Chamber and committees

The overall recruitment and retention of Professions Allied to Medicine (PAMs), which include occupational therapists, remains healthy although there are some recognised difficulties in particular geographic areas and with some specialist posts.

The employment of occupational therapists in the NHSiS is a matter for NHS Trusts.

The Electronic Health Record (EHR) is a longitudinal record of care and relevant health issues about an individual containing summarised information on important health events throughout a patient's life. It will be accessible, appropriately and with the patient's consent, to a range of healthcare professionals caring for an individual patient. It is expected that such records will, in the first instance, be made available to support out of hours and accident and emergency services. The creation of Electronic Health Records is a key part of the NHS in Scotland Information Management & Technology Strategy, now being refreshed, and targets for the establishment of such records will be announced soon.

These three services are funded as National Services within the NHS in Scotland. A review of their National Service status has recently been carried out by the National Services Advisory Group and the group's recommendations are being considered. A decision on these recommendations will be made shortly.

Meningitis A is very rare in the UK and there have been no cases for at least five years and no significant outbreaks since the early 1970s.The Scottish Centre for Infection and Environmental Health (SCIEH) has confirmed the cases of meningitis B and C and the rarer serogroups W135, X and Y as set out in the table below for years 1998,1999 and 2000 to date. The tables also provide details of deaths by serogroups where these were known:

2000
Meningitis Strain	Confirmed cases	% of Tested Cases	No.of Deaths
Not Grouped	123	-	10
B confirmed	84	56%	1
C confirmed	53	35%	8
Non groupable	5	3%	0
W135	5	3%	0
X	0	0%	0
Y	4	3%	0
Total Cases:	274
Total Deaths			19

1999
Meningitis Strain	Confirmed cases	% of Tested Cases	No.of Deaths
Not Grouped	141	-	9
B confirmed	105	50%	5
C confirmed	95	45%	8
Non groupable	1	0%	0
W135	3	1%	1
X	3	1%	0
Y	3	1%	0
Total Cases:	351
Total Deaths			23

1998
Meningitis Strain	Confirmed cases	% of Tested Cases	No. of Deaths
Not Grouped	139	-	5
B confirmed	70	40%	3
C confirmed	75	43%	6
Non groupable	6	3%	0
W135	2	1%	0
X	2	1%	1
Y	3	2%	0
Other	16	9%	0
Total Cases:	313
Total Deaths			15

Notes: % Cases - refers to the percentage of cases for which a serogroup has been confirmed.Deaths - refers to the numbers of total deaths, which have been confirmed as having been infected with this serogroup.

The Scottish Care Information (SCI) Programme will produce computer software products which NHS Trusts can use in conjunction with their own or commercial software to support priority activities, to enable information about a patient to be shared by clinical staff within the Trust or with the patient's GP and to serve as the basis for the Electronic Patient Record and Electronic Health Record.

In conjunction with other related initiatives, SCI will provide healthcare professionals with the right information where it is needed. Faster outpatient booking process is expected and improved exchange of information between primary and secondary care resulting in more appropriate referrals and more effective transfer of information on discharge from secondary care. Patients will benefit from not having to repeatedly give the same information to different parts of the same organisation and will have the reassurance that the clinicians have appropriate access to their clinical history. The benefits to NHS include better value for money for IM&T investment and the provision of IT systems and standards which have a high degree of compatibility.

Cancer is one of the Scottish Executive health priorities and a specific research priority.

a) Over the last three financial years, the Scottish Executive has awarded the following funding in cash terms to cancer research.

	1997-98 £ million	1998-99 £ million	1999-2000 £ million
1. Direct funding - Research Projects	0.6	0.7	1.2
2. Indirect Funding - to support research in NHS in Scotland	Not available	4.7	6.2
3. Scottish Cancer Therapy Network	0.2	0.2	0.2
4. Cancer Equipment initiative			0.5

Notes:

1. A breakdown of total awards made to cancer research projects in 1997-98, 1998-99 and 1999-2000 by cancer type is provided in the table below. Details on individual projects, which may run for up to three years, are available from the National Research Register (NRR), a copy of which is in the Scottish Parliament Information Centre (SPICe).

