To ask the Scottish Executive how it recognises the additional cost of providing health services for people from (a) disadvantaged communities and (b) rural areas.
Currently the fundingfor Hospital and Community Health Services and GP Prescribing is distributed viathe Arbuthnott Formula. The formula assesses each health board’s relative need forfunding, using information about its population size and characteristics that influencethe need for health care, and costs of delivery, in terms of hospital services,community services and GP prescribing. The main drivers of the formula are:
share of the Scottishpopulation living in the board area;
age structure of thepopulation and relative number of males and females;
morbidity and lifecircumstances (MLC), and
unavoidable excesscosts of delivering health care in different geographical areas.
An index is calculatedfor each element of the formula for each care programme in such a way that it compareseach board’s position with the national average. By calculating each index in thisway, the values can then be multiplied by the population share to determine howmuch more (or less) resource each board requires compared with its basic populationshare due to age-sex, MLC and unavoidable excess costs.
In terms of disadvantagedcommunities, the MLC index is used alongside the age sex index to determine thehealth care “needs” of a health board’s population. The MLC index directs resourcestowards health boards with higher premature death rates and greater socio-economicdeprivation.
The excess costs indextakes account of the costs of supplying health services in remote and rural areasby giving greater weight to those health boards with more sparsely distributed populations.