr Jon Hargreaves, Chief Executive of Scottish Water to respond. His response is as follows:Scottish Water is in on-going discussions with all local authorities about key development sites and the need for water and sewerage provisions. A further round of discussions will take place shortly to gather more information and this will be used to identify future investment priorities as part of the quality and standards process. In addition, Scottish Water will be keeping the Scottish Executive, local authorities, Scottish Enterprise, developers, and housing associations informed about any development constraints.

I have asked Dr Jon Hargreaves, Chief Executive of Scottish Water to reply. His response is as follows:Between April 2003 and March 2005 approximately 700 projects (including major projects) will be completed, with additional smaller projects also being delivered. Scottish Water defines a major project as having a value of more than £3 million and the schemes above this value which are forecasted to be complete in 2003-04 and 2005-06 are listed in the table.

Project Name	Year	Description of Investment
Water - Supply and Treatment
Aultbea WTW	2003-04	To achieve compliance with lead and trihalomethanes (THMs) standards and Cryptosporidium Direction 2000
Dundee (Clatto) WTW Ph 1&2	2003-04	To meet Cryptosporidium Direction 2000 and Drinking Water Directive - Lead
Glengap and Penwhirn WTWs Upgrading	2003-04	To comply with lead and trihalomethanes (THMs) standards and Cryptosporidium Direction 2000
Golspie-Brora (Backies) Water Treatment Works	2003-04	To achieve compliance with trihalomethanes (THMs) standards.
Helensburgh Water Supply Upgrading	2003-04	To achieve compliance with the Drinking Water Directive - Lead
Perth (Gowans Terrace) Water Treatment Works	2003-04	Compliance with Cryptosporidium Direction 2000
Taynuilt Water Supply Upgrading	2003-04	New membrane plant to meet Drinking Water Directive - Lead
Turriff Water Treatment Works	2003-04	To achieve compliance with lead and trihalomethanes (THMs) standards and Cryptosporidium Direction 2000
Dingwall (Assynt) Water Supply	2004-05	To achieve compliance with lead and trihalomethanes (THMs) standards and Cryptosporidium Direction 2000
Invercannie Membrane	2004-05	To achieve compliance with lead standards and Cryptosporidium Direction 2000
Afton WTW - Refurbishment and Process Improvements	2004-05	To achieve compliance with lead and trihalomethanes (THMs) standards.
Water - Distribution
Dundee - Duplication of Lintrathen to Clatto Trunk Main	2003-04	Laying an additional trunk water main to secure the supply to a large area in Tayside
East Kilbride - North	2003-04	Rehabilitation work on Grade 4 and 5 mains to maintain service
Penicuik- N.Borders Water Supply	2003-04	Improvements to increase security and quality of supply
Sewage - Wastewater Treatment
Balmedie WWTP	2003-04	To provide treatment capacity to meet the Urban Wastewater Treatment Directive Coastal and Bathing Water Directive
Bonnybridge WWTP Phase 2	2003-04	Improvement of treatment process to meet Urban Wastewater Treatment Directive - Inland Waters Sewage Treatment Directive
Lochcarron WWTP	2003-04	To provide a new Waste Water Treatment works and collection system to meet the Urban Wastewater Treatment Directive Coastal
Longniddry, Aberlady & Gullane Waste Water Treatment improvement scheme	2003-04	Improvement of Treatment process to meet Urban Wastewater Treatment Directive Coastal
Newton Stewart STW	2003-04	Improvement of Treatment process to meet Urban Wastewater Treatment Directive Coastal
Wick WWTP	2003-04	To meet the Urban Wastewater Treatment Directive Coastal
Cockburnspath WWTP & Berwickshire Outfalls	2003-04	To provide treatment capacity to meet the Urban Wastewater Treatment Directive Coastal and Bathing Water Directive
Kames and Tighnabruaich ST Facilities	2003-04	Provides 2 new Waste Water Treatment Works to meet Urban Wastewater Treatment Directive Coastal
Brodick ST Facilities	2004-05	Improvement of Treatment process to meet Urban Wastewater Treatment Directive Coastal
Cove and Kilcreggan ST Facilities	2004-05	Improvement of Treatment process to meet Urban Wastewater Treatment Directive Coastal
Lamlash ST Facilities	2004-05	Provides new Waste Water Treatment Works to meet Urban Wastewater Treatment Directive Coastal
Linwood & Johnston WWTP Rationalisation	2004-05	Transfer of sewerage from Linwood and Johnston WWTP's to Erskine WWTP for treatment - meets Control of Pollution Act 1974
Millport ST Facilities	2004-05	New Waste Water Treatment Works to comply with the Bathing Waters Directive - Sewage
Tarbert ST Facilities	2004-05	Provides new Waste Water Treatment Works to meet Urban Wastewater Treatment Directive Coastal
Tayport WWTP	2004-05	Provision of treatment facilities to meet Urban Wastewater Treatment Directive Coastal
Tobermory ST Facilities	2004-05	Provision of treatment facilities to meet Urban Wastewater Treatment Directive Coastal
Ullapool WWTP &CSOs	2004-05	First Time Provision to meet Bathing Waters Treatment Directive CSO's and Urban Wastewater Treatment Directive Coastal CSO's
Whiting Bay ST Facilities	2004-05	Provision of Treatment Facilities to meet Urban Wastewater Treatment Directive Coastal
Sewage - Collection
Esk Valley Burghs - Cso Regulation	2003-04	Remove 8 CSO's to meet the Urban Wastewater Treatment Directive - Inland Waters CSO's
Dunfermline Trunk Sewer Duplication	2004-05	Replacement of Victorian Sewer to comply with Control of Pollution Act 1974

