Chamber and committees

It is not the case that children's health needs have not been addressed in the Arbuthnott Review. First, the proposed resource allocation formula includes a set of age and sex cost weights based on evidence about the use made of services by different age and sex groups. These show, for example, that children under 5 make more intensive use of services than children in older age groups. Second, the proposed formula also involves an assessment of the influence of morbidity and life circumstances on the relative healthcare needs of the total population of each Health Board area. This assessment is based on an analysis of the use of services by people from different areas in Scotland, including the relative use of health services by children from affluent and deprived areas. The Yorkhill NHS Trust submitted comments on the Arbuthnott Report during the consultation period. As you know, I asked Sir John Arbuthnott to reconvene the Steering Group to consider the comments made on the report and to provide me with revised recommendations. The concerns raised by Professor Cockburn will be considered as part of this further work.

Figures for the calendar years 1997, 1998 and 1999 are shown in the table below.

Health Board Area	1997	1998	1999 3
of Treatment	Percentage of births induced
Argyll and Clyde	28.9	27.7	30.1
Ayrshire and Arran	20.5	23.2	27.0
Borders	16.3	19.0	22.2
Dumfries and Galloway	16.5	22.0	21.0
Fife	24.4	24.0	23.8
Forth Valley	29.5	30.0	36.1
Grampian	18.9	22.7	25.2
Greater Glasgow	26.7	31.5	34.0
Highland	27.9	26.6	27.7
Lanarkshire	23.1	21.6	21.8
Lothian	23.0	24.0	24.0
Orkney	2.2	0.8	1.6
Shetland	8.7	9.9	14.1
Tayside	19.9	19.9	23.3
Western Isles	24.8	30.3	28.6
Scotland	23.7	25.5	27.1

Notes:

1. The figures exclude Home births and births at non-NHS hospitals.
2. From 1998, where four or more babies are involved in a delivery, birth details are recorded only for the first three babies delivered. Prior to 1998, birth details were recorded only for the first two babies delivered.
3. The 1999 figures are as yet provisional.

Year end is 31 March.

The table below shows the average length of time, in days, spent in hospital after the birth of the first child and subsequent children in the years 1990-91, 1994-95 and 1998-99.There has been a gradual reduction in the length of time spent in hospital by post- natal mothers, which reflects changed practices. This has also responded to the wishes of mothers to leave hospitals earlier and to the change of policy in providing more post- natal care by midwives in the community. However the provision of care is based on a flexible approach and mothers who feel they would benefit from a longer stay can do so.Length of post-natal stay (days)

	1990-91	1994-5	1998-99
All maternities	3.9	3.3	2.9
First maternities	4.6	4.1	3.6
Other maternities	3.2	2.7	2.4

Notes:

1. Maternities are defined as pregnancies which result in a live or stillbirth, multiple pregnancies counting only as one.

2. Excludes maternities delivered at home or at non-NHS hospitals.3. The figures for 1998-99 are as yet provisional.

It is for Greater Glasgow Health Board to determine how to organise services to meet the health care needs of the local population. Such provision must take account of declining numbers of births and changes in provision across the country, which reflect a shift in balance towards community provision. Further details are available from Greater Glasgow Health Board.In considering the provision and configuration of maternity services, local Health Boards are expected to take account of the 1993 Policy Review of the Provision of Maternity Services in Scotland. This recommended a move to increasing the choice for the woman, greater continuity of care and a move to midwife led care while at the same time maintaining the safety of both mother and baby.

Information on the median waiting times for cataract surgery for the year ending 30 September is given in the table.Median waiting time for cataract surgery¹: Year ending 30 september 1999^p

Health Board	Median Wait (Days)
Argyll and Clyde	85
Ayrshire and Arran	78
Borders	42
Dumfries and Galloway	121
Fife	114
Forth Valley	83
Grampian	103
Greater Glasgow	103
Highland	98
Lanarkshire	126
Lothian	78
Orkney	78
Shetland	80
Tayside	62
Western Isles	187
Scotland	87

Source SMR0

p Provisional¹ Cataract Surgery defined as primary operation OPCS4 C17-C75 and any mention of ICD 10 diagnosis H25, H26, H28.0, H28.1 or H28.2

Products and services subject to age restriction are wide-ranging and some are governed by consumer protection legislation which is reserved. However, the Scottish Executive is examining measures for better enforcement of the law to tackle those who make illegal sales to young people within the powers available to the Scottish Parliament.

There is no such thing as "metropolitan" status in Scotland, and I refer you to my reply of 29 July 1999 to question S1W-573.

The Scottish Executive and the UK Government will shortly be publishing a road safety strategy for the period to 2010. The strategy will underpin new and challenging targets for casualty reductions which will build on the progress already made. Fatal and serious casualties in Scotland have halved since the early 1980s.

The Scottish Executive will continue to provide funds to the Scottish Road Safety Campaign for the development of road safety education and publicity materials, including the current "Foolsspeed" campaign. It will also continue to fund the operation of the Children's Traffic Club in Scotland, to ensure that road safety education is available free to all three- and four-year-old children in Scotland.The Scottish Executive reviews annually accidents on trunk roads and investigates clusters of accidents at particular locations and routes with high accident rates. This enables necessary remedial measures to be carried out.

Health boards and NHS Trusts have to plan and deliver services which meet the needs of their local population within the resources allocated to them and taking account of national and local priorities. A patient may require an ultrasound examination or barium x-ray for various clinical reasons, and the priority attached to each case is a matter for the clinical judgement of the doctor concerned. The impact on patient outcomes from differing waiting times for these investigative/diagnostic procedures would depend on the nature of the patient's condition at the time of referral.The Scottish Executive is committed to improving waiting times, addressing all stages of a patient's care pathway through the Health Service, and to creating greater equity of access across the country. As I announced in Parliament on 16 December, we will be working with the NHS across Scotland over the coming months to establish national maximum waiting times, to be met by March 2000, in the three national clinical priorities of heart disease, cancer and mental illness.

The deployment of police officers to specific duties is an operational matter for Chief Constables. The police are committed to the principles of the Best Value approach as a means of increasing the efficiency of forces and improving the already high standards achieved for response times.