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Building a Better Scotland
HEALTH AND COMMUNITY CARE
To improve the health and quality of life of people in Scotland and deliver integrated community care services, making sure there is support and protection for those members of society who are in greatest need
A society's willingness to improve the health of its population and its capacity to provide high quality care for its sick and vulnerable is a clear test of its aspirations towards fairness and compassion. If Scotland is to pass that test, we must ensure that we provide the best health care that we can - swift, effective and centred on the needs of the patient.
We are working to improve health and to revitalise the National Health Service and community care services in Scotland. New initiatives are being developed to create a step change in improving health. We are taking a comprehensive approach that draws together activity across the whole range of the Executive's responsibilities and focuses on closing the opportunity gap through: improving the future health of children and young people; delivering integrated community care services to improve the quality of life of those needing assistance; delivering health improvements to disadvantaged people of all ages; and closing the health gap between the most disadvantaged and the average for Scotland, and between those in rural and urban areas.
The health and community care budget will increase over the next three years by 280 million, 869 million and 1574 million, with these additional resources being focused on improving the nation's health and the health service. By 2005-06 these record levels of investment will deliver planned expenditure of 8.6 billion - keeping Scotland's health provision at European levels. These record levels of funding for the NHS provide an exceptional opportunity to reform and modernise the health service in Scotland to ensure it provides the service we deserve.
This investment will make real improvements in Scotland's health, improvements that will:
- meet growing demand for health services - providing fairer access to more services locally, adopting medical advances and meeting the expectations of patients;
- develop and improve primary care services and improve access to dental care;
- reduce waiting times for outpatient, inpatient or day case treatment - particularly for the most serious cases and for those who need help most;
- reduce delayed discharges from hospital into the community - helping to reduce waiting by freeing up hospital beds;
- reflect changes in medical and technological advance - modernising the services we provide, improving the quality of care;
- provide new drugs where clinically appropriate;
- secure a more flexible workforce - equipping them to deliver a more patient-focused service;
- improve the recruitment and retention of front line staff;
- deliver visible improvements in care for patients, for example in the clinical priority areas of cancer, coronary heart disease and mental health;
- invest in buildings and information technology - improving the infrastructure supporting our health services;
- make patients' experience of the NHS better through use of technology - giving them access to better treatment, more advice, information and assistance; and
- improve services for older people - providing them with community care, easing their access to services, improving their quality of life.
Improving the Health of the People of ScotlandOur health as individuals and as a nation is determined by a complex interaction of different factors - physical, social, environmental, as well as personal. Health improvement is an issue that impacts on the economy, education and social justice. Many of our policies and agendas already recognise the potential for contributing towards a step-change in Scotland's health. Our intention is to increase this impact by better co-ordination and focusing action in a new way. We are more than doubling the money allocated specifically to health improvement as we are determined to change our historical position on health. This is a long-term challenge and we are focusing additional resources of 23/50/100 million across the Executive on improving our health by supporting, for example: - integrated early years action building on the childcare strategy;
- expanding the Active Primary Schools Programme and supporting a School Sports Development Officer in every secondary school to raise the level of physical activity for school children;
- implement the recommendations of the school meals expert panel, in particular improving the nutritional content; and
- improving mental well-being across Scotland and action to reduce the rate of suicide.
