Chamber and committees

Health boards and local authority Social Work Departments incur expenditure in relation to mental health.

In terms of NHS expenditure, mental illness is equated with the specialties of General Psychiatry, Adolescent Psychiatry, Child Psychiatry and Geriatric Psychiatry.

The figures for 1997-98 and 1998-99 are provided in the publication Scottish Health Service Costs for each of the years. Figures relating to expenditure by health boards are not yet available for 1999-2000.

The following table sets out the net revenue expenditure by local authority social work departments on services for people with mental health problems. The source of data for 1997-98 is different to that for 1998-99 and 1999-2000. Care should be taken when making comparisons as the categories in which expenditure data are collected are different for these two sources.

Local Authority Social Work Expenditure on Mental Health 1997-98 to 1999-00 (£ million)
			1997-98		1998-99	1999-2000
					Provisional Outturn	Budget Estimate
Net Expenditure			30.1		33.5	36.8

Source: 1997-98 Figures as reported by local authorities on local financial returns (LFR3 Social Work). 1998-99 and 1999-2000 as reported by local authority on Provision Outturn Budget Estimate (POBE) returns.

Health boards and local authority Social Work Departments incur expenditure in relation to mental health.Health boards receive an allocation based on weighted capitation. They are then required to provide a Health Improvement Plan in conjunction with their partner Trusts to meet the health requirements of their resident population, in line with national priorities.In terms of NHS expenditure, mental illness is equated with the specialties of General Psychiatry, Adolescent Psychiatry, Child Psychiatry and Geriatric Psychiatry.The information provided in the following table groups the expenditure for inpatients, outpatients and day patients to provide a total hospital figure. The expenditure figures are for 1998-99 which are the latest available.

Health Board Expenditure on Mental Illness
Year	Total	Hospital	Community	Hospital	Community
	£ million	£ million	£ million	%	%
1998-99	415	377	38	91%	9%

Source: Scottish Health Service Costs 1998-99.Health boards report actual expenditure. The information available from health boards regarding expenditure on mental illness treatment is provided on the basis of patient category i.e. inpatient; outpatient; day patient and community.The health board expenditure reflects the costs of services purchased, and may not equate exactly with the cost of treatment for mental illness.The following table details the breakdown of net revenue expenditure by social work departments on mental health services. 1997-98 is provided as a detailed breakdown is not available for more recent years.

Local Authority Social Work Expenditure on Mental Health 1997-98 (£ million)
		Net Expenditure	% of Total
Residential & Nursing Homes		5.9	20%
Day Centres		7.1	23%
Other Services		17.1	57%
Total		30.1

Source: As reported by local authorities on local financial returns (LFR3 Social Work).

The Health Technology Board for Scotland will provide boards with advice on the clinical and cost effectiveness of new and existing treatments. Boards will be expected to take account of that advice in the decisions they make about the availability of treatments. Boards will also be expected to justify any decision not to follow the advice of the new board; both in the public eye (the advice of the board will be public) and within clinical governance.

The Health Technology Board for Scotland will assess new and existing drugs and treatments solely on the evidence of their clinical and cost-effectiveness.

The Health Technology Board for Scotland will be a single source of evidence-based advice to health service decision makers on the clinical and cost effectiveness of new and existing health technologies. Health boards will take account of the new board's advice to ensure that the people they serve have access to the most effective healthcare and treatment available.

Among the first tasks of the new Health Technology Board for Scotland will be to establish and obtain wide agreement to the methodology it will use to assess the clinical and cost-effectiveness of new and existing health technologies.

The Health Technology Board for Scotland will be a single source of evidence-based advice on the clinical and cost-effectiveness of treatments and drugs. It will work closely with the NHS and patient representatives to ensure that effective innovations move quickly into mainstream practice, so ensuring that all the people of Scotland have access to the most effective treatment available.

Health boards will take account of the advice of the Health Technology Board for Scotland in reaching their decisions. They will also be expected to justify any decision not to follow the advice of the new board; both in the public eye (the advice of the board will be public) and within the context of clinical governance.

In spite of unprecedented levels of activity in many parts of Scotland, the NHS acquitted itself extremely well in the light of recent winter pressures through a combination of sound planning and the sheer commitment and hard work of its staff.

However, there is no room for complacency. As part of its aim of continual improvement of services for patients, the NHS in Scotland will, with its planning partners, be reviewing winter planning arrangements. As part of these arrangements, I have already intimated that I am commissioning a group representing a wide range of interests to consider how those arrangements can be improved in future.I expect to be in a position to commission that group shortly so that its recommendations can inform planning for next winter.

On the basis of the latest available information, discharge arrangements for 2,391 patients have been delayed for more than two days.

From 1 April this year this information will be collected quarterly against agreed national definitions. The first national data will be available shortly after the first census on 30 June.