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The Scottish Government is committed to meeting the needs of children with autism. We want all children and young people to reach their full potential. It is imperative that children who are displaying violent behaviours, whether it be in a school or social settings, are provided with access to locally based support.

Children and young people should feel happy, safe, respected and included in the learning environment and all staff should be proactive in promoting positive relationships and behaviour in the classroom, playground, and wider learning community. There are a range of strategies and programmes which schools can and do use to improve relationships and behaviour including good behaviour management and behaviour support teams; solution oriented approaches and restorative approaches; and nurture approaches and programmes to help develop social, emotional and behavioural skills.

Education authorities and other agencies have duties under the Additional Support for Learning Act 2004 (as amended) to identify, provide for and keep under review the additional support needs of their pupils, including children and young people with autism. This would include strategies for management of behaviour.

Children with mental health issues have access to Child and Adolescent Mental Health Services; where violent behaviours indicate a mental health problem then CAMHS support may be appropriate. Under Integration Authorities’ arrangements it is the responsibility of NHS Boards and Local Authorities to ensure they meet the needs of their local population, including considering access to locally-based support to children and young people with Autism Spectrum Disorder.

In Scotland we have a clear route for new drugs to be appraised through the long standing Scottish Medicines Consortium (SMC).

SMC will consider a resubmission for the use of ibrutinib (Imbruvica®) in adult patients with chronic lymphocytic leukaemia (without genetic changes known as 17p deletion or TP53 mutation) who have received at least one prior therapy and for whom fludarabine-based regimens are inappropriate at their meeting on 7 March 2017 and expect to publish their advice on 10 April 2017.

In Scotland we have a clear route for new drugs to be appraised through the long standing Scottish Medicines Consortium (SMC).

Where SMC accept medicines for routine use in Scotland, Health boards are expected to make the medicine or its equivalent available to patients. SMC published ‘accepted for restricted use’ advice on 8 August 2016 for ibrutinib(Imbruvica®) for treatment of adult patients with chronic lymphocytic leukaemia (CLL), who have received at least one prior therapy, or in first line therapy in the presence of 17p deletion or TP53 mutation who are unsuitable for chemo-immunotherapy. This advice is line with the recent NICE decision for access to ibrutinib(Imbruvica®) in England and Wales.

It is for NHS boards, local authorities and Alcohol and Drug Partnerships (ADPs) to assess the need for, the design and delivery of local services, including for those facing problems caused by prescribed or over the counter medication.

At a national level the Scottish Government have contributed to the recent report by the Advisory Council on the Misuse of Drugs looking at the ‘Diversion and Illicit Supply of Medicines’, and are currently considering the recommendations from the report. Scottish Government have also supported the development of the ‘Clinical Guidelines on Drug Misuse and Dependence’ which set out best practice for those providing pharmacological interventions for drug misusers, ensuring Scottish representation on the expert review group and leading on consultation with those with key interests in Scotland. The updated guidelines will be promoted across Scotland once published.

The Scottish Government funds the NHS in Scotland to make available both antidepressants and psychological therapies to people who are depressed, in keeping with contemporary treatment of depression.

Prescribing of anti-depressants is a clinical decision for a patient’s doctor and there is evidence that GPs in Scotland assess and treat depression appropriately in line with good clinical and prescribing practice (http://www.gov.scot/Publications/2014/07/5712).

Clinicians are encouraged to review a patient’s medications regularly to ensure their continued clinical appropriateness, and to achieve the best possible health benefit from the prescribed medicines, thus minimising unnecessary reliance.

Psychological therapies should not be seen simply as an ‘alternative’ to antidepressant medication. There is a great deal of evidence to support the use of different forms of psychological therapies for the treatment of depression – both alone and in combination with medication. A useful evidence source is the Matrix of Psychological Therapies produced by NHS Education Scotland (http://www.nes.scot.nhs.uk/media/20137/Psychology%20Matrix%202013.pdf).

The resources required for implementation of Part 4 of the Children and Young People (Scotland) Act 2014 (the Act), relating to Named Person duties, including the costs to bodies required to implement the duties, is set out in the financial memorandum to the Children and Young People (Scotland) Bill. This can be accessed at:

http://www.scottish.parliament.uk/S4_Bills/Children%20and%20Young%20People%20(Scotland)%20Bill/b27s4-introd-en.pdf.

The Scottish Government is committed to improving pedestrian safety through a number of initiatives highlighted in Scotland's Road Safety Framework to 2020. Following a mid-term review of the Framework held earlier this year it was identified that vulnerable road users, including pedestrians would be a priority focus. An outcome to reduce the number of pedestrian casualties through good design, appropriate speed management, high awareness of and compliance with, road traffic laws and safe practices by all road users was agreed. We are now working with local authorities and key stakeholders to implement a range of initiatives to positively influence casualty reduction and improve driver and pedestrian behaviours.

Furthermore, we are also committed to bringing forward legislation, which aims to improve accessibility for all pedestrians by protecting their rights and safety by prohibiting parking on pavements and, at dropped kerbs as well as double parking. To ensure that any legislation is fit for purpose and will command public confidence and support, we have set up a Stakeholder Working Group to undertake a full review and public consultation. The consultation is due to be published in the New Year.

Scotland’s Road Safety Framework to 2020 contains an ultimate vision of a future where no-one is killed on Scotland’s roads and is underpinned by challenging casualty reduction targets.

While accident and casualty reduction is our key driver, the recent mid-term Review of the Framework saw partners formally adopt a Safe System approach which recognises that road users make mistakes and requires that the road system is designed to take account of human error and vulnerability. This approach requires us to undertake measures across the 3 road safety E's of engineering, education and enforcement to ensure we have safer roads and roadsides, safer speeds and safer road users.

The recruitment of markers is an operational matter for the Scottish Qualifications Authority (SQA). I have asked the Chief Executive of SQA to write to you outlining the robust processes in place to ensure that markers are appropriately qualified.

At present the wearing of high visibility clothing for cyclists is not mandatory and there are currently no plans to review or change this.

However, high visibility clothing can play a role in preventing accidents, which is why we continue to work through Road Safety Scotland to promote the advice in the Highway Code on safe cycling, including encouraging cyclists to ensure that they are visible to other road users and take steps to safeguard themselves by wearing appropriate clothing.