Chamber and committees

The Strategic Transport Projects Review (STPR) has recommended a targeted programme of measures to improve road standards on the A82 between Glasgow and Oban/Fort William and reduce accident severity rates between Fort William and Inverness.

In addition to a general upgrade of the route, the measures would include:

carriageway widening at selected locations between Tarbet and Inverarnan and Corran Ferry and Fort William, and

physical works including climbing lanes at Loch Tulla, overtaking lay-bys aimed at providing safer overtaking opportunities and improving journey time reliability and safety targeted measures such as hard strips, junction improvements and local realignment.

On the section between Fort William and Inverness, measures recommended to reduce accident severity include physical works aimed at providing safer overtaking opportunities, hard strip provision for agricultural vehicles and junction improvements.

A timetable for undertaking this work will be set in the context of overall affordability and our commitments to other STPR proposals.

Within the current programme work is progressing to deliver improvements at Pulpit Rock and a new Western bypass at Crianlarich. We are currently engaging with interested stakeholders, including Hitrans and SPT to discuss a vision for the A82.

There are three ways in which a person may be subjected to compulsory measures of treatment under the civil regime in the Mental Health (Care and Treatment) (Scotland) Act 2003 (the 2003 Act), namely: (a) emergency detention; (b) short-term detention, and (c) long-term detention or compulsory measures under the authority of a compulsory treatment order. In addition, mentally disordered offenders may be made subject to compulsory measures of treatment by the courts under the Criminal Procedure (Scotland) Act 1995 (the 1995 Act).

The majority of compulsory measures of treatment for mental disorder are first approved by either the Mental Health Tribunal for Scotland under Part 7 of the 2003 Act (compulsory treatment orders) or by a court under the 1995 Act in relation to mentally disordered offenders. The two exceptions to this prior authority for treatment for mental disorder by a court or tribunal are: civil emergency detention under Part 5 of the 2003 Act, and short-term detention under Part 6 of the 2003 Act.

In relation to emergency detention, the authorised period of detention is just 72 hours and the purpose of the detention is to determine what medical treatment requires to be provided to the patient. There is no general authority to give treatment for mental disorder under an emergency detention certificate.

A short-term detention certificate does enable treatment to be given, in accordance with part 16 of the 2003 Act. Volume 1, Chapter 10 of the Mental Health (Care and Treatment) (Scotland) Act 2003 Code of Practice provides guidance on the provision of medical treatment for mental disorder which are set out in part 16, including the issue of consent.

It is always a matter of regret if any patient experiences a serious adverse event associated with medication. The risks associated with medicines must be considered against the potential benefits of the treatment and antipsychotics are extremely effective medicines for the treatment of serious conditions including schizophrenia, agitation, anxiety, mania and aggression. The decision to treat a patient with an antipsychotic drug is primarily based on clinical judgement taking into account the patient''s condition as well as the risks and benefits of treatment.

The Medicines and Healthcare products Regulatory Agency (MHRA) and the expert independent scientific advisory group the Commission for Human Medicines continuously monitor the safety of all medicines available on the UK market. The MHRA ensures that all medicines are supplied with product information which accurately reflects current knowledge and contains the necessary information to aid the safe use of medicine. This includes information about risk minimisation measures for important risks and, where appropriate, also as advice about how patients should be monitored and under what circumstances consideration should be given to stopping the medicine.

More generally, it is important to note that the occurrence of an adverse event may not necessarily mean that it was caused by the medicine. Many factors have to be taken into account in assessing causal relationships, including the possible contribution of concomitant medication and the patient''s underlying condition.

NHS boards have procedures in place to allow for a change of Responsible Medical Officer (RMO) and for seeking second opinion medical reports.

The Compulsory Treatment Order (CTO) made by the Mental Health Tribunal will specify the hospital for treatment or the care package in the community; this may include, where appropriate, an independent health care facility. Volume 2, Chapter 3 of the Mental Health (Care and Treatment) (Scotland) Act 2003 Code of Practice provides guidance on potential conflicts of interest where treatment in an independent health care service is proposed.

Volume 2, Chapter 2 of the Mental Health (Care and Treatment) (Scotland) Act 2003 Code of Practice provides guidance on the mental health officer''s interview with the patient. The guidance does not stipulate who may or may not be present at such interviews, although it is expected that independent interviews with the patient by medical professionals would be carried out separately. This is an issue which has already been drawn to officials'' attention and will be considered in the next review of the Code of Practice.

Section 45(1) of the Mental Health (Care and Treatment) (Scotland) Act 2003 places an mental health officer (MHO) under a duty to interview a patient before the granting of a short-term detention certificate. This is reinforced in Volume 2, Chapter 2 of the Mental Health (Care and Treatment) (Scotland) Act 2003 Code of Practice, which provides guidance and best practice as regards the full duties on the MHO, including their interview with the patient, ascertaining the name and address of the patient''s named person, and informing the patient of independent advocacy rights.

One of the criteria for a person to be made subject to compulsory measures of treatment under the Mental Health (Care and Treatment) (Scotland) Act 2003 is that they have a mental disorder. I refer the member to the answer to question S3W-27157 on 22 September 2009. 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/Apps2/Business/PQA/Default.aspx.

The Expert Group on Infertility Services is expected to start its work in autumn 2009. Six monthly reports from the group, once set up, will be shared with Parliament.

It is for individual NHS boards to decide where patients in their area receive IVF treatment. The Expert Group on Infertility Services, when formed, will consider how best to ensure equity of access to IVF across NHS boards in Scotland.

Antipsychotic medicines are an important group of medicines that are very effective in the treatment of conditions such as schizophrenia, agitation, anxiety, mania and aggression. The use of such medicines is recommended within clinical guidelines such as those produced by the Scottish Intercollegiate Guidelines Network (SIGN).

As with all medicines, the available data on efficacy and safety are carefully considered at the time of licensing to ensure the benefits outweigh any potential risks. Once marketed, the safety of all medicines, including antipsychotics, is monitored by the Medicines and Healthcare products Regulatory Agency (MHRA) and the independent scientific expert advisory group the Commission on Human Medicines. Any new safety concerns that arise are thoroughly evaluated and the balance of risks and benefits is kept under continuous review.

All medicines have the potential to cause unwanted side-effects. The side-effects associated with antipsychotic medicines are well recognised and information and guidance on the use of these treatments is available from a number of sources such as the British National Formulary www.bnf.org and the Patient Information Leaflet, which should be supplied with the medicine.

In every case, the decision whether or not to prescribe any treatment for a patient depends on the clinical judgement of the doctor concerned wherever possible in consultation with the patient and also bearing in mind the risks and benefits of treatment.