Seòmar agus comataidhean

I am currently consideringthese matters and will make an announcement in due course.

The NHS Reform (Scotland)Bill will make provision for a new duty on NHS boards to co-operate to advancethe health of the people of Scotland. That duty will underpin the work currently underwayin boards to draw together a framework for regional planning. The frameworkwill make it clear that boards must participate in regional planning, thatdecisions reached in regional planning groups are binding and it will set outarrangements for dispute resolution. We will ensure that an assessment ofregional planning activity forms part of the annual accountability review foreach NHS board.

While this is primarily amatter for NHS Argyll and Clyde and NHS Greater Glasgow, I would expect appropriateclinical advice to form part of the development of the report.

The Scottish Executive’s guidanceto NHS boards on regional planning makes it clear that it is vital to engagesenior clinical staff in the process. I fully expect that the need to involveclinicians will be part of the framework for regional planning currently beingdrawn together by NHS board Chief Executives.

The new consultants’ contractprovides a number of specific advantages, not least a considerable increase inthe contracted time devoted to direct patient care, up from 21 hours per weekto at least 30 hours per week for each full-time consultant. The overarchingbenefit to be derived from the contract is to provide NHSScotland with thetools to more effectively manage consultants’ time and workload. The jobplanning process allows managers, for the first time, to critically examine andtransparently timetable all of a consultant’s activities, and to agree how consultants’working commitments and practices can best contribute to NHS objectives. Inthis way managers will be able to explicitly and more effectively manageconsultant activity in order to secure the capacity they require to improveservices to patients and, where appropriate, take forward the re-design ofservices.

The proposal to establish aninspectorate for the Crown Office and Procurator Fiscal Service (COPFS) was thesubject of consultation at the end of 2003. The outcome of this consultationwas a broad welcome for these proposals. I have published a summary of the responsesat www.crownoffice.gov.uk.Following this positive response, the Inspectorate of Prosecution in Scotlandstarted work at the end of December 2003, under the leadership of an interiminspector.

The Scottish Executive will this week advertise the post of Chief Inspector of Prosecution ofScotland. The creation of the inspectorate is an important step for the COPFSas it strives to build its reputation as an open and accountable public serviceand secure the public’s confidence in its ability to prosecute crime.

Yes. Myministerial colleagues and I spent considerable time over the summer of 2003consulting with communities across Scotland about antisocial behaviour. Problems with groups of people causingalarm and distress were raised many times and we found widespread support forour proposals to strengthen the powers of the police to deal with such groups.That dialogue with the people affected by antisocial behaviour has continuedand will continue throughout the progress of the bill and beyond.

The Executive is committedto securing substantial efficiency savings at Scottish Water as the principalmeans of easing pressure on water and sewerage charges for all customers,including those in low income and vulnerable households. In addition,particular assistance to low income households is provided through the linkbetween water charges and the council tax banding and discount arrangements.

TheExecutive is assessing the impact that ending the current Water and SewerageCharges Reduction Scheme will have in light of harmonisation of charges. Adecision on whether any further action is required will be made in light ofthis assessment.

In terms of collecting waterand sewerage charges, local authoritiesare currently responsible for collecting charges for domestic customers. Thisis an efficient and customer friendly way of charging. It enables customers to payfor two services with one bill; and it avoids them having to meet, throughhigher water bills, the costs that otherwise would arise from having toestablish and maintain a separate billing system for water and sewerageservices.

Thepractice of local authorities collecting water and sewerage charges is also thebasis of the crucial link between charges and the council tax banding anddiscount arrangements. Giving Scottish Water responsibility to collect chargeswould not only result in increased bills for customers, it would undermine thesearrangements to the detriment of low income and vulnerable households.

The Executive has no plansof directing Scottish Water to pursue a policy of household metering.

It is not possible todistinguish the symptoms of deep vein thrombosis which may have been triggeredby air travel from those of deep vein thrombosis in people who have not flownrecently or at all, so it would not be possible to issue such specificguidance. Though the Executive does not issue clinical advice to medicalprofessionals directly, the Scottish Intercollegiate Guidelines Network (SIGN),which is funded by the Executive, has issued advice on what may be done toprevent or reduce the risk of venous thromboembolism, including deep veinthrombosis, developing in the first place. The good practice clinical guidelineProphylaxis of Venous Thromboembolism was published in October 2002 andincludes a section on long distance travel. SIGN guidelines are made availableto the NHS at all levels, and are kept under regular review to take account ofnew published research.

All acute hospitalsthroughout Scotland will be able to treat DVT. The treatment is not normallycomplicated, however, and many cases are managed by the patient’s GP orself-managed by the patient after instruction. In cases of recurrent DVT, whichrequire investigation for an underlying predisposition to form clots(thrombophilia), screening is widely available across NHS Scotland.