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Scotland’s Spending Plans and Draft Budget 2011-12

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Chapter 8 Health and Wellbeing

PORTFOLIO RESPONSIBILITIES

The Health and Wellbeing portfolio is responsible for helping people to maintain and improve their health, especially in disadvantaged communities, and for delivering high quality healthcare. The portfolio works to provide good quality, sustainable and affordable housing, tackles homelessness and helps regenerate Scotland's communities. Our remit also includes tackling discrimination, promoting equality and sport.

SUPPORTING RECOVERY AND INCREASING SUSTAINABLE ECONOMIC GROWTH

Scotland's healthcare sector directly supports sustainable economic growth by providing continuous improvement in the quality of services it provides. It helps those out of work because of poor health return to employment and, by improving the health and wellbeing of those in work, reduces sickness absence, promotes motivation and increases productivity. As Scotland's single biggest employer, with more than 168,000 employees across the country, it makes an important contribution to local economies. The portfolio further contributes to sustainable economic growth by tackling the discrimination and inequality that prevent people from participating fully in the labour market and reaching their full potential.

The healthcare sector also contributes to economic growth through its significant investment in world-leading healthcare related research and development in medical and life sciences technology.

Tackling inequalities and promoting equality help to support more cohesive communities, foster good relations and create the conditions which make Scotland a more attractive place to come to visit, live and work.

The portfolio's lead role in supporting the 2014 Commonwealth Games will stimulate investment of around £2 billion in infrastructure for Games venues and associated transport networks and support an estimated 1200 jobs across Scotland. The Games will bring particular benefits to the East End of Glasgow where the injection of housing development and supporting infrastructure will promote sustainable economic growth. More broadly, our support for this and other major sporting events will create jobs and boost the tourism industry.

The portfolio has responsibility for regenerating Scotland's communities; working with partners to provide homes and places for people to live, work and flourish which in turn will enable them to contribute most productively to economic growth.

OUR NATIONAL OUTCOMES

The policies, activities and expenditure of the Health and Wellbeing portfolio contribute to all of our National Outcomes. Among the most significant are:

  • We live longer, healthier lives;
  • Our children have the best start in life and are ready to succeed;
  • We have tackled significant inequalities in Scottish society;
  • We have improved the life chances for children, young people and families at risk;
  • We live in well-designed, sustainable places where we are able to access the amenities and services we need; and
  • We reduce the local and global environmental impact of our consumption and production.

The portfolio makes the most significant contribution to ensuring that the people of Scotland live longer, healthier lives by providing high quality healthcare and by focusing on prevention and early intervention to reduce key health risk drivers of premature mortality, such as alcohol misuse, smoking, mental illness, and poor mental wellbeing.

The emphasis on early healthcare intervention from conception through early childhood within the portfolio will make a significant contribution to ensuring that our children have the best start in life and are ready to succeed.

The portfolio has an important role to play in tackling the significant inequalities in Scottish society through building on the success of Keep Well. We will also promote equality and fair treatment by promoting equality across our healthcare services, and will support NHS Boards in tackling discrimination, prejudice and the barriers to equality of opportunity.

The portfolio has an important contribution to make in improving the life chances for children, young people and families at risk, including support for preventative measures focusing on the early years, parenting support, education and learning support, employability services, drugs and alcohol services, community policing and services targeted at particular groups such as looked after children, offenders and children affected by domestic abuse.

The portfolio will give priority to regenerating Scotland's communities, helping to ensure that we live in well-designed, sustainable places where we are able to access the amenities and services we need. In particular, we will work with partners to ensure the right quality, quantity and types of homes and places for people to live and work. Assisting vulnerable households through the difficult economic times ahead will make a key contribution to the delivery of this outcome. Health facilities are designed to support sustainable delivery of health services and provide appropriate environments for the delivery of modern healthcare.

The portfolio will contribute to reducing the local and global environmental impact of our consumption and production through our investment in insulating our homes and tackling fuel poverty through the Energy Assistance Package and our Home Insulation Schemes and through a range of other programmes set out in our Energy Efficiency Action Plan.

