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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.

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.

The table below gives the total number of prescription items dispensed, and the percentages of proprietary and generic products.¹

Information on dispensing details for branded products still on patent, and branded products for which a generic equivalent existed, is not recorded centrally and is not available in the form requested.

Prescription Items Dispensed in Scotland - 1995-96 to 1999-2000

	1995-96	1996-97	1997-98	1998-99	1999-2000
Total items dispensed	53,263,578	54,985,962	57,192,917	58,797,506	60,908,779
% dispensed as generic	41.72%	44.34%	47.01%	48.69%	49.49%
% dispensed as proprietary	58.28%	55.66%	52.99%	51.31%	50.51%

Notes:

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

It is too early to quantify what savings may be attributable to the work of the Common Services Agency's fraud investigation unit, which has been in operation since July, but this is a matter which will be examined further in the light of experience. The unit will also focus on deterring fraud against the NHS.

The Practitioner Services Division of the Common Services Agency went live in October 2000 with a new data capture, validation and pricing system for processing pharmacists' claims for payment in respect of dispensed prescriptions. Software for processing ophthalmic claims is being developed and that system is expected to go live early next year.

The Scottish National Blood Transfusion Service (SNBTS) already operates an appointment system at its five main donor centres. SNBTS is committed to improving this system and will assess donor feedback with a view to offering the facility more widely if demand is shown to exist. However, an appointment system does not appeal to all donors, and SNBTS is also committed to retaining its "walk in" facility.

Scottish Healthcare Supplies (SHS), a Division of the Common Services Agency with responsibility for arranging central contracts for the NHS in Scotland, is committed to ensuring that any goods, equipment or services placed on contract are safe, of optimal quality and represent good value for money. SHS has negotiated a wide range of national contracts for common usage, and these have generated substantial savings for the NHS in Scotland. The Scottish Executive continues to work to seek further improvements in this area.

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.

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.

Currently, the level of resources allocated for capital investment in the NHS in Scotland during 2000-01 and 2001-02 total £179 million and £194 million respectively. In addition, capital resources of £30 million were made available during 2000-01 for investment in medical equipment and other areas of the NHS.

Any resources carried forward from the previous year due to capital slippage will be added to future year totals.