Chamber and committees

The benefits of planned careand early pre-discharge planning are well known. The care programme approach(CPA) which has a long history is designed to provide structured continuingcare for those with more complex needs. Properly approached and applied the CPAis likely to show the benefits evidenced in Nairn and Ardersier.

The CPA has been promotedand encouraged at every opportunity in recent years, given its joint working,joint delivery of services components. We continue to encourage its applicationat every opportunity most recently in our work with the agencies on thepreparation of Local Joint Implementation Plans to deliver on the Mental Health(Care and Treatment) (Scotland) Act 2003.

Estimates on the impact of the Mental Health (Care and Treatment) (Scotland) Act 2003 on the mental health officer (MHO)workforce were reached in consultation with the Association of Directors ofSocial Work and COSLA. £2.5 million per annum additional funding has been madeavailable for 2004-05 and 2005-06. This should allow for the employment of anadditional 50-60 (whole-time-equivalent) MHOs across Scotland.

The Scottish Executive commissioned research from the Scottish Development Centre for MentalHealth on the capacity of MHO services to meet existing and future statutory demand.This research, launched at a conference in October 2003, examined service modelsand supports in place throughout Scotland. The findings will assist local authorities inexamining and redesigning existing MHO services to maximise the availability ofMHOs.

The Scottish Executive is facilitating the development of national standards for Mental HealthOfficer services, as intimated in the policy document: Renewing MentalHealth Law. Agreed standards will assist in the provision of a moreefficient and responsive MHO service.

Dr Grant’s published interimreport of the National Mental Health Services Assessment (Bib number: 30239) highlightsproblems that can occur in patient transfers. That report calls for flexibleand responsive 24-hour support services to be developed which are sensitive tolocal geography. This fits broadly with the findings of the Remote and RuralAreas Resource Initiative (RARARI) Bid 79 report (Bib number 31082).

I have invited the partneragencies to prepare Joint Local Implementation Plans to deliver on the Mental Health (Care and Treatment) (Scotland)Act 2003 and in doing so have drawnattention to relevant recommendations of the RARARI report.

Publication of the interimand locality reports from the National Mental Health Services Assessment (Bib numbers30239, 30221-30234, 30236) co-incided with the publication by the Remote andRural Areas Resource Initiative (RARARI) of Recommendations for the SafeManagement of Acutely Disturbed Psychiatric Patients (Bib number 31082).

These reports draw attentionto the importance of places of safety and alternatives to police stations whenpeople are in crisis. The Mental Health(Care and Treatment) (Scotland) Act 2003 doesrecognise that there will be circumstances where there is no immediatealternative other than to use a police station. However, the emphasis is onalternatives. I have invited the partner agencies to prepare Joint LocalImplementation Plans to deliver on the new provisions and in doing so havedrawn attention to relevant recommendations from the RARARI report.

The information requested isnot held centrally.

Dr Grant, in her publishedinterim and locality reports of the National Mental Health Services Assessment (Bib.numbers 30239, 30221-30234, 30236), has drawn attention to the importance ofplaces of safety and has referred to alternatives to police stations whenpeople are in crisis. The Mental Health (Care and Treatment) (Scotland)Act 2003 does recognise that there will be circumstances where there is noimmediate alternative other than to use a police station. However, the emphasisis on alternatives.

This is a matter for educationalbodies, NHS boards and other organisations in rural areas to consider. The Scottish Executive has encouraged the development of education, training and research inrural areas through bodies such as the University of the Highlands andIslands and the Highlands and Islands Research Institute. It has also ensuredthat the additional costs of providing health care in rural areas are reflectedin NHS boards’ funding allocations.

The Bid 79 report (Bibnumber 31082) covers a range of issues from Human Rights Act compliance totraining and staff governance issues. There are key recommendations forimprovement to the services provided to remote and rural areas and the Executivehas already drawn these recommendations to the attention of the statutory agencies.

Some £1 million has beenprovided to NHS boards and their partners to support planning for delivery of the Mental Health (Care and Treatment) (Scotland) Act 2003. They will be providing Joint LocalImplementation Plans by 31 March and I would expect these to deal appropriatelywith the recommendations in the Bid 79 report.

Localauthorities and managers of serviceshave responsibilities to monitor and improve their performance. Overall, the Scottish Executive undertakes monitoring through the Social Work Services Inspectorate annualreport and periodic thematic and specific reports by the Inspectorate. TheChildren and Young People Delivery Group is taking forward work to strengthenlocal quality assurance systems and external inspection of children’s services.Revised guidance for local authorities onplanning co-ordinated children’s services will be issued later this year. The Scottish Executive has collated and published performance by local authorities and other service providers under the time intervalsmonitoring group. Audit Scotland reports to the Scottish Parliament provide independentassessment of performance.

At individual case level,children’s hearings will monitor progress at review hearings. The AntisocialBehaviour etc. (Scotland) Bill proposes a new power for reporters and hearingsto refer local authorities to thecourts if there are concerns that statutory obligations are not being met.

The Executive’s Reviewof the Children’s Hearings System will explore how children’s hearings'decisions and the outcomes of those decisions can be more consistently recordedand monitored to improve the service for children.

There are no national standardsfor the frequency of contact between a social worker and a child onsupervision.

Children’s Hearings havewide ranging powers to make whatever disposals they consider appropriate tomeet the individual needs of the child. If service providers such as local authorities and voluntary agenciescan make an appropriate disposal available, the hearing may consider it as acondition of the supervision requirement.

Measuresproposed in the Antisocial Behaviour etc (Scotland) Bill will further extend the range of disposals,e.g. the power to impose electronic monitoring on young people as one elementof a package of support measures. The Scottish Executive has increased funding tosupport the Children’s Hearings system and improve service delivery.

Later this year we will lookconstructively and critically at how the system is operating, where and how itmight be made more effective in addressing the needs of children, young peopleand their families.