NHS Scotland

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NHS Scotland
NHS Scotland.png
Wfm victoria quay.jpg
Many central functions of NHS Scotland are housed at the Scottish Government's Victoria Quay building in Leith, Edinburgh.
Public healthcare service overview
Formed 1948
Preceding agencies Highlands and Islands Medical Service
Emergency Hospital Service
Jurisdiction Scottish Government
Headquarters St Andrew's House, Regent Road, Edinburgh, EH1 3DG
Employees 140,000
Annual budget £11.35 billion (2010-11)
Minister responsible Alex Neil, Cabinet Secretary for Health and Well-being
Deputy Ministers responsible Shona Robison, Minister for Commonwealth Games and Sport
Michael Matheson, Minister for Public Health
Public healthcare service executive Derek Feeley, Director-General Health and Social Care and Chief Executive of NHSScotland
Parent department Health and Social Care Directorates
Child agencies 14 regional NHS Boards
Healthcare Improvement Scotland
NHS 24
NHS Health Scotland
NHS National Services Scotland
NHS National Waiting Times Centre
Scottish Ambulance Service
State Hospitals Board for Scotland
Key documents National Health Service (Scotland) Act 1947
National Health Service (Scotland) Act 1972
National Health Service (Scotland) Act 1978
National Health Service Reform (Scotland) Act 2004
National Performance Framework
Single Outcome Agreements
Website Official website

NHS Scotland is the publicly funded healthcare system in Scotland. Health and social care policy and funding are the responsibility of the Health and Social Care Directorates of the Scottish Government. The current Cabinet Secretary for Health and Well-being is Alex Neil and the head of staff is the Director-General Health and Social Care and Chief Executive of NHSScotland, Derek Feeley.[1]

NHS Scotland had an operating budget of £11.35 billion in 2010–11, funding the employment of approximately 140,000 staff, including more than 47,500 nurses, midwives and health visitors and over 3,800 consultants. In addition, there are also more than 12,000 doctors, family practitioners and allied health professionals, including dentists, opticians and community pharmacists, who operate as independent contractors providing a range of services within the NHS in return for fees and allowances.[2]

Health and social care are devolved issues in the United Kingdom and the separate public healthcare bodies of Scotland, England and Wales are each commonly referred to as "National Health Service". The NHS in Scotland was created as an administratively separate organisation in 1948 under the ministerial oversight of the Scottish Office, before being politically devolved in 1999. This separation of powers and financing tends to be hidden from the general public due to the co-ordination and co-operation where cross-border emergency care is involved.

Origins and history[edit]

The service was founded by the National Health Service (Scotland) Act 1947 (since repealed by the National Health Service (Scotland) Act 1978). This Act provided a uniform national structure for services which had previously been provided by a combination of the Highlands and Islands Medical Service, local government, charities and private organisations which in general was only free for emergency use. The new system was funded from central taxation and did not generally involve a charge at the time of use for services concerned with existing medical conditions or vaccinations carried out as a matter of general public health requirements; prescription charges were a later introduction in 1951.

Before 1948[edit]

Prior to the creation of Scotland's NHS in 1948, the state was involved with the provision of healthcare, though it was not universal. Half of Scotland’s landmass was already covered by the Highlands and Islands Medical Service, a state-funded health system run directly from Edinburgh, which had been set up 35 years earlier. In addition, there had been a substantial state-funded hospital building programme during the war years. Scotland also had its own distinctive medical tradition, centred on its medical schools rather than private practice, and a detailed plan for the future of health provision based on the Cathcart report.[3]

Health Boards[edit]

Current provision of healthcare is the responsibility of 14 geographically-based local NHS Boards and a number of National Special Health Boards. In April 2004 the NHS became an integrated service under the management of NHS Boards. Local authority nominees were added to Board membership to improve co-ordination of health and social care. Trusts were abolished and hospitals are now managed by the acute division of the NHS Board. Contracted services such as GPs and pharmacies are contracted through the NHS Board, but work in Community Health Partnerships based largely on local authority boundaries and serving up to 100,000 people and including local authority membership of their Boards. Some now also provide social care now called Community Health & Care Partnerships

Elections to Health Boards[edit]

In January 2008, the Scottish government announced plans for legislation to bring in direct elections to Health Boards, believing that such a measure would help restore public confidence.[4]

NHS Scotland Health Boards
No Name
1 NHS Ayrshire and Arran
2 NHS Borders
3 NHS Dumfries and Galloway
4 NHS Western Isles (Gaelic: Bòrd SSN nan Eilean Siar)
5 NHS Fife
6 NHS Forth Valley
7 NHS Grampian
8 NHS Greater Glasgow and Clyde
9 NHS Highland
10 NHS Lanarkshire
11 NHS Lothian
12 NHS Orkney
13 NHS Shetland
14 NHS Tayside
15 NHS24
Map of Health Boards

Former Health Boards[edit]

NHS Argyll and Clyde now no longer operates. Its responsibilities were shared between NHS Highland and NHS Greater Glasgow on 1 April 2006, and the latter was renamed NHS Greater Glasgow and Clyde. The part of the NHS Argyll and Clyde area which transferred to NHS Highland corresponds to the Argyll and Bute council area.

