Annual Report 1999-2000 ANNUAL REPORT 1999-2000

HEALTH BOARD AND NHS TRUSTS HEADQUARTERS as at October 2000 Contents Head Office NHS Trusts within the Greater Dalian House Glasgow Health Board area 350 St Vincent Street Chairman’s Foreword 4 Glasgow G3 8YZ Greater Glasgow Primary Care Tel: 0141-201 4444 NHS Trust Greater Glasgow Partnership Forum 6 Fax: 0141-201 4401 1055 Great Western Road Textphone: 0141-201 4400 Glasgow G12 OXH Improving Health in Partnership 6 Tel: 0141-211 3600 Non-Executive Members North Glasgow University Hospitals Health Issues 11 NHS Trust Chairman 300 Balgrayhill Road David Hamblen PhD FRCS Elderly Care 11 Glasgow G21 3UR Vice Chairman Tel: 0141-201 4200 Mental Health 12 Gordon Dickson Mlitt PhD FCII FIRM South Glasgow University Hospitals Fiona Marshall MB ChB DCH DRCOG NHS Trust People with Learning Disability 12 MRCGP 1345 Govan Road Glasgow G51 4TF Greater Glasgow Drug Action Team 12 Brian Whiting MD FRCP (Glasgow and Tel: 0141-201 1100 Edinburgh) F.Acad.Med.Sci Waiting Lists 13 Yorkhill NHS Trust John Gray Yorkhill Consultations 14 Ronnie Cleland BA Glasgow G3 8SJ Tel: 0141-201 0000 Elinor Smith MCIBS Complaints 14 Andrew Robertson OBE LLB Greater Glasgow Health Council 15 Forrester Cockburn CBE, FRSE, MD, FRCP (Edin & Glas), FRCS (Ed) Hon, FRCPCH Audit Committee 15 (Hon) DCH Board Members 16 Executive Members Chief Executive Annual Accounts 18 Chris Spry BA MHSM Director of Public Health Harry Burns MBChB MPH FRCS(Glasg) MFPHM Director for Commissioning Catriona Renfrew MA MHSM Director of Finance Scott Haldane BA CA Director of Health Promotion Carol Tannahill BA (Hon) MFPHM (Hons) MPH PhD All Board members can be contacted at the head office

2 3 Chairman’s Foreword ANNUAL REPORT 1999-2000

This Annual Report spans a period that took us into the new Millennium, though fortunately with modern fit-for-purpose buildings offering patients, our Health Improvement Programme As Chairman of the the most up to date treatment by specialist seeks to increase the emphasis on preventing this did not result in any of the predicted problems with computers and administration of Public ’’ clinical staff working in settings, which are ill-health by initiatives on smoking prevention, Glasgow Healthy City Services. This was due to a great deal of hard work and forward planning by Board and Trust staff, friendly and convenient. To preserve local drug misuse, safety in the workplace, and Partnership I also have who gave up much of their own holiday time to ensure that things went without a hitch. In fact access for patients, we are proposing to develop increasing levels of physical activity. It is only a close involvement with they did and in retrospect the election of a new Scottish Parliament in June 1999 had a much two new Ambulatory Care and Diagnostic by better health promotion, combined with Centres (ACADs), which with the modern measures to overcome inequalities in access the Glasgow City Council greater influence on the activities of the Health Board throughout the remainder of the year. The advances in diagnostic and treatment methods to health care, that we can hope to improve and the other partners devolution to Scotland of powers for the management of its health and social services and the will be able to provide over 85% of patient the health of our population to a level appointment of a new Minister for Health and Community Care has resulted in an acceleration requirements on a ‘walk in and walk out’ basis. comparable with the best in the UK. who are working to The Board continues to be very active and I wish to thank all the staff of the Board of the changes which had been initiated by the proposals in the White Paper ‘Designed to Care’. reduce health inequalities involved in the new partnerships, which are for their efforts in achieving so much in a year of by improving people’s The new models of partnership working an additional 21 leaflets to provide more beginning to address the social deprivation great turbulence and change. We were pleased which had already been developed following detailed information on request, covering factors which are now acknowledged as to welcome Councillor John Gray as a new physical, mental and broader determinants of health in the City. Board Member and were particularly delighted the creation of the new Acute and Primary specific areas of interest will back this up. This social well-being. Care Trusts, were strengthened by the will be followed by a series of public meetings Most importantly our membership of the by the award of a well-deserved OBE in the New formal appointment of their four Chairs as and briefings to both local and national politicians, Glasgow Alliance has brought the public health Year’s Honours List to Ms Sue Williams, our