Note:WTW - Water Treatment Works, WWTP - Wastewater Treatment Plant, CSOs - Combined Sewer overflows

There is general awareness across NHSScotland that past practice, under which organs were retained at post-mortem examinations without the knowledge or consent of the family, was unacceptable. Since early 2000, all trusts in Scotland have adapted their procedures to ensure that the form they use is explicit about the permissions being given, and that information about the implications of a hospital post-mortem examination is available to parents who wish it.MEL(2001)21 of April 2000 instructed trusts to ensure that relatives were fully and sensitively informed of the organisation's policy on post-mortem examinations, including why the examination was thought necessary, how it would be carried out, whether organs would be retained and the options for their subsequent disposal.The interim report by the review group on retention of organs at post-mortem, published in February 2001, contained a clear recommendation that no hospital post-mortem examination should be undertaken without the agreement of relatives, and no organs should be retained without their specific consent. It also set out a code of practice designed to ensure that the lessons of the past were implemented. The Scottish Executive endorsed these recommendations.This approach is enshrined in the standards on the management of hospital post-mortem examinations, published in March 2003 by NHS Quality Improvement Scotland. These standards are mandatory across NHSScotland.The agreement of the relatives is not required where the Procurator Fiscal has instructed a post-mortem examination, but organs will only be retained in such cases where this is necessary to determine the cause of death and generally only until diagnosis is complete. The Procurator Fiscal will ensure that families are fully informed and disposal of the organ is effected in accordance with families' wishes.

The information requested is not available centrally on a monthly basis. The table gives data for the period 1 July 2002 to 30 June 2003 and includes brains and other organs retained for diagnostic purposes following post-mortem examinations instructed by the Procurator Fiscal and carried out in a hospital setting."Retention" has been taken to mean any case where the organs were not returned to the body immediately but were kept, with the agreement of the family, even for a short time, for purposes of diagnosis, or for other purposes such as medical education or research, and then disposed of in consultation with the family.