OUR ACHIEVEMENTS

  • We have made a significant contribution to the marked reductions in mortality rates from the three big killers - cancer, heart disease and stroke. Over the past four years NHSScotland has made some significant improvements which have already improved outcomes for the people of Scotland. Between 1995 and 2009, there has been a 60 per cent decrease in premature mortality from Coronary Heart Disease ( CHD), a 54 per cent decrease from stroke and a 22 per cent decrease from cancer.
  • Since 2007 the initial Keep Well programme of inequalities targeted health checks has successfully engaged more than 85,000 people. Local outcomes of reductions in blood pressure and cholesterol, and of people quitting smoking as a result of the programme are very positive, and if sustained should in time lead to a reduction in cardiovascular mortality and morbidity.
  • On smoking, we acted decisively by increasing the age of purchasing tobacco from 16 to 18 on 1 October 2007. In May 2008, we launched a smoking prevention action plan, Scotland's Future is Smoke-free which set out an ambitious programme of measures designed specifically to prevent smoking among children and young people. We have invested record sums in smoking cessation measures - more than £40 million in the current Spending Review period. There has been an increase of 73 per cent in smokers successfully quitting (one month post quit date) with the support of NHSScotland stop smoking services.
  • We have backed our radical action on alcohol misuse with a record £100 million investment in prevention, treatment and support services. This, along with our reform of local Alcohol and Drug Partnerships is significantly improving services to those in need. Through the alcohol brief interventions programme, NHS Boards are on target to help almost 150,000 people to reduce their risk of requiring services in the future.
  • Through significantly increased investment we achieved a step change in Hepatitis C services, putting Scotland at the forefront of international efforts to tackle this condition, which has become a major public health challenge particularly among vulnerable groups.
  • We have ensured greatly improved access to services through significant reductions in maximum waiting times standards. Waiting times standards for a first outpatient consultation following a GP or dentist referral and for inpatient and day case treatment have reduced from 6 months to 12 weeks. A new standard for diagnostic tests for the eight key diagnostic tests such as MRI and CT scans of six weeks has been introduced. Cancer patients are treated faster than ever, with urgently referred patients being treated within 62 days.
  • We secured the delivery of Free Personal Care by providing an extra £40 million a year, agreeing with COSLA a fair and consistent approach to the delivery of Free Personal Care across the country. This will continue to improve the lives of older people and their carers.
  • We have made significant progress towards the abolition of prescription charges with charges currently reduced to £3. From 1 April 2011 we will abolish the prescription charge.
  • We were at the forefront of the successful UK-wide response to the H1N1 flu pandemic. Measures we took included a successful vaccination programme with higher uptake rates than in other parts of the UK, a doubling of critical care capacity, and the establishment of the Scottish Flu Response Centre within NHS 24 which reduced pressures in primary care and was a vital source of information for the Scottish public.
  • We have reduced the number of Clostridium difficile infections by 63 per cent and MRSA by 63 per cent, introduced a national screening programme for MRSA and invested more than £50 million in the fight against Healthcare Associated Infection. In our drive to continue to reduce Healthcare Associated Infections we have established an independent Healthcare Environment Inspectorate to improve standards in hospitals. The Inspectorate will ensure the highest standards of infection prevention and cleanliness with the aim of building public confidence.
  • In 2010 we jointly published with COSLA a Carers and Young Carers Strategy which sets a framework for action for the next five years aimed at supporting carers and sustaining them in their caring role, while enabling young carers to be children first and foremost. Further as set out in chapter 14, local government will continue to work with the Scottish Government towards maintenance of an extra 10,000 weeks respite provision.
  • We published Scotland's first ever Dementia Strategy and are making good progress towards meeting the national target to increase the number of people registered with a diagnosis of dementia.
  • We made considerable progress in implementing Living and Dying Well - a national action plan for palliative and end of life care in Scotland to ensure that people are supported to live as well as possible, in their preferred place of care, at the end of their lives.
  • We have invested in the child and adolescent mental health ( CAMHS) workforce with a 29 per cent increase since 2008, and have introduced a HEAT target to reduce the waiting time for access to specialist CAMHS services.
  • Nurse agency spend reduced by 69 per cent from £28 million in 2006-07 to £8.2 million as of 2009-10. Agency staff now only account for 0.6 per cent of total nursing and midwifery capacity.
  • We have continued to invest in the NHS and have successfully delivered a varied capital investment programme which totals £1.676 billion over three years - an increase of 19.9 per cent on the previous three years. In 2010 the First Minister opened the £17.7 million Aberdeen Dental School which exemplifies an innovative design and helps reduce the NHS's carbon footprint.
  • We kept open A&E services at Ayr and Monklands hospitals, reversing the previous administration's decision to close these services.
  • We established NHS Research Scotland ( NRS), an initiative initially developed to streamline the process of obtaining research and development approval for multi-centre research studies in Scotland, which will deliver major efficiencies to industry. This is regarded as crucial to attracting pharma industry to invest in research in Scotland.