Non-Executive Directors to the Health Board. issues of employment, housing and education Nurse Adviser. The year ahead promises to be

The new members — Ronnie Cleland, Forrester into the regeneration agenda represented by equally as challenging with the finalisation of ’’ The public consultation Cockburn, Andrew Robertson, and Elinor Smith the new Social Inclusion Partnerships (SIPs). our proposed plans for reconfiguring hospital Professor David L. Hamblen CHAIRMAN ’’exercise will be the — were a welcome addition to our depleted As Chairman of the Glasgow Healthy City services, maternity services, and care in the ranks of non-executives following the retirement Partnership I also have a close involvement community. The reconfiguration of our own biggest ever mounted of three Board members at the end of last year. with the Glasgow City Council and the other organisation within the Board has been in Scotland with the The value of this closer working relationship partners who are working to reduce health designed to facilitate these developments inequalities by improving people’s physical, and I am very grateful to the staff who distribution of leaflets between Trusts and Board has been evident in taking forward mental and social well-being. This is being have embraced these changes so readily. outlining the proposals some of the major issues addressed through local community health I am confident that the establishment of through the letterboxes influencing the health of projects, encouraging physical activity, improving the Local Partnership Forum will enable our population, perhaps diet, particularly in schoolchildren, and by better us to improve working relationships of 400,000 households. most noticeably in the transport and public safety. and support the personal development A dedicated phoneline Strategy to modernise Work continues with our partners in all that they deserve. Glasgow’s Hospital Services. the Local Authorities to redesign the delivery Finally, I would wish to take this and website, as well A vast amount of preliminary The NHS in Glasgow takes the healthy of care for the elderly and for those with opportunity of thanking our Non-Executive as an additional 21 work with the public, patient eating message out on the streets as learning disabilities by shifting the emphasis Director, Agnes Samuel, who will be leaving leaflets to provide more groups, and NHS staff had informed our part of the Lord Provost’s Procession. from long term institutional care to care in the the Board at the end of September. She has proposals, which were finally launched in April community. made major contributions to our work, detailed information on 2000. The public consultation exercise will be so that when the process ends in December The clinical priorities for the Board remain particularly around women’s health request, covering specific the biggest ever mounted in Scotland with the 2000 we should have a very clear local view on unchanged and focus on cancer, coronary issues, and we extend our distribution of leaflets outlining the proposals the proposals. These seek to deal with the heart disease and stroke, mental health, best wishes to her for areas of interest will through the letterboxes of 400,000 households. problem of Glasgow’s out-dated hospital and services to children. As well as addressing the future. back this up. A dedicated phoneline and website, as well as stock over the next 10 years and to replace it these by supporting and improving services for

