Most people who use mental health services receive treatment without being subject to an order or certificate under the Mental Health (Scotland) (Care and Treatment) Act 2003. For some individuals however, compulsory treatment is used to provide the person with medical treatment to alleviate suffering and for the protection of both the person and others. Compulsory treatment is only allowed under mental health legislation in Scotland in very strict circumstances.

Firstly, certain criteria must be met before an order or certificate can be granted. For a 28 day short-term detention certificate (STDC), this includes that an approved medical practitioner considers it likely that the patient has a mental disorder (as defined by the 2003 Act) and that the patient’s decision making ability is significantly impaired by their disorder and without treatment the patient could be of significant risk to their own health, safety and welfare, or to the safety of others. The patient can appeal the granting of an STDC to the independent Mental Health Tribunal. A longer term order can only be granted by the Tribunal, and the application must have the support of two doctors who agree that the criteria for the order are met.

Secondly, treatment under the 2003 Act is governed by a range of safeguards. For certain treatments, including medication given for more than two months, a Designated Medical Practitioner, an experienced psychiatrist appointed by the Mental Welfare Commission, must agree to the treatment.

In addition to this, the 2003 Act is based in rights and principles and contains tools to support patients in expressing their will and preferences. The principles include that any function should be carried out for the maximum benefit of the patient, with the minimum necessary restriction on the freedom of the patient and having regard to the views of the patient and of any carer. Under the 2003 Act, any service user has the right to support from an independent advocate, the right to appoint a named person to represent their interests and the right to make an advance statement setting out how what treatment they would and would not like to receive when unwell

The Scottish Government is currently considering this finding from Action on Hearing Loss Scotland's 'Time to raise the standards' report.

Information on cancer survival at one and five years after diagnosis in Scotland for children, teenagers and young adults who were diagnosed with cancer between 2007 and 2011 has been placed with the Parliament Information Centre (Bib. number 58278).

Evaluation is an important part of our campaigns and is undertaken in a variety of ways according to the scale and nature of the campaign, the target audience and has been proportionate to the budget for each campaign. Where relevant, new campaigns are tested before launch to evaluate their appeal to the target audience. At the end of campaigns, we measure the level of audience reach, awareness, understanding of campaign messages and / or behaviour change. The results of such evaluation are used to inform future campaigns.

For example, the recent ‘Eat Better, Feel Better’ campaign evaluation consisted of a survey with the target audience, analysis of digital analytics and evaluation of partnership activity. The Scottish Government Communications Plan 2016-17 contains a case study about this campaign: http://www.gov.scot/Resource/0050/00508199.pdf.

The Scottish Government provides policies, frameworks and resources to NHS Boards to allow them to deliver services that meet the needs of their local populations.

Within this context, the actual provision of healthcare services, including (a) a dedicated psoriatic arthritis integrated clinic and (b) the provision of mobile MRI and ultrasound scanners to treat people with psoriatic arthritis in Lothian region is a matter for Lothian Health Board, taking into account national guidance, local service needs and priorities for investment.

The specific information is not available centrally as outpatient waiting times information is collected at specialty level only. I understand that patients with suspected psoriatic arthritis are mostly likely to be referred to a dermatologist. The following tables provides information on the waiting time for a dermatology outpatient consultation for each year from June 1999 to June 2016.

It should be noted that due to data collection changes data has been provided from two different data collection systems and data from June 2009 is not directly comparable with earlier years median waits.

NHSScotland: Median Waiting Time For A First Outpatient Dermatology Consultation: June 1999 to June 2003

Source ISD: SMR(00)

NHSScotland: Median Waiting Time For A First Outpatient Dermatology Consultation: June 2004 to June 2008

Source ISD: SMR(00)

NHSScotland: Median Waiting Time For A First Outpatient Dermatology Consultation: June 2009 to June 2012

Source; ISD New Ways Data Warehouse

NHSScotland: Median Waiting Time For A First Outpatient Dermatology Consultation: June 2013 to June 2016

Source; ISD New Ways Data Warehouse

Scottish Government investment in cancer research is primarily through the Chief Scientist Office (CSO). CSO supports cancer research through a number of mechanisms. These are:

• Over £40 million annually in the NHS to meet the additional costs of hosting research. Of this around £10 million per annum supporting the cost of cancer research (including research into rare tumours) carried out in the NHS. This figure is not routinely broken down into tumour type.

• CSO invests £350,000 per annum in the Experimental Cancer Medicine Centres Network (in collaboration with a number of other funders) to assist in delivery of early phase cancer studies. This figure is not broken down into tumour type

• CSO also invests £438,000 annually in the Scottish Cancer Research Network to increase and sustain clinical trial activity in cancer care. This figure is not broken down into tumor type

• Funding of cancer research studies submitted to the Chief Scientist Office research committees. Applications generated by the research community are assessed based on scientific excellence. The funding level is subject to quality of applications submitted.

An analysis of currently active studies funded though the CSO committees shows that the following amounts have been committed for projects specifically aimed at rare cancers. The definition of rare is a tumour not included in the 10 most common cancers listed by incidence in the ISD report Cancer Incidence in Scotland (2014) published on May 17 2016.

Classical Hodgkin Lymphoma £226,312

Malignant Pleural Mesothelioma £194,556

Oesophagogastric Carcinoma £143,624

Acute Lymphoblastic Leukaemia £176,624

Glioblastoma £174,582

Further indirect support is provided through an annual contribution (currently around £10 million) from CSO to the major National Institute for Health Research programmes that cover a broad range of health research including cancer research across the UK

The treatment for psoriatic arthritis is prescribed and managed by the hospital service, information on this is not centrally held. The prescribed medication typically has multiple uses, as a result information on the number of people treated for psoriatic arthritis is not held separately.

The number of people diagnosed with Psoriatic Arthritis in each NHS Board is not held centrally. The following table shows patients who have been admitted to hospital with a diagnosis of Psoriatic Arthritis in each calendar year since 1999. However this is likely to underestimate the total number since many cases will be treated in a primary care setting only.

Source: SMR01,ISD Scotland

*Following ISD Statistical Disclosure Control Protocol, any cells with count values of 4 or less have been suppressed in order to protect the confidentiality of potentially personally identifiable information.

1. A full list of the ICD10 diagnosis codes used to identify patients can be found in the attached notes.

Notes:

1. Up to six diagnoses (one principal diagnosis and five secondary diagnoses) may be recorded per hospital episode, using the International Classification of Disease Codes, Tenth Revision (ICD-10). All six diagnostic positions were used to identify the relevant cases.

2. The primary diagnosis is defined as the main condition treated or investigated during the relevant episode of healthcare. The five secondary diagnoses describe other conditions which the patient may have.

3. The following paired ICD10 codes were used to identify the relevant cases 'L40.5 D' + any of the following:

'M07.0 A'

'M07.1 A'

'M07.2 A'

'M07.3 A'

'M09.0 A' (Juvenile)

Information collected by National Records of Scotland is set out in the following table.

Deaths where Alcoholic Liver Disease [1] was the underlying cause, Scotland, 1999 to 2015

[1] Deaths classified under the International Classification of Diseases. 1999 figures based on the 9^th revision (ICD-9) using codes 571.0 to 571.3. 2000 figures onwards based on 10^th revision (ICD-10) using code K70.

[2] Deaths registered during the calendar year.