We worked in partnership with colleagues across NHSScotland to establish a new shared focus on pursuing excellence in our healthcare services through the development of the Healthcare Quality Strategy for NHSScotland. This strategy will now become the overarching context for the prioritisation of policy development and improvement as we face the challenges of the future, both in terms of securing improvement in the quality of healthcare services, and in achieving the necessary efficiencies.

Housing and Regeneration

  • Responding to the credit crunch and recession, we supported the wider housing market and enabled the retention of skilled employees through accelerating £120 million of investment in affordable housing supply in 2008-09 and 2009-10, protecting an estimated 2,500 jobs.
  • Through a £80 million investment in new council houses we will support the construction of 3,300 new homes for social tenants and support more than 2000 jobs in construction and related trades. This is the first central government support for new council housing in more than 20 years and, combined with ending the right to buy on new social housing, will increase availability of council house stock.
  • Over the period 2007-10, 5,351 households were helped into home ownership through the Low cost Initiative for First Time buyers ( LIFT), including 2,625 households through the Open Market Shared Equity Pilot.
  • Over the period 2010-12, innovation in the financing and delivery of affordable housing for rent and ownership is delivering new affordable rented homes in rural areas in partnership with private landowners, and 100 households are being helped into home ownership in 2010-11 through a new supply shared equity scheme developed with the house building industry.
  • The National Housing Trust initiative, delivered through a financial partnership with 12 local authorities, is enabling the approval of at least 1,000 new affordable homes for rent including future options for home ownership.
  • Investment of £92 million in Urban Regeneration Companies has helped transform some of our most deprived communities and helped create jobs.
  • The Energy Assistance Package ( EAP) was introduced in April 2009 to assist families and older people suffering fuel poverty. More than 67,000 families were helped in the first year. The EAP will create or sustain over 400 jobs. The scheme and its predecessor, the Central Heating Programme, has installed over 40,000 heating and insulation measures since April 2007.
  • We introduced area-based Home Insulation Schemes offering free or low cost energy efficiency measures to 500,000 households which has helped them save money, address fuel poverty and combat climate change. Delivery from early phases has led to savings in household fuel bills worth £23 million over the lifetime of the measures.
  • Responding to the impact of the recession, we helped 850 households to avoid repossession by doubling funding for the Home Owner Support Fund, and introduced the strongest legislative protection anywhere in the UK for those at risk of repossession.

We continued to support local authorities as they move towards meeting the 2012 target that entitles all unintentionally homeless households to settled accommodation.

Sport

  • We were the successful bidder for hosting the 2014 Commonwealth Games and in our bid to improve Scotland's level of participation in sport we have started to roll out community sport hubs throughout Scotland with 24 already identified.
  • We have made considerable investment in upgrading and developing Scotland's sporting facilities infrastructure. Since 2008 we have provided over £11.5 million through sportscotland in direct support to projects across Scotland, as we believe that sport has the potential to significantly transform lives in every community. For example, over the past 3 years we have seen the upgrading of the pavilion and pitches at Seedhill Playing Fields in Paisley; enhancements to the mountain biking tracks at Fort William; new facilities for juniors players at Orkney Golf Club; and a new skatepark at Saughton in Edinburgh.
  • In addition we have invested over £16 million through our national and regional sports facilities strategy to help deliver a new Regional Indoor Football Centre at Toryglen in Glasgow; a new Sports Village in Aberdeen, the creation of the Peak Centre in Stirling and new state of the art sporting facilities at Ravenscraig in Motherwell.

Equalities and Social Inclusion

  • We supported a wide range of activity to promote and to tackle issues of inequality and discrimination, violence against women and domestic abuse.
  • We introduced the Forced Marriage Protection Bill in September 2010 which will provide civil remedies for those at risk of forced marriages and victims of forced marriage.
  • We developed for consultation a new set of public equality duties to help bodies take forward their responsibilities under the Equality Act 2010.

MANAGING PRESSURES AND CUTS IN PUBLIC EXPENDITURE

The scale of the total reduction in the Scottish Government budget for 2011-12 has required tough decisions to be taken about expenditure across government and careful consideration of pressures and priorities in all portfolios. However, the health budget has received the full Barnett consequentials of £280 million towards its resource budget. This has lifted the resource budget by 2.7 per cent to £10.8 billion. Within the Health and Wellbeing portfolio, the year on year cuts in cash terms on capital budgets is £171 million. Notwithstanding the increase in NHS funding, issues such as the ageing population, new technology and the cost of drugs means that the NHS will still face considerable budget pressures. These pressures mean that the NHS will need to deliver maximum value from our investment through a focus on increased efficiency while protecting the quality of care. Taking into account these pressures, we have considered all areas of expenditure within the Health and Wellbeing portfolio, the scope for efficiencies and the contribution that spending programmes make to sustainable economic growth and the delivery of portfolio priorities.

