Chamber and committees

Public concern around proposed changes to their local NHS services is understandable. The NHS must develop ways of engaging the local population in dialogue about how future NHS reforms will take shape and how they will affect the quality of care and delivery of services. Draft interim guidance was issued to the NHS in May 2002 on “Consultation and public involvement in major service change” and this is being revised to reflect comments received from a number of stakeholders and the experiences of consultation across Scotland. The new guidance “Informing, Engaging and Consulting the Public in Developing Healthand Community Care Policies” will issue shortly and places a new focus upon informing and engaging with the public as soon as considerations of service change begin.

The NHS Reform (Scotland) 2004 places a new duty upon the NHS to involve the public and boards must be able to demonstrate that they have taken genuine steps to inform, engage and consult the public over changes to services. This will be assessed by the Scottish Health Council which is being established as a body which will provide independent reports to the NHS, the Health Department and Scottish ministers.

To acknowledge the changes that are taking place in the way health services are delivered, a National Framework for Service Change in NHSScotland is being developed to support the change process ahead. A National Framework Advisory Group has been established to drive forward the review and is being led by Professor David Kerr and is due to report in March 2005. Comments from the public have been welcomed as a key part of the review. A newsletter describing the work of the group was distributed to NHS staff and to the public which poses a number of questions on the future and seeks views on them. The advisory group has begun holding regional meetings for the public across Scotland.

Information on vacant nursing posts in NHS Scotland is published on the Scottish Health Statistics website under Workforce Statistics, at www.isdscotland.org/workforce.

Section E gives details of nursing and midwifery staff employed in NHS Scotland. In particular, table E10 shows the whole-time equivalent (WTE) number of nursing and midwifery staff vacancies, broken down by NHS board area. WTE adjusts headcount staff figures to take account of part-time staff. Latest available figures are at 31 March 2004.

Information on nursing and midwifery posts in NHS Scotland is published on the Scottish Health Statistics website under Workforce Statistics, at www.isdscotland.org/workforce.

Section E gives details of nursing and midwifery staff employed in NHS Scotland. In particular, tables E12 and E16 show the usage of agency nurses and bank nurses respectively, broken down by NHS board over a three-year period. Both tables are shown in terms of hours and average whole time equivalent.

The latest information available from the teacher vacancies survey returned by local authorities at February 2004 is given in a set of tables Full-time Equivalent Teacher Vacancies in Schools which has been placed in the Parliament’s Reference Centre (Bib. number 32903).

The table shows the headcount and whole time equivalent (WTE) number of consultant vacancies at 30 September 2003, broken down by NHS Board. WTE adjusts to take account of part-time working. Latest available figures are at 30 September 2003.

NHSScotland Workforce Statistics, Consultant Vacancy Posts by NHS Board

At 30th September 2003

NHS Board	Headcount	WTE
Scotland	245	235.4
NHS Argyll and Clyde	16	14.9
NHS Ayrshire and Arran	11	11.0
NHS Borders	6	6.0
NHS Dumfries and Galloway	10	9.5
NHS Fife	21	20.4
NHS Forth Valley	7	7.0
NHS Grampian	10	8.5
NHS Greater Glasgow	59	57.3
NHS Highland	15	15.0
NHS Lanarkshire	42	39.8
NHS Lothian	26	26.0
NHS National Services Scotland (formerly CSA)	3	2.5
NHS Orkney	1	1.0
NHS Shetland	2	1.9
NHS Tayside	10	8.9
NHS Western Isles	4	4.0
Golden Jubilee	1	1.0
State Hospital	1	0.7

Source: ISD Scotland.

The table shows the number of consultant vacancies and those filled by locums at the census point of 30 September 2003, broken down by NHS board. Locums covering short and long-term consultant absence e.g. covering sick leave, are not included.

NHSScotland Workforce Statistics Consultant Vacancies Filled by Locums by NHS Board

As at 30th September 2003

NHS Board	Number of Consultant Vacancies	Number of Vacancies Filled by Locums
Scotland	245	78
NHS Argyll and Clyde	16	6
NHS Ayrshire and Arran	11	3
NHS Borders	6	2
NHS Dumfries and Galloway	10	8
NHS Fife	21	5
NHS Forth Valley	7	3
NHS Grampian	10	4
NHS Greater Glasgow	59	12
NHS Highland	15	5
NHS Lanarkshire	42	10
NHS Lothian	26	16
NHS Orkney	1	0
NHS Shetland	2	0
NHS Tayside	10	2
NHS Western Isles	4	2
Golden Jubilee	1	0
State Hospital	1	0

Source: ISD Scotland.

We have chosen 10 Closing the Opportunity Gap targets to drive action to tackle poverty and deprivation in Scotland and to build on the progress made towards our Social Justice Milestones.

The targets that we have chosen are:

Target A: Reduce the number of workless people dependent on Department for Work and Pensions (DWP) benefits in Glasgow, North and South Lanarkshire, Renfrewshire and Inverclyde, Dundee, and West Dunbartonshire by 2007 and further by 2010.

Target B: Reduce the proportion of 16 to 19-year-olds who are not in education training or employment by 2008.

Target C: Public sector and large employers to tackle aspects of in-work poverty by providing employees with the opportunity to develop skills and progress in their career. NHSScotland will set an example by providing 1,000 job opportunities, with support for training and progression once in post, between 2004 and 2006 to people who are currently economically inactive or unemployed.

Target D: To reduce health inequalities by increasing the rate of improvement for under 75 coronary heart disease mortality and under 75 cancer mortality (1995-2003) for the most deprived communities by 15 per cent by 2008.

Target E: By 2008, ensure that children and young people who need it have an integrated package of appropriate health, care and education support.

