« Previous | Contents | Next »
Listen
Foreword
Dear First Minister,
It gives me pleasure to present my first report on Health in Scotland since being appointed Chief Medical Officer. For most of my professional career, I have been concerned with the health of populations disadvantaged by social or economic conditions. Investment focussed on improving the health of the poorest sections of the community remains a priority if we are to see Scotland's overall level of health match that of our European neighbours. Fortunately, such investment is happening and, in future years, I hope to report that it is having a positive impact. In the meantime, there are encouraging signs that a number of health indicators in Scotland are beginning to improve significantly.
Breastfeeding rates are up and there is real evidence that the dental health of children is being significantly improved by the efforts of teachers, parents and NHS staff. There is also evidence that efforts to improve road safety for children are having a considerable effect in reducing admissions to hospital and death rates from accidents. An important contributor to child health is immunisation. Overall, the uptake of immunisation in the young is good. It is encouraging to see that the acceptance of MMR immunisation has improved over the past year although it remains short of its 95% target. Outbreaks of measles, rubella and mumps can be highly damaging to children and it is important that we continue efforts to reassure parents of the benefits to their children from having them immunised.
Mortality from cancer and heart disease is also improving. Although the number of cancers being diagnosed has increased over the past four decades, mortality has fallen. This trend is undoubtedly due to improved techniques for diagnosis and treatment within NHSScotland. An important observation is the considerable decline in lung cancer incidence in men. The ban on smoking in public places should maintain the progress made in reducing smoking rates in Scotland and we may see a time when lung cancer becomes relatively rare in our community. Mortality from coronary heart disease in under 75s has fallen by 46% over the past decade. Again, reduction in smoking prevalence has had an important effect on heart disease risk but it is also important to acknowledge the contribution the NHS has made in making available new treatments for the prevention and treatment of heart disease.
Although life expectancy across Scotland as a whole is improving, the significant adverse impact on health of alcohol is now obvious. Mortality from cirrhosis of the liver amongst males in Scotland has overtaken that in other European countries including France which has had the highest rate for much of the 20th century. Although causes other than alcohol might contribute to a small degree to this rise, there is little doubt that the vast majority of cases are alcohol associated. An updated Alcohol Action Plan for Scotland is required to maintain and, indeed, re-energise efforts to convince Scots of the significant harm to health caused by excessive consumption of alcohol.
Overall, I believe that the evidence shows that Scotland's health status is improving in many respects. I believe that these improvements are clear evidence that Scots are increasingly taking action on many of the major health challenges facing them. There are some areas, however, where greater effort is required.
Yours sincerely,
Dr Harry Burns
Chief Medical Officer
November 2006
« Previous | Contents | Next »