In respect of NHSScotland the fiscal environment will have an impact on the timing of delivery of some capital projects currently in development. The Scottish Government is exploring other financing options in conjunction with the Scottish Futures Trust to maximise capital investment in NHSScotland on a sustainable financial basis.

Key pressures within Housing and Regeneration in 2011-12 include meeting the commitments for capital investment made as part of the Economic Recovery Programme, and also maintaining a forward programme for new housing to continue progress towards our 2012 homelessness target, to support the economy and Scottish jobs, and to provide a range of housing options, particularly for people unable to access the housing market.

In order to reduce the level of spending within Housing and Regeneration, we have taken the following difficult decisions:

  • to reprofile some housing and regeneration capital spending; and
  • to focus the support available to those affected by the economic downturn.

OUR PRIORITIES

The Health and Wellbeing portfolio will be responsible for public spending totalling £11.9 billion in 2011-12. Funding allocated to healthcare will be £11.4 billion, of which Territorial Boards and Special Boards will receive a core allocation of £8.6 billion. £390.8 million will be allocated to Housing and Regeneration, £66.4 million to Sport, £27.5 million to Social Inclusion and Equalities and £10.9 million to the Food Standards Agency.

Our total healthcare funding in 2011-12 of £11.4 billion reflects an increase of £190.5 million. This comprises annually managed expenditure of £100 million, net capital funding of £488.2 million and resource funding of £10.8 billion. Resource funding has increased by £280 million, from £10,504.2 million to £10,784.2 million. This is the full amount of the budget consequentials arising from the increase to health in England and delivers on the Scottish Government's commitment to pass on the resource budget consequentials in full to the NHS in Scotland.

Health and Wellbeing

Building on the firm foundation established over recent years our key priorities for health for 2011-12 will be to:

  • protect the most vulnerable people in our society through early intervention and by promoting equality; and
  • achieve world-leading quality in healthcare and maximise value through increased efficiency.

Protecting the Most Vulnerable in Our Society though Early Intervention and Promoting Equality

We will continue to address the significant health inequalities that exist in Scotland. In recent years, significant advances have been made in protecting and enabling society's most vulnerable people but substantial challenges remain. We believe that action in children's early years is the most fundamental and effective form of early intervention to address poor health. Evidence shows that the early years are crucial in developing a person's strengths and the assets they will need to maintain their health and wellbeing in the future. We will also continue to support wider preventative services, such as parenting support, education and learning support, employability services, drugs and alcohol services, community policing and services, with a particular focus on vulnerable groups, such as looked after children, offenders and children affected by domestic abuse. We will do this by implementing the Getting it Right for Every Child approach across all relevant parts of our Health services.

Building on the success of the Keep Well/Well North programme of health checks, we will extend a programme of inequalities-targeted, high risk primary prevention to all NHS Boards' activities from 2012-13. Evidence tells us that this is an effective and efficient approach to delaying the onset of cardiovascular disease and to tackling excess premature mortality within deprived communities.

It is still the case that age, race, gender, gender identity, disability, sexual orientation and religion can impact on a person's health and wellbeing and, therefore, on Scotland's economic and social wellbeing. We will promote equality and fair treatment for people of Scotland and across Government activity to tackle discrimination, prejudice and the barriers to equality of opportunity.

Achieving World-Leading Quality in Healthcare and Maximising Value through Increased Efficiency

By concentrating on what really matters to people, we have established three Healthcare Quality Ambitions for Scotland which will focus our combined efforts to become a world leader in healthcare quality:

  • Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.
  • There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times.
  • The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.

We will implement the Healthcare Quality Strategy in partnership with Local Authorities, the independent sector and the public and will report on the progress we are making towards achieving our Healthcare Quality Ambitions and aim of becoming a world leader in healthcare quality.

We will provide a strengthened focus on supporting NHS Boards to increase efficiency and productivity and will prioritise approaches which simultaneously improve the quality of healthcare services but do not compromise quality, such as eradicating harmful and wasteful variation and implementing key modernisation programmes. As part of this process we will reduce the number of senior managers in the NHS by 25 per cent by the end of the next Parliament.

As part of our approach to achieving world leading quality in our healthcare services, we will continue our focus on tackling HAI through the work of the HAI Task Force.

