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The creation of the Scottish Parliament and the development of this Plan are inextricably linked. They have 'grown up' together. Since the Scottish Parliament was established, health and NHS issues have been to the fore more than any other policy area. More correspondence, parliamentary questions and debates have been on health related issues than on any other subject.
This should perhaps come as no surprise, given that health and community care spending accounts for more than one third of the total devolved Scottish budget. It is also an issue which impacts on the life of everyone in Scotland.
The Executive welcomes the degree of scrutiny and public discussion of health issues which has taken place since devolution. We are particularly grateful for the constructive and informative role played by the Parliament's Health and Community Care Committee. We believe that the development of a healthier Scotland and a modern NHS depends upon the full and effective involvement of the public and requires a high level of public accountability for policy makers and public services.
We believe that all those with an interest in the health of our nation and in the future of our NHS should seek to foster well-informed, mature public debate on these vital issues. The Executive therefore hopes that the publication of this Plan will help to stimulate and inform that debate.
Health and devolution
In an average year before devolution some 1,500 parliamentary questions were asked of the Secretary of State for Scotland, across the full range of his responsibilities. In the first six months of this year there were 1,100 Scottish parliamentary questions on health related matters alone.
In the period immediately before devolution there was only one debate at Westminster on Scottish health issues, and that was a short adjournment debate. In the first 18 months of the Scottish Parliament there have been around 50 debates on health and community care matters.
This Plan is not just another Government policy document. It is a plan for action and a plan for change. And it is addressed directly to communities and patients: the people who value health and healthcare services and the people whose views count most.
The views and opinions of the public are at the heart of this Plan. Over 3,000 people contributed their views in one of the largest ever attitude surveys on the NHS in Scotland. The survey results are summarised at the end of the Plan. Ministers met patients and staff to hear about their experiences at first hand. Independent researchers conducted in-depth discussions with groups of staff and patients from Shetland to Irvine. Those views anchor the Plan in what matters to people in Scotland. Examples of what we heard appear throughout this plan.
The aims and priorities of this Plan find their roots in detailed policy statements developed over recent years both by Government and by a wide range of other organisations representing both patients and staff. The emphasis is on translating this policy into practice. Devolution gives us the opportunity. Investment gives us the means.
We now have, through this year's Spending Review, a substantial and sustained injection of new resources into the health budget. The health budget is due to rise from £4.9 billion in 1999-2000 to £6.7 billion in 2003-04. We are now investing more than £1,000 every year in health for every person in Scotland. Our funding proposals set out in Fair shares for all mean that, for the first time, we have a formula for distributing funds to NHS Health Boards that fully recognises the influence of deprivation and remote and rural areas on Scotland's health and healthcare needs. Every NHS Health Board will receive an increase in funding of at least 5.5% in 2001-02 - twice the current rate of inflation.
This is investment for a purpose: to improve our health and create a 21st-century health service. Among our investment priorities are:
New and continuing investment in health and healthcare allows us to break away from the short-termism of the past and make that investment count for the future. We will invest to modernise the NHS. We will invest to allow the NHS to address national priorities. Not just for today's health needs - but also for those of our children.
The Plan is a milestone and a signpost on the way to a healthier Scotland. For key parts of the health and healthcare system, it:
This Plan is the start of a process not an end in itself. It does not, nor should it, address every action and every area of work that is necessary to bring change about. It sets direction. It identifies priorities. Over the next few months, we will publish detailed change programmes covering:
We will welcome views on how change can be achieved. Anyone who wants to contribute can contact us at the addresses set out at the end of this document.
Delivering change demands a lead from government, and this Executive will provide that lead. But better health cannot be achieved just by Government regulation or by spending more money. Change happens where people at the front line are given the responsibility, the freedom, the skills and the resources to do a better job. We must change the culture of health and healthcare services to give people better healthcare services and make Scotland a healthier nation.
Publication of this Plan also marks a step change in our drive to identify, describe and disseminate good practice and, in turn, to improve standards universally and fairly across Scotland. We can learn from good practice across Scotland. Examples are highlighted throughout this document. We can also look beyond our own national boundaries to draw upon experience from elsewhere in the UK and abroad where this will be of benefit to our work here in Scotland.
Each section of this Plan describes ways in which the Executive will work with the NHS in Scotland and other key stakeholders in the coming months to improve health, reduce health inequalities, promote social justice and take forward change.
This Plan sets a challenge for the Executive, the NHS, Local Authorities and others. Every person in Scotland has a stake in better health. Everyone can contribute ideas, energy and commitment. To achieve our core aims, we will work with everyone who wants better health for themselves and for Scotland.
"THIS PLAN IS NOT JUST ANOTHER GOVERNMENT POLICY DOCUMENT"
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