These are in addition to many other health improvement initiatives that will form part of this co-ordinated approach, including, for example, additional resources for reducing alcohol problems across Scotland, encouraging more people to stop smoking and promoting healthy eating. More details are set out in the relevant portfolio chapters. |
OBJECTIVES AND TARGETS
OBJECTIVE 1
Work towards a step change in life expectancy for Scots, particularly disadvantaged members of the community, including children and older people |
Target | 1 | Achieve a 50% reduction in death from coronary heart disease in people under 75 between 1995 and 2010. |
Target | 2 | Achieve a 20% reduction in death from cancer in people under 75 between 1995 and 2010. |
Target | 3 | Achieve a 50% reduction in death from cerebrovascular disease (stroke) in people under 75 between 1995 and 2010. |
Target | 4 | Achieve a reduction in smoking from 35% to 33% between 1995 and 2005 and to 31% by 2010. |
Target | 5 | Achieve a reduction in the incidence of adults exceeding weekly drinking limits for men from 33% to 31% between 1995 and 2005 and to 29% by 2010 and for women from 13% to 12% between 1995 and 2005 and to 11% by 2010. |
OBJECTIVE 2
Ensure that health care providers provide swift and appropriate access to health care, covering primary, community and acute care |
Target | 6 | Ensure access to a member of a primary care team within 48 hours. |
Target | 7 | No patient should wait longer than six months for a new outpatient appointment by 2006. |
Target | 8 | Ensure that maximum wait from urgent referral to treatment for all cancer cases is no more than two months by 2005. |
Target | 9 | No patient should wait more than six months for inpatient or day case treatment by 31 December 2005. |
OBJECTIVE 3
Improve the patient's experience of the services provided by the NHS |
Target | 10 | Develop a national framework for improving the quality of clinical care by April 2004. |
Target | 11 | All hospitals to have made significant progress towards the Clinical Standards Board for Scotland standards on infection control and clean hospitals by April 2003 and to make further progress each year thereafter. |
OBJECTIVE 4
Improve services for older people, at home and in care settings |
Target | 12 | Progressively enable more older people to live and be cared for in their own homes in each year to March 2006. |
Target | 13 | Ensure by 2005 that all those with unmet need for free personal care are identified and receive the services they need. |
What we will do
Over the Spending Review period we will:
- create a Centre for Change and Innovation to support the drive for reform within NHSScotland;
- invest in improving the treatment of coronary heart disease, stroke, cancer and mental illness, utilising the latest technologies;
- make provision to treat additional hospital cases as outpatients, day cases or inpatients;
- train 10,000 nurses and midwives - an additional 1,500 - and increase the total number of NHS consultants by 600 - ensuring that Scotland has the staff it needs to provide high quality healthcare;
- invest at least 750 million in buildings and IT - building modern and pleasant hospitals and primary care facilities, improving patients' experience of the NHS;
- invest 20 million a year to provide 1,000 community places for people leaving hospital - reducing waiting times imposed by delayed discharges;
- spend 125 million a year on personal and nursing care for the elderly - improving their quality of life;
- roll out NHS 24 across the country - giving swift access to advice and assistance, particularly in remote areas;
- invest at least 36 million to modernise and improve GP and dental facilities - improving access for those who need it most, making primary care more effective and efficient;
- fund measures to improve the recruitment and retention of NHS frontline staff - allowing large increases in staffing levels; and
- develop a wider role for nurses to get the full benefit of their skills and enabling release of doctors to focus where their skills are needed.
Food Standards Agency ScotlandTo be trusted as Scotland's most reliable source of advice and information about food, to protect and improve the safety of the food people eat, and to help people to choose a healthy diet. We will deliver a measurable increase in public confidence in the way food safety and standards are managed in Scotland. We will make sure that issues of public concern are debated openly and that our advice and information is freely available. One of our key goals is to reduce food-borne illness in Scotland, contributing to a 20% reduction across the UK by 2006. We will deliver a national food hygiene campaign, implement our Hazard Analysis and Critical Control Point (HACCP) strategy across food businesses and undertake research into various food-borne pathogens. We are committed to improving the effectiveness of food law enforcement, which plays a crucial role in protecting the public, ensuring that food imports consistently meet our standards and guaranteeing that the food we purchase is what it claims to be. |
Providing consumers with clear and accurate information is essential to enable them to make informed choices about their diet. To improve food labelling we will support international negotiations and work with food manufacturers and retailers to improve information on a voluntary basis. Our Scottish Nutrition Strategy will focus on a partnership-based approach, supporting the Scottish Diet Action Plan. We will work to deliver long-term improvements in diet and nutrition, education forming an important part of making sure that the public, and children in particular, have access to information and practical food and cooking skills.
Spending Plans
m | 2002-03
Plans | 2003-04
New Plans | 2004-05
New Plans | 2005-06
New Plans |
Hospital, Community and Family Health Services | 6,442.4 | 7,178.5 | 7,760.2 | 8,421.9 |
Other Health Services | 139.5 | 94.7 | 98.6 | 141.4 |
Community Care | 8.8 | 12.5 | 12.5 | 12.5 |
Food Standards Agency | 5.5 | 6.1 | 9.6 | 9.7 |
Total | 6,596.2 | 7,291.8 | 7,880.9 | 8,585.5 |
Mental Illness Specific Grant | 13.3 | 13.3 | 13.3 | 13.3 |
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