Chamber and committees

The system of bonuses and penalties for Trusts based on performance against New Deal targets and standards which I announced in September 1999 was intended to act as an incentive to overcome the remaining obstacles to full compliance. At the time the latest returns from Trusts indicated that only 10% of junior doctors in Scotland were working outside the 56 hour limit. The detailed work which the New Deal Implementation Support Group (ISG) undertook with Trusts prior to its report to me in March 2000 revealed that the scale of non-compliance was greater than previously reported.

In the light of information from the ISG, I informed Trusts that, while I remained determined that junior doctors' hours and working conditions must be improved as a matter of priority, I would postpone the imposition of financial penalties provided that they initiated remedial action. The ISG has since worked with Trusts to identify problems and develop solutions in this area. The concept of introducing incentives for those Trusts to meet New Deal targets has subsequently been incorporated into the agreement between the UK Health Departments and the BMA for a new contract for junior doctors. The contract which took effect from 1 December will reward the most hard pressed junior doctors and provide a real financial incentive for Trusts to reduce doctors' hours. The cost to Trusts of non-compliant posts will increase significantly at intervals throughout the next two years. The Scottish Executive has worked with the Scottish Junior Doctors' Committee (SJDC) and NHS Trusts in Scotland to implement the contract.

On 28 June I announced that we would recruit 100 extra junior doctors in Scotland to be targeted at areas with an identified need for additional resources. We have already appointed 40 junior doctors in shortage specialties. The remaining 60 will be in place by the end of this financial year.Health boards were recently given their revenue allocations for 2001-02. The average increase in unified budgets is 6.5% which represents a cash increase of over £270 million. This is on top of significant increases in funding during 2000-01. It is the responsibility of health boards to determine local priorities for the use of funds including meeting the targets and standards of the New Deal for Junior Doctors.

The New Deal Implementation Support Group (ISG) meets regularly. Its last meeting was on 20 November 2000.The group is continuing to work with NHS Trusts to help them improve junior doctors' hours and working conditions through advisory visits to individual Trusts, the delivery of training and education workshops and the provision of supporting material. To increase its capacity I have agreed to expand the group by recruiting a further six junior doctors on secondment to provide specialised support on local action to reduce hours. The ISG is also working with the Health Department, NHS Trusts and the Scottish Junior Doctors' Committee to implement the new contract for junior doctors.

To date, 2,640 mobile phones have been issued under this initiative.

Community nurses, midwives and health visitors who can expect to receive mobile phones under this initiative will have them early in the New Year.

Initially, 12 nurse and midwife consultant posts are being established in Scotland. Three of these consultants are already in post.

A further nine posts were announced on 5 December and recruitment to these will take place shortly.

It is our intention to review the contribution of these posts to patient care and then make plans for a further roll out.

63% (660 out of 1,055) of general practices in Scotland responded to the Scottish Centre for Infection and Environmental Health's (SCIEH) end-October request for influenza immunisation uptake data for the 65-year-old and over at risk group. From the responses received, 50.1% (284,353) of patients aged 65 and over, from those practices which responded, had received the vaccine as at 31 October 2000. This includes that considerable progress is being made towards meeting the Scotland-wide target of 60% uptake. Further data will be collated by SCIEH to reflect the position at 30 November and 31 December.

Influenza immunisation is also recommended for patients with chronic illnesses. There are no reliable statistics of the number of people in this group, and uptake data are not available.

Health boards, NHS Trusts and local authorities have been asked to put in place arrangements to evaluate uptake of the flu vaccination by staff.

The primary function of the National Diet Action Co-ordinator will be to co-ordinate and to help maximise the effectiveness of the wealth of activity underway, at both national and local level, to implement the recommendations of the Scottish Diet Action Plan, "Eating for Health". Priority tasks will include working with primary producers, manufacturers, retailers and caterers, all of whom have a key role in influencing people's food choices.

This £44 million surplus money arose out of the internal market in the NHS, created by the previous UK Government. Under Treasury rules the money was frozen and conferred no additional spending power, and ordinarily it would have been returned to the Treasury.

In order to keep this money in Scotland, officials negotiated an agreement with the Treasury. As it conferred no additional spending power it was agreed that the money must be used in a way which does not count as public expenditure. The repayment of debt principal does not count as public expenditure and it was finally agreed that The Executive could use the money for the redemption of housing debt as part of the Housing Stock Transfer Scheme.

The NHS financial regime requires that Trusts make a 6% return on capital assets. This 6% is paid through a mixture of dividends on public dividend capital (effectively a payment reflecting the value of public sector capital tied-up in the Trust) and interest on debt. Even if the debt were repaid, a return of 6% would still be charged. There would therefore be no benefit if the NHS debt were repaid.

The redeployment of this money was part of a general reallocation package announced on 6 October 1999, which included extra funds for health.

The arrangement for using the money to redeem housing debt, as part of housing stock transfer schemes, is a novel scheme for making good use of money which would otherwise have had to be returned to the Treasury.