Chamber and committees

NHS 24 will be advertisingfor a director of nursing before the end of this month. Over the past sixmonths an interim director of nursing has been in post with full Executive statuson the NHS 24 Board.

The Executive is committedto ensuring that public transport is accessible to people with disabilities.Under the partnership agreement the Executive is committed to assessingimproved public transport concessions for disabled people.

The assessment will, amongother things, look at the barriers to accessible transport for disabled people,enhanced concessionary fares and options for door to door travel. To achievethis we will work with public transport providers, the Mobility and AccessCommittee for Scotland, voluntary and other interested bodies. We are aboutto commence a public consultation on how best to take forward the assessmentand extending the concessionary bus fare scheme to a national off-peak schemefor older and disabled people.

Ministers have also approveda £0.5 million per annum budget to pilot rural demand responsive transportbetween 2004-06 and a further £0.5 million per annum to pilot urban communitytransport/demand responsive transport over the same period.

The reportin question is a working paper commissioned some time ago from Information andStatistics Division by the Health Department. The department is reviewing theinformation presented in the paper. A number of actions to address the issueshighlighted are already under way, both at departmental and NHS board/localauthority level. Examples include use of joint NHS/social care rapid reactionteams to help organise care and treatment of elderly patients at home; and workbeing undertaken by the Centre for Change and Innovation on patterns ofemergency NHS care. The overall aim is to ensure that patients are treated inthe most suitable environment and experience the highest possible quality ofcare.

The Executive is assessingthe impact that ending the current Water and Sewerage Charges Reduction Schemewill have in light of harmonisation of charges. A decision on whether anyfurther action is required will be made in light of this assessment.

It is not possible toproduce firm estimates of the actual or additional costs to the NHS ofproviding free prescriptions for the whole population of Scotland orfor the patient groups specified.

The NHS currently receivesaround £47 million per year from prescription charge income. This income wouldbe lost if prescriptions were provided free. In addition NHS spending on GPservices, the drugs bill and pharmacists’ remuneration could rise if peopleobtained on prescription items that they would previously have bought over thecounter. Such increases, though likely, cannot be quantified. Cost reductionsare unlikely to exceed £1 million per year, made up of administrative savingson certain prescription fraud prevention measures, prescription charge refundsand pre-payment certificate services which would no longer being required.

The costs or savings whichwould arise from providing free prescriptions for people suffering from aterminal illness or long-term health problems cannot be estimated. The numberof people that fall into these groups is not known, neither is the numberrequired to pay for their prescriptions under the current prescription chargingarrangements. Consequently, it is not possible to identify and cost the drugsprescribed or the number of prescriptions written for these patients. Peoplesuffering from a terminal illness who are receiving palliative care in hospitalor in a hospice do not pay for their prescribed drugs.

It is for NHS Boards to determine the need for local therapyservices and to provide the services required.

The Partnership Agreementcommits to increasing overall numbers of Allied Health Professionals (AHPs),including speech and language therapists, by 1,500 by 2007. Working groups establishedas part of the AHP strategy Future Directions are already looking at initiatives to improverecruitment and retention and clinical placements. Arange of professional development and leadership opportunities is beingdeveloped to retain the existing workforce. In addition, £1million has been made available for additional student places in priority areasincluding speech and language therapy, funding is available to support a“return to practice” initiative and alternativeroutes to state registration are currently being explored.

The allocation of places tospecific subject area is rightly a matter for individualinstitutions.

Higher education institutionsare autonomous bodies and legislation precludes Ministers from directing funds to particularinstitutions or courses. The Scottish Higher Education Funding Councilis responsible for allocating places to broad subject groups and for takinga strategic overview in key areas.

The information requested isnot available centrally.

NHS QualityImprovement Scotland (then the Health Technology Boardfor Scotland) approved the use of donepezil,rivastigmine and galantamine for mild to moderate Alzheimer's disease in April2001. Doctors can prescribe these drugs, if clinically appropriate, as onecomponent of treatment.

There are currently no plansto introduce a nutritional signposting scheme in Scotland.