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While the Scottish Government sets strategic policies for the NHS in Scotland, it is for each NHS Board to plan their workforce to ensure that enough professional staff and facilities are available to provide the best possible care for patients in a variety of settings. NHS Boards account for Health Visitor staff retirement as part of the workforce planning process.

The age profile of the current Health Visitor workforce has been published by ISD Scotland since March 2015 to support workforce planning and can be found on the workforce statistics website at:-

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-06-06/Health_Visitors_M2017.xls

The Scottish Government does not hold this information centrally. Local information may be available from each NHS Board.

The commitment to increase the number of qualified health visitors by 500 is unprecedented and is almost a 50% increase in the number of qualified health visitors in Scotland. From March 2014 to March 2017 there are at least an additional 242 Whole Time Equivalent health visitors in post. The total number of students completing health visitor training courses from the September 2014 to June 2017 is 486.

Workforce data on Health Visitors in contracted hours (part-time or full-time) is published quarterly by ISD Scotland and is available from March 2015 onwards at the workforce statistics web site:-

https://www.isdscotland.org/Health-Topics/Workforce/Publications/2017-06-06/Health_Visitors_M2017.xls

Health Visitors were part of a recent review of community nurses data. Therefore, information on the Health Visitor workforce prior to March 2015 is not comparable with previous years.

The significant investment in training and recruiting additional health visitors by this Government since 2014 of over £40 million, the refreshed role of health visitors and the publication of a Universal Health Visiting Pathway: Pre-birth to pre-school in 2015 have all contributed to make health visiting an attractive career.

The Broadband 2.0 report that was published by the British Infrastructure Group of MPs in July 2017 raises some interesting issues, particularly around consumer protection in relation to broadband. However, the analysis of speeds which informed the league table of worst performing areas is somewhat flawed, in that it is primarily based on data gathered from consumer speed tests not actual broadband availability. As a result, the figures reflect the speeds available as part of individual consumers’ packages; not the top speed that may be available on faster, more expensive packages.

Ofcom’s annual Connected Nations reports set out information on both broadband availability and take-up across Scotland. Their 2016 report highlighted that, while there is still more to do in terms of extending coverage in our more rural authorities, superfast broadband coverage in Scotland increased by 14% over the last 12 months – the largest increase of any of the UK nations

Telecoms, like defence and foreign affairs, is a matter reserved to the UK Government, meaning UK Ministers have the power to force broadband infrastructure providers to do more, particularly in rural areas. However, to date, they have chosen not to do so and their emerging plans for a Universal Service Obligation for broadband fall well short of our ambitions. That is why the Scottish Government has committed to delivering 100% superfast broadband access by 2021.

The “Evidence Review of the Potential Wider Impacts of Climate Change Mitigation Options: Built Environment Sector” (http://www.gov.scot/Publications/2017/01/3358) published in 2017 to inform the draft Climate Change Plan found evidence that measures to improve the energy efficiency of homes, including by insulating them, can result in benefits to residents’ health, particularly among those living in fuel poverty. Physical health benefits can arise from warmer homes; and mental health benefits can arise from reduced energy bills and hence reduced stress.

In addition, GoWell, funded by the Scottish Government, published the research “Can housing improvements cure or prevent the onset of health conditions over time in deprived areas?” (http://link.springer.com/article/10.1186/s12889-015-2524-5/fulltext.html) in November 2015. This research indicated that receipt of fabric works was associated with higher likelihood of recovery from mental health problems and circulatory conditions. Receipt of central heating was also associated with higher likelihood of recovery from circulatory conditions. The research also noted that health gains from housing improvements appears most likely when targeted at those in greatest health need. GoWell also published in November 2016 “Housing improvements, fuel payment difficulties and mental health in deprived communities” (http://www.tandfonline.com/doi/full/10.1080/14616718.2016.1248526) which showed that increases in the difficulty to pay fuel bills is associated with worsening mental health. The analysis showed that the biggest positive impact on paying fuel bills was either gaining, or remaining in, employment.

The Fuel Poverty Evidence Review published in 2012 by the Scottish Government examined evidence on the relationship between cold homes and poor health outcomes. It concluded that there was evidence suggesting that there was an association between thermal comfort and physical and mental well-being.

The Scottish Government would welcome any commercial investment that will improve Scotland’s digital infrastructure. We would want any such investment, however, to help deliver the superfast broadband connections that our rural communities need, not just the 10Mbps that the UK Government has decided is sufficient; and we would be concerned if the form of the investment had a negative impact on the delivery of our investment plans.

It is vital, therefore, that the UK Government shares the full detail of BT’s proposal with us, so that we can assess whether and how it will contribute to Scotland’s superfast ambitions. We have again called upon the UK Government to set up a working group, involving the devolved administrations and Ofcom, to consider the impact of this offer as a matter of urgency.

The remaining infrastructure necessary for a national e-Purse is being procured and we are currently engaging with transport operators on implementation.

This issue was discussed at the Islands Transport Forum on 21 June 2017 at which both HITRANS and ZetTrans were represented.