The Scottish Government

« Previous | Contents | Next »

Listen

HEALTH AND WELLBEING

Portfolio Responsibilities

People living in Scotland should enjoy the best physical and mental health they can, free from preventable illness and disability. Our people, in all their diversity, should have every opportunity to fulfil their potential and be the best that they can be. Good health and wellbeing and ensuring that people's life chances are not stifled by inequality because of, for example, their gender or ethnicity, are vital in delivering our Purpose.

By making Scotland healthier through tackling health inequalities and supporting healthier lifestyles and choices, supplemented by early interventions and anticipatory, responsive services, we will increase the productivity of Scotland's workforce, reduce absenteeism, improve public sector efficiency and increase participation in the labour market. By tackling discrimination and prejudice and supporting people and communities to flourish, we will contribute to making Scotland a fairer, safer and stronger place.

Our aim is to support people to lead longer, healthier lives and our approach will involve a particular focus on the health and wellbeing of the areas and communities with the worst health record.

This means taking on the challenge of the health inequalities that currently exist in Scotland, including the gap in healthy life expectancy, to improve the life chances that are needed to support better health. It also means ensuring that services are high quality, responsive, person-centred, convenient, and efficient. In response to increasing demands and expectations, Scotland's health and care services must continue to harness the most advanced technology and treatments and put these within reach of all of those who need them.

We also aim to ensure that the structural conditions are in place for people to reach their full potential. That means challenging the barriers to success for individuals and society by ensuring our policies are joined-up and that they are assessed for the impact on equality.

Policies and programmes within the Health and Wellbeing portfolio support the achievement of our objective for a healthier Scotland, promoting greater wellbeing among all those living in Scotland. They also underpin the delivery of other programmes across portfolios to promote equality and to tackle poverty, disadvantage, and discrimination.

The portfolio is responsible for developing and implementing effective policies and programmes that:

• protect and improve the health of the people of Scotland;
• tackle health inequalities;
• promote equality, and tackle discrimination, prejudice and disadvantage;
• provide high quality health care and social care services, person centred and close to home;
• promote social inclusion and reduce poverty;
• increase the supply of good quality, affordable housing and prevent and tackle homelessness;
• regenerate communities; and
• promote physical activity and participation and success in sport.

The Portfolio includes funding for the delivery of the Commonwealth Games 2014 and to support sporting performance as well as increasing participation in sports. Funding is also provided to the Food Standards Agency Scotland whose work is integral to supporting the agreed food and health priorities of the Scottish Government by aiming to improve the diet and nutrition and to help shift the balance from knowledge to lifestyle change.

Summary of Key Spending Priorities

The Health and Wellbeing portfolio is responsible for public spending totalling £11.7 billion in 2009-10.

This represents £2,281 for every person living in Scotland. The cost of running the NHS for 2009-10 will be approximately £11.1 billion. Around 70% of this is spent on pay costs. A further 12% is spent on prescription drugs, covering products dispensed in the community and in hospitals. The remainder of the NHS budget is invested in buildings and associated running costs, medical equipment, supplies and IT. As well as treating patients, this spending on the NHS also supports people to improve their health and prevent illness and so contributes to reducing inequalities.

The Health and Wellbeing portfolio will also improve the supply of good quality, affordable housing and help create successful and sustainable communities across Scotland, promote equality and tackle discrimination; promote sport and sporting success; regenerate communities; and promote social inclusion.

Local Government responsibilities for delivering national priorities and services relating to the Health and Wellbeing portfolio are set out within the Local Government section.

Our main priorities are briefly described below:

Improving health and better public health

We attach high priority to actions to improve health and prevent illness, as part of the outcome of increasing people's healthy life expectancy by:

• reducing the harm done by the misuse of alcohol;
• introducing immunisation to reduce the risk of cervical cancer;
• enhancing national screening programmes to help detect potentially serious illness early and to target anticipatory treatment; and
• actions to help people, especially children, tackle obesity in support of our diet and physical activity strategies.

