National Service Framework published

Developed after public meetings around Scotland, it calls on people to take more responsibility for their own health, view the NHS as a service delivered mainly in local communities rather than hospitals, anticipate and prevent rather than react.

It leads to Delivering for Health, a programme of action to implement the recommendations. The framework was developed by a team headed by Glasgow-born Professor David Kerr, a cancer expert at Oxford University.

Abolition of NHS Trust

The 2004 Act completes the process of abolishing the internal market in Scotland. Health boards are now the single tier of governance and accountability.

New Community Health Partnerships are established with resources and decision making power to work with boards and involve patients and a broader range of staff in their work.

Paramedics give clot-busting drugs

Paramedics give clot-busting drugsThis highlights the huge transformation in the role of ambulance crews over sixty years. Basic stretcher bearers with first aid training at that time, they are now highly trained clinicians diagnosing and treating patients at the scene rather than just ferrying them to hospital.

In 1948, various fleets were operated by hospitals, the Red Cross, St Andrew’s Ambulance Association and the National Coal Board.

Adults With Incapacity Act (AWIA) passed

The new Scottish Parliament addresses a hugely complex area of deep concern to more than 100,000 families across Scotland.

It is long overdue and sixty organisations give evidence to the parliament’s new scrutiny committees.

The net result is widely welcomed – protection for vulnerable adults and clarity for those looking after them and making important decisions on their behalf.

Not front page news but a real breakthrough for patients and the public in Scotland nonetheless.

Free Personal Care report comes out

The commission is chaired by Sir Stewart Sutherland, then principal of Edinburgh University.

There had been stories of pensioners forced to leave residential homes with their savings exhausted, or to sell their houses.

But the cost to the NHS of looking after increasing numbers of the elderly had been highlighted by Aneurin Bevan himself way back in 1949. Free personal care half a century later became a flagship Scottish policy.

Designed to Care published

The tone of policy is different in Scotland which stresses longer-term planning and integration of services as opposed to England which encourages a range of health care providers and a modified version of the market model.

The 47 Scottish trusts are merged into 28. Local Health Care Co-operatives are created to bring local services together and managed clinical networks are promoted to co-ordinate treatment from family doctor to specialist diseases such as diabetes and heart disease.

MRSA control unit set up

Staphylococcus aureus was first identified in the 1870s in Aberdeen by Sir Alexander Ogston. He thought it looked like a bunch of golden grapes and that is what it means in Greek.

It was used by Sir Alexander Fleming as a target for penicillin but it became resistant and methicillin was developed as a result.

The dangers of drug resistance were known through early Medical Research Council trials in the 1940s. But it has nevertheless grown both in the community and in hospitals.

Community Care and Mental Health rolled out

Community Care and Mental Health rolled outApplying to a range of other services, one of the main results is closure of large, long-stay hospitals for people with mental health problems or learning disabilities.

Treatment of mental illness benefits from new drug therapies from the early days of the NHS. In 1949 Dingleton Hospital in the Borders was one of the first in the world to unlock its wards allowing patients access to the wider community.

Private Finance Initiative introduced

Private Finance Initiative introducedAims to solve chronic shortage of new hospital investment by removing this from Treasury spending restrictions and speed up building in the wake of some notoriously slow NHS-led projects.

The first Scottish PFI hospitals are at Hairmyres and Law in Lanarkshire and the new Edinburgh Royal Infirmary.

Internal Market introduced

Internal Market introducedThe UK White Paper Working for Patients, published in January, sets out the policy which sees patients more as consumers and introduces an “internal market” with separate purchasers and providers of services.

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