NHS Scotland
From Wikipedia, the free encyclopedia
 |
Please help improve this article or section by expanding it. Further information might be found on the talk page or at requests for expansion. (April 2007) |
NHS Scotland (sometimes NHSScotland) (Gaelic: SNN Alba or Bòrd slàinte na Alba) is the publicly funded healthcare system of Scotland.
The National Health Service (NHS) in Scotland is one of the original three national health systems created in the United Kingdom after World War II; it remains a separate body from the other systems although co-ordination and co-operation with the other systems in the UK tends to hide the organisational separation from their users where "cross-border" or emergency care is involved. In 2006, the NHS in Scotland had around 158,000 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.[1]
Healthcare policy and funding is the responsibility of the Scottish Government's Health and Wellbeing Directorate. The current Cabinet Secretary for Health and Wellbeing is Nicola Sturgeon and the Director-General (DG) Health and Chief Executive, NHSScotland is Dr Kevin Woods.[2]
Contents |
[edit] Origins and History
The service was founded by the National Health Service (Scotland) Act 1947 (since repealed by the National Health Service (Scotland) Act 1978). This Act did not originate free public health services in Scotland (which had already existed in some form for many years without universal application but provided a uniform national structure for services which had previously been provided by a combination of 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.
[edit] Health Boards
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 NHSBoards. 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 GP's 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
[edit] Elections to Health Boards
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.[3]
| NHS Scotland Health Boards | |||||||||||||||||||||||||||||||
|
|
||||||||||||||||||||||||||||||
[edit] Former Health Boards
NHS Argyll and Clyde is now defunct. Its responsibilities were shared between NHS Highland and NHS Greater Glasgow on 1 April 2006, and these boards are now named NHS Highland and Argyll and NHS Greater Glasgow and Clyde. The part of the NHS Argyll and Clyde area which transferred to NHS Highland corresponds approximately to the Argyll and Bute council area.
[edit] Special Health Boards
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:-
- NHS Health Scotland[4] (Public health and health education)
- NHS Quality Improvement Scotland[5]
- Scottish Ambulance Service[6] (The single public emergency ambulance service in Scotland)
- The Golden Jubilee National Hospital[7] is a special NHS Board in Scotland with the purpose of reducing waiting times using a single modern hospital located at Clydebank. It was previously a private sector hospital built at a cost of £180 million, but was bought in 2002 by the Scottish Executive for £37.5 million after it failed to produce a profit despite being established with the help of a subsidy provided by a previous government.[8]
- The State Hospitals Board for Scotland[9] is responsible for the State Hospital for Scotland and Northern Ireland at Carstairs, which provides high security services for mentally disordered offenders and others who pose a high risk to themselves or others.
- NHS 24[10] runs a 24 hour telephone helpline serving Scotland.
- NHS Education for Scotland[11] (training and e-library)
- NHS National Services Scotland[12] It is the common name for the Common Services Agency (CSA) providing services for NHS Scotland boards.
[edit] Other divisions
Other subdivisions of the Scottish NHS include:-
Health Protection Scotland (Part of NHS National Services Scotland responsible for health protection)
[edit] Central Register
The Central Register[13] keeps records of patients resident in Scotland who have been registered with any of the health systems of the United Kingdom. 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.
[edit] Patient Identification
Scottish patients are identified using a 10 digit number known as the Community Health Index or CHI[14] This number is normally formed using the patients Date of Birth followed by 4 numbers 2 numbers generated at random, a number identifying Gender at Birth (men are odd, women are even) and a check digit.[15] Uptake of this number varies throughout the Health Boards with the best being NHS Tayside with 99% usage and the worst NHS Dumfries and Galloway with 73% usage. See Section 2.17.K of[16]
[edit] Overseeing and Representative Bodies
The Mental Welfare Commission for Scotland is an independent statutory body which protects mentally disordered people 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[17] took over from local Health Councils on 31 March 2005.
[edit] Quality of Healthcare
There are various regulatory bodies in Scotland, as is the case throughout the UK, both government-based (e.g. Department of Health, General Medical Council, Nursing and Midwifery Council) and non-governmental-based (e.g. Royal Colleges). Some of these organisations have high world-wide standing.
With respect to assessing, maintaining and improving the quality of healthcare, unlike in the USA and many other developed countries where hospital accreditation groups independent of central government are utilised, the Scottish government take on both the role of suppliers of healthcare and assessors of the quality of its delivery through groups organised directly by government departments, such as SIGN.
This lack of separation of government from healthcare delivery is often seen as weakness and has the potential to over-politicise healthcare, especially over issues of funding and geographical distribution of services. The fact that the body who are underwriting the bills (ie. the government) have a political stake in how the NHS runs is potentially divisive. Scandals and other difficulties, such as hospital "superbugs", often become political issues simply as a result of media coverage, and the response is often driven by political considerations rather than by science and by evidence-based medicine. In addition, the problems of ensuring quality and improvement in the growing private sector in Scottish healthcare have not yet been solved.
To try to solve this problem, an independent hospital accreditation group, or groups, responsible for surveying hospitals and other healthcare facilities, similar to the role of the Joint Commission in the USA and the Trent Accreditation Scheme in Hong Kong, may be a viable alternative for solving some of these problems and concerns.
[edit] Current developments
The SNP government, elected in May 2007, has made clear that it is hostile to the idea of market led solutions to problems in the health service. Nicola Sturgeon signaled an end to future partnerships between the NHS and the private sector which she felt amounted to the use of public money to help the private sector "compete" with the NHS.[18]
[edit] References
- ^ About the NHS in Scotland NHS Scotland
- ^ Strategic Board of the Scottish Government. Scottish Government. Retrieved on 2008-01-01.
- ^ Health Board elections outlined BBC News, January 2008
- ^ NHS Health Scotland
- ^ NHS Quality Improvement Scotland
- ^ Scottish Ambulance Service
- ^ Golden Jubilee National Hospital
- ^ (Scottish Parliament Official Report 20 June 2002)
- ^ State Hospitals Board for Scotland
- ^ NHS 24
- ^ NHS Education for Scotland
- ^ NHS National Services Scotland
- ^ Central Register
- ^ CHI Advisory Group[1]
- ^ ISD Data Dictionary - Community Health Index (CHI) Number
- ^ Greater Glasgow and Clyde Delivery Plan 2007/08[2]
- ^ Scottish Health Council
- ^ Plans to end private cash for NHS BBC News June 21, 2007
[edit] External links
- NHS Scotland official website
- Map of all Uk Hospitals also showing accommodation for patients and visitors
|
|||||