Special Health Boards[edit]

Local Health Boards are supported by a number of non-geographical Special Health Boards providing national services(some of which have further publicised subdivisions), including:

Other divisions[edit]

Other subdivisions of the Scottish NHS include:-

Health Protection Scotland (Part of NHS National Services Scotland responsible for health protection)

Scottish National Blood Transfusion Service

Central Register[edit]

The Central Register keeps records of patients resident in Scotland who have been registered with any of the health systems of the United Kingdom.[14] It is maintained by the Registrar General. Its purposes include keeping GPs' patient lists up to date, the control of new NHS numbers issued in Scotland and assisting with medical research.

Patient identification[edit]

Scottish patients are identified using a ten-digit number known as the CHI Number.[15] These are used to uniquely identify individuals, avoiding problems such as where health records of people with similar birth dates and names may be confused, or where ambiguously spelled or abbreviated names may lead to one patient having several different health records. In addition, CHI numbers are quoted in all clinical correspondence to ensure that there is no uncertainty over the patient in question. A similar system of NHS reference numbers has since been instituted by NHS England and Wales.

Overseeing and representative bodies[edit]

The Mental Welfare Commission for Scotland is an independent statutory body which protects people with a psychological disorder who are not able to look after their own interests. It is funded through the Scottish Executive Health Department, and follows the same financial framework as the NHS in Scotland.

The Scottish Health Council took over from local Health Councils on 31 March 2005.[16]

Quality of healthcare[edit]

There are various regulatory bodies in Scotland, as is the case throughout the UK, both government-based (e.g., Scottish Government Health Directorates, Nursing and Midwifery Council) and non-governmental-based (e.g., General Medical Council, Royal Colleges).

Recent developments[edit]

The SNP government, elected in May 2007, has made clear that it opposes the use of partnerships between the NHS and the private sector.[17] Health Secretary Nicola Sturgeon voiced opposition to what she termed the "creeping privatisation" of the NHS, and called an end to the use of public money to help the private sector "compete" with the NHS.[18]

In September 2008, the Scottish Government announced that parking charges at hospitals were to be abolished except where the car parks were managed under a private finance initiative scheme:[19]

Prescription charges were abolished in Scotland in 2011.

See also[edit]

References[edit]

  1. ^ "Strategic Board of the Scottish Government". Scottish Government. Retrieved 2011-06-06. 
  2. ^ About the NHS in Scotland NHS Scotland
  3. ^ What made Scotland different? 60yearsofnhsscotland.co.uk. Retrieved 25 October 2008.
  4. ^ Health Board elections outlined BBC News, January 2008
  5. ^ "NHS Health Scotland". Healthscotland.com. Retrieved 2010-07-11. 
  6. ^ "NHS Quality Improvement Scotland". Nhshealthquality.org. Retrieved 2010-07-11. 
  7. ^ "Scottish Ambulance Service". Scottishambulance.com. Retrieved 2010-07-11. 
  8. ^ "Golden Jubilee National Hospital". Gjnh.scot.nhs.uk. Retrieved 2010-07-11. 
  9. ^ "(Scottish Parliament Official Report 20 June 2002)". Scottish.parliament.uk. 2010-06-01. Retrieved 2010-07-11. 
  10. ^ "State Hospitals Board for Scotland". Show.scot.nhs.uk. Retrieved 2010-07-11. 
  11. ^ "NHS 24". NHS 24. Retrieved 2010-07-11. 
  12. ^ "NHS Education for Scotland". Nes.scot.nhs.uk. 2010-05-16. Retrieved 2010-07-11. 
  13. ^ "NHS National Services Scotland". Nhsnss.org. Retrieved 2010-07-11. 
  14. ^ [1][dead link]
  15. ^ "National Committee Services: CHI Advisory Group: About Us". Scottish Health Service Centre. NHS National Services Scotland. 2008. Retrieved 2008-11-30. 
  16. ^ "Scottish Health Council". Scottish Health Council. Retrieved 2010-07-11. 
  17. ^ http://www.scotland.gov.uk/News/This-Week/Speeches/Healthier/nhs-future
  18. ^ Plans to end private cash for NHS BBC News June 21, 2007
  19. ^ "NHS car parking charges abolished". BBC News. 2008-09-02. Retrieved 2009-02-07. 

External links[edit]