Promoting equalities, reducing inequalities and tackling disadvantage

We will also introduce ranges of programmes and projects to promote equality, reduce inequalities and tackle disadvantage that address:

• increasing the supply of good quality sustainable housing;
• violence against women and hate crime;
• the promotion of equality, the mainstreaming of equality into government policies and activities and the reduction of discrimination and prejudice ; and
• cross-cutting and innovative approaches to tackle poverty and disadvantage.

Accessible, responsive and people-centred services

We will also have accessible, responsive and people-centred services which will:

• support the achievement in NHS Scotland of a maximum wait of 18 weeks from GP referral to a hospital consultant until treatment begins for patients by the end of 2011;
• introduce a new screening programme to detect MRSA in hospital patients at admission, and a continuation of work to prevent the spread of infection, reduce serious illness, and release hospital resources for use by other patients. In addition resources will be specifically utilised to tackle Clostridium Difficile ( C-Diff); and
• phasing out prescription charges for those who still pay for them and providing free eye tests for everyone.

Sport and the Commonwealth Games

We will increase participation in sport, improve sporting performance and achieve the successful delivery of the 2014 Commonwealth Games.

We also have a number of other priorities within the four main headings covering the Health and Wellbeing portfolio.

Spending Plans for 2009-10 are set out below.

Table 3.01: Detailed spending plans (Level 2).

Table 3.02: Detailed spending plans (Level 2 real terms) at 2008-09 prices.

Budget changes

Changes to our spending plans since the publication of the Draft Budget 2008-09 are as follows:

Health

• Increase funding for NHS and Special Health Boards by £9.4/10.2/10.3m, (including new funding of £8.0/8.3/8.5m), in respect of NHS Boards specific issues and pressures;
• increase of £36.6/46.1/43.7m from Miscellaneous Other Services to Pharmaceutical Services Contractors' Remuneration, General Dental Services and General Ophthalmic Services reflecting the settlement of one year deal for Pharmaceutical Services Contractors' Remuneration and General Dental Services and a three year deal for General Ophthalmic Services including a phased introduction of free eye tests for everyone in Scotland;
• re-phasing of eHealth programme by a decrease of £5.0m in 2008-09 and an increase of £5.0m in 2009-10.
• decrease of £6.2/6.2/6.2m, distributed across a number of programme lines, due to a reclassification of staffing costs for secondee / Scottish Government staff working in SG Health and Wellbeing; and
• further refinement to previous cost estimates distributed across a number of programmes by a decrease of £0.4/0.9/0.8m, reflecting further work undertaken since the Comprehensive Spending Review in 2007.

Housing and Regeneration

• increase of £30.0/70.0/-100.0m as part of a package of Scottish Government actions to strengthen the Scottish economy, delivery of affordable homes across Scotland will be accelerated by bringing forward up to £100 million of affordable housing investment to be spent this year and next, rather than 2010-11 as originally planned;
• Net decrease of £1.7/1.7/1.7m for Affordable Housing Investment Programme reflecting an increase of £0.4/0.4/0.4m from former Communities Scotland running costs budget and transfer £2.1/2.1/2.1m to Research and Analytical Services for housing related research previously funded from the Affordable Housing Investment Programme;
• decrease of £20.5/20.4/20.4m, following the abolition of Communities Scotland and the establishment of the Scottish Housing Regulator. Of this, £20.1/20.0/20.0m will be transferred to the Scottish Government's running costs and the balance added to the Affordable Housing Investment Programme;
• increase of £1.4/1.6/1.7m to Regeneration Programmes from local government, following an earlier over-allocation to Local Government for Community Regeneration Fund loan payments; and
• decrease of £3.0/3.0/3.0m following the abolition of Communities Scotland with Cost of Capital Charge and Depreciation budget being transferred to Scottish Government's Administration portfolio.

Wellbeing

• Decrease of £13.0/13.0/13.0m for Promoting Social Inclusion broken down as £11.6/11.4/11.3m transferred to Local Government for Fairer Scotland Fund and loan repayments programmes and £1.4/1.6/1.7m to Regeneration programmes; and
• decrease of £1.0/1.0/1.0m for Promoting Equality transferred to Age and Older People to take forward grants relating to "All our Futures: Planning for a Scotland with an Ageing Population".