Delivering world-leading healthcare services for people will require strong partnership working across health and care services. In recognition of the pressures on the health and social care system in a challenging fiscal climate, the Scottish Government has allocated £70 million in 2011-12 within the NHS Budget to a Change Fund for NHS Boards and partner local authorities to redesign services to support the delivery of new approaches to improved quality and outcomes. By ensuring that older people remain independent in their own homes, Health Boards and local authorities will be able to focus on reducing unnecessary hospital admissions and speeding discharge after a crisis. This will result in better outcomes for older people and ease the pressure on acute hospital provision.

The Reshaping Care for Older People programme will continue, as part of the implementation of the Healthcare Quality Strategy, to address the challenges faced by a rapidly increasing older population at a time of financial constraint while at the same time delivering better outcomes for older people. This will be achieved by remaining focused on the key policy goal of optimising the independence and wellbeing of older people at home or in a homely setting.

From December 2011, NHSScotland will deliver the 18 weeks Referral to Treatment standard. Shorter waits can lead to earlier diagnosis and better outcomes for many patients as well as reducing unnecessary worry and uncertainty for patients and their relatives. It also reduces inequalities by addressing variations in waiting times across Scotland.

Housing and Regeneration

We will support economic growth with an extra £600 million investment in new affordable housing supply through use of £55 million of new government funding, helping to support around 7,500 jobs. We will build around 6,000 new affordable homes, including for new social tenancies.

We will support Urban Regeneration Companies ( URC), with priority investment in Clyde Gateway URC to support delivery of a successful Commonwealth Games.

We will continue our successful Energy Assistance Package and Home Insulation Scheme.

Spending Plans for 2011-12 are set out below.

Table 8.01: Spending plans (Level 2)

2010-11
Budget
£m

2011-12
Draft Budget
£m

Health

11,181.9

11,359.8

Housing and Regeneration

488.0

393.8

Equalities and Social Inclusion

27.5

27.5

Sport

54.1

66.4

Food Standards Agency Scotland

10.9

10.9

Total

11,762.4

11,858.4

of which:

DEL Resource

10,747.5

11,014.4

DEL Capital

914.9

744.0

AME

100.0

100.0

Table 8.02: Spending plans (Level 2 real terms) at 2010-11 prices

2010-11
Budget
£m

2011-12
Draft Budget
£m

Health

11,181.9

11,148.0

Housing and Regeneration

488.0

386.5

Equalities and Social Inclusion

27.5

27.0

Active (including Sport)

54.1

65.2

Food Standards Agency Scotland

10.9

10.7

Total

11,762.4

11,637.4

of which:

DEL Resource

10,747.5

10,809.1

DEL Capital

914.9

730.1

AME

100.0

98.2

Health

Table 8.03: More detailed spending plans (Level 3)

Resource

2010-11
Budget
£m

2011-12
Draft Budget
£m

NHS and Special Health Boards

8,402.2

8,625.7

Education and Training

Workforce

25.9

28.5

Nursing

150.1

150.4

Primary and Community Care Services

General Medical Services 1

700.1

700.1

Pharmaceutical Services Contractors' Remuneration

187.8

186.0

General Dental Services

356.6

396.6

General Ophthalmic Services

88.0

93.0

Improving Health and Better Public Health

Health Improvement and Health Inequalities

51.1

58.5

Pandemic Flu

6.1

5.4

Health Screening

8.5

8.0

Tobacco Control

12.3

12.3

Alcohol Misuse

42.3

42.3

Health Protection 2

38.8

40.0

Mental Wellbeing

6.0

6.0

Healthy Start

8.5

12.4

Mental Health Legislation and Services

12.1

15.3

Specialist Children's Services

19.4

21.4

General Services

Research

64.6

68.6

Distinction Awards

28.0

26.0

Access Support for the NHS

101.3

101.3

Improvement and Support of the NHS

18.9

18.9

Clean Hospitals / MRSA Screening Programme

20.4

28.4

eHealth

100.0

90.0

Miscellaneous Other Services 3

158.4

152.3

Scottish Commission for the Regulation for Care 4

16.6

16.6

Resource Income

(119.8)

(119.8)

10,504.2

10,784.2

CAPITAL

594.4

496.7

Investment 5

(16.7)

(8.5)

Capital Income

577.7

488.2

AME - NHS Impairments6

100.0

100.0

TOTAL HEALTH

11,181.9

11,372.4

Transfer to Sport : Commonwealth Games 20147

-

(12.6)

Total8

11,181.9

11,359.8

Of which:

DEL Resource

10,504.2

10,771.6

DEL Capital

577.7

488.2

AME

100.0

100.0

Notes:

