4: A Healthier Scotland

The Health Service, just like other public services, faces a difficult and challenging environment in the years ahead. In order to meet these challenges NHSScotland will need to be adaptable and even more efficient. And, as ever, the NHS will rely on all its staff to continue to deliver the high standards of patient care that has been a hallmark of the NHS in Scotland.

During these difficult times the Scottish Government will defend and protect the NHS. We will continue to put patients at the heart of our health service ensuring that they receive a prompt and professional service in a clean environment. And we will work in partnership with all NHS staff to ensure that we get through these difficult financial times working together to deliver the best services possible for patients.

The Scottish Government will continue to develop the Scottish model of a mutual health service. We reject policies which promote the privatisation of the NHS and we are concerned that the wholesale structural upheaval being pursued by the UK coalition government threatens the integrity of the NHS.

We shall continue to deliver on our waiting times targets; we shall give patients a waiting times guarantee and a right to complain; we will abolish prescription charges from April next year and we will continue to cut levels of C difficile infection and other healthcare associated infections.

As we go forward, the Scottish Government will continue to work with our NHS, local government and other partners to make Scotland a healthier nation by:

    * implementing our Healthcare Quality Strategy so that the NHS provides the best healthcare every time for every person. This will impact on everyone working for or with NHSScotland and applies to the full range of healthcare activities - from health improvement to rehabilitation;
    * putting patients at the heart of the NHS in Scotland. The Patient Rights Bill aims to improve patients' experiences of using health services by providing greater certainty about waiting times for treatments, introducing a right to complain and supporting people to become more involved in their health and healthcare;
    * providing, through the Keep Well and Well North programmes, targeted health checks for people in all of Scotland's most deprived communities and helping to reduce preventable inequalities between their health and that of other communities. This is part of wider developments in Primary Care that also include piloting regular heath checks for all Scots between the ages of 40 and 74, and the roll out across Scotland of a pioneering web-based self assessment for 40 year olds: "Life Begins at 40";
    * raising the profile of, and engaging the public in, our Reshaping Care for Older People programme, which will help us to devise and promote a new model of health and social care in Scotland that is fair, affordable and sustainable. We intend to publish key delivery outcomes later this year;
    * progressing towards our ambitious target of 18 weeks from referral to the start of treatment, including assessment and diagnostic tests. The hard work and skill of frontline staff has delivered exceptionally short waiting times for outpatient appointments, key diagnostic tests and inpatient treatment that will ensure very good progress towards the 18 week target during the next year. This will be augmented by the Patient Rights Bill's proposed 12 week treatment time guarantee for eligible patients;
    * continuing to work with stakeholders to deliver the commitments set out in Better Cancer Care, our national cancer action plan. The plan includes two new waiting times targets that will ensure more people are included in the existing 62 day target and a new 31 day target from decision to treat to first treatment. Both targets will be in place by 2011;
    * continuing to make substantial progress on implementing our Alcohol Framework including progressing the Alcohol etc. Bill, which contains provisions to introduce minimum unit pricing - which has the potential to save lives and reduce crime - and bans irresponsible off-sales promotions, places a duty on licensing boards to consider raising the off-sales purchase age to 21, requires an age verification policy to be in place and introduces a power to impose a social responsibility levy on some retailers;
    * providing record investment and practical support to help local Alcohol and Drug Partnerships deliver substantial improvements in prevention and treatment services;
    * reducing waiting times to 26 weeks for access to child and adolescent mental health services by 2013 and expanding the specialist workforce by 15-20% between 2007-08 and 2011-12;
    * continuing to develop and deliver health's contribution to the Early Years Framework by, for example, introducing a refreshed Maternity Services Strategy to better address health inequalities for the very youngest and expectant mothers;
    * stepping up our drive to prevent children and young people from smoking by implementing the measures contained in the Tobacco and Primary Medical Services (Scotland) Act 2010, including bans on the display of tobacco and related products in shops and cigarette sales from vending machines. We will also defend the Act against the legal actions which have been mounted by the tobacco industry;
    * bringing forward a Health (Certification of Death) Bill to change the system of death certification in Scotland - increasing the quality and accuracy of medical death certificates and providing better public health information to help ensure that public health resources can be directed where needed;
    * continuing to work with national and local partners on the delivery of our sexual health and HIV action plans to improve sexual health and wellbeing, including measures to reduce unintended teenage pregnancy and sexually transmitted infections;
    * delivering the HPV vaccination programme to protect Scotland's young women against the risks of cervical cancer;
    * investing in the voluntary sector to support respite care for carers of all ages, as part of our recent carers strategies: Caring Together for adults and Getting it Right for Young Carers. This recognises the huge contribution made by carers of all ages to their families and to society, highlights that carers are equal partners in the care of their loved ones, and will help them to continue their crucial work; and
    * continuing to invest in new and refurbished sports facilities and increasing our support for high performance sport to help our medal chances in both the 2012 Olympics and the 2014 Commonwealth Games. We will use the Games as a catalyst to leave a lasting legacy throughout Scotland of which we can all be proud. In particular, Active Nation will use the spirit and excitement of the Games to motivate Scots to get more active and get more out of life.