Health

Table 3:03 More detailed spending plans (Level 3).

Notes:

1. Figures analysed by individual NHS and Special Health Boards in Table 3.04 below.

2 Allocations for 2008-09 to 2010-11 for General Medical Services are still to be decided and are subject to pay negotiations with the professional groups concerned.

3 Allocation for both Pharmaceutical Services Contractors' Remuneration and General Dental Services have now been agreed for 2008-09. Figures for 2009-10 and 2010-11 have not been agreed and will also be subject to negotiation for these two years.

Table 3.04: NHS and Special Health Boards spending plans.

Notes:

4. Budgets for 2009-10 and 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. The indicative budgets are based on an indicative 3.2% uplift to NHS and Special Health Boards; although the overall totals will remain the same, the individual NHS Boards figures will change for 2009-10 and 2010-11 following agreement of the updated NHS resource funding formula.

5. NHS and Special Health Boards receive funding on a net of income basis but funding at level 3 is shown on a gross basis with income shown on a separate line.

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.

The cost of running the NHS for 2009-10 will be approximately £11.1 billion. Around 70% of this goes on staff salaries - the NHS employs 150,000 people and is the single biggest employer in the country. A further 12% goes on prescription drugs, covering products dispensed in community pharmacies and hospitals. The remainder of the NHS budget goes into buildings and associated running costs, medical equipment and supplies, and IT. As well as treating patients, this spending on the NHS also supports people to improve their health and prevent illness, and so contributes to reducing inequalities.

In 2009-10 we will continue to support health improvement and reducing health inequalities by focusing resources as follows:

• reducing the harm done by the misuse of alcohol;
• introducing immunisation to reduce the risk of cervical cancer;
• adding to the existing national screening programmes to help detect potentially serious illness early;
• reducing smoking;
• actions to help people, particularly children, tackle obesity in support of our diet and physical activity programmes; and
• actions to strengthen primary care services in the most deprived areas of Scotland, identifying people at particular risk of preventable, serious ill health.

Budget changes

• Increase funding for NHS and Special Health Boards by £9.4/10.2/10.3m, (including new funding of £8.0/8.3/8.5m), in respect of NHS Boards specific issues and pressures;
• increase of £36.6/46.1/43.7m from Miscellaneous Other Services to Pharmaceutical Services Contractors' Remuneration, General Dental Services and General Ophthalmic Services reflecting the settlement of one year deal for Pharmaceutical Services Contractors' Remuneration and General Dental Services and a three year deal for General Ophthalmic Services including a phased introduction of free eye tests for everyone in Scotland;
• re-phasing of eHealth programme by a decrease of £5.0m in 2008-09 and an increase of £5.0m in 2009-10.
• decrease of £6.2/6.2/6.2m distributed across a number of programme lines, due to a reclassification of staffing costs for secondee / Scottish Government staff working in SG Health and Wellbeing; and
• further refinement to cost estimates distributed across a number of programmes by a decrease of £0.4/0.9/0.8m reflecting work undertaken since the Spending Review in 2007.

Housing and Regeneration

Table 3.05: More detailed spending plans (Level 3).

What the budget does

The Housing and Regeneration Level 2 contributes to our Purpose and Strategic Objectives by increasing the supply of good quality, affordable housing and regenerating Scotland's communities.

In 2009-10, we will:

• continue to work to improve the supply and quality of housing across all tenures;
• support first time buyers through shared equity schemes and develop a Homeowners' Support Fund to help home owners at particular risk of repossession as a result of the credit crunch;
• continue to support large-scale projects to achieve the comprehensive regeneration of targeted areas and to enable targeted regeneration action to tackle poverty in the most disadvantaged communities;
• following the recommendations to be made by the Scottish Fuel Poverty Forum, take forward policies to better achieve the target of eradicating fuel poverty; and
• continue to work with local government and third sector partners to prevent and tackle homelessness and to provide housing support services to vulnerable people to enable them to continue to live independently in their own homes.

