This item was published during the term of a previous administration that ended in April 2007
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White Paper on Scotland's health
27/02/2003
A blueprint to transform Scotland's health and its health
services was outlined today.
Key points in the White Paper
Partnership for Care include the abolition of
NHS Trusts, and a new guarantee of treatment on time.
Health Minister Malcolm Chisholm said:
"Over the lifetime of the next Parliament, we plan to
increase investment in health from £6.7 billion to £9.3
billion, an annual increase of 5.5% in real terms.
"That is high by historic standards but it will only deliver
the necessary improvements if it is matched by a programme of
modernisation that is based on the needs of patients.
"This White Paper is about the promotion of health in the
broadest sense and the creation of a health service that is fit
for the 21
st century. At the heart of its vision is a culture
of care that is developed and fostered by a new partnership
between patients, staff and Government."
Key points are:
- More local health care - a wider range of services
delivered locally in communities. Stronger role for Local
Health Care Co-ops, evolving into new Community Health
Partnerships.
- Abolition of NHS trusts and new requirements to devolve
authority to frontline units and involve their
professionals.
- New guarantee of treatment on time, initially for
certain heart surgery, but to be extended to services with
national waiting time targets. New local targets for
specialities.
- Vigorous independent monitoring of services by NHS
Quality Improvement Scotland (NHSQIS) to ensure highest
standards of care and cleanliness. The Executive will take
tough action where serious failings emerge.
- A new Scottish Health Council, as part of NHSQIS, to
involve the public in NHSScotland.
- Patients to be partners in decision making - plans for
an Integrated Care Record owned jointly by patients and
their health care professionals. A new statement of
patients' rights and responsibilities and new complaints
procedure.
- A new £26m fund for change and innovation to build a
new model NHS designed not by centralised bureaucracy but
by clinicians with patients in the driving seat and
removing barriers between primary and hospital care.
- More help for staff through professional development
and training to encourage new skills and roles to meet the
needs of the NHS. A new approach to workforce
planning.
Mr Chisholm said:
"This is a genuine Scottish document to meet the needs of
Scotland. It is part of an ongoing devolution process -
devolving power and responsibility to clinicians and
patients.
"We have talked for some time about patient-centred services
but today we are signalling a step change so that looking at
services from a patient's point of view becomes the key driver
of change in the health service.
"This has specific outcomes such as a new complaints
procedure, a Patient Information Initiative and a new statement
of Patient Rights and Responsibilities but underlying these
specific initiatives is a more fundamental culture change that
involves patients at every stage as partners in care and key
contributors to quality improvement.
"There is also a new emphasis on the role of staff, and
frontline staff in particular, as leaders of change in the
health service. We shall increase the capacity of the NHS
workforce, develop new workforce planning arrangements, improve
opportunities for continuing professional development and
establish reformed pay systems. We shall also ensure that
healthcare teams are given the support and the tools and the
freedom to redesign services and improve patient care.
"One of the key themes of this White Paper is
decentralisation of decision making and an end to traditional
command and control approaches to reforming the health service.
We shall ensure that there are schemes of decentralisation
within each NHS Board and this will be backed up by
legislation."
Existing Local Health Care Co-operatives will evolve into
new Community Health Partnerships. These will have stronger
roots in their local communities through local accountability
and closer links with local authority social work services.
NHS Boards will be required to establish a Service Redesign
Committee, with a strong involvement of clinicians and other
health professionals, with representation from each Community
Health Partnership.
An additional £26m will be allocated in the next financial
year to NHS Boards to modernise services - based on robust
plans supplied by the boards. They will also be supported by
the Centre for Change and Innovation by funding pilot projects,
supporting redesign and helping to share best practice.
The Minister continued:
"Our first priority in improving services must be to improve
waiting times, because that is the first concern that we hear
expressed by patients. A major national piece of work has been
launched to reduce outpatient waiting through redesign and
other changes.
"This process will be matched by increased investment in
e-health or information technology and the appointment of a
clinician as Director of Clinical Information in each NHS Board
to take this forward.
"Our emphasis on integration and decentralisation has
implications for the future of Trusts. The existence of
separate NHS Trusts covering the same areas as NHS Boards has
not yielded clear benefits, but has confused accountability and
obstructed the integration of services. We shall therefore
require NHS Boards to submit plans to dissolve Trusts and
establish new decentralised operating units with a strong role
for frontline staff.
"All these measures will ensure the improvement and
modernisation of health services but we shall never achieve the
health outcomes we want unless there is parallel progress on
the broader health improvement agenda. This will require a
sustained effort that involves, not just the Scottish Executive
and NHSScotland, but local authorities, employers, trade
unions, community planning partners and local communities.
"We will publish a Health Improvement Challenge shortly to
set out in more detail how we will focus actions on four
groups: children in early years, teenagers, people at work, and
local communities. We are backing this with plans costing
almost £250 million over the next three years on a range of
measures to improve health.
"This White Paper signals a direction of travel, to enable
us to go forward together. It takes a broad view of health. It
puts the patient first. It recognises the importance of
national standards of healthcare and independent inspection of
performance. It sets out specific reforms to devolve power and
to involve the health professionals, in order to modernise
services, and so reduce waiting times.
"Of course the implementation of these measures, including
the legislation, must be a matter for the next
Parliament."