Hansard

I agree absolutely with Des McNulty's point. I can assure him that my colleagues throughout the Executive are considering how all the resources that we put to work across Scotland can be used to tackle deprivation effectively. Of course, I have a particular responsibility to ensure that that is done effectively within the NHS. However, the NHS's capacity to work effectively in partnership with local authorities, voluntary organisations, social inclusion partnerships and many others will determine how effective they in turn can be.

At a national level, we have demonstrated our commitment to that area. Indeed, we have given increased impetus to it by fulfilling our pledge to create a health improvement fund. It is significant that although that fund is NHS money that is being channelled through local health boards, much of it will be targeted towards multi-agency projects and work that will be done jointly by the NHS and other bodies. An unprecedented £26 million package of investment is being funded from the entire Scottish allocation of revenues from the tax on tobacco.

On top of that package, we are investing £15 million in our major national health demonstration projects, which will provide test beds for action for the whole country. Again, those projects have been developed on a holistic, multi-agency basis and will consider how action can be taken to improve health on all fronts. I am pleased to say that the Have a Heart Paisley project, which is devoted to preventing coronary heart disease across a broad range of fronts, will be launched next week—in Paisley, as members might guess. The demonstration projects on children's health and sexual health will follow soon.

We are working on more initiatives, such as the new national physical activity task force, which will be launched early in the new year. Arrangements are also in hand for the appointment a national co-ordinator to drive forward work on improving the nation's diet.

Partnership is the key to success of all of our efforts: partnership within government; partnership between organisations such as the NHS, local authorities, schools and voluntary organisations; partnership with communities; and partnership with the Scottish people themselves.

Some important steps towards partnership were set out in the "Review of the Public Health Function in Scotland", which was led by Sir David Carter and published in December. The document laid the groundwork for significant changes and suggested new approaches, which we are introducing, such as building health boards into public health organisations, creating managed public health networks along the lines of managed clinical networks, reviewing the role of public health nurses and establishing the public health institute.

Backed by £1 million from the health improvement fund, the new institute will bring focus and drive to the many strands of public health activity. As I said in July when we committed ourselves to establishing the institute, its task is to make Scotland an example of what can be done. Scotland will be a case study in what needs to be done no longer. I am pleased to confirm that the new director will be appointed shortly and I look forward to the institute getting down to work at an early date.

As I have said before, as well as doing more and spending more to improve health, we must constantly strive to do better. We must act on the best evidence, make the most effective interventions, learn from others and share what we have learned.

I am pleased that Scotland has played a leading part in the joint ministerial committee on health, which brings together the devolved Administrations and the UK Government.

We are making important contacts further afield. I visited Finland earlier in the year and on Monday I met the European Community health commissioner, David Byrne, in Brussels. We had a useful and constructive discussion on how Scotland could contribute to and benefit from collaborative efforts to improve health on the European stage. This week I also met a range of non-governmental organisations and health experts from France and Finland. As well as learning from them, I was also pleased to be able to set out some of the groundbreaking work that is under way in Scotland.

These are two-way contacts and I am particularly pleased that a leading Finnish health expert, Erkki Vartianinen, will come to Scotland soon on a visiting fellowship. He will work with Scottish researchers and health boards on ways of tackling heart disease. As many members know, Finland has been highly successful in that area.

We held our first ever Healthy Scotland convention in July, which will be an annual event that brings together the full range of people who are working to improve our health. Side by side with Government, health and education professionals will sit alongside employers and trade unions, voluntary organisations and charities. They will come together to address a common goal, because that is as it must be if we are to be effective.

Closer to home, the Executive is taking action too. We have restructured the health department to integrate public health and the management of the NHS in Scotland, and we are forging closer working, policy development and spending plans across the Executive to improve health together.

We are creating the structures and the networks and we must continue to build on that work at a local level. I will give an example of how that is happening on the ground. The health care professionals who work in the new local health care co-operatives are the people for whom all the statistics that I have quoted become the daily, often heartbreaking, reality.

It is understandable that we talk a great deal about what goes on in Scotland's hospitals during our debates on the health service. However, we must remember that 90 per cent of contacts with the health service begin and end in primary care settings, with general practitioners, health visitors, midwives, pharmacists, community physiotherapists and occupational therapists, social workers and many others who work day in, day out to deliver better health and better health care in our communities.

The new LHCCs are crucial to the NHS's contribution to improved health at local level. LHCCs give us a local focus for primary health care, involving local authority services, voluntary groups and, most important, the community itself. That new way of working is enabling and empowering people to come together, not just to deliver services, but to assess and address the needs of the community itself.

We can learn lessons from such working patterns and apply them more widely. People can come together across traditional institutional boundaries to deliver services now and to play a key joint role in determining how resources should be invested in the future.

To deliver action and results on the ground we must help everyone into health, from children and young people through to adults during their working lives and as they get older. We need to help them not just in hospitals and clinics, but where they spend their lives: at home, in classrooms, in the community and in the workplace. Health starts at birth and even before. Children must get the best start in life, and I want us to reduce the numbers of low birth-weight children born in Scotland.

We are increasing support for health in the early years and will continue to do so. The health improvement fund is already being put to work, providing practical measures to make a difference. It is providing fresh fruit to infants to improve their diet, a new educational media campaign to promote better child and family health, and expanded health service support through sure start Scotland.

As children and young people develop, they need support that is shaped to meet their needs. We are investing to provide that support, through a major expansion of school breakfast clubs, starting with schools in deprived areas. We are providing more fruit and salad bars in schools, building on work in new community schools. We are introducing measures to reduce suicide among young people, particularly young men. We will also be creating a sexual health strategy and providing more support for advice services for young people, together with our national demonstration project Healthy Respect.