§ Mr. WatsonTo ask the Secretary of State for Scotland (1) what consultation he intends should take place with local authorities in Scotland in respect of the changes to public health departments proposed by the Shields report; [34397]
(2) pursuant to section 6.1.1 of the Shields report, what arrangements are currently in place across Scotland for communication and liaison between directors of public health and local authorities. [34447]
§ Lord James Douglas-HamiltonThere is no formal consultation on the Shields report or the NHS management executive letter that implements it. In their capacity as designated medical officers, directors of public health have the opportunity for regular contact with local authorities. A recent management executive letter emphasised the contribution designated medical officers could make to increased collaboration with local authorities on health matters, bearing in mind the potential the new single tier structure for a co-ordinated approach to health improvement. I would expect any proposed changes at local level in consequence of the Shields report with implications for local authorities to be the subject of discussion between the health boards and local councils concerned.
§ Mr. WatsonTo ask the Secretary of State for Scotland what changes in the numbers of those employed by health boards in Scotland he estimates will result from the implementation of the Shields report recommendations. [34446]
§ Lord James Douglas-HamiltonThe most recent estimates suggest health board management and administration spending will average £13.28 per head in 1996–97. A £10 per head target therefore implies a reduction in spending of one quarter. There may well be consequent reductions in administrative staff.
§ Mr. WatsonTo ask the Secretary of State for Scotland (1) what assessment he has made of correlations between levels of health and overall expenditure by health boards in Scotland; and if he will list the available date by health board; [34448]
(2) for what reasons the committee which prepared the Shields report was not required to consider links between levels of mortality, morbidity and social and economic deprivation. [34449]
240W
§ Lord James Douglas-HamiltonThe revenue funding allocation formula for health boards is based on population adjusted for age, sex and morbidity. The data are given in Scottish health authorities revenue allocation tables published annually by the information and statistics division of the common services agency of the national health service in Scotland. The committee reviewed the roles and responsibilities of health boards. Considering links between levels of mortality, morbidity and social and economic deprivation was not therefore in the committee's remit.
§ Mr. WatsonTo ask the Secretary of State for Scotland (1) if he will list evidence on the effectiveness of different models of health promotion delivery presented to the committee preparing the Shields report evaluated by his Department; and with whom consultation took place on this part of the report; [34450]
(2) what assessment he has made of the recommendations contained in section 6.1.2 of the Shields report in respect of arm's length delivery of health promotion. [34456]
§ Lord James Douglas-HamiltonA number of health boards in Scotland already contract with NHS trusts for the delivery of health promotion services. The report suggests that all boards should consider contracting for this service element in order to evaluate the service on a more objective basis. The letter implementing the report suggests that the contract would normally be with an NHS trust, but that other models that improve local partnerships may be appropriate.
§ Mr. WatsonTo ask the Secretary of State for Scotland if funds for health service development will be exempted from target costs for health board management and administration of £10 per head of population set out in the Shields report. [34451]
§ Lord James Douglas-HamiltonThe purpose of the £10 target is to produce additional funds for health care and developments for patients.
§ Mr. WatsonTo ask the Secretary of State for Scotland, pursuant to section 6.1.1 of the Shields report, if directors will retain the right to independent comment and the publication of independent reports on all matters affecting the health of their local population. [34452]
§ Lord James Douglas-HamiltonSection 6.1.1 of the report makes it clear that the committee would not wish to undermine the freedom of directors of public health to make an independent report or statement about the health of the local population.
§ Mr. WatsonTo ask the Secretary of State for Scotland, pursuant to the recommendations contained in the Shields report, if health boards will be permitted to keep centrally those functions which they consider necessary to protect and promote public health. [34453]
§ Lord James Douglas-HamiltonThe report makes it clear that protecting and promoting public health is a key responsibility of health boards. However, it is not necessary for all of the services to be provided by boards themselves.
241W
§ Mr. WatsonTo ask the Secretary of State for Scotland (1) for what reason the Shields report committee was not required to analyse variations in expenditure on management and administration between health boards in Scotland; and to what extent such analysis was required to be carried out on the basis of individual functions or departments across health boards in Scotland; [34454]
(2) for what reason the Shields report committee was not required to analyse variations in expenditure between health boards in Scotland; and to what extent analysis was required to be carried out on the basis of individual functions or departments. [34455]
§ Lord James Douglas-HamiltonThe Shields committee was given figures showing that the variation in management and administration was from £10.46 per head to £18.82 a head in mainland health boards based on their 1994–95 annual accounts. Health boards themselves have analysed the variation in costs and numbers of staff across 10 functions. This work was aided by the Accounts Commission.