Seòmar agus comataidhean

The Scottish Government published the analysis of responses to the public consultation on successor arrangements and community care grants and crisis loans for living expenses on 27 February. We have been working with stakeholders to develop options for a successor scheme and have agreed with local authority leaders that we will work with local government to have a scheme in place for April 2013, which will be subject to review.

Territorial boards have been given a revenue resource allocation increase of £215 million for 2012-13, an average increase over the equivalent 2011-12 allocation of 2.9%. Special health boards allocations have increased by 0.8%; in addition, differential efficiency savings have been allocated to the elements of special boards budgets not providing direct patient care.

Details of Boards revenue resource allocations for 2012-13 and indicative figures for 2013-14 to 2014-15 are as follows:

The 2011-12 baseline on which the uplift has been calculated has been restated reflecting in-year recurrent allocations to both territorial and special health boards.

The uneven spread of revenue resource uplift across territorial boards is due to various funding allocations being made on a basis other than the NRAC formula i.e. £76 million Access Support, £32 million NRAC funding parity, £22 million Prisoner Healthcare transfer to NHSScotland and £10 million additional funding to support the Adult Social Care Change Fund.

The Capital allocation is part of a £2 billion capital programme during the four years of the CSR. In 2012-13 the allocation of £580.9 million represents a record high for the health capital investment programme.

Details of boards capital resource allocations for 2012-13 and indicative figures for 2013-14 to 2014-15 are as follows:

The Proceeds of Crime Act allows the Scottish Government to seize illegal gains from organised crime and uniquely, through the highly successful CashBack for Communities initiative, invest the ill-gotten gains of criminal activity back into community programmes, facilities and activities largely for young people to the ultimate benefit of Scottish communities across the length and breadth of the country.

I am rightly proud to be able to say that through CashBack, we have invested over £44 million to benefit some 600,000 young people and the communities they live in right across Scotland.

CashBack funding is not allocated on a geographical basis. Rather, the Scottish Government allocates available funds to partner organisations, who are responsible for running projects across Scotland; delivering outcomes to give our young people positive, purposeful and constructive opportunities to contribute to Scottish society.

I have today written to the Chief Executive of NHS Greater Glasgow and Clyde to confirm my decision in relation to the proposals concerning the inpatient mental health services previously provided by the Christie Ward at the Vale of Leven Hospital.

I have carefully considered all the available information and representations and am of the view that there are compelling arguments that the repatriation of the service is not in patients or local people’s interests. As such, I have approved the board’s decision.

When I approved the Vision for the Vale of Leven Hospital in July 2009, I specifically asked that further work was undertaken in relation to local adult inpatient mental health services which, at the time, were delivered from the Christie Ward. The board has previously made the case – which I accepted – that an inpatient mental health ward on the Vale site of 12 or less beds would not be sustainable, or in the best interests of patients. However, I wanted to defer a final decision in order that this be based on a report on the actual trends in demand. As such, NHS Greater Glasgow and Clyde and the Vale Monitoring Group which I set up to monitor the implementation of the vision were asked to consider demand for the inpatient service, as well as the provision of enhanced community services, over the agreed time period to ensure that the final decision taken would be fully informed by the best available information and meaningful trends in data. I am grateful to both the board and the monitoring group for the considerable work that has been undertaken to this end.

It is of course regrettable that some of the lay members of the monitoring group recently resigned their positions. I did, however, meet the former members on 9 November to listen to their views and ensure that they formed part of my consideration of the board’s proposal. I will also reflect carefully on their experiences and perceptions of the monitoring group in future decision making.

Whilst I recognise the strength of local feeling in support of the service previously delivered from the Christie Ward, I feel the board has made a compelling case that continuing to provide inpatient mental health services from Gartnavel Hospital, alongside enhanced community based services, is in the best interests of local patients. The evidence presented clearly demonstrates that local demand for the inpatient service is consistently running at fewer than 12 beds. That said, I note that there has been a recent upturn in demand and that the lay members of the monitoring group were understandably concerned that there is sufficient capacity for local need provided at Gartnavel Hospital; and that the boarding out of patients is minimised. In approving the board’s proposal, I have therefore asked that this activity is kept under close review to ensure that local people can continue to benefit from the inpatient service at Gartnavel, where this is clinically appropriate.

Whilst the demand for inpatient beds has received a great deal of attention it is by no means the only part of the consideration. It is certainly the case that in other areas in Scotland improvements in patient experience and outcomes have been achieved by moving to more community-focused mental health services. This also means that the vast majority of patients receive the care they need in their local community. I believe the board has provided compelling evidence which supports the increased provision of mental health services in the community; and which demonstrates how this shift in the balance of care has positively affected local patient and carer experience. Whilst welcoming the enhanced local provision, the lay members of the monitoring group sought assurance that local people would not be denied inpatient treatment where this is necessary. I know the board and local clinicians will be able to assure local people that patients will continue to receive high quality care which is appropriate to their clinical needs.

There is one additional element to the decision making in this case that was not apparent at the start of the process. The regrettable fire and destruction of the Christie Ward last summer has meant that the inpatient service for local people has been provided from Gartnavel Hospital for over a year. I am clear that there would need to be robust evidence to support repatriating the service on the Vale site. Given the important context noted above on service demand and enhanced community provision, and having carefully considered the clinical, financial and logistical issues, I am of the view that there are compelling arguments that the repatriation of the service is not in patients or local people’s interests.

Whilst I am convinced that this is the right decision I want to reiterate my commitment to a strong future for the Vale of Leven Hospital, as evidenced by my endorsement of the Vision for the Vale which ended a decade of damaging uncertainty. Local people can be assured that, under this government, high quality services will be maintained and developed at the Vale.

The Care Inspectorate and the Scottish Government produce publications annually which provide information about pre-school education and childcare provision across Scotland– as set out in the answer to question S4W-03810 on 15 November 2011.

There are no additional plans to centrally audit the use of private and community nurseries within local authority areas.

All answers to written parliamentary questions are available on the parliament’s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.