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NHS Reform (Scotland) Bill Briefing 69




Briefing 69 on...

NHS Reform (Scotland) Bill

August 2003


This briefing paper provides an overview of the NHS Reform (Scotland) Bill as introduced in the Scottish Parliament on 26th June 2003. This covers the first draft of the Bill as it has yet to have had a reading in the Scottish Parliament or be examined by any Parliamentary Committee.


In drafting this Bill the Scottish Executive intends to legislate to abolish NHS Trusts, establish community health partnerships, ensure co-operation in delivering regional services, increase public involvement and promote health improvement.

All of these policy objectives will be underpinned by new powers for the Scottish Ministers to intervene in the case of service failure, as a last resort, to ensure that health care is delivered to acceptable standards.

Each of the issues are described further in the following sections.

Policy Objectives

Dissolution of NHS Trusts

Although the Scottish Executive expects that the remaining NHS Trusts will be dissolved voluntarily using existing powers; the Bill will remove all references to NHS Trusts from the Statute Book.

Community Health Partnerships (CHP's)

The Bill makes provision requiring Health Boards to submit for approval by the Scottish Ministers schemes for the establishment of CHP's, which would cover the whole Health Board area.

The development of community health partnerships (CHPs) are seen by the Scottish Executive as a key building block in the modernisation of services, with a vital role in partnership, service integration and redesign.

The policy intention is to see CHPs, as successors to Local Health Care Co-operatives (LHCCs), having a more consistent and strengthened role in service planning and delivery, with better accountability to local communities.

This will also include the development of a local public partnership forum (PPF) for each CHP to support effective dialogue with local communities.

It is not intended that CHPs should become independent bodies separate from Health Boards, but that they should have a statutory function within Boards, thereby providing those involved in the provision of community based care a greater say in the design and delivery of services.

Regional Planning

The Scottish Executive believes that there are some services that may be better carried out at a national or regional level. One example is the Managed Clinical Networks (MCN's) for cancer services which are organised on a regional basis.

This requires closer co-operation between Health Boards and other agencies (such as the Scottish Ambulance Service, NHS24 etc). The Bill provides Health Boards with a statutory duty to co-operate with each other with a view to securing and advancing the health of the people of Scotland.

Ministerial Intervention

The Scottish Executive believes that their current powers to intervene in any part of the NHS that is failing to meet key standards are too slow and cumbersome. The Bill therefore allows Ministers to transfer responsibility for failing services or those likely to fail, to another Health Board or expert team.

Before invoking these powers the Executive should have explored other means for restoring the service, or quality of service.

Public Involvement

The Bill will impose a duty to secure public involvement on Health Boards and Special Health Boards while abolishing local health councils and replacing them with a new public involvement structure.

This new body, the Scottish Health Council, will monitor the performance and effectiveness of Health Boards in relation to public involvement, and will report regularly on the results.

To aid the Scottish Health Council there will be Local Advisory Councils in each Health Board area, providing information on local views relating to the involvement activities of their local health services.

The Local Advisory Councils are also expected to develop good links with local voluntary organisations and patient groups to promote good communication and partnership between all those with an interest in public involvement.

Health Promotion

The Bill provides Ministers with a specific duty to promote health improvement. It enhances both Ministers and Health Boards capacity to act, other than through the NHS and voluntary organisations as at present, and to provide a link to the community planning agenda.

This gives Ministers the powers to allocate funding directly in support of health improvement as well as allowing greater opportunities to direct how such monies are spent by local authorities and other bodies.


The implementation of this Bill will have an impact on the organisation of the NHS in Scotland. There are a number of implications of which members should be aware.

Although UNISON Scotland generally supports the abolition of NHS Trusts there may be implications concerning the transfer of Trust staff. The Community Health Partnership's also raise staffing issues, especially concerning those who may be directly employed by Local Health Care Co-operatives.

There are also other implications relating to public involvement with some concern that the new Scottish Health Council will be too centralised.

Action for Branches

This briefing is primarily for information purposes, however branches should look at the Bill and discuss the implications for members and for the NHS in general.

UNISON Scotland will also be responding to a separate consultation on Community Health Partnerships, which will be on our website.


Further Information

Contacts list:

Kenneth MacLaren: k.maclaren@unison.co.uk

Dave Watson: d.watson@unison.co.uk

@ The P&I Team
14 West Campbell St
Glasgow G26RX
Tel 0845 355 0845
Fax 0141-307 2572