1. Allocations for 2011-12 for General Medical Services are still to be decided and are subject to UK pay negotiations with the professional groups concerned.
2. Hepatitis C Action Plan is now included within the Health Protection line.
3. £32 million has been transferred from Miscellaneous Other Services to Territorial Boards in respect of Prescription Charges funding in 2010-11. The balance of funding to fully abolish Prescription Charges is included in the increase in funding to Boards in 2011-12.
4. The Scottish Commission for the Regulation of Care will be merged within the new Social Care and Social Work Improvement Scotland ( SCSWIS) from April 2011.
5. The 2010-11 Capital Investment figure includes £20 million contingent funding in respect of Pandemic Flu which was not available for spend elsewhere in the health budget. After excluding this figure the reduction in capital spend is £69.5 million which reflects the Department of Health Consequentials reduction.
6. Health Impairments which is Annually Managed Expenditure was previously included within Miscellaneous Other Services.
7. Transfer to Sport: Commonwealth Games 2014. The £12.6 million additional funding for Commonwealth Games 2014 in 2011-12 has been identified from contingency funding for Pandemic Flu together with procurement efficiencies within eHealth.
8. 2010-11 position has been restated reflecting transfers in respect of the removal of the cost of capital following revised HM Treasury guidance, transfer of funding in respect of Adult Support and Protection Act to Local Government and other corporate transfers.

Table 8.04: Territorial and Special Health Boards spending plans

2010-11 Budget
£m

2011-12
Draft Budget
£m

Territorial and Special Health Boards

NHS Ayrshire and Arran

561.5

579.2

NHS Borders

163.2

168.3

NHS Dumfries and Galloway

235.8

243.2

NHS Fife

494.0

509.7

NHS Forth Valley

392.2

404.7

NHS Grampian

666.8

687.9

NHS Greater Glasgow and Clyde

1,835.3

1,893.5

NHS Highland

473.2

488.2

NHS Lanarkshire

793.9

819.0

NHS Lothian

1,005.5

1,037.4

NHS Orkney

30.8

31.8

NHS Shetland

35.8

36.9

NHS Tayside

580.9

599.3

NHS Western Isles

56.5

58.3

Total Territorial Boards

7,325.4

7,557.4

NHS Waiting Times Centre

37.8

38.2

NHS Scottish Ambulance Service

194.8

199.5

NHS National Services Scotland

253.2

248.2

NHS Quality Improvement Scotland

17.2

16.5

NHS State Hospital

33.9

34.3

NHS 24

56.9

57.4

NHS Education for Scotland

400.0

392.0

NHS Health Scotland

21.4

20.6

Total Special Boards

1,015.2

1,006.7

Other
Income

61.6

61.6

Total

8,402.2

8,625.7

Notes:

1. 2010-11 position has been restated reflecting transfers in respect of the removal of the cost of capital following revised HM Treasury guidance and other internal transfers.
2. Budgets for 2010-11 are indicative and will change as final funding allocations are calculated according to the NHS Resource funding formula that will be updated later this financial year and includes a provision for progressing towards parity in baseline formula.
3. NHS Quality Improvement Scotland will merge into Health Improvement Scotland as at April 2011.

What the budget does

The budget supports services and initiatives designed to help people in Scotland to live longer and healthier lives with reduced health inequalities; and to provide more sustainable, high quality and continually improving healthcare services close to home.

NHS Boards allocations will increase overall by 2.7 per cent. However, the increase for Territorial Boards will be 3.2 per cent, reflecting our commitment to direct resources as far as possible to frontline services.

To achieve this and also to support an increase for Special Boards delivering direct patient care, such as the Scottish Ambulance Service, we have adopted a different approach to 2011-12 funding where a differential efficiency target has been set.

NHS Boards provide free and universal frontline healthcare services for patients and their families. NHS Boards will build on their recent achievements in order to deliver quality healthcare services. They will continue to improve health and wellbeing through the millions of reliable frontline healthcare interactions that really matter to people. Through their Local Delivery Plans, NHS Boards will demonstrate how they will deliver accelerated improvements for key priorities including a continued focus on tackling health inequalities, improving access to elective mental health and substance misuse services, and reducing healthcare associated infection.

In addition to formula-based allocations to Territorial Boards, the capital budget will support the commencement of construction on the adult and children's hospitals as part of the New South Glasgow Hospitals Project.

The capital budget will also support delivery of projects across Scotland including the continuation of the £105 million Emergency Care Centre in Aberdeen due to complete in 2012-13 and completion of projects including Acute Mental Health Services in Dumfries; the Chalmers Hospital in Grampian; Migdale Community Hospital in Highland; Airdrie Resource Centre in Lanarkshire; the Royal Victoria Hospital in Edinburgh; and Nuclear Medicine facilities at Ninewells Hospital. Programmes will continue to support the replacement of vehicles and defibrillators by the Scottish Ambulance service, as well as national programmes to support radiotherapy equipment replacement and the roll out of the hub initiative. We will also ensure the delivery of a range of other health projects, including the Royal Sick Children's Hospital and Department of Clinical Neurosciences in Edinburgh through the NPD approach outlined in chapter 3.

