Chamber and committees

The cost of sending patients with chronic pain to pain management centres outside Scotland was:

(a) 2008-09 - £229,559

(b) 2009-10 - £184,937

(c) 2010-11 - £206,685 for the first six months.

These costs are shared across all NHS boards as part of the national risk share arrangements administered by National Services Division. A board''s contribution is calculated on its percentage share of the baseline allocation.

There has been an increase in the referrals of patients being treated in 2010-11 in comparison to previous years. This is due to outreach clinics now being held in Scotland where the consultant can see a greater number of patients for assessment which has led to an increase in patients being referred outside of Scotland.

The £400 million announced for short breaks in England between 2011 and 2015 follows the overall UK Comprehensive Spending Review (CSR) decisions. We understand that the funding, which will not be ring-fenced, will be allocated to primary care trusts.

The Scottish Government received consequentials from the UK CSR in the normal way, which were reflected in Scotland''s draft budget. The £400 million is not new money over and above the decisions made during the CSR.

We are taking action on a number of fronts. The Carers Strategy, published in July, contains a number of different actions to help promote the development of flexible, personalised short breaks services. I announced £1 million for short breaks in 2010-11, which we have rolled forward, resulting in £5 million in total for short breaks between 2010 and 2015. This is being allocated to the National Carers Organisations, who have now announced a Short Breaks Fund to help support and sustain carers and young carers. Subject to parliamentary approval of the draft budget, there will also be £2 million in 2011-12 for short breaks for families with severely disabled children and £5 million to support carers and young carers through the Carer Information Strategies.

As part of the concordat commitment to deliver an extra 10,000 respite weeks, we provided local authorities with £2.82 million in 2010-11. This £2.82 million, reduced by the 2.6% applying to total local authority spending, will be in the overall local government settlement to councils. Councils will be required to agree to deliver certain commitments, including continuing to work with the Scottish Government towards implementation of the Carers and Young Carers Strategy at local level, including the maintenance of an extra 10,000 weeks respite care.

Local authorities'' net revenue expenditure on support for carers, including respite care, was £134.74 million in 2008-09.

There are provisions in the draft Self-directed Support Bill for support to carers, which might include respite. Our proposals will be subject to consultation that will take place before the end of 2010.

In recognition of the pressures on the health and social care system in a challenging fiscal climate, the Scottish Government has allocated £70 million in 2011-12 within the NHS budget to a Change Fund for NHS boards and partner local authorities to redesign services to support the delivery of new approaches to improved quality and outcomes. By ensuring that older people remain independent in their own homes, health boards and local authorities will be able to focus on reducing unnecessary hospital admissions and speeding discharge after a crisis. This will result in better outcomes for older people and ease the pressure on acute hospital provision. Given the vital role performed by carers, we expect local partnerships to invest an appropriate proportion of their change fund allocation in provision that specifically supports carers.

The announcement of £400 million for short breaks in England over four years does not mean that Scotland will fall behind in short breaks provision. Our own plans, with investment, are robust.

It is for individual health boards to determine how they will achieve the target having regard to the guidance to boards that has been placed in the Scottish Parliament Information Centre (Bib. number 52181).

The criteria that will apply in determining which posts will go in the proposed 25% reduction in senior managers in the NHS is set out in the guidance issued to boards which has been placed in the Scottish Parliament Information Centre (Bib. number 52181).

The Scottish Government published Partnership Matters, first issued in 2005, subsequently refreshed in 2007 and again in May 2009. This is a guidance document which describes the roles and responsibilities of local authorities, NHS boards and voluntary organisations to support people with additional support needs who wish to study, or are currently studying at Scotland''s colleges or universities. This guidance included developing staff training and guidance; enhancing central support facilities; developing drug and alcohol policies; employing wardens or organising peer support in student residencies, and promoting awareness of stress triggers and periods of increased vulnerability.

In relation to this, the Scottish Further Education Unit (SFEU) was funded by the Scottish Government to develop a website to provide information and resources for college and university staff related to promoting student mental health improvement.

Projects currently in partnership with the NHS include: Sharing Practice In Mental Health Improvement between NHS Lothian and the Charlie Waller Memorial Trust, looking at the mental health of students, and the Student Mental Health Group Glasgow, which is a collaborative project between the six universities in Glasgow City and NHS.

All student mental health improvement initiatives can be found at the SFEU Website, mentioned above, which was launched in 2007:

http://www.scotlandscolleges.ac.uk/ssmh/ssmh/case-studies-ssmh.html.

The Scottish Government does not intend to formally respond to the Glasgow Anti-stigma Partnership report, There''s More to Me. However, we welcome the findings of this report.

We are currently supporting the Lesbian, Gay, Bisexual and Transgender (LGBT) Centre for Health and Wellbeing, in partnership with NHS Lothian, to conduct a project which will contribute to the understanding of LGBT communities and their mental health and wellbeing needs, and deliver specialist mental health support for LGBT people in Lothian.

In Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009-2011 we made a commitment to fund NUS Scotland to deliver a three-year project aimed at long-term gains in mental health improvement practices. As part of that project NUS conducted a piece of research: Silently Stressed: a survey into student mental wellbeing published in October 2010. This will inform priorities for the remainder of the project and for any future work.

Guidance through the Fair for All Agenda, to eliminate and promote equality of opportunity for everyone, is available to help NHS staff understand and meet their responsibilities under the Disability Discrimination Act, and to support NHS Scotland in implementing the Gender Equality Scheme Duty, which assesses progress in achieving gender equality outcomes and provides information and good practice examples of LGBT people using NHS services.

Through this overarching agenda, Fair for All “ LGBT has been mainstreamed within NHS Health Scotland, and is determining the focus to deliver accessible, high quality and sensitive services which fully meet the needs of Scotland''s LGBT population.

From July 2010, the Scottish Government has been funding the LGBT Centre for Health and Wellbeing to run the Demonstration Project, to provide learning and create the foundations for lasting and sustainable cultural change in relation to responding to the needs of LGBT people who experience mental health problems. The project is designed to help us learn how best to support LGBT people across Scotland, it is being guided by a Lothian based advisory group, with a wide ranging membership of stakeholders, such as NHS Lothian, Choose Life and see me, to inform its development and to encourage engagement across health, social care and equality services, communities and organisations. The projects aims to: increase access to health care and support services for LGBT people; tackle the mental health risk factors affecting LGBT people; work to promote resilience and strengthen the capacity of the LGBT community, promote the mental health and wellbeing of individuals, and provide specialist mental health input for LGBT people experiencing mental health problems.

The draft budget, including the £5 million for Carer Information Strategies (CIS), has to be approved by the Scottish Parliament. Subject to this approval, the £5 million will be used to support carers and young carers just as the £9 million for CIS over the three years to March 2011 is benefitting carers and young carers. I will be taking the views of NHS health boards and the national carers organisations on the use of the £5 million in 2011-12.