Chamber and committees

The table below shows the average length of time, in days, spent in hospital after the birth of the first child and subsequent children in the years 1990-91, 1994-95 and 1998-99.There has been a gradual reduction in the length of time spent in hospital by post- natal mothers, which reflects changed practices. This has also responded to the wishes of mothers to leave hospitals earlier and to the change of policy in providing more post- natal care by midwives in the community. However the provision of care is based on a flexible approach and mothers who feel they would benefit from a longer stay can do so.Length of post-natal stay (days)

	1990-91	1994-5	1998-99
All maternities	3.9	3.3	2.9
First maternities	4.6	4.1	3.6
Other maternities	3.2	2.7	2.4

Notes:

1. Maternities are defined as pregnancies which result in a live or stillbirth, multiple pregnancies counting only as one.

2. Excludes maternities delivered at home or at non-NHS hospitals.3. The figures for 1998-99 are as yet provisional.

It is for Greater Glasgow Health Board to determine how to organise services to meet the health care needs of the local population. Such provision must take account of declining numbers of births and changes in provision across the country, which reflect a shift in balance towards community provision. Further details are available from Greater Glasgow Health Board.In considering the provision and configuration of maternity services, local Health Boards are expected to take account of the 1993 Policy Review of the Provision of Maternity Services in Scotland. This recommended a move to increasing the choice for the woman, greater continuity of care and a move to midwife led care while at the same time maintaining the safety of both mother and baby.

Lothian Health Board receives an annual general revenue allocation. It is for the Board to determine within the funds available how to manage and deliver local healthcare services that meet the healthcare needs of their resident population, including oncology and renal services. For 2000-01 Lothian Health Board has been allocated a unified budget of £571.5m, an increase of 5.4% over that for 1999-2000.

It is not the case that children's health needs have not been addressed in the Arbuthnott Review. First, the proposed resource allocation formula includes a set of age and sex cost weights based on evidence about the use made of services by different age and sex groups. These show, for example, that children under 5 make more intensive use of services than children in older age groups. Second, the proposed formula also involves an assessment of the influence of morbidity and life circumstances on the relative healthcare needs of the total population of each Health Board area. This assessment is based on an analysis of the use of services by people from different areas in Scotland, including the relative use of health services by children from affluent and deprived areas. The Yorkhill NHS Trust submitted comments on the Arbuthnott Report during the consultation period. As you know, I asked Sir John Arbuthnott to reconvene the Steering Group to consider the comments made on the report and to provide me with revised recommendations. The concerns raised by Professor Cockburn will be considered as part of this further work.

I welcome any contribution to the store of knowledge about malnutrition.

Malnutrition in hospitals has been the subject of research over a number of years and the complex nature of the effect of illness on indicators of nutritional status is a factor that has to be taken into account. It is important to make a distinction between malnutrition due to lack of nutritious food and that caused by the metabolic response to illness and injury.We are however taking steps to tackle malnutrition on a number of fronts. The Scottish Executive Health Department has asked Health Boards to apply nutritional standards in all NHS facilities and a multi-disciplinary advisory group is taking forward further work on this. In the wider context, the Scottish Diet Action Plan, with the help of Scottish Executive funding, provides the framework for a range of initiatives. These include promoting healthy diet in local communities and schools; assessing and managing nutritional status in the community through district nursing and health visiting services; and applying rigorous standards to dietary needs in nursing homes. Nutrition of elderly people also features in our Clinical Effectiveness Programme.

The continuing care and support of patients discharged from Lennox Castle Hospital is key to the success of the initiative. Greater Glasgow Health Board, Greater Glasgow Primary Care Trust and the Local Authorities involved have jointly planned the alternative care so that it specifically meets the ongoing needs of the patients, with the aim that no patient is discharged until an appropriate care package is in place.

Lorna Naismith was given early retirement on grounds of organisational change due to trust reconfiguration. She did not receive the sum mentioned, the major part of that figure - £268k - represents the capitalisation costs for the pension which the employer is obliged to set aside to cover future payment of the pension until normal retiral age. The Trust reconfiguration process was a managed one which has been audited and shown to provide value for money to the NHS in Scotland. The process is expected to save £100 million for investment in patient care.

Local authority capital expenditure in 1990-91, including water and sewerage and housing, was £1.7 billion at current prices. Total capital spending by local authorities in 2000-01 will not be known until the end of that financial year, therefore, a comparison is not possible. I have, however announced the provisional non-housing allocations which also no longer include water and sewerage for 2000-01: question S1W-2651 refers. In practice, the Government only limits the part of local authority capital expenditure which it supports through capital allocations. Further information on capital expenditure by local authorities is given in my letter of 9 September sent in response to questions S1W-743 and S1W-744. A copy is available from the Scottish Parliament Information Centre.

Products and services subject to age restriction are wide-ranging and some are governed by consumer protection legislation which is reserved. However, the Scottish Executive is examining measures for better enforcement of the law to tackle those who make illegal sales to young people within the powers available to the Scottish Parliament.

Information on the median waiting times for cataract surgery for the year ending 30 September is given in the table.Median waiting time for cataract surgery¹: Year ending 30 september 1999^p

Health Board	Median Wait (Days)
Argyll and Clyde	85
Ayrshire and Arran	78
Borders	42
Dumfries and Galloway	121
Fife	114
Forth Valley	83
Grampian	103
Greater Glasgow	103
Highland	98
Lanarkshire	126
Lothian	78
Orkney	78
Shetland	80
Tayside	62
Western Isles	187
Scotland	87

Source SMR0

p Provisional¹ Cataract Surgery defined as primary operation OPCS4 C17-C75 and any mention of ICD 10 diagnosis H25, H26, H28.0, H28.1 or H28.2