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NHS boards are required to meet the health care needs of their resident population from within the funding made available to them. Ending car park charges does not change that and brings those NHS boards which currently charge into line with the nine NHS boards which have not introduced car parking charges.

Funding is being made available to assist those NHS boards which have factored car parking income into their financial plans over the financial year 2008-09. This action will give those NHS boards time to put in place measures to manage the financial implications of the removal of car park charges from 1 April 2009 onwards.

The Scottish National Blood Transfusion Service plan to publish the results of the consultation on their strategy for the next five years by the end of September 2008.

Distant Islands Allowance is paid to eligible staff by NHS Highland, NHS Orkney, NHS Shetland and NHS Western Isles. Total costs for each board have been as follows:

NHS Board	2005-06 £000	2006-07 £000	2007-08 £000
NHS Highland	48	57	56
NHS Orkney	371	523	567
NHS Shetland	840	840	840
NHS Western Isles	579	712	725

 

The funding for hospital and community health services and GP prescribing is determined by the Arbuthnott formula. This formula is designed to take account of any unavoidable excess costs of supplying services to a board''s population, including the Distant Islands Allowance. Under Arbuthnott and the revised NHSScotland Resource Allocation Committee formula, the island NHS boards receive higher cost adjustments than any of the mainland boards, reflecting their unique position and costs pressures.

The funding for hospital and community health services and GP prescribing is allocated to the 14 mainland and island NHS Boards via the Arbuthnott formula. The formula determines the share of funding received by each board based on the relative need for health care services of their population, adjusted for the unavoidable excess costs of supplying services to them.

For hospital services, the Arbuthnott formula includes an adjustment based on the relationship between the costs of delivering services and an indictor of remoteness. The costs are based on the ratio between a board''s actual expenditure and what their expected expenditure would be if they delivered services at the national average cost. The remoteness indicator is based on the number of road kilometres per 1,000 people. For community health services, the adjustment is based on a combination of a model that simulates travel times and costs in different geographical areas and the costs of providing services in remote general practices. Due to their relatively small size, the island boards receive a uniform remoteness adjustment.

The Arbuthnott formula has recently been reviewed by the NHSScotland Resource Allocation Committee (NRAC) and their revised formula will operate from 2009-10. The revised excess costs adjustment for hospital services takes account of the difference between delivering a given service at national average costs and the actual local cost. NRAC took account of concerns raised by rural NHS boards by including two separate categories for island towns and island rural areas in their costs adjustment. This will help to ensure that the particular issues related to delivering services on islands are fully recognised. The island categories receive the highest cost adjustment of any category of residence used in the proposed formula. The community services adjustment was updated to reflect up to date data.

Health expenditure per head of population in 2006-07 was as follows:

NHS Orkney	£1,955
NHS Shetland	£1,799
NHS Western Isles	£2,253

 

Health expenditure per head of population for the Argyll islands is not available.

No. After careful consideration we have concluded that NHS Orkney''s plans to reorganise GP cover will not be subject to independent scrutiny.

The Cabinet Secretary for Health and Wellbeing wrote to the chair of NHS Orkney on 16 August 2008 regarding the matter of independent scrutiny for the reconfiguration of GP services.

Independent scrutiny will only be applied to cases of major service change and only where the benefits outweigh the costs. This will be judged on a case-by-case basis by Ministers and the bar will be set high.