In 2011-12 our priorities will be to:

  • protect frontline healthcare services;
  • implement Scotland's first National Dementia Strategy in full and take forward the work to improve post-diagnostic information and support and to improve the care in general hospital settings;
  • support older people and those with long term conditions to remain independent in their own homes or in the community, by a focus across Health Boards and local authorities on supported self management, reducing unnecessary hospital admissions and speeding discharge after a crisis;
  • support NHSScotland to eliminate waste and drive modernisation programmes;
  • support NHSScotland to achieve productivity and efficiency gains without compromising quality through the implementation of the new Efficiency and Productivity plan;
  • implement the Healthcare Quality Strategy;
  • identify and eradicate harmful and wasteful variation;
  • continue to reduce Healthcare Associated Infection;
  • continue to protect and enable the most vulnerable in our society by addressing health inequalities and, through early interventions, to support our children;
  • deliver the 18 week Referral to Treatment standard;
  • continue to address the major public health challenges facing Scotland, including alcohol misuse, smoking, obesity, sexual health and Hepatitis C;
  • invest a further £25 million within NHS Boards to keep our commitment to abolish prescription charges;
  • continue to fund free personal care;
  • deliver the Obesity Route Map Action Plan;
  • increase levels of physical activity and participation in sport;
  • support people in Scotland to maintain their health through commencement of the implementation of the recently enacted tobacco control legislation and the implementation of the provisions of the Alcohol Etc (Scotland) Act;
  • begin the roll out of abdominal aortic aneurism screening for men aged 65;
  • continue to work to support measures which respond to the needs of equality communities and help to address the inequalities they experience;
  • commence delivery of the three-week waiting time target for alcohol misuse services;
  • reflect the importance of our person-centred approach to improving healthcare quality by gathering new information and taking related action on patient, carer and staff experience and patient reported outcomes, and through the enactment of the Patients' Rights Bill;
  • continue to focus on patient safety by rolling out our successful approaches across acute, mental health and primary care;
  • maintain our commitment to research;
  • begin the implementation of the 25 per cent reduction in management costs; and
  • continue investment in new and replacement health facilities, IT and equipment.

Housing and Regeneration

Table 8.05: More detailed spending plans (Level 3)

2010-11
Budget
£m

2011-12
Draft Budget
£m

Supporting Economic Growth / Housing Supply 1

280.3

268.5

Supporting Sustainability 2

104.6

83.9

Supporting Transitions 3

77.4

57.2

Scottish Housing Regulator

4.7

4.2

Less Income

(20.0)

(20.0)

Non Recurring Budget Consequentials 4

41.0

-

Total

488.0

393.8

of which:

DEL Resource

167.0

153.9

DEL Capital

321.0

239.9

AME

Notes:

1. In 2010-11 includes resources from previous level 3s : AHIP - Regeneration Programmes - Private Housing.
2. In 2010-11 includes resources from previous level 3s : AHIP - Home Insulation - Energy Assistance Package - Private Housing.
3. In 2010-11 includes resources from previous level 3s : AHIP - Wider Role - Regeneration Programmes - Community Engagement - Tackling and Preventing Homelessness - Housing Voluntary Sector Grant Scheme - Social Housing - Private Housing - Communities Analytical Services.
4. In 2010-11 the Housing and Regeneration budget received non-recurring budget consequentials arising from UK budget announcements. (£31 million in respect of Supporting Economic Growth/Housing Supply (Affordable Housing Investment Programme) and £10 million for Supporting Sustainability (Home Insulation).

What the budget does

In 2011-12 we will meet the commitments for housing and regeneration capital investment which commenced during the recession and continue to support the economy and protect the supply of new homes. This can be achieved jointly with partners, using less taxpayer investment for each new home by leveraging more funding from other sources.

In detail, in 2011-12, we will:

  • introduce a new £50 million competitive funding arrangement to allow all suppliers to provide new affordable homes;
  • expand the National Housing Trust initiative to maximise the delivery of new affordable homes;
  • build on the successful developer New Supply Shared Equity pilot scheme;
  • maintain our successful Energy Assistance Package and Home Insulation Scheme;
  • use the new £50 million Scottish Joint European Support for Sustainable Investment in City Areas ( JESSICA) Fund to target sustainable investment in the most disadvantaged areas and then recycle gains into further projects in the future; and
  • give transitional support to tenants and homeowners to improve their options in the economic downturn - including the Home Owners Support Fund, Wider Role Fund and Open Market Shared Equity Programme focused on helping existing social tenants.