Budget changes

• increase of £30.0/70.0/-100.0m - as part of a package of Scottish Government actions to strengthen the Scottish economy, delivery of affordable homes across Scotland will be accelerated by bringing forward up to £100m of affordable housing investment to be spent this year and next, rather than 2010-11 as originally planned. Some £60m will be committed from national government programmes ³ and, in line with the Concordat, a further £40m from local government;
• Net decrease of £1.7/1.7/1.7m for Affordable Housing Investment Programme reflecting an increase of £0.4/0.4/0.4m from former Communities Scotland running costs budget and transfer £2.1/2.1/2.1m to Research and Analytical Services for housing related research previously funded from the Affordable Housing Investment Programme;
• decrease of £20.5/20.4/20.4m, following the abolition of Communities Scotland and the establishment of the Scottish Housing Regulator. Of this, £20.1/20.0/20.0m will be transferred to the Scottish Government's running costs and the balance added to the Affordable Housing Investment Programme;
• increase of £1.4/1.6/1.7m to Regeneration Programmes from local government, following an earlier over-allocation to Local Government for Community Regeneration Fund loan payments; and
• decrease of £3.0/3.0/3.0m following the abolition of Communities Scotland with Cost of Capital Charge and Depreciation budget being transferred to Scottish Government's Administration Capital Charges budget.

Wellbeing

Table 3.06: More detailed spending plans (Level 3).

What the budget does

The social inclusion budget supports wellbeing through cross-cutting work to tackle poverty and disadvantage. 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. All of this is essential to supporting our Purpose of ensuring that there are opportunities for all of Scotland to contribute to, and benefit from, sustainable economic growth.

In 2009-10 we will continue the promotion of equality and the reduction of discrimination and prejudice and introduce cross-cutting and innovative approaches to tackle poverty and disadvantage.

Budget changes:

• Decrease of £13.0/13.0/13.0m for Promoting Social Inclusion broken down as £11.6/11.4/11.3m transferred to Local Government for Fairer Scotland Fund and loan repayments programmes and £1.4/1.6/1.7m to Regeneration programmes; and
• decrease of £1.0/1.0/1.0m for Promoting Equality transferred to Age and Older People to take forward grants relating to "All our Futures: Planning for a Scotland with an Ageing Population".

Sport

Table 3.07: More detailed spending plans (Level 3).

What the budget does

The Sport budget will support delivery of our priority goals for sport in Scotland: increasing participation, improving sporting performance and creating a legacy through major events such as the Olympic and Paralympic Games and Commonwealth Games. The elements of the Budget that relate to the delivery of the 2014 Commonwealth Games will help to support the work of the Organising Committee that is leading on the practical elements of games delivery. The early priorities of the Organising Committee are the establishment of appropriate systems, such as those relating to marketing, security, financial management and procurement. The Budget will also help to fund an extensive programme of site development at the Games venues. The Scottish Government funding will be supplemented by a proportionate contribution from Glasgow City Council.

Food Standards Agency Scotland

Table 3.08: More detailed spending plans (Level 3).

What the budget does

The Food Standards Agency Scotland ( FSAS) contributes to the Health and Wellbeing portfolio and is responsible for developing and running effective policies and programmes that:

• protect and improve the health of the people of Scotland;
• tackle health inequalities;
• to deliver nutritional aspects of the Scottish Governments 5 Strategic objectives (wealthier, smarter, healthier, safer and greener Scotland); and
• to enable consumers in Scotland to make informed choices on food and promote healthier eating, to reduce food borne illness and diet related diseases.

FSAS is responsible for devolved matters relating to food safety and standards in Scotland and is accountable to Scottish ministers.

It's role and responsibilities include:

• advising Ministers on food safety and standards issues;
• developing policy and proposing legislation;
• setting standards and auditing all 32 Scottish local authorities' food enforcement activities;
• giving the public advice on diet and nutrition and food; and
• providing timely and effective responses to food related incidents.

Central Government Grants To Local Authorities

Table 3.09: More detailed spending plans (Level 3).

What the budget does

Following the Concordat agreement between the Scottish Government and local authorities, most of the previous budget for ring-fenced grant was added to the budget for general support to local authorities. This table shows the seven remaining areas where there are ring-fenced grants to local authorities (or similar bodies) for housing and regeneration purposes.

« Previous | Contents | Next »