Chamber and committees

The Scottish Executive expects health boards to carry out effective public consultation on proposals for significant service changes and developments. The Executive welcomes the fact that Greater Glasgow Health Board is actively seeking to improve their arrangements for public consultation. It is for the GGHB to decide what advice it needs to commission to assist it in that process.

Mental illness is equated with the specialties of General Psychiatry, Adolescent Psychiatry, Child Psychiatry and Geriatric Psychiatry.The information available from health boards regarding expenditure on mental illness treatment is provided on the basis of patient category i.e. in-patient; outpatient; day-patient and community. In answering this question, secondary mental health services has been interpreted to mean hospital-based services, i.e. in-patient, outpatient, and day-patient categories only.The following table presents the aggregate expenditure on this group of patients for the periods 1996-97 until 1998-99 expressed in terms of 1998-99 prices.

Hospital Based Expenditure on Mental Health Services
Year	Expenditure in terms of 1998-99 Prices(£ million)	% of Total HCH
1996-97	380	12.6%
1997-98	377	12.2%
1998-99	376	12.1%

Source: Scottish Health Service Costs.

In 1995-96 health boards did not consistently identify the costs of Community Psychiatric Teams. It is therefore not possible to provide meaningful comparative figures for this period.

Expenditure figures for 1999-2000 are not yet available, and health boards will not be in a position to provide forecasted expenditure for 2000-01 until later this year.

There has been a steady reduction in the real terms expenditure on hospital-based treatment commensurate with the increase in community based health spend as part of the Executive's Modernisation agenda to provide support for Mental Health patients in the community. This additional support is provided not only by the NHS in Scotland, but extends to care in the community provided by local authorities.

Prior to 1 April 1996 the amount which local authorities could spend on improvement and repairs grants was determined by the Secretary of State. CoSLA asked that this arrangement be discontinued. Since that date it has been for authorities to set their own budgets for this purpose.

The Scottish Executive recognises and encourages the valuable contribution that the voluntary sector makes in raising funds for and in commissioning medical research. We are also committed to ensuring that our agencies, non-departmental public bodies and the NHSiS actively encourage and promote the work of the voluntary sector. As an example of this, the Chief Scientist's office is currently funding a small research project to the value of over £8,000 on enhancing the relationship between health voluntary organisations and the NHSiS.

The Scottish Executive has no plans, however, for the integration of the NHSiS with the voluntary sector in relation to medical research.

The capital spending of authorities would remain public expenditure even if the requirement for local authorities to have the consent of Scottish Ministers to undertake capital spending were abolished. This would have to be reflected in public spending totals, which would not themselves change. In these circumstances, an adjustment to the assigned budget to reflect the changed treatment of local authority capital spending may be appropriate, and consequently there may be no net benefit to the Assigned Budget or, ultimately, local authority spending.

In our Programme for Government, we made a commitment to work across the Executive to promote modern government, of which one of the main themes would be customer-focused policy development and service delivery.

We will put the citizen at the centre through our commitment to inclusive policy-making, and civic participation in all its forms. The public can make a real contribution to better policies at both local and national level. We are encouraging that contribution through our support for the Scottish Civic Forum, through the £3 million Listening to Communities programme, through the £10 million Working for Communities programme and through the increasing use of the possibilities offered by the Internet.

We will also work across the public sector to deliver citizen-focused services that are provided in such a way as to meet the needs of the citizens, not the convenience of the service provider. In particular, we will seek to overcome obstacles to joined-up working through a variety of means, and will seek to involve and meet the needs of all different groups in society. For example, the First Minister announced on 30 March his decision that the Executive's target for delivery of 100% of its services online by 2008 was being brought forward to 2005. At a practical level, I recently announced the £25 million Modernising Government Fund, which is designed to help take forward projects involving the innovative provision of improved public services, and particularly encourages partnership working.

Opportunities exist at every level in schools within the curriculum for the teaching of development education, including awareness of Third World development issues.

The Scottish Consultative Council on the Curriculum are working with the Department for International Development to produce resources and support materials on development education for teachers.

The delivery of benefits advice is an operational matter for the Benefits Agency, and is a reserved matter. However, we recognise the importance of the take-up of benefit and pension entitlement in the elimination of poverty in Scotland. We welcome current efforts to maximise take-up and are in regular contact with UK Government ministers and Departments on these and other matters.

The Scottish Executive is determined to face the challenges posed by cancer. We have pledged to tackle the root causes of ill health and work over the next 10 years to promote healthier living and reduce mortality from cancer by 20%.Specific initiatives designed to address these pledges and the Scottish Executive's approach to public health generally are set out in the White Paper, Towards a Healthier Scotland, a copy of which has been placed in SPICe.This is a challenging and wide ranging programme including:

• additional investment of £1 million to aid smoking cessation programmes;
• promoting healthier lifestyles and diet including the appointment of a Scottish Diet Co-ordinator;
• establishment of Healthy Living Centres via the New Opportunities Funding initiative (£34.5 million);
• The Cancer Challenge
- a pilot programme to test the feasibility of a national screening programme for earlier detection of colorectal cancer;
• a formalised cancer genetics programme for breast, colorectal and ovarian cancer to provide advice and counselling for individuals who may be at increased risk based on their family history.

The substantial additional investment in public health and health promotion, announced in the Scottish Parliament on 22 March, will further strengthen our efforts to help reduce the incidence of cancer in Scotland.

The NHS in Scotland is committed to ensuring that the highest quality of care is provided to all patients. It is important that patients with chronic conditions such as epilepsy, who may be on long-term drug treatment, are regularly reviewed. The frequency of such reviews is a matter for the clinical judgement of the relevant consultant. Existing national clinical guidelines published by Scottish Intercollegiate Guidelines Network in 1997 on The Diagnosis and Management of Epilepsy in Adults are scheduled for review this year.