Seòmar agus comataidhean

Funding of £1.1 million tosupport the expanded remit of NHSScotland (CFS) will be made available in thenext financial year. In November, I approved the recommended option of a ShortLife Working Group set up to prepare an options paper in respect of theextension of the CFS’s counter fraud role from family health services to thewhole of the NHS in Scotland. That option was the provision of a full counterfraud service to NHSScotland, to include more extensive pro-active deterrenceactivities, through a centrally based, professionally qualified team of counterfraud specialists dedicated only to counter fraud work. The CFS is currentlyconsidering the practical aspects of expanding its remit, including officeaccommodation needs and recruitment, induction and training of additionalstaff, working with NHS boards to agree co-operative arrangements. For thispurpose, it has set up an extended role project team composed of existingstaff. Once arrangements are completed, the CFS will focus on its extendedrole. I should emphasise that there will be a concentration on deterrence andprevention activities to reduce fraud in the NHS to an absolute minimumalongside investigative activity. In the interim period, the CFS will continuewith its work of countering fraud in the family health services.

The information requested is shown in the following table

Percentage of:	1991 Census	2001 Census
Persons living in households with no access to a car	34	26
Economically active men who are unemployed 1	14	7
Persons living in private households with a density of more than one person per room	7	5
Employed persons who are in routine/semi-routine NS-SeC  occupational categories 2	36	28

Sources: 1991 Census data on car access andhousehold density are published in Housing & Availability of Cars (Scotland) Report and Report for Scotland (Part 1)

1991 and2001 data on economic activity and occupational category are published in the RegistrarGeneral's 2001 Census Report to the Scottish Parliament available on theGeneral Register Office for Scotland’swebsite (www.gro-scotland.gov.uk/grosweb/grosweb.nsf/pages/scotcen4)

2001 dataon car access in available on the 2001 Scottish Census Results On-Line website (www.scrol.gov.uk)

2001 dataon household density were provided by the General Register Office for Scotland

Notes:

1. Figuresare for males aged 16-74 and exclude full time students.

2. The 2001Census uses the new National Statistics Socio-economic Classification and the 1991Census data were retabulated to this classification for purposes of comparison.

The level of funding required by each NHS board area will be determined by the job plans agreed between individual consultants and their managers over the next few months.

Information on vacancies is reported annually by NHS trusts. Establishment and vacancy figures across Scotland for qualified speech and language therapy staff for each of the last five years are shown in the following table.

Speech And Language Therapy Vacancies Whole Time Equivalent Trend: At 31 March ^{1, 2}

Establishment	1999 1, 3	2000 1	2001 2	2002 2	2003
	660.9	640.8	773.0	790.0	837.1
Vacancies	44.6	25.9	45.6	57.2	55.7
Vacancies As Percentage Of Establishment	6.7	4.0	6.2	7.2	6.7

Source: Allied HealthProfessionals vacancies ISD(M)36, ISD Scotland. The vacancy figures relate toposts vacant at 31 March (except for the 1999 figure, which relates to postsvacant at 30 April), irrespective of when the vacancy arose.

Notes:

1. Figures for 1999 and 2000should be treated with caution because, in each year, two Trusts did notprovide the requested information.

2. Figures for 2001 and 2002should be treated with caution because, in each year, one Trust did not providethe requested information.

3. The 1999 survey waschanged to be collected at 30 April instead of 31 March.  This was due to Trustconfiguration.

The assessment of the impactof ending the scheme has now been completed.

The assessment entailed astatistical analysis of the impact that ending the scheme would have on thoseaffected by it.

In light of the assessment,the Executive has announced the continuation of the scheme beyond 31 March 2004.

The Executive consultedScottish Water, the Water Industry Commissioner and local authorities beforedeciding to extend the scheme.

Populations for each deprivation quintile based on the Carstairs Index of Deprivation relating to 1991 are provided in the following table.

