Chamber and committees

If any adjustmentsare made in health boards’ relative funding based on National Resource Allocation Committee’s (NRAC) report, I have confirmed that noboard would receive less funding than it does at present and any changes would bephased in over a number of years as has been the practice under both the previousSHARE and Arbuthnott formulae.

The earliest any proposedrevisions to the formula could be implemented is 2009-10.

The details of NRAC’sassessment of the impact of moving from Arbuthnott to NRAC are set out in table7.8 on page 85 of chapter 7 of the NRAC Final Report, a copy of which is availablein the Scottish Parliament Information Centre (Bib. number 43807). If all NRAC’sproposed changes to the Formula were implemented then this would result in the redistributionof £81.9 million (or 1.2%) of the total HCHS budget. This relatively small percentagefigure includes some significant changes for individual health boards.

The Arbuthnott Formulais the result of multiplying a series of indices together, and as such there isno specific share of the budget allocated for rurality. The formula includes anadjustment for the unavoidable excess costs of delivering services to remote andrural areas. This resulting index is used along with indices for the age-sex profileand morbidity and life circumstances of the health boards’ populations to determinehow much more (or less) resource each board requires compared with its basic populationshare.

Currently the fundingfor Hospital and Community Health Services and GP Prescribing is distributed viathe Arbuthnott Formula. The formula assesses each health board’s relative need forfunding, using information about its population size and characteristics that influencethe need for health care, and costs of delivery, in terms of hospital services,community services and GP prescribing. The main drivers of the formula are:

share of the Scottishpopulation living in the board area;

age structure of thepopulation and relative number of males and females;

morbidity and lifecircumstances (MLC), and

unavoidable excesscosts of delivering health care in different geographical areas.

An index is calculatedfor each element of the formula for each care programme in such a way that it compareseach board’s position with the national average. By calculating each index in thisway, the values can then be multiplied by the population share to determine howmuch more (or less) resource each board requires compared with its basic populationshare due to age-sex, MLC and unavoidable excess costs.

In terms of disadvantagedcommunities, the MLC index is used alongside the age sex index to determine thehealth care “needs” of a health board’s population. The MLC index directs resourcestowards health boards with higher premature death rates and greater socio-economicdeprivation.

The excess costs indextakes account of the costs of supplying health services in remote and rural areasby giving greater weight to those health boards with more sparsely distributed populations.

The Arbuthnott Formulais the result of multiplying a series of indices, and as such there is no specificshare of the budget allocated for deprivation. The formula includes adjustmentsfor the “needs” of the population - based on indices for the age-sex profile andmorbidity and life circumstances of the health boards population. The resultingindex is used along with an index of unavoidable excess costs of delivering servicesto remote and rural areas to determine how much more (or less) resource eachboard requires compared with its basic population share.

The report raisessome very important issues which must be considered within the context of the currentSpending Review. I am currently studying the report and its recommendations carefully,and have sent it to the Convener of the Health and Sport Committee asking that committeeto let me have its views by the end of November. I have also sent the report tothe chairs and chief executives of health boards.

Information on thecosts of specific clinical procedures is not available centrally.

The running costsof the community midwifery units at these three hospitals is not held centrally.Information in the Scottish Health Service Costs publication does not explicitlyidentify the costs associated with community midwifery at hospital level.

The information requestedis not held centrally.

The information requestedis not held centrally.

I refer the memberto the answer to question S3W-3306 on 12 September 2007. Allanswers to written parliamentary questions are available on the Parliament’s website,the search facility for which can be found at http://www.scottish.parliament.uk/webapp/wa.search.