Chamber and committees

The Scottish Executive recognises that modern acute hospital care for elderly patients must be supported by rehabilitation that meets individual need. This position was set out clearly in the report of the Acute Services Review, which identified the value of initiatives designed to provide support and rehabilitation at home immediately following discharge, and also revalue of both - acute rehabilitation for older people with more complex needs. Our work on modernising the NHS in Scotland provides a context in which to build on such developments and further strengthen the links between acute and primary care in the interests of older patients. This approach to the concept of intermediate care takes account of Scottish circumstances and innovations in the pursuit of high quality and cost-effective care designed to maintain access to acute services for older people and at the same time maximise their subsequent independence.

Our Programme for Government sets out our commitment to ensuring that access to health services must be determined by need and not by place of residence.

We are taking that forward in a number of ways. We are setting up the Health Technology Board for Scotland to ensure that effective new treatments can move swiftly into mainstream NHS use across Scotland as a whole. Implemented against a background of clinical governance, this single source of advice should help eliminate so-called 'post-code prescribing'.

The work of the Scottish Intercollegiate Guidelines Network and the Scottish Needs Assessment Programme provides clinicians across Scotland with authoritative advice on specific topics. The Clinical Standards Board for Scotland's emphasis on national agreement of clinical standards for specific conditions is a further way of encouraging uniform provision of high quality health care across Scotland.

In primary care, the Local Health Care Co-operatives (LHCC) Best Practice Group provides a vehicle for looking at access to primary care. Many LHCCs have already undertaken needs assessments for their localities, often in conjunction with the public health departments of their local health board. This enables them to find local answers to local problems, making sure health care resources are targeted on those who need a particular service or treatment.

In the acute sector, there is an important role for Managed Clinical Networks in promoting access to services, as locally as possible where that can be done without compromising patient safety. The system of designating certain services on a national basis helps ensure patients have access to highly complex but low volume procedures regardless of where in Scotland they happen to live.

In 1999 the National Audit Office reported in its publication The Scottish Ambulance Service: A Service for Life that approximately one-third of patients calling for a 999 emergency ambulance had no or only minor illness. This was based on analysis of a sample of patients who had used the service. The Scottish Ambulance Service is carrying out a more detailed analysis of the nature of calls made to the service as part of its investigation into the case for introducing a priority-based dispatch system for emergency ambulances.

The Executive has had direct discussions with Comhairle Nan Eilean Siar and the Defence Housing Executive concerning the disposal of MoD properties in Benbecula. In addition, Scottish Homes has been involved in discussions about surplus MoD housing in Helensburgh and in Unst, Shetland.

The information broken down by health board area is as follows:

Health Board Area	1997-98	1998-99	1999-2000
Argyll and Clyde	4.84%	6.30%	6.50%
Ayrshire and Arran	4.89%	6.34%	5.25%
Borders	4.21%	3.78%	3.47%
Dumfries and Galloway	4.71%	5.67%	7.19%
Fife	3.41%	3.22%	4.11%
Forth Valley	3.60%	5.55%	6.44%
Grampian	5.60%	6.42%	5.20%
Greater Glasgow	9.84%	10.80%	8.72%
Highland	3.91%	4.78%	4.23%
Lanarkshire	6.48%	7.11%	7.70%
Lothian	6.51%	8.10%	9.31%
Orkney	0.40%	0.65%	2.25%
Shetland	1.26%	3.61%	3.78%
Tayside	4.32%	5.23%	5.92%
Western Isles	1.64%	5.57%	5.48%
Scotland	5.54%	6.55%	6.46%

Reducing staff absence levels is a matter for the Scottish Ambulance Service. As part of the Occupational Health and Safety Strategy for the NHS in Scotland, the Scottish Executive expects NHS employers to set and meet targets to reduce sickness absence. The Executive is taking work forward to establish data gathering mechanisms that should allow areas of concern or good practice to be identified both at national and local level.

The Scottish Executive has issued no such guidance. However, we have issued guidance to local authorities on local transport strategies which makes very clear that such strategies should address the particular travel requirements of those with special needs.

Procedural guidelines for local authorities undertaking stock transfers and a code of practice on tenant participation and stock transfers will be published shortly. These publications will recommend that councils involve tenants in the selection of the tenants' adviser.

The information requested is not available centrally.

A total of £500,000 for a national programme of training in tenant participation was provisionally allocated for the three years 1999-2000 to 2001-02 by the Scottish Executive. No Scottish Office resources had previously been allocated specifically for this purpose. The table shows the grants paid to individual recipients in the year 1999-2000 and the amounts awarded so far in the current financial year.

Organisation	Amount Paid 1999-2000	Amount Awarded 2000-01
Positive Action in Housing	£25,250	£31,656
Chartered Institute of Housing	£18,500	£31,500
Tenants Information Service	£52,820	£40,350
Tenant Participation Advisory Service	£25,000	£20,783
Tenant Involvement in the Islands, Grampian and Highland Rural Areas	£12,300	£38,000
Total for Year	£133,870	£162,289