This progressive programme of activity aims to develop a world-class health system for all of Scotland to tackle health inequalities and to tackle Scotland's key health issues. It builds on the already significant achievements that are making Scotland a healthier nation. These include:

    * almost all patients waiting no more than nine weeks for inpatient and day case treatment - three weeks better than the current standard of 12 weeks and compared with 26 weeks in 2007. Outpatients are now receiving appointments within 12 weeks, down from 26 weeks in 2007, and the waiting time standard now includes patients referred from wider sources than a GP or dentist. This means that over 300,000 more patients a year benefit from quicker access to outpatient care;
    * improving support and care for people with dementia and their carers, and ensuring that people with dementia are treated with dignity and respect by working with our partners to implement Scotland's first ever National Dementia Strategy;
    * being at the forefront of the successful UK-wide response to the H1N1 flu pandemic. A range of measures were taken by the NHS in Scotland and the Scottish Government to minimise the impact of the virus. These included a successful vaccination programme with higher uptake rates than in other parts of the UK, a doubling of the critical care capacity, and the establishment of the Scottish Flu Response Centre within NHS 24, which reduced pressures in primary care and was a vital source of information to the Scottish public;
    * reducing prescription charges to ensure fewer patients are put-off collecting their prescription medication due to cost;
    * enabling the first ever health board elections to take place, resulting in ten new members joining Dumfries and Galloway Health Board and twelve joining Fife Health Board. These new members will help shape and deliver local NHS services by bringing a greater awareness of local issues and opinions and ensuring that these are at the heart of the Boards' decision making processes;
    * establishing the independent Healthcare Environment Inspectorate to drive up standards in tackling hospital infections in Scotland. The Inspectorate will ensure the highest standards of infection prevention and cleanliness with the aim of building public confidence. Every acute hospital will receive at least one announced and one unannounced inspection within a three-year cycle, with more visits if necessary; and
    * increasing access to dental services by, for example, opening the new Aberdeen dental school and improving children's oral health particularly amongst the most deprived groups.

Going forward, the Scottish Government will also continue to improve Scotland's housing and regenerate its communities. Working with local authorities, Registered Social Landlords and the private sector, we are:

    * shaping future housing policy to meet the challenges ahead on housing need and environmental issues through the Housing: Fresh Thinking, New Ideas discussion;
    * bringing forward a Private Rented Housing Bill to tackle unscrupulous rogue landlords who operate outwith the law and make life a misery for tenants and their neighbours, destroy communities and tarnish the reputation of the many good private landlords in Scotland;
    * implementing the new and innovative £50 million Joint European Support for Sustainable Investment in City Areas ( JESSICA) funding model which will lever cash from Europe, as well as from public and private sector partners, to support regeneration, jobs and economic recovery; and
    * extending the impact of the Energy Assistance Package to improve delivery of energy conservation and efficient heating systems throughout Scotland. The expansion of the Home Insulation Scheme will help tackle climate change and fuel poverty and provide work for energy and insulation companies.

This builds on the significant achievements already made in improving Scotland's housing and regenerating communities, including:

    * bringing into force the Home Owner and Debtor Protection (Scotland) Act 2010 to ensure increased protection for homeowners in threat of repossession;
    * investing a record £675 million in affordable housing in 2009-10; starting more social sector houses than at any time since the 1970s; and allocating £80 million to 23 local authorities to support the construction of 3,300 new council homes; and
    * introducing a Housing Bill that, amongst other things, progresses our review of the Right to Buy legislation, to make it more responsive to local needs and to safeguard social housing.

http://www.scotland.gov.uk/Publications/2010/09/09094254/5