Equalities and Social Inclusion

Table 8.06: More detailed spending plans (Level 3)

2010-11
Budget
£m

2011-12
Draft Budget
£m

Promoting Social Inclusion

7.2

7.2

Promoting Equality

20.3

20.3

Total

27.5

27.5

of which:

DEL Resource

27.5

27.5

DEL Capital

AME

* The responsibility for the Social Inclusion budget will transfer to Education and Lifelong Learning portfolio in 2011-12

What the budget does

The budget supports wellbeing through cross-cutting work to tackle poverty and disadvantage, in particular, meeting our commitments in our tackling poverty framework Achieving our Potential.

In 2011-12, our priorities will be to:

  • implement our Child Poverty Strategy;
  • take forward the Tackling Poverty Board recommendations to further develop the Achieving Our Potential framework; and
  • embed tackling poverty considerations throughout mainstream services.

The equality budget is used to promote equality and fair treatment for the wellbeing of the people of Scotland to mainstream equality across Government activity and to tackle discrimination prejudice and the barriers to equality of opportunity.

In 2011-12, our priorities will be to:

  • support interventions which will promote equality, reduce inequalities and tackle disadvantage; and
  • focus on the equality issues around employment and the economy.

Sport

Table 8.07: More detailed spending plans (Level 3)

2010-11
Budget
£m

2011-12
Draft Budget
£m

Active - Sport and Physical Activity

42.5

39.2

Active - Glasgow 2014: Delivery of Commonwealth Games

11.6

27.2

Total

54.1

66.4

of which:

DEL Resource

38.0

50.5

DEL Capital

16.1

15.9

AME

What the budget does

The budget provides support for the development of physical activity and sport within Scotland in order to increase Scotland's level of participation and improve our national sporting performance. We will use the Commonwealth Games in Glasgow as a catalyst to encourage Scotland to become a healthier, fitter and more active nation.

There are also a range of programmes and interventions funded through other portfolios which contribute towards increasing physical activity and encouraging everyone to lead a more active lifestyle. Examples of this include the development of local and national walking and cycling routes, and of cycle training. These sustainable and active travel interventions amount to around £17 million in 2010-11.

The Sport budget provides the main contribution to the operational costs of staging the Glasgow 2014 Commonwealth Games. The Scottish Government is working in partnership with Glasgow City Council, Commonwealth Games Scotland and the 2014 Organising Committee to ensure that the Games are an outstanding success.

The activity above directly supports the aims set out in Preventing Overweight and Obesity in Scotland: A Route Map towards a Healthy Weight. In addition, the new school curriculum will include 2 hours of quality PE for all children and young people further supporting our ambitions for Scotland as a sporting/physically active nation.

Cashback funding has also been a significant contributor and has successfully utilised sport as a mechanism to engage young people through diversionary activities. This funding will continue to be used to provide opportunities over the spending review period, part of this is £2 million to be used to support sporting facilities.

In 2011-12, our priorities will be to:

  • sustain and improve participation in sport;
  • contribute to the successful delivery of the 2014 Commonwealth Games; and
  • implement a network of Community Sports Hubs which will bring together local people to participate in sport and physical activity in their own community.

Food Standards Agency Scotland

Table 8.08: More detailed spending plans (Level 3)

2010-11
Budget
£m

2011-12
Draft Budget
£m

Food Safety

7.3

7.3

Eating for Health

2.0

2.0

Choice (making it easier for consumers to make informed choices)

1.6

1.6

Total

10.9

10.9

of which:

DEL Resource

10.8

10.9

DEL Capital

0.1

-

AME

What the budget does

The Food Standard Agency Scotland ( FSASs') main purpose is to improve food safety and encourage a balanced diet. The primary focus of the work carried out by the FSA in Scotland is to protect the Scottish public from the risk of consuming contaminated food. The FSAS develops, delivers and implements effective policies, projects, scientific research and consumer engagement events.

In 2011-12, our priorities will be to:

  • protect and improve the health of the people of Scotland by ensuring food entering the market or produced in the UK is safe to eat;
  • reduce foodborne-illness and diet-related diseases through a proportionate, risk-based regulatory regime;
  • achieve reductions in levels of saturated fat, salt and calories in food products and encourage the development, promotion and availability of healthier options and portion sizes; and
  • enable all consumers in Scotland to make informed choices and to understand about food, hygiene and a healthy diet, both in the home and where they choose to eat.