Trust	Brains	Other Organs
Argyll and Clyde Acute Hospitals NHS Trust	0	0
Ayrshire and Arran Acute Hospitals NHS Trust	6	3
Dumfries and Galloway Acute Hospitals NHS Trust	0	0
Fife Acute Hospitals NHS Trust	0	0
Forth Valley Acute Hospitals NHS Trust	7	0
Grampian University Hospitals NHS Trust	45	4
Highland Acute Hospitals NHS Trust	0	0
Lanarkshire Acute Hospitals NHS Trust	3	0
Lothian University Hospitals NHS Trust	97	37*
North Glasgow University Hospitals NHS Trust	9	1
South Glasgow University Hospitals NHS Trust, including the Institute of Neurological Sciences	46	1
Tayside University Hospitals NHS Trust	0	0
West Lothian Healthcare NHS Trust	0	0
Yorkhill NHS Trust	8	0

Note:*The other whole organs are mainly hearts. The number reflects the practice of retaining organs for a short period (between one and several weeks) as part of the active pathology teaching programme which is included in the curriculum of the University of Edinburgh Medical School. The consent of the relatives for the use of these organs in medical education was obtained in every case.

The Cremation (Scotland) Amendment Regulations 2003, which came into operation on 27 June 2003, put beyond doubt the legality of cremating body parts removed at post-mortem examination, whether that was a hospital post-mortem examination or one instructed by the procurator fiscal. These regulations are a direct response to a recommendation from the review group and are intended to address the problems which families told the review group they had been experiencing.Greater Glasgow NHS Board continues to meet the costs of burial or cremation of organs which relatives have asked to have returned to them.

The current legislation relating to hospital post-mortem examinations is the Human Tissue Act 1961 which provides for the use of parts of bodies of deceased persons for therapeutic purposes and purposes of medical education and research and with respect to the circumstances in which post-mortem examinations may be carried out. In terms of the 1961 act, two different sets of circumstances need to be considered. Section 1(1) of the act provides: "If any person, either in writing at any time or orally in the presence of two or more witnesses during his last illness, has expressed a request for his body or any specified part be used after his death for therapeutic purposes or for purposes of medical education or research, the person lawfully in possession of his body after his death may, unless he has reason to believe that the request was subsequently withdrawn, authorise the removal from the body of any part or, as the case may be, the specified part, for use in accordance with the request". Section 1(2)(a) of the 1961 act provides that the person lawfully in possession of the body can authorise the removal of any part of the body for the purposes of medical education or research if, after reasonable inquiry, he has no reason to believe that the deceased had expressed an objection to the body being so dealt with after death, and had not withdrawn that objection. The 1961 act is generally regarded as unsatisfactory, and the Executive has accepted the recommendation from the Review Group on Retention of Organs at Post-Mortem that it should be repealed and replaced. This will be done as soon as a suitable legislative opportunity arises.

In fulfilment of one of the recommendations in the first report of the Review Group on Retention of Organs at Post-Mortem, Audit Scotland carried out a validation review, published in March 2002, of the total number of organs held in trusts from 1948 to 2000 from both hospital post-mortem examinations and those instructed by the procurator fiscal. These included organs held in hospital archive/museum collections; those held awaiting instructions for disposal, and those undergoing tests to provide diagnoses. Of the 10,862 organs retained, 4,010 were brains. Many of these were held in university trusts which include specialist units such as the Institute of Neurological Sciences in Glasgow and the CJD Unit in Lothian with a particular interest in research involving brains.Information on the number of organs retained over the past 10 years is not held centrally.

The review group has produced two sets of recommendations. The first were contained in its initial report, published in January 2001. These were intended to ensure that the role of relatives, particularly parents, in the post-mortem examination process is recognised and respected. These have for the most part been, or are being, implemented. The second set of recommendations relates to the second phase of the review group's work, the report on which was published in November 2001. Its remit for that phase of its work was to look at the underlying legislation and suggest reforms. These recommendations, on which the Executive consulted extensively, will be reflected in the legislation referred to in the answer given to question S2W-1207 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.

This is a matter for NHS bodies which have day-to-day responsibility with no information of the nature requested being held centrally. However, no delays in the development of new hospitals or related facilities resulting from the inadequate provision of water and sewerage by Scottish Water have been brought to the attention of the Scottish Executive.

Scottish Water's progress in its first year and in the first year of the review period can only be determined once audited accounts are available. The Water Industry Commissioner will review performance in his next cost and performance report.