Chamber and committees

A total of £13.5 million, formerly paid as GP Fundholding Management Allowances has been redistributed on a weighted capitation basis to support the work of LHCCs in 1999-2000. In future years this funding will form part of Health Boards' unified budgets.

The introduction of Primary Care Trusts was part of the overall reconfiguration of NHS Trusts in Scotland that is expected to yield net savings of £6 million per annum. With mergers having taken place in all 12 mainland Health Board areas, the saving per Board area will be £500,000 on average. It is for individual Primary Care Trusts to manage their own resources and decide how much of their funding should be made available for the development of primary care services.

No funding has been allocated to Health Boards specifically to relieve bed blocking. Health Boards are given an annual general allocation to meet the health care needs of their resident populations. It is for Health Boards to determine, within the funds available, how to manage and deliver local health care services to meet these needs. All Health Boards and NHS Trusts work with their local authority partners to explore avenues to reduce or remove delays in discharges from NHS care. This is reflected in each Health Board's Health Improvement Programme and in Trust Implementation Plans.

The information requested can not be identified separately. A wide range of expenditure and action by Health Boards and NHS Trusts contributes to relieving bed blocking. This includes effective discharge planning, improving rehabilitation services and other developments falling to the NHS acting alone or working together with local authorities and other partners. This is reflected in each Health Board's Health Improvement Programme and in Trust Implementation Plans.

The cost per patient week for those awaiting discharge from NHS care varies by specialty, to a range of £700 to £1000.The cost per resident week of a social work funded place in a nursing/residential home varies by client group, type of home and area in the range of £220 to £360.

All Health Boards and NHS Trusts continue to work with their local authority partners in addressing all avenues, including financial, to reduce or remove delays in discharge from NHS Care. This is an ongoing in-year process and features as an integral part of each Health Board's Health Improvement Programme. This ongoing task takes account of planning for any additional pressures which may arise over the millennium period.

The conclusions of the National Review of Resource Allocation for the NHS in Scotland were published on 15 July, in the form of the report 'Fair Shares For All'. In order to give Members and the general public sufficient time to consider the Review's recommendations I have decided that the report should be subject to consultation for a period of four months from the date of publication. The Parliamentary Committee for Health and Community Care will be briefed on the Review and I look forward to hearing their views on some of the key issues. A copy of the Review's report has been sent to each member and has been laid in the Parliamentary Library. The Review's remit asked it to bring forward recommendations with the aim of promoting fair access to healthcare, based on the health needs of each area Health Board. This has involved the use of a wide range of relevant deprivation indicators in order to assess needs associated with deprivation. The full list of the indicators used by the Review are included in the report.

I have written to the British Dental Association inviting them to a meeting to discuss oral health issues.

A commitment to the achievement of the 56 hour target here in Scotland has already been given and I can restate our determination to see that fully implemented. We have announced joint plans with the British Medical Association (BMA) to support NHS Trusts' implementation of New Deal standards and I have written to the Chairman of the Junior Doctors Committee in Scotland to arrange a meeting to discuss this and other issues concerning junior doctors.

Tackling Coronary Heart Disease (CHD) has been one of the clinical priorities of the National Health Service in Scotland for some years.Scotland's CHD burden means that we must find ways to stop people getting the disease in the first place. The Scottish Executive is taking forward a £15m demonstration project under the White Paper Towards a Healthier Scotland which will build on international experience in promoting primary prevention of CHD. We are also addressing the needs of those with the established disease. We are raising the coronary artery bypass graft (CABG) rate to 616 per million population by the end of March 2000, thereby treating the disease at a less advanced stage and minimising delays that lead to avoidable disease and death. Our CHD Task Force is also working on an assessment of the appropriate rate for the Scottish population for both CABG and angioplasty, and I shall want to take account of the implications of that work. We also need to look at ways of improving cardiac rehabilitation services across the country. The overall aim of the Task Force's work is to make sure that people with CHD have equity of access to the network of cardiac services and are not disadvantaged by factors such as age or where they live.

The Scottish Executive is committed to ensuring that Health Boards and NHS Trusts continue work with other agencies, including local authorities, to cope with periods of peak demand as part of the process of managing effectively the services provided to patients. They have been asked to plan particularly for the additional demands that may arise over the 1999-2000 New Year holiday period.