4 ’’ 5 ANNUAL REPORT 1999-2000

Greater Glasgow Partnership Forum, An Overview

The highlight of the last 12 months was the involvement in the Greater Glasgow has once again been the forerunner of Working within local communities, we have been involved in A breakdown of health expenditure was completed for ranking of priorities around the Health Improvement Programme breaking the barriers in partnership working. Service strategies establishing 7 new geographical Social Inclusion Partnerships the year for our SIP areas. The average spend per resident (HIP). Within the industrial relations context, traditional activities such as laboratories, maternity and radiology are more soundly (SIPs), 3 thematic SIPs and the conversion of 4 priority partnership in a partnership area was £708 compared to £621 per head — such as the development of a common approach to based. Long term workforce planning — the real test of developing areas. As a partner agency, we have been active at all levels of for people not living in a partnership area. This positive Occupational Health & Safety Services — achieved consensus a quality health service that is accessible to all — is being promoted decision making within SIPs. Within the geographical SIP areas investment into SIP areas reflects the higher levels of illness without too much difficulty, leaving the debate free to despite all the day-to-day operational pressures. local priorities for improving health have emerged as: experienced by residents and the additional investment being concentrate on costs and priorities. And, perhaps most importantly of all, relationships between • tackling drug misuse and addictions directed by the Board. Partnership is at its best, however, when it involves trade Directors and Trade Union Officials, between Managers and • child and family health union officials and lay representatives in decisions that go to the heart Representatives of Staff, these are constantly being examined • food and nutrition of what services should be provided in Glasgow. One distinctive against a background of genuine co-operation and a desire to • territoriality and violence, including domestic abuse way of achieving that was to invite two full-time officials to participate make Glasgow the best. • tackling poverty in the Health Improvement Programme Steering Group — It has been a joint effort and a lot of people are giving a lot • reducing vulnerability of exclusion amongst young people and a salutary experience it has been. of time to ensure partnership works better in Greater Glasgow. Another way was for management and staff representatives It would be remiss, however, not to single out the Chief Executive, to take time out to try to seek agreement on the priority to be Chris Spry, whose vision and commitment has been responsible ...in Partnership with Communities attached to dozens of items of expenditure arising out of the HIP. for so much of the success achieved so far. Such a meeting focused everybody’s minds on the real benefits of Key initiatives include:- partnership — pulling ideas on how to develop quality services by Mike Fuller, Two pilot Pathfinder projects in the Working for Communities A health development worker for the Horizons Project for patients, both in NHS settings and in the wider community. Regional Officer, MSF Programme, in Greater Easterhouse and South Lanarkshire, in Pollok was recruited to support people isolated by health including setting-up a Community Health Shop in Barlanark problems — through training and education programmes. providing a focus for primary care, voluntary sector and community The Kool Kids Children’s Health Club initiative was developed Improving Health in Greater Glasgow in Partnership... activities which support health. with Glasgow City Council to encourage primary school aged Two SIP areas worked together with the Healthy City children to become more active, to use local sports facilities, and Given that many of the fundamental determinants of health Good progress was made in each of the Alliance’s priorities for Partnership to prepare a bid for the Starting Well to take greater interest in their own and each other’s well being. require action that lies beyond the direct aegis of the NHS, health and well-being — child health, mental health, tobacco and Demonstration Project for Scotland. The bid was successful Ali Paton lends her support to the Kool Kids Club. we work with other agencies and local communities to improve physical activity — and the vast majority of actions are being and will bring £3million for programmes to life circumstances and to put in place services, facilities and delivered on schedule, or ahead of time. improve child and family health, through policies that help to improve health. The overarching approaches The lead partnership for health in the city is the Glasgow providing intensive support to families, training of Community Planning with each of the local authorities within Healthy City Partnership. Key outputs from its working groups and recruitment of local parents, and increasing Greater Glasgow are fundamental to this. In Glasgow City, include the production of, and consultation on, a Food and Health the number of health visitors in both areas. the process is included in the work of the Glasgow Alliance. Action Framework, initial development of a tobacco strategy, CAF (Community Action on Food) was The work of the Alliance is strongly influenced by the views attention to environment and health issues, and some new work launched during 1999 and is an innovative food and priorities expressed through the Glasgow Citizens’ Panel, to support health promotion for people with learning difficulties. and nutrition project offering a café, food which identified crime and drugs in their communities as being We were also delighted that during the year the City Council co-operative and training centre, run by and of particular concern. In response, the Alliance established increased its corporate commitment to health issues by establishing for local people in Clydebank. This is a jointly three Peoples’ Juries on Drugs, and partner agencies, together a Health Forum, involving elected members and lead officers funded initiative with West Dunbartonshire with the Drug Action Team, have given commitments to from all departments, in considering priorities for council action Partnership. Nick Nairn, the celebrity chef, actively consider and respond to the Juries’ recommendations. to improve the City’s health. is CAF’s patron.

6 7 ANNUAL REPORT 1999-2000

...in Partnership with Communities ...in Partnership with Other NHS Organisations

