Chamber and committees

My colleagues and I are very pleased with the overwhelmingly positive feedback that has been received following the publication of Our National Health: A plan for action, a plan for change.

Information on the total number of non-consultant career grade and non-standard grade staff employed by the NHS in Scotland is detailed in the following tables. Tables 1 and 2 show the number of medical and dental non-consultant career grade staff before and after the April 1999 reconfiguration of NHS Trusts; Tables 3 and 4 show the number of medical and dental non-standard grade staff before and after Trust reconfiguration. The tables should be read in conjunction with the notes below.

Table 1 - Medical and Dental Non-Consultant Career Grade³ Staff

Headcount by NHS Trust, 1995 to 1998

		1995	1996	1997	1998
Scotland4		1,936	1,857	1,891	1,903
Ayrshire & Arran Health Board Headquarters		1	1	2	2
South Ayrshire Hospitals NHS Trust		26	30	28	23
North Ayrshire and Arran NHS Trust		40	43	43	45
Ayrshire and Arran Community Health Care NHS Trust		61	61	49	44
Borders Health Board Headquarters		1	1	1	1
Borders General Hospital NHS Trust		9	9	8	9
Borders Community Health Services NHS Trust		16	16	16	14
Argyll & Clyde Health Board Headquarters		3	3	4	4
Royal Alexandra Hospital NHS Trust		25	23	23	21
Inverclyde Royal NHS Trust		13	12	18	18
Renfrewshire Healthcare NHS Trust		67	63	68	66
Lomond Healthcare NHS Trust		23	22	36	29
Argyll & Bute NHS Trust		34	35	38	38
Common Services Agency		39	39	33	26
Fife Health Board Headquarters		1	2	1	-
Queen Margaret Hospital NHS Trust		19	18	19	32
Fife Healthcare NHS Trust		79	74	73	71
Kirkcaldy Acute Hospitals NHS Trust		38	39	41	38
Greater Glasgow Health Board Headquarters		8	5	5	5
Southern General Hospital NHS Trust		19	19	21	19
Yorkhill NHS Trust		42	42	36	35
Victoria Infirmary NHS Trust		29	28	26	23
West Glasgow Hospitals University NHS Trust		54	57	59	51
Glasgow Royal Infirmary University NHS Trust		33	30	25	21
Stobhill NHS Trust		16	17	15	13
Glasgow Community & Mental Health Services NHS Trust		104	103	102	107
Glasgow Dental Hospital and School NHS Trust		55	65	65	70
Highland Health Board Headquarters		5	4	6	6
Raigmore Hospital NHS Trust		34	29	31	34
Caithness and Sutherland NHS Trust		21	19	23	23
Highland Communities NHS Trust		42	43	50	56
Lanarkshire Health Board Headquarters		1	2	1	2
Monklands and Bellshill Hospitals NHS Trust		29	26	32	30
Law Hospital NHS Trust		22	24	23	31
Hairmyres & Stonehouse Hospitals NHS Trust		19	15	14	18
Lanarkshire Healthcare NHS Trust		80	77	80	90
Grampian Health Board Headquarters		4	4	4	4
Aberdeen Royal Hospitals NHS Trust		79	80	74	69
Grampian Healthcare NHS Trust		97	96	98	115
Moray Health Services NHS Trust		21	23	21	21
Orkney Health Board		12	13	13	17
Lothian Health Board Headquarters		21	7	7	22
West Lothian NHS Trust		54	48	49	45
Royal Infirmary of Edinburgh NHS Trust		58	61	71	74
Edinburgh Sick Children's NHS Trust		27	23	23	21
Western General Hospitals NHS Trust		21	18	16	18
East & Midlothian NHS Trust		26	31	29	23
Edinburgh Healthcare NHS Trust		69	62	63	54
Tayside Health Board Headquarters		2	2	1	-
Dundee Teaching Hospitals NHS Trust		77	56	58	56
Perth & Kinross Healthcare NHS Trust		41	38	41	36
Dundee Healthcare NHS Trust		46	43	46	41
Angus NHS Trust		21	21	26	27
Forth Valley Health Board Headquarters		3	5	5	5
Stirling Royal Infirmary NHS Trust		18	16	20	23
Falkirk & District Royal Infirmary NHS Trust		14	13	27	25
Central Scotland Healthcare NHS Trust		66	64	61	62
Western Isles Health Board		16	15	13	14
Dumfries & Galloway Health Board Headquarters		2	2	2	1
Dumfries & Galloway Acute & Maternity Hospitals NHS Trust		43	40	41	46
Dumfries & Galloway Community Health NHS Trust		62	51	49	57
Shetland Health Board		12	9	5	10

Notes:

1. Source: Medical and Dental Manpower Census, ISD Scotland.

2. Data is as at 30th September for the years shown.

3. Non-consultant career grades include Directors of Public Health, Chief Administrative Dental Officers, Assistant Chief Administrative Dental Officers, Medical Advisors, Assistant Prescribing Advisors, Associate Specialists, Staff Grade, Senior Clinical Medical Officers, Clinical Medical Officers, Senior Dental Officers, Dental Officers, Limited Specialists, Hospital Practitioners, Dental Advisors, Para 94 App, Para 107 App.