2. Programmes of research which are supported in the NHS in Scotland can be very broad and encompass a range of subjects. Because of this, we are not able to provide a figure/percentage spend on cancer for 1997-98 and, for 1998-99, we are able to provide only a broad estimate. For 1999-2000 however, we asked NHS providers to specify spend on priority areas, like cancer, separately. We are unable to provide a breakdown by cancer type.

3. The Scottish Cancer Therapy Network aims to ensure that optimal treatment is available to all cancer patients in Scotland. Its work includes involvement in trials, developing guidelines about cancer management/treatment and auditing the impact of these guidelines.

4. This one-off initiative funds capital equipment items to support general research on cancer.

In addition to its own research programme, the Scottish Executive Health Department collaborates with other UK Health Departments and the Medical Research Council (MRC) to develop and maintain an effective partnership for the promotion, funding and management of UK medical research. The MRC is the main agency through which the UK Government supports biomedical and clinical research and it is estimated to spend around £28.5 million per year directly on research into cancer. The results of the projects undertaken throughout the UK will inform the future direction of research and treatment of this disease.

The MRC also funds a large body of basic research including the study of molecules and cells, genetics, and injections and immunity, which will underpin advances in cancer research as well as other diseases.

b) At present, the Scottish Executive funds research mainly by response-mode and therefore cannot supply an estimate of future funding on cancer. Its current research funding mechanisms are, however, under review and one aim of the review is to ensure that priority areas such as cancer are adequately resourced.

Breakdown by Cancer Type of Cancer Research Projects Funded

Type of cancer	1997-98 £K	1998-99 £K	1999-2000 £K
Bladder	27	45	19
Bowel	59	100	199
Breast	202	89	291
General	89	136	225
Gynaecological	87	171	154
Haematological	17	-	18
Head & neck	43	50	10
Skin	-	19	68
Upper gastrointestinal	81	93	174
Total	605	703	1,158

Reducing waiting for patients at all stages in their use of health services is one of the Executive's key objectives for the NHS in Scotland. We are currently working with the service on the development of all-Scotland maximum waiting times in the national clinical priorities of cancer, heart disease and mental health.

Action to reduce hospital waiting lists is primarily for health boards and NHS Trusts. The Executive has put substantial extra investment into the NHS in Scotland, including targeted investment to help reduce waiting. Coupled with new ways of working and delivering services, this will help the service to achieve sustained improvements.

The following tables give the information requested for UK graduates (Table 1) and Scottish graduates (Table 2). The information has been provided by the Medical Careers Research Group (MCRG) at the University of Oxford. MCRG ask all those who graduate from UK medical schools about their employment history, providing a long-term picture of medical careers. They do not survey graduates every year. The most recent four years for which data are available are the graduates of 1996, 1993, 1988 and 1983.

The numbers recorded as not currently working in medicine include those who will rejoin the profession after a temporary career break.

Table 1: All UK medical graduates two years after graduation

	1996 graduates in 1998	1993 graduates in 1995	1988 graduates in 1990	1983 graduates in 1986*
Total responders	2,509	2,803	2,823	3,275
Not in medical profession	71	86	124	126
%	2.8	3.1	4.4	3.8

* After three years: data for two years unavailable.

Table 2: All Scottish graduates two years after graduation

	1996 graduates in 1998	1993 graduates in 1995	1988 graduates in 1990	1983 graduates in 1986*
Total responders	413	439	456	459
Not in medical profession	8	11	16	13
%	1.9	2.5	3.5	2.8

* After three years: data for two years unavailable.

The number of medical students graduated in Scotland in each of the last five years for which figures are available are shown in the following table. The table should be read in conjunction with the notes below.

	1993-942	1994-95	1995-96	1996-97	1997-98
Dentistry	1,049	125	135	143	125
Medicine		1,090	903	930	977
Allied to Medicine5	1,520	2,094	2,825	4,030	5,671

Notes:

1. Source: Scottish Executive, Higher Education Statistics Agency (HESA).

2. Separate figures for Dentistry and Medicine in 1993-94 are not readily available.

3. Figures are for full-time students, from both Higher and Further Education Institutions, who successfully completed a higher education course in Scotland.

4. Higher education courses are defined as those at HNC/HND level and above.

5. Allied to Medicine includes courses such as Pharmacology, Opthalmics and Nursing.

6. 1998-99 data will be published in November 2000.

The information requested is not available centrally.