Chamber and committees

As indicated in Our National Health: A plan for action; a plan for change, the Executive will shortly undertake a fundamental review of medical workforce planning. This review will address the possibility of establishing fast-track graduate-entry medical degree courses in Scotland.

The commitment scheme has been developed between the UK Health Departments and the British Dental Association, in a response to a recommendation by the independent Doctors and Dentists Review Body (DDRB). In making its recommendation on commitment payments, the DDRB considered that the scheme should: reward past and present commitment to the NHS; require a high threshold of NHS gross fee earnings; commence the first payments to general dental practitioners after about 10 years service in the NHS; and provide a further boost to NHS earnings at a later stage in GDPs' careers once again based on length of service criteria.The NHS gross fee earnings threshold of £25,000 was set following discussions between the Health Departments and the British Dental Association.I am aware that there have been some concerns about whether the commitment scheme is achieving its underlying purpose in areas where there is limited population, and have asked officials to review this during the coming financial year.

The Scottish Diet Action Plan, Eating for Health, promotes the provision of healthy food choices and health education in order to encourage individuals to choose a balanced diet. This, along with physical exercise, helps to prevent obesity and, thus, the development of non-insulin dependent diabetes in later life.

The Scottish Diet Action Plan Eating for Health and the White Paper Towards a Healthier Scotland provide the framework for action to promote healthy eating and physical activity.Our National Health: A plan for action, a plan for change reiterated the role of local authorities and schools through the commitment to support, via the Health Improvement Fund, the provision of fruit for infants, and breakfast clubs and fruit/salad bars in school settings. In addition, the Physical Activity Task Force will be tasked with producing a strategy to increase physical activity in all age groups in Scotland.

I refer the Member to the answer given to question S1W-12481.

Our National Health: A plan for action, a plan for change has as amongst its core aims involving people and communities in the design and delivery of health services. The plan therefore commits the Executive to a number of initiatives aimed at improving the way in which the NHS consults on service developments. These include reviewing the statutory guidance on formal consultation to ensure that it meets the needs of modern healthcare systems, and takes into account the changes to NHS planning announced elsewhere in that plan. We will also provide guidance, training and support to local NHS leaders to enable them to involve the public effectively in the management of changes to local services.

The Code of Practice on Openness for the NHS in Scotland makes a presumption of openness and accessibility of information. In response to a recent request for advice from an NHS Trust, the Executive confirmed that the Code does not, however, require the NHS to provide information already widely available publicly or where to do so would result in an unacceptable diversion of resources from patient care.Requests for information are considered on an individual basis and decisions on whether to provide information depend on the subject matter and content. It is not normal practice to seek ministerial approval for the handling of each such request. Under the proposed Freedom of Information Bill, requests will continue to be considered case by case.

Mental health is one of three clinical priorities for the NHS in Scotland and resources are being allocated to reflect this. The Scottish Executive Health Department works with the NHS, local authorities, inspection and support groups to ensure that appropriate standards of care and treatment are provided for people with mental illness. Where deficiencies are found, the first priority is to ensure that action is taken to meet the needs of patients without delay.

Responsibility for ensuring that health professionals are fit to practise rests both with their employer and with their regulatory body.

However, in Scotland we are also concerned about the issues which the National Clinical Assessment Authority (NCAA) in England is being established to address in respect of doctors and dentists. Although we have no plans to set up a NCAA, we have a number of mechanisms in place or in preparation which serve the same purposes as this new English body, without requiring the establishment of a new body.The report Suspensions - A New Perspective, which was published in 1999, dealt with issues of performance in career grade medical and dental staff and proposed the approach which we have decided to adopt in Scotland. Concerns about performance should be tackled by constructive intervention at an early stage, with specific advice and support from External Clinical Advisory Teams from the Royal Colleges in Scotland and the Scottish Expert Reference Group.Two groups are currently examining how to apply the principles of this approach to general practitioners and to doctors and dentists in training.

No detailed estimates are available of the costs of HAI to the NHS in Scotland. A broad estimate of the incidence and impact of HAI, prepared by the Scottish Office Health Department in 1999 as part of a project on HAI surveillance, indicated that a central estimate of the total annual cost would be approximately £21.6 million. This work also suggested that the cost of avoidable HAIs was approximately £3.9 million. These costs are subject to substantial uncertainty. They do not include the cost of treating HAI manifesting in the community, or costs incurred outside the NHS.More information about the incidence and costs of HAI is expected to become available from the planned national surveillance system, once it is introduced.