4. There is an element of double counting of "heads" in this table because doctors can hold contracts in more than one Trust.

Table 2 - Medical and Dental Non-Consultant Career Grade³ Staff

Headcount by NHS Trust, 1999

Scotland4		1,936
Ayrshire & Arran Health Board Headquarters		3
Ayrshire & Arran Acute Hospitals NHS Trust		73
Ayrshire & Arran Primary Care NHS Trust		55
Borders Health Board Headquarters		2
Borders Acute Hospital NHS Trust		7
Borders Primary Care NHS Trust		11
Argyll & Clyde Health Board Headquarters		4
Argyll & Clyde Acute Hospitals NHS Trust		61
Lomond & Argyll Primary Care NHS Trust		24
Renfrewshire & Inverclyde Primary Care NHS Trust		60
CSA		26
Fife Health Board Headquarters		2
Fife Acute Hospitals NHS Trust		63
Fife Primary Care NHS Trust		74
Greater Glasgow Health Board Headquarters		5
Yorkhill NHS Trust		33
South Glasgow University Hospitals NHS Trust		39
North Glasgow University Hospitals NHS Trust		180
Greater Glasgow Primary Care NHS Trust		102
Highland Health Board Headquarters		4
Highland Acute Hospitals NHS Trust		45
Highland Primary Care NHS Trust		79
Lanarkshire Health Board Headquarters		2
Lanarkshire Acute Hospitals NHS Trust		85
Lanarkshire Primary Care NHS Trust		89
Grampian Health Board Headquarters		3
Grampian University Hospitals NHS Trust		105
Grampian Primary Care NHS Trust		98
Orkney Health Board		25
Lothian Health Board Headquarters		6
Lothian University Hospitals NHS Trust		100
Lothian Primary Care NHS Trust		80
West Lothian Healthcare NHS Trust		50
Tayside University Hospitals NHS Trust		115
Tayside Primary Care NHS Trust		84
Forth Valley Health Board Headquarters		4
Forth Valley Acute Hospitals NHS Trust		41
Forth Valley Primary Care NHS Trust		64
Western Isles Health Board		13
Dumfries & Galloway Health Board Headquarters		2
Dumfries & Galloway Acute & Maternity Hospitals NHS Trust		50
Dumfries & Galloway Primary Care NHS Trust		62
Shetland Health Board		5

Notes:

1. Source: Medical and Dental Manpower Census, ISD Scotland.

2. Data is as at 30th September 1999.

3. Non-consultant career grades are as detailed in the notes for Table 1.

4. There is an element of double counting of "heads" in this table because doctors can hold contracts in more than one Trust.

Table 3 - Medical and Dental Non-Standard Grade³ Staff

Headcount by NHS Trust, 1995 to 1998

	1995	1996	1997	1998
Scotland	20	25	49	13
Ayrshire and Arran Community Health Care NHS Trust	-	-	* 7	*-
Inverclyde Royal NHS Trust	-	-	1	-
Kirkcaldy Acute Hospitals NHS Trust	-	-	-	1
Glasgow Dental Hospital and School NHS Trust	3	2	3	2
Highland Health Board Headquarters	8	9	7	1
Lothian Health Board Headquarters	-	-	*16	* 1
Royal Infirmary of Edinburgh NHS Trust	5	8	7	2
Edinburgh Sick Children's NHS Trust	-	-	1	1
Western General Hospitals NHS Trust	3	5	5	3
Edinburgh Healthcare NHS Trust	1	1	1	-
Dundee Teaching Hospitals NHS Trust	-	-	-	1
Central Scotland Healthcare NHS Trust	-	-	1	1

Notes:

1. Source: Medical and Dental Manpower Census, ISD Scotland.

2. Data is as at 30th September for each of the years shown.

3. Non-standard grades may include Honorary Dental Surgeons, Hospital Specialists, Trust Grade Doctors, Salaried General Dental Practitioners in the Community, Dental Practice Advisors and Clinical Research Fellows.

4. *The fluctuation in figures between 1996, 1997 and 1998 for Lothian and Ayrshire and Arran is a result of changes in the coding of certain grades of staff.

Table 4 - Medical and Dental Non-Standard Grade³ Staff

Headcount by NHS Trust, 1999

Scotland	9
Ayrshire & Arran Health Board Headquarters	1
Lomond & Argyll Primary Care NHS Trust	1
Fife Acute Hospitals NHS Trust	1
North Glasgow University Hospitals NHS Trust	2
Lothian Health Board Headquarters	2
Tayside University Hospitals NHS Trust	1
Forth Valley Primary Care NHS Trust	1

Notes:

1. Source: Medical and Dental Manpower Census, ISD Scotland.

2. Data is as at 30th September 1999.3. Non-standard grades are as detailed in the notes for Table 3.

From 30 September this year, comprehensive patient-specific national information is collected quarterly and published by the Information and Statistics Division of the NHS in Scotland (ISD Scotland).

The next census date is 15 January 2001. The information gathered will be published the following March after data quality assurance by ISD and data verification by health and social care agencies.

The New Deal Implementation Support Group (ISG) plans to submit its next report in March 2001. The report will include the latest information on NHS Trust compliance with targets and standards on junior doctors' hours and working conditions.

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.

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

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

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.