This item was published during the term of a previous administration that ended in April 2007
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NHS reform bill launched
27/06/2003
The Scottish Executive today published landmark
legislation to bring the structure of NHSScotland up to
date.
Introduced to the Scottish Parliament by Health Minister
Malcolm Chisholm, the National Health Service Reform
(Scotland) Bill takes forward proposals in the White Paper,
"Partnership for Care" and fulfils the commitments in the
Scottish Executive's Partnership Agreement to bring forward
legislation to reform the NHS.
The key provisions contained within the Bill would:
- Remove NHS Trusts
- Establish new Community Health Partnerships
(CHPs)
- Place a duty on Health Boards to involve the public
more closely in planning, developing and operating the
NHS. This will be supported by the setting up of a new
Scottish Health Council
- Oblige Health Boards to co-operate in developing
more effective regional planning of health
services
- Give Ministers new powers to intervene to secure
the quality of healthcare services
- Give Ministers and Health Boards a new, direct
responsibility for promoting health improvement
Commenting on the publication of the Bill, Mr Chisholm
said:
"This Bill will continue and build on the process of NHS
reform to help modernise the service and ensure that
patients' needs and interests are placed at the heart of
everything the service does.
"Our White Paper Partnership for Care, which we
published earlier this year set out the way ahead for
devolving power and responsibility to staff at the front
line and for involving and engaging the public. The NHS
Reform Bill turns these key principles into action.
"We also made clear in Partnership for Care that we
would align NHS structures with our policies on integrated
healthcare and a seamless patient journey. This is an
important aspect of modernisation. So we will complete the
process of replacing NHS Trusts, which were established to
promote competition and not co-operation and have outlived
their usefulness.
"The Bill will remove all references to NHS Trusts from
the Statute Book. This will mark the end of the process of
dissolving Trusts; a process that has taken us towards a
more efficient health service that can respond to local
needs. Already some NHS areas are moving towards this goal
with NHS Trusts in Dumfries and Galloway and the Borders
having been dissolved and Argyll and Clyde soon to
follow.
"The Bill will help to ensure that as much healthcare as
possible is delivered by community-based staff. The
Community Health Partnership provisions in the Bill are a
key building block in making services more responsive and
effective. CHPs will be crucial in getting resources and
responsibility to frontline staff and ensuring effective
delivery of local healthcare.
"Taking further forward the Health Department's policy
framework Patient Focus and Public Involvement, which
encouraged the NHS to engage more directly with the public,
this Bill will place a duty on Health Boards to involve the
public. A Scottish Health Council (SHC) with a strong local
presence will be set up to monitor how well Boards are
doing in terms of public involvement.
"Of course, it is not only the public that should be
involved in NHS planning. Provisions in the Bill place a
duty on Boards to co-operate with each other and Special
Health Boards such as the Scottish Ambulance Service and
NHS24 in order to improve service planning and delivering
services across the country.
"The Scottish Executive's policy is that NHSScotland
should offer high quality care to all users of the service
no matter where they live or what their circumstances are.
If a part of the NHS is consistently failing to meet key
standards then, as a last resort, Ministers need to be able
to intervene to improve performance. Existing powers of
intervention are broad-brush and take time to operate.
"This Bill will give the Executive powers to intervene
quickly where it is necessary. It will provide the means to
sort out things that have failed, to transfer
responsibility for running a service that is in trouble to
another Board or to a specially-constituted team until
performance is turned around.
"Moving on to the health improvement aspects of the
Bill, we all agree on the need to tackle Scotland's poor
health record. We can only bring about long-term and
sustainable improvement by attacking the causes of
ill-health and promoting positive health and well being and
it is important that NHSScotland is fully involved in
getting those messages across.
"A statutory obligation is introduced in the Bill to do
this. Ministers too should have duty of care to promote a
healthy lifestyle and specifying a clear Ministerial power
in this area will allow myself and my successors to show
clear national leadership in improving the health of the
nation.
"Overall, I consider these measures to be a means of
transforming and modernising the health service in
Scotland. Specific reforms to put the patient at the heart
of NHSScotland, involve our healthcare professionals and
devolve power, will enable us to move forward together in
shaping a modern health service for the people of
Scotland."
The Bill is in three main parts:
- Organisation and operation of the NHS
- Promotion of Health Improvement
- Supplementary
It has nine sections which are as follows:
- Dissolution of NHS Trusts: Modifications of
enactments
- Community Health Partnerships
- Health Boards: Duty of Co-operation
- Powers of intervention in case of service
failure
- Public involvement
- Dissolution of local health councils
- Duty to promote health improvement
- Ancillary provision
- Commencement and short title
CHPs are intended to evolve from Local Health Care
Co-operatives (LHCCs), which were established following the
1997 White Paper "Designed to Care". The envisaged role for
CHPs is to:
- Ensure patients and communities, and a broad range
of healthcare professionals, are fully involved in the
planning and review of services
- Establish a substantive partnership with local
authority services
- Play a more influential role in service redesign
locally
- Act as a focus for integrating health services,
both primary and specialist, at local level
- Play a pivotal role in delivering health
improvement for their local communities