Under the terms of the NationalHealth Service (General Medical Services Contracts) (Scotland) Regulations 2004,immediately necessary treatment must be provided on request to any person as a resultof an accident or emergency at any place within the practice area, within core hours.

Where the general practitioneris providing treatment within a contract where responsibility for out of hours serviceshas been retained, the requirement to provide immediately necessary treatment alsoapplies to that period.

Where the GP practice opts totransfer its out of hours responsibility, then the health board will be requiredto have in place alternative arrangements which must meet national accreditationstandards, currently under development. These standards will be used to providethe assurance that suitable and safe arrangements are in place to provide primarymedical services out-of-hours for people across Scotland.

NHS boards are in the processof developing their plans for the re-provision of out-of-hours services and at thisstage we do not yet have final details on the content of these individual plans.

Following the reportsfindings, the Accounts Commission has now asked Audit Scotland to carry outfurther work to establish in more detail how the Code of Guidance on FundingExternal Bodies (the Code) and Following the Public Pound is beingapplied by local authorities.

The Accounts Commission willalso consider if the Code itself needs revision. Once this review has beencompleted Scottish ministers intend to use powers provided by Section 51 of theLocal Government in Scotland Act 2003 to require compliance with the Code.

It is for local authorities,in the first instance, to ensure that such arrangements secure Best Value. Thisbecame a statutory obligation on commencement of relevant sections of the LocalGovernment in Scotland Act 2003, and is now backed by an audit and enforcementframework in which the Accounts Commission for Scotland takes a key role.

In addition, the managementof funding agreements is one of the issues covered in the Code of Guidance onFunding External Bodies and Following the Public Pound (the Code)published by COSLA and the Accounts Commission. The Scottish Executive welcomes the decision to review adherence to the code in light of theLocal Government in Scotland Act 2003, and to revise it as necessary. TheAccounts Commission’s recent report, Following the Public Pound, is partof this review process.

Once this review has beencompleted Scottish ministers intend to use powers provided by Section 51 of theLocal Government in Scotland Act 2003 to require compliance with the Code.

All hydroelectric output in Scotland isclassified as renewable. Established stations with a capacity of up to 20MW andwhich have been refurbished since 1990 are also eligible for support under theRenewables Obligation (Scotland). Established stations with a capacity in excess of20 megawatts are not eligible for support, while new schemes of any size areeligible. This ensures that support is targeted at new generating plant.

Arrangementsfor the early release of prisoners are prescribed in the Prisoners and CriminalProceedings (Scotland) Act 1993 as amended. There are no plans in place to amendthose provisions. The Sentencing Commission for Scotland will as one of its first tasks be considering and makingrecommendations on the arrangements for early release.

Our policyis that the Care Commission will be self-funding through feesby 2006-07. Fees for the regulation of childminders and children’s day careservices will however continue to be subsidised.

We intend to use thebuilding regulations to introduce a requirement to install sprinkler systems inthe following categories of new or converted buildings:

·high rise flats

·residential care units

sheltered housing.

Local government grant methodologyhas been agreed with COSLA and local authorities following extensive andcollective consultation over a number of years. It takes account of a widerange of factors influencing local authority spend to ensure a fairdistribution of grant. For these islands authorities it also takes account of the additional costs of delivering services in the islands, giving the threewholly island councils significantly higher allocations per head of population thanany of the mainland councils, through the distribution of the Special IslandsNeeds Allowance.

If there is clear evidencethat an NHS board has failed to provide adequate and appropriate foot care inline with clinical need as determined by the appropriate healthcareprofessional the issue would be dealt with through the Health Department’sperformance management arrangements with the NHS board concerned.

NHS boards are required to ensurethat the services they provide meet the standards set for the NHS. NHS QualityImprovement Scotland has responsibility for this area and published standardsfor NHSScotland are available at www.nhshealthquality.org.

In addition podiatristsproviding NHS services are required to meet standards set by professional andregulatory bodies. The Health Professions Council provides information onexisting standards for podiatrists at:

www.hpc-uk.org/publications/standards/Standards_of_Proficiency_Chiropodists.pdf;and further information is available from the Society of Chiropodists andPodiatrists at www.feetforlife.org.