Target F: Increase the average tariff score of the lowest attaining 20 per cent of S4 pupils by 5 per cent by 2008.

Target G: By 2007 ensure that at least 50 per cent of all “looked after” young people leaving care have entered education, employment or training.

Target H: By 2008, improve service delivery in rural areas so that agreed improvements to accessibility and quality are achieved for key services in remote and disadvantaged communities.

Target J: To promote community regeneration of the most deprived neighbourhoods, through improvements by 2008 in employability, education, health, access to local services, and quality of the local environment.

Target K: By 2008 increase the availability of appropriate financial services and money advice to disadvantaged communities to reduce their vulnerability to financial exclusion and multiple debts.

The detail of several targets will be agreed in consultation with key stakeholders:

For target A, local employment partnerships will be asked to agree the size and nature of the target for their area, by February 2005. For example, the Glasgow Welfare to Work Forum set targets in 2003, to reduce the number of working age people claiming key benefits by 15,000 by the end of 2007 and 30,000 by the end of 2010.

For target B, as part of our work to develop an employability framework, we will analyse the make-up of the NEET (not in education, employment ortraining) group and their reasons for disengagement from school, work or further education. We will then specify the level of reduction that we seek to achieve.

For target H, working with an advisory group of representatives from key delivery agents and rural communities, we will agree the rural areas to be targeted, consult with local communities to identify the key services to be improved, and agree with the relevant community planning partnerships the specific targets for improvements to accessibility and quality to be achieved.

The issue of the age of capacity in relation to children’s rights is wide-ranging and cuts across a number of portfolio interests. Scrutinising all legislation which impacts on children’s rights is a major undertaking about which internal discussions have commenced. The Cabinet Delivery Group on Children and Young People will consider the issue at its next meeting.

I am delighted that 39 regional governments were represented at the 5th Conference of Minister-Presidents of regions with legislative powers (REGLEG), which I chaired in Edinburgh on 29 and 30 November 2004.

The Edinburgh Declaration, which the Conference adopted, expresses the support of REGLEG for the Constitutional Treaty signed on 29 October 2004 and welcomes the provisions in the Treaty which enhance the role of the regions with legislative powers in Europe. The Declaration points the way for further reforms to improve the quality of European legislation and its responsiveness to differing regional circumstances; to reduce the burden of unnecessary regulation; to ensure that decisions are taken as close as possible to the citizen, and to allow the regions with legislative powers to fulfil their potential as key agents in bridging the gap between the European Union and its citizens. The Edinburgh Declaration is available in the Parliament’s Reference Centre (Bib. number 34594).

The conference was the culmination of the Scottish Presidency of REGLEG, a year in which we have taken every opportunity to promote the interests of the regions with legislative powers in discussions with European Commissioners and other key decision-makers in Europe.

Under the Sewel Convention, the UK Government does not normally legislate with regard to devolved matters in Scotland without the consent of the Scottish Parliament. This is an important part of the devolution settlement, signifying respect for the role of the Scottish Parliament.

Within the context of this Convention, the Executive recommends that the Scottish Parliament should consent to legislation at Westminster only when this would deliver clear benefits for Scotland. I am pleased that we have been able to identify and agree specific opportunities for several of the bills within the UK Government’s new legislative programme to make beneficial provision for Scotland, on matters that are within the legislative competence of the Scottish Parliament and on matters which relate to the executive competence of the Scottish ministers.

In accordance with the Sewel Convention and the procedural undertakings that have been given, we will present the Parliament with a motion and detailed explanatory memorandum in relation to each of those Bills as soon as possible after they are introduced at Westminster, in order to maximise the scope for scrutiny and debate. The bills are:

·the Animal Welfare Bill – to ensure that people who are banned from keeping animals in England and Wales, following conviction for cruelty to animals there, continue also to be banned from keeping animals in Scotland.

·the Constitutional Reform Bill – to create a UK-wide Supreme Court, establishing a clear and transparent separation between the judiciary and the legislature.

·the Disability Discrimination Bill – to put Scotland on the same footing as the rest of the UK on new public sector duty to promote equality of opportunity for disabled people.

·the European Union Bill – to ensure that the devolution settlement is taken into account in legislation to enable the ratification andimplementation in UK law of the EU Constitutional Treaty and to allow areferendum on the Treaty to take place.

·the Gambling Bill – to modernise powers for Scottish ministers to regulate gambling in Scotland.

·the Inquiries Bill – to modernise the law for the conduct of inquiries into matters of public concern.

·the International Organisations (Immunities and Privileges) Bill – to ensure that the devolution settlement is taken into account in legislation that secures the position of specified international organisations.

·the National Lottery Bill – to provide power for Scottish ministers to issue directions to the Big Lottery Fund and allow a Scottish Committee to exercise all the functions of the Fund in relation to devolved expenditure.

·the Railways Bill – to provide greater responsibility for rail within Scotland to the Scottish ministers, including an extended role with regard to infrastructure.

·the Serious Organised Crime and Police Bill – to strengthen the fight against serious organised crime with the creation of a new UK-wide agency and other measures.

Legislating in this way has a number of benefits for Scotland. For bills (like the Inquiries Bill and the Serious Organised Crime and Police Bill) that include provisions on matters that are within the legislative competence of the Scottish Parliament, it enables useful provision to be made in areas of mutual interest without delay or disruption to our own legislative programme. For Bills (like the Gambling Bill and Railways Bill) that include provisions that relate to the executive competence of the Scottish ministers, it enables powers and functions to be exercised by the Scottish ministers rather than UK Ministers.

In order to maximise this potential, we will maintain our dialogue with the UK Government over the coming weeks and months to see whether further opportunities can be identified.  If that proves to be the case, we will bring them to the attention of the Parliament as soon as possible.