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Partnership for Care Scotland's Health White Paper Briefing 58


Partnership for Care Scotland's Health White Paper

March 2003
Scottish Executive Health Minister Malcolm Chisholm launched the Health White Paper Partnership for Care on Thursday 27 February 2003. The Executive claim the White Paper is about the promotion of heath in the broadest sense. It says it builds on its previous publication Our National Health: A plan for action, a plan for change, developing the themes of:

  • patients and national standards as key drivers for change

  • frontline staff as leaders of the change process.

White Paper Summary

In Summary the White Paper proposes:

  • Unified NHS Boards, abolition of NHS Trusts, and new requirements to devolve authority to frontline staff and to involve professionals.
  • New Community Health Partnerships, more accountable to local communities, better matched with social work services and better able to represent local interests within the NHS Boards.
  • A new Scottish Health Council to involve the public in NHSScotland
  • A Change and Innovation Fund to help NHS Boards improve services for patients.
  • A new guarantee of treatment on time, initially for certain heart surgery, but to be extended to services with national waiting time targets. New clinical and local service targets.
  • A Patient Information Initiative and a new complaints procedure, to give patients and carers better information and a stronger voice.
  • A Health Improvement Challenge focused on four groups: children in early years, teenagers, people at work and communities.

Legislation will be needed to implement some of these changes.

White Paper Detail

The White Paper looks at the seven themes detailed below:

Health Improvement

  • A new approach to improve health in Scotland and to reduce health inequalities. The approach links health with other areas of public policy Education, Housing, the Environment and Employment - recognising the role of Community Planning.
  • Involves statutory and voluntary sectors, working with local communities, trade unions and employers.
  • Health Inequality Indicators will work towards a target for reducing health inequalities will be set in consultation with Local Authorities and NHS partners.

  • New action focused on four broad areas: the early years, teenage transition, the workplace, and in communities.
  • Legislation to secure the place of Health Improvement in Community Planning.

Listening to Patients

  • A new statement of a patient's rights and responsibilities.
  • Patients treated as full partners in their healthcare.
  • Ensuring people's needs are met regardless of age, gender, ethnicity, disability, religion, sexual orientation, mental health, economic or other circumstance. Implementing Fair For All.
  • Recognising and supporting the roles of informal carers, and the voluntary sector.
  • Better NHS complaint handling with new legal rights if necessary.
  • Better health information through a Patient Information Initiative and NHS 24.

Quality, National Standards and Inspection

  • New waiting times targets, to be achieved through sharing good practice, supporting staff in redesigning services, leadership from the National Waiting Times Unit, maximising use of the former HCI, and booking spare capacity in the private sector for those waiting longest.
  • Patients and public involved in developing standards.
  • NHS Quality Improvement Scotland inspecting performance against standards.
  • Clear arrangements for intervention, with statutory powers to tackle service failure.

Partnership, Integration and Redesign

  • Legislation to create new Community Health Partnerships matched better with Social Work services and with stronger roots in the community. Development of the partnership with social care and the Joint Future Agenda.

  • New ways to involve health professionals and the public in redesigning services.

  • New Scottish Health Council to help the public engage with the Health Service.

Empowering and Equipping Staff

  • The White Paper recognises that a strengthened partnership between staff and employees involving Trade Unions is essential to the continual improvement of public services.
  • More resources for workforce planning and development; and new support for continuing professional development and training.
  • Better reward systems for staff at all levels.
  • Major investment in information services to achieve an Integrated Care Record.

Organising for Reform

  • Abolition of NHS Trusts.
  • A requirement on NHS Boards to devolve authority and involve clinicians in service redesign.
  • Cost-effective support services.

Roles and Responsibilities

  • A recognition of the roles and responsibilities of the Scottish Executive, employer, employees, trade unions, the voluntary sector, patients and the general public.

Issues for UNISON

UNISON Scotland initial response has been to welcome the introduction of this White Paper. Jim Devine, Scottish Organiser for Health described it as "practical, pragmatic and principled", and the next step in the strategy to create a healthcare system that is patient and client centred but also appreciates the contribution of its staff.

  • The role of trade unions and the work of the NHS in Scotland Partnership Forum is evident throughout the White Paper, with a clear acknowledgement to the role and value of staff and trade unions. The importance of consultation and partnership with trade unions is highlighted.
  • Equally the importance of staff involvement in service redesign and delivery is emphasised. UNISON must build on this.
  • Roles and responsibilities for patients is an important new perspective as UNISON campaigns against abuse towards staff.

  • The proposals to look at health in the workplace is to be welcomed, clearly trade unions have an important role to play.
  • Further development of the Joint Future Agenda has implications for UNISON's health and local government membership
  • The use of the private sector causes some concerns. We have to address the real issues of resources, skills and staff.
  • The greater involvement of the voluntary sector in the Partnership for Care raises issues of resources and capacity for UNISON members within the voluntary sector.

Action for Branches:

Branches should look at the White Paper and discuss the implications for members, the NHS and public health.


Further Information:

The Health White Paper: http://www.scotland.gov.uk/library5/health/pfcs-00.asp

Executive Summary: http://www.scotland.gov.uk/library5/health/hwps-00.asp

Patient Leaflet on White Paper:




Scottish Executive | Scottish Parliament | Briefings Home



See also...

The Health White Paper: http://www.scotland.gov.uk/

Executive Summary: http://www.scotland.gov.uk/

Patient Leaflet on White Paper: