< Previous | Contents | Next >

Health Protection in Scotland - A Consultation Paper

Chapter 1: Introduction

1. Good health protection is at the heart of a healthy Scotland. Put simply, health protection means protecting each of us, young and old, from hazards, which can damage our health, whether from disease or from biological, chemical, radiological and physical processes. Protecting health is of course an individual and collective responsibility. This consultation paper is focussed on the latter, and seeks views on the future direction of health protection in Scotland.
2. Health improvement is high on the health agenda, manifested in the White Paper "Towards a Healthier Scotland" in 1999. This set priorities, targets and a framework for investment in good health and a coherent attack on health inequalities and the causes of ill health, based on a comprehensive and co-ordinated use of health and other resources and agencies capable of influencing health. The White Paper was followed, by the Chief Medical Officer’s "Review of the Public Health Function in Scotland", which paves the way for a revitalised and integrated approach to public health; "Nursing for Health" the Chief Nursing Officer’s review of the contribution of nurses, midwives and health visitors to improving the public's health in Scotland; and by "Our National Health, a plan for action, a plan for change," which set out priorities for investment and reform to deliver a modern 21^st century NHS, and for maintaining the momentum to build a national effort to improve health, including commitments to curb healthcare associated infection, to address anti-microbial resistance and to tackle the rising trends in sexually transmitted infections. There is thus a solid platform on which to build robust arrangements for protecting our health in Scotland.
3. There are compelling reasons for reviewing health protection arrangements in Scotland:

• there is a rapidly developing background of environmental and infectious threats which affect us now and could in the future.
• we need to put in place arrangements which are capable of addressing, monitoring and responding to a widening variety of environmental and infectious hazards.
• it is critical to shape a clear agenda, within which we can develop health protection services, consistent with the demands and challenges of the 21^st century.
• recognising public anxieties over issues such as food safety and MMR, the importance of assuring the general public that systems and procedures are adequate to respond effectively to actual and potential threats, including biological terrorism, and
• the requirement to ensure that health protection, as an essential component of health improvement, makes a maximum contribution to the overall drive to better health in Scotland.

4. Changes under consideration elsewhere in the UK also provide an opportunity for considering whether we can improve arrangements for collaboration and co-ordination across the UK, while preserving the distinctive features of arrangements in Scotland (and elsewhere).
5. "Getting Ahead of the Curve – A Strategy for combating infectious diseases", which the Chief Medical Officer in England published on 10 January 2002, set out proposals aimed at strengthening specialist support for health protection by bringing together, within one Agency, responsibility for a range of health protection functions.
6. In the light of consultation, the intention is that a special health authority (SHA) will be created as an England and Wales body from 1 April 2003. The SHA will be responsible for the functions currently performed by:

• the Public Health Laboratory Service (but not, in general, its clinical diagnostic microbiology services, which are transferring to the NHS, nor media production);
• the Microbiological Research Authority;
• the National Focus for Chemical Incidents, Regional Service Provider Units, and the National Poisons Information Service;
• the health protection functions provided by Consultants in Communicable Disease Control and other health protection staff; and
• the advice and other functions provided by regional health emergency planning advisors and their staff.

If legislative time allows, the aim is to establish the new Agency as an executive non-departmental public body from 1 April 2004. At that point, it is intended that the Agency will take on the functions to be discharged by the new special health authority (which will be wound up) and other functions, in particular, radiological protection functions which the National Radiological Protection Board currently performs for the UK Government and the National Assembly of Wales. This would leave the National Radiological Protection Board as a body with responsibilities in Scotland only.

7. The rationale is that the co-location of these responsibilities will enhance the capability to tackle health protection issues, including infectious disease, and chemical and radiation hazards.
8. In Wales, it is proposed that the Health Protection Agency will assume a more limited role, offering higher level advice and guidance to Wales. It is also envisaged that the HPA will take the lead on chemical incident advice and management. A National Public Health Service - Wales, will shortly be established and it is proposed that communicable disease control staff, and the PHLS in Wales (which includes CDSC Wales) will become part of this NPHS-W. That health protection structure will work closely with the HPA to ensure action on an England and Wales basis when needed i.e. emergency planning, counter measures, new policies and in specific work involving reference laboratories.

   How We Will Use this Document  

9. The following chapters sketch the scope of health protection in Scotland and the current organisational arrangements, and pose a number of questions on which we would appreciate views. The responses will help shape the institutional, organisational and procedural arrangements we need to put in place to optimise health protection in Scotland, with a particular focus on:

a. how we should define the scope of health protection;

b. major issues for health protection in Scotland;

c. the organisational and legislative arrangements which might best be made for the delivery of health protection in Scotland; and

d. whether, and if so to what extent, it would be beneficial for Scottish arrangements to link into the proposed Health Protection Agency in England and Wales;

10. A list of the consultees is at Annex 1; but the document is being placed on the web and is thus widely accessible. Though the aim is for the proposed Health Protection Agency in England and Wales to come into operation from 1 April 2003, there is no presumption that any changes in Scotland flowing from this consultation will match that timetable. Implementation will need to reflect the scope and scale of any agreed changes.
11. To help inform debate on the issues set out in this consultation paper, the Executive intends to follow its normal practice of making available to the public, on request, copies of the responses received. The Executive will assume, therefore, that responses can be made publicly available in this way. If, however, respondents indicate that they wish all, or part, of their responses excluded from this arrangement, confidentiality will be strictly respected.

Responses should be sent to:

Sandra Smith
Public Health Division
Scottish Executive
Room 3E(S)
St Andrew’s House
Regent Road
Edinburgh
EH1 3DG

< Previous | Contents | Next >