Chamber and committees

The Scottish Executive recognises and encourages the valuable contribution that the voluntary sector makes in raising funds for and in commissioning medical research. We are also committed to ensuring that our agencies, non-departmental public bodies and the NHSiS actively encourage and promote the work of the voluntary sector. As an example of this, the Chief Scientist's office is currently funding a small research project to the value of over £8,000 on enhancing the relationship between health voluntary organisations and the NHSiS.

The Scottish Executive has no plans, however, for the integration of the NHSiS with the voluntary sector in relation to medical research.

In our Programme for Government, we made a commitment to work across the Executive to promote modern government, of which one of the main themes would be customer-focused policy development and service delivery.

We will put the citizen at the centre through our commitment to inclusive policy-making, and civic participation in all its forms. The public can make a real contribution to better policies at both local and national level. We are encouraging that contribution through our support for the Scottish Civic Forum, through the £3 million Listening to Communities programme, through the £10 million Working for Communities programme and through the increasing use of the possibilities offered by the Internet.

We will also work across the public sector to deliver citizen-focused services that are provided in such a way as to meet the needs of the citizens, not the convenience of the service provider. In particular, we will seek to overcome obstacles to joined-up working through a variety of means, and will seek to involve and meet the needs of all different groups in society. For example, the First Minister announced on 30 March his decision that the Executive's target for delivery of 100% of its services online by 2008 was being brought forward to 2005. At a practical level, I recently announced the £25 million Modernising Government Fund, which is designed to help take forward projects involving the innovative provision of improved public services, and particularly encourages partnership working.

The capital spending of authorities would remain public expenditure even if the requirement for local authorities to have the consent of Scottish Ministers to undertake capital spending were abolished. This would have to be reflected in public spending totals, which would not themselves change. In these circumstances, an adjustment to the assigned budget to reflect the changed treatment of local authority capital spending may be appropriate, and consequently there may be no net benefit to the Assigned Budget or, ultimately, local authority spending.

The delivery of benefits advice is an operational matter for the Benefits Agency, and is a reserved matter. However, we recognise the importance of the take-up of benefit and pension entitlement in the elimination of poverty in Scotland. We welcome current efforts to maximise take-up and are in regular contact with UK Government ministers and Departments on these and other matters.

Opportunities exist at every level in schools within the curriculum for the teaching of development education, including awareness of Third World development issues.

The Scottish Consultative Council on the Curriculum are working with the Department for International Development to produce resources and support materials on development education for teachers.

The information requested is not available centrally.

It is for health boards and NHS Trusts to plan and deliver services which meet the need of their local population. In doing so, they take account of the effectiveness of different healthcare interventions, including laser treatment.

The Scottish Executive is, of course, taking forward a range of measures to reduce the levels of smoking by people in Scotland. These include health education and promotion activities such as Smokeline; targeted help for groups such as pregnant women; and targeted smoking cessation services and nicotine replacement therapy, which is available free of charge to those least able to afford it.

The Scottish Executive is determined to face the challenges posed by cancer. We have pledged to tackle the root causes of ill health and work over the next 10 years to promote healthier living and reduce mortality from cancer by 20%.Specific initiatives designed to address these pledges and the Scottish Executive's approach to public health generally are set out in the White Paper, Towards a Healthier Scotland, a copy of which has been placed in SPICe.This is a challenging and wide ranging programme including:

• additional investment of £1 million to aid smoking cessation programmes;
• promoting healthier lifestyles and diet including the appointment of a Scottish Diet Co-ordinator;
• establishment of Healthy Living Centres via the New Opportunities Funding initiative (£34.5 million);
• The Cancer Challenge
- a pilot programme to test the feasibility of a national screening programme for earlier detection of colorectal cancer;
• a formalised cancer genetics programme for breast, colorectal and ovarian cancer to provide advice and counselling for individuals who may be at increased risk based on their family history.

The substantial additional investment in public health and health promotion, announced in the Scottish Parliament on 22 March, will further strengthen our efforts to help reduce the incidence of cancer in Scotland.

The NHS in Scotland is committed to ensuring that the highest quality of care is provided to all patients. It is important that patients with chronic conditions such as epilepsy, who may be on long-term drug treatment, are regularly reviewed. The frequency of such reviews is a matter for the clinical judgement of the relevant consultant. Existing national clinical guidelines published by Scottish Intercollegiate Guidelines Network in 1997 on The Diagnosis and Management of Epilepsy in Adults are scheduled for review this year.

Mental illness is equated with the specialities of General Psychiatry, Adolescent Psychiatry, Child Psychiatry and Geriatric Psychiatry.

The information available from health boards regarding expenditure on mental illness treatment is provided on the basis of patient category i.e. inpatient; outpatient; day-patient and community. It is therefore not possible to identify the expenditure on patients treated in psychiatric hospitals alone.

The information provided in the following table groups the expenditure for inpatients, outpatients and day-patients to provide a total hospital figure.

The health board expenditure reflects the costs of services purchased, and may not equate exactly with the cost of treatment for mental illness.

The table provides per capita expenditure, per health board, for hospital and community provision of mental illness treatment for the period 1996-97 up to and including 1998-99.

	Expenditure per capita in Hospitals			Expenditure per capita in the community
Health Board	1996-97	1997-98	1998-99	1996-97	1997-98	1998-99
	£	£	£	£	£	£
Argyll & Clyde	79	79	80	0	2	3
Ayrshire & Arran	59	55	68	5	5	7
Borders	75	71	72	10	12	12
Dumfries & Galloway	67	71	70	4	4	4
Fife	69	66	68	3	5	5
Forth Valley	74	72	75	3	6	6
Grampian	74	76	78	2	3	5
Greater Glasgow	68	70	67	11	11	17
Highland	64	60	59	4	5	6
Lanarkshire	49	58	59	6	5	5
Lothian	77	79	84	2	3	3
Orkney	51	45	39	5	5	5
Shetland	17	20	18	4	4	4
Tayside	93	93	95	6	8	8
Western Isles	68	73	70	4	4	4
Average	70	71	73	5	6	7

Source: Scottish Health Service Costs 1996-97, 1997-98 and 1998-99 (SFR 13.0).Note: Weighted population is used to allow health board comparisons and has been used to calculate the per capita spend. Note that an updated figure was not available for 1998-99, so the 1997-98 weighted population figures were used.

We would be very happy to consider the views of the Scottish Low Pay Unit so far as they concern matters which are within the responsibilities of the Executive.