Chamber and committees

Establishing a serogroup for a case of meningococcal disease is straightforward if the organism itself has been isolated from the patient. However, it is good clinical practice for suspected cases to be given antibiotics as soon as possible, even before transfer to a hospital. In such cases, in particular where antibiotics have been successful, isolation of the organism is frequently impossible (around two thirds of the total) because the treatment makes the organism more difficult to extract.

Technical improvements in diagnostic techniques are being made all the time, and the level of submission of specimens to the Scottish Meningococcal Reference Laboratory which carries out such testing, has never been higher.

This information is not held centrally. NHS in Scotland employers are required to be working towards attaining the "Positive about Disability Two Ticks Symbol" and ensuring the health service is working towards the guidelines in the Employment Service Code of Good Practice on the Employment of Disabled People. The Symbol requires employers to:

• interview all applicants with a disability who meet the minimum criteria for a job vacancy and consider them on their merits;
• ask disabled employees at least once a year what the employer can do to make sure disabled employees can develop and use their abilities at work;
• make every effort when an employee become disabled to make sure the employee remains in employment;
• take action to ensure that key employees develop an awareness of disability needed to make the employers commitments work;

each year employers are required to review their commitments and achievements, plan ways to improve on them and let all employees know about progress and future plans.

The Scottish Executive is committed to extending the upper age range of routine invitation for breast screening to include those aged (64-70).

I have commissioned a task group to prepare an implementation plan for this extension of the screening programme and look forward to receiving the plan by spring 2001.

There are no plans to extend the age range (20-60 years) for cervical cancer screening.

The information is set out in the table below.¹ The general index of retail prices has been used to deflate the average gross ingredient cost into real terms, using 1995-96 as a baseline.

Average Gross Ingredient Cost of General and Proprietary Items Dispensed 1995-96 to 1999-2000

	Generic		Proprietary
Financial Year	Average cost per item £	Total cost of all items dispensed £	Average cost per item £	Total cost of all items dispensed £
1995-96	1.80	39,320,610	12.72	388,274,138
1996-97	2.01	48,201,533	13.54	407,937,513
1997-98	2.72	71,981,179	13.89	414,375,875
1998-99	2.63	74,064,879	14.41	427,385,527
1999-2000	3.66	105,354,734	15.07	455,592,429

Notes:

1. Excludes appliances, dressings, oxygen and unallocated items, which cannot be defined as generic or proprietary.

Currently, the Community Health Index (CHI) number cannot be used as the sole identifier when GPs are making claims for item of service payments. Whilst GPs do currently use the CHI numbers to make claims for items of service, another form of identification is also required.

The project entitled "Carriage on hypervirulent meningococci before and after introduction of serogroup C conjugate polysaccharide vaccine in the UK" is due to submit a progress report in November 2000 with the possibility of the study being extended until the end of October 2002.

A number of initiatives which use electronic data interchange are underway. An important initiative is being taken forward as "Electronic Clinical Communications Implementation" (ECCI). This programme will establish widespread electronic clinical communications between primary and secondary care over a three-year programme. These communications include:

• widespread clinical email including seeking consultant's opinion;
• co-ordinated referral information;
• electronic booking - protocol based where appropriate;
• test ordering and results receiving;
• discharge letters and summaries and clinic letters; and
• information in support of shared care.

Other national projects being led by Common Services Agency include GP practices submitting patient registration data electronically to Practitioner Services Division (PSD), with over 50 practices now live. Similar electronic links to PSD are currently in planning covering payments to dentists. A project to provide community pharmacists with access to NHSnet is underway; this would be an important step towards enabling transmission of prescriptions from GP Practices to community pharmacists.

The Scottish National Blood Transfusion Service (SNBTS) has already established six locality based collection teams throughout Scotland, and hold 2,000 sessions per year in communities and workplaces. SNBTS is currently reviewing its National Collection programme to assess the feasibility of establishing further teams.

Although there were shortages of generic drugs during 1999-2000, contingency arrangements already in place ensured both that patients continued to receive their medicines and that community pharmacists were appropriately reimbursed. Scottish Executive Health Department officials are in regular contact with the Scottish Pharmaceutical General Council to ensure that these arrangements continue to achieve these twin objectives in cases of shortages.

I also support the steps taken by the Department of Health to commission a fundamental review of the way the generics market serves the needs of Primary Care. I will be looking carefully at the department's conclusions and the implications for Scotland.

The information is shown in the table below.

Number of Children and Adults in Scotland Registered with the General Dental Service (GDS)

Financial Year	Child Registrations	Adult Registrations
1990-91	423,104	1,065,303
1991-92	620,696	1,864,835
1992-93	626,645	1,901,623
1993-94	632,720	1,861,265
1994-95	623,874	1,849,884
1995-96	635,945	1,942,469
1996-97	637,743	2,027,245
1997-98	710,064	2,034,688
1998-99	726,124	1,891,328
1999-2000	754,545	1,972,310

Notes:

1. Registering of patients with dentists was first introduced when a new dental contract came into force in October 1990. During 1990-91 registrations were under-counted as patients were only added to the dentists registered list when they visited a dentist after this date.

2. Prior to 1 September 1996 adult registrations lapsed after 24 months and child registrations lapsed at the end of the following calendar year unless the patients returned to the practice. This contributed to the fall in adult numbers between 1997-98 and 1998-99.

3. A new payment system for dentists was introduced in April 1999. Prior to this, records for new patients, patients registering after a period of being lapsed and patients whose information had been written or captured incorrectly were excluded from the registration figures and so some under-counting occurred.