Census populations by Carstairs Deprivation Quintile and Health Board

Carstairs Deprivation Quintiles : Population

Health Board	1-Least Deprived	2	3	4	5-Most Deprived	Total
Ayrshire and Arran	55,132	51,019	99,351	97,764	68,697	371,963
Borders	26,369	50,082	20,090	6,756	0	103,297
Argyll and Clyde	72,280	66,985	62,064	117,470	110,628	429,427
Fife	51,829	65,058	139,303	69,710	12,235	338,135
Greater Glasgow	148,621	76,120	86,822	117,566	467,925	897,054
Highland	25,587	81,951	74,770	19,328	1,533	203,169
Lanarkshire	19,957	117,027	96,185	147,794	171,348	552,311
Grampian	230,862	101,940	99,392	59,350	11,549	503,093
Orkney	0	19,608	0	0	0	19,608
Lothian	176,852	140,152	141,919	217,117	50,531	726,571
Tayside	102,374	92,376	62,909	49,789	75,575	383,023
Forth Valley	61,537	50,545	92,361	53,714	12,715	270,872
Western Isles	0	13,159	10,941	380	5,113	29,593
Dumfries and Galloway	28,830	68,093	19,734	30,964	0	147,621
Shetland	511	13,499	8,509	0	0	22,519
Scotland	1,000,741	1,007,614	1,014,350	987,702	987,849	4,998,256

Source: GROScotland, national census data.

Censuspopulations by Carstairs Deprivation Quintile and Health Board

CarstairsDeprivation Quintiles: % Population

Health Board	1-Least Deprived	2	3	4	5-Most Deprived	Total
Ayrshire and Arran	14.8%	13.7%	26.7%	26.3%	18.5%	100.0%
Borders	25.5%	48.5%	19.4%	6.5%	0.0%	100.0%
Argyll and Clyde	16.8%	15.6%	14.5%	27.4%	25.8%	100.0%
Fife	15.3%	19.2%	41.2%	20.6%	3.6%	100.0%
Greater Glasgow	16.6%	8.5%	9.7%	13.1%	52.2%	100.0%
Highland	12.6%	40.3%	36.8%	9.5%	0.8%	100.0%
Lanarkshire	3.6%	21.2%	17.4%	26.8%	31.0%	100.0%
Grampian	45.9%	20.3%	19.8%	11.8%	2.3%	100.0%
Orkney	0.0%	100.0%	0.0%	0.0%	0.0%	100.0%
Lothian	24.3%	19.3%	19.5%	29.9%	7.0%	100.0%
Tayside	26.7%	24.1%	16.4%	13.0%	19.7%	100.0%
Forth Valley	22.7%	18.7%	34.1%	19.8%	4.7%	100.0%
Western Isles	0.0%	44.5%	37.0%	1.3%	17.3%	100.0%
Dumfries and Galloway	19.5%	46.1%	13.4%	21.0%	0.0%	100.0%
Shetland	2.3%	59.9%	37.8%	0.0%	0.0%	100.0%
Scotland	20.0%	20.2%	20.3%	19.8%	19.8%	100.0%

Source: GRO Scotland, national census data.

This information is not heldcentrally. Where the presenting problem is primarily of sexual dysfunction werecognise that patients may benefit from specialist referral. The arrangementsfor such services will vary from health board to health board. Sexual dysfunctionmay underlie a host of presentations and is a feature of much chronic anddisabling disease. All healthcare professionals are likely to come across sexualdysfunction in a variety of settings.

We wish to spend the budgetin some of the more socially disadvantaged urban areas between February 2004and March 2006. City Councils were invited to bid for funds to support pilotprojects which would help to regenerate areas by providing improved access toemployment, training opportunities, shopping and health services and which fellinto 1 of the following 4 categories:

(1) a new scheme;

(2) an existing scheme whichis able to expand its services to a broader locality or more client groups;

(3) a new or existing schemewhich will work with a commercial operator for the first time; and/or

(4) a new or existing schemein a Social Inclusion Partnership area.

Individual care programmes,including psychological interventions, are a matter for clinicians inconsultation with the relevant professional staff/multi-disciplinary andmulti-agency team. Care and support in each case should always be based onindividually assessed needs.

Only Ebixa is currentlyindicated for treating moderate to severe dementia in Alzheimer’s disease.However, the Scottish Medicines Consortium recently advised that Ebixa was notrecommended for use in NHSScotland.

I have been given assurancesthat the appointment of a Nurse Director to NHS Quality Improvement is apriority for them, however delays in the implementation of their new structure,of which this post is a part, has delayed this appointment. The Nurse Directorof NHS Quality Improvement Scotland, who they assure me be in place by March 2004at the latest, will serve as a full member of the senior management team, willbe an Executive Director of the Board, and will report directly to the Chief Executive.