The number of children wearing cycle helmets during cycle The breastfeeding initiative was rolled out to other areas of Planning has been taking place to set up an innovative model The Exercise Referral Scheme has continued to expand proficiency training has increased as a result of the Greater the city which had breastfeeding rates below 20%, and support of health care which will bring together the Family Planning with more than 76% of GPs in our area now using the service and Pollok Cycle Helmet Initiative, a partnership with Glasgow City groups have now been set up in Parkhead, Townhead, Bridgeton, Service, the Genito-Urinary Medicine and Sexual Health Service over 4,000 patients referred. Patients are offered one-year Council. The aim is to roll-out this initiative city-wide over time. Govanhill, Gorbals, Pollok and Possilpark. The initiative is seen as and the Centre for Women’s Health. Housed in the refurbished of reduced price access to Glasgow City Council sport and leisure an important way to improve support in the community for and modernised Eye Infirmary Building in Sandyford Place, the facilities. Patients with existing heart disease can now also be women who want to breastfeed. Sandyford Initiative will offer a wide range of confidential health referred onto the scheme after completing a hospital assessment. The Chinese Health Force continued to monitor and assess services, advice and information at a convenient city-centre location. An evaluation report from the first stage of the scheme is the health needs within the Chinese community, to organise health There will be easy access without referral from a doctor. Services now available. awareness days and to enable better access to health services. will be designed to meet the specific needs of women, men and The Glasgow Physical Activity Forum and Argyll and Clyde The Chinese Well Women Project produced an audio-tape young people and will ensure full access for disabled people Health Board have developed a joint physical activity and capturing the experience of being counselled on issues that are and for those who use minority languages. A health information health training programme to provide consistent, high quality significant to new immigrants as well as first or second generation library linked to the Glasgow City Council library service will be information and training for all professionals with a role in Chinese Scots. We have also been consulting on a proposal for open to the public. promoting physical activity. a Healthy Living Centre for the Chinese community. The Sandyford Initiative will be managed by the Primary Care GGHB together with Glasgow University and the Health Work with the deaf community became well-established Trust but a wide-range of organisations and groups will be involved Education Board for Scotland carried out a randomised with a programme focusing on improving access to health in identifying the future direction of the service and it will link to controlled trial of an information pack aimed at promoting active Youngsters supporting the Cycle Helmet Initiative. information and health services for deaf people and raising other activities developed by the Sexual Health Planning and commuting — walking or cycling part or all of the way to work. Health Spot was developed in Castlemilk to enable young awareness among health professionals of the needs of deaf people Implementation group and the Women’s Health Policy group. The trial showed that the pack increased active commuting and it people to access and use health services more effectively by using the health service. Components of this programme include: The service opened on 31st July 2000. is now being distributed nationally to Scottish workplaces through providing them at youth events. the Scotland’s Health at Work Award Scheme. The Energiser Project in Drumchapel was set up using • a health information point was set up in the Centre for A full review and evaluation of the work of Glasgow 2000, the European, Social Inclusion Partnership and GGHB funding. The Sensory Impaired People in Partick; city’s tobacco control initiative, was completed in preparation for project offers pre-vocational training to people recovering from • video and leaflets produced jointly with Lanarkshire Health the re-launch of the service as Smoking Concerns in April 2000. long-term mental health problems, focussing on confidence- Board and the deaf community to raise issues related to The evaluation highlighted significant advances in tobacco control building, access to information, and helping participants to breast screening and breast awareness for deaf women; in the city with more workplaces and public places (e.g. cinemas, become more integrated into community life. • deaf awareness training sessions for GGHB staff; transport) adopting smoking policies. The Govan Youth Access Project took a lead role in • and work with the media to investigate improving the An oral health promotion programme, Healthy Teeth for tackling issues of territorialism amongst young people. Shared communication of emergency information. Life, was launched targeting parents and carers of activities and training will continue to be developed. pre-fives. The programme has supported The Elderly Care Visitor Project in the Gorbals was Focus Groups looking at people’s experience of the health a range of pilot initiatives, including developed jointly by the GGHB, the City Council, the Local services and their views on how these could be improved have early registration and a bottle to cup Health Care Co-operative (LHCC) and community organisations, been held with Deaf Women, Deaf Men, Deaf Young People, promotion which will be integrated into and recently secured additional SIP funding. The project trains Deaf Older People and the Deaf Asian Group. primary care services across our area. and employs local people to carry out safety checks and repairs in the homes of elderly people.

Multi-language leaflet for women about surviving domestic violence.

8 9 ANNUAL REPORT 1999-2000

...in Partnership with Other Organisations Health` Issues Arising Through the Year...

Norma Greenwood, Health Promotion Programme Manager, vital, and we produced leaflets focusing on safer injecting and A programme to vaccinate the high risk groups — children disease in the local community. Additional work is continuing received the first ever Lord Provost’s Award for Road Safety information on Hepatitis C for both drug users and professionals. and students — against the Meningococcal C (meningitis) virus around this issue. for her contribution to partnership working in the area of Grants to support innovative alcohol and sexual health related was carried out. Controversy surrounded the prescribing of Beta Interferon Road Safety. projects were awarded to Anniesland College and Glasgow College We were concerned about the health implications of erecting and in light of this we are undertaking an in-depth study into Our campaign with Strathclyde of Nautical Studies for the Chlamydia campaign, and Clydebank mobile phone masts close to residential areas and areas where the needs of Multiple Sclerosis patients in Greater Glasgow Fire Brigade increased fire safety College received a grant to develop a drug and alcohol policy for children play. Our advice to local authorities was to adopt a to consider the most effective interventions to improve their awareness in houses of multiple students. The campaign precautionary approach to the siting of these masts and await the quality of life. occupancy. Students at University or to raise awareness of results of the independent inquiry being undertaken by the Concerns linking the MMR vaccine with Chron’s Disease College in Glasgow used the website Chlamydia is being Department of Health. and Autism led to concern in the uptake of the vaccination which and materials produced in conjunction rolled out to all further Local concerns were raised about the health implications of has fallen by 5% to 91%. There is no evidence to suggest that with the campaign. education colleges. living near to Paterson’s tip. We carried out a disease incidence such a link exists. If the rate falls to under 90% we will begin to Concerns over the number of overdose-related deaths study which showed that there was not sufficient evidence, of the see measles outbreaks occurring with the potential for long resulted in us working with the Scottish Drug Forum to produce major potential outcomes likely to be associated with chemical term neurological and respiratory problems associated with a wallet that contains cards with information on overdose, how exposures, to implicate Paterson’s tip as a serious factor in causing contracting the measles virus. to avoid it and what to do if someone overdoses. Hepatitis C infection, is a major public health problem in Glasgow, affecting approximately 14,000 people. It is largely transmitted through the sharing Elderly Care

of injecting equipment, especially Working in partnership with NHS Trusts, Local Authorities and • improvements have been made in commissioning home care needles and syringes, during illicit Service Users continues to be a priority in developing elderly services. services. Hospital ward staff at the Southern General and Victoria drug use. Prevention activities are Over the past year, work has progressed through the North Infirmary can now directly commission such services that enable and South Glasgow Elderly Groups to develop and progress older people to be discharged more quickly and with essential redesign proposals for Elderly Services. This work has included: support services in place. It is now planned to extend this • securing appropriate and timely discharge of all the people approach to hospitals in the North of Glasgow; from hospital; • a review and outreach service for the elderly has been established • we have completed the pilot of a single assessment process to at the Glasgow Royal Infirmary. This service is working to break identify the needs of all the people. This work was undertaken the cycle of crisis intervention by providing regular specialist in South West Glasgow and it is now planned that it will be multi-discipline review of older people who have previously adapted and shared more widely; been admitted to hospital on a regular basis; and Professor Hamblen • developing joint work between health and social care colleagues • an initial review was undertaken of day hospital services. presents the Gold in some LHCC areas; The outcome of this review is now being considered through award to West • a joint elderly supported discharge team has been established the North and South Glasgow Elderly Working Groups. Whitlawburn Housing at Stobhill to develop packages of care that will ensure effective Association and discharge of patients and maintain patients in the community Stobhill Hospital as in the crucial period immediately after discharge; part of Scotland’s Health at Work. Five workplaces received silver and ten received the bronze award.

10 11 ANNUAL REPORT 1999-2000

Progress in Mental Health Waiting Lists

Four new teams were established at Drumchapel/Bearsden, 1999. The review produced the Modernising Mental Health The focus has remained on reducing numbers waiting for inpatient 31st March 2000. Trusts now continue to work to ensure that the Pollok/Darnley, Pollokshaws and Castlemilk to complete the Services document on which we consulted in May. Some of the and day case treatments. The national target was that Trusts must target will be maintained during 2000/01. In addition no patients network of Adult Community Mental Health Teams. key proposals included:- continue to reduce waiting lists to below the numbers waiting waited in excess of the 12 month maximum waiting time guarantee The Joint Mental Health Strategy was developed in partnership • improved inpatient care in purpose built facilities at 31st March 1997. In Glasgow the target was achieved by at 31st March 2000. with the local authorities, Primary Care Trust and Yorkhill Trust, • significant reduction in NHS continuing care beds Numbers waiting within each Trust are as follows: to set out the requirements for a comprehensive mental health • increased range of community based services, and service. Further work required to be done on the precise details • the development of new more specialist mental March 1997 March 2000 of the services and a joint review was completed in October health services North Glasgow University Hospitals NHS Trust 7934 7729 South Glasgow University Hospitals NHS Trust 4412 4107 Yorkhill NHS Trust 764 913* People with a Learning Disability Total 13,110 12,749 * The March 2000 figure for Yorkhill NHS Trust includes additional lists to those included in the March 1997 figure and is therefore not directly comparable. A new joint learning disability strategy was developed during disability. In drafting the strategy, a wide range of people fed into the the year with a joint general manager appointed to take forward proposals and the consultation responses endorsed the direction the agenda. The strategy is radical with significant changes in the of travel. Further work will continue through the Learning Outpatient Appointments way services are designed and delivered for people with a learning Disability and Planning Group on the implementation plans. The number of patients waiting for first outpatient consultation within 15 weeks. The figure of 81% represents a marginal drop, across all specialties totalled 30,200 at 31st March 2000. Of that however, as the table below shows we remain above the Scottish number 68 % waited less than 9 weeks, with a total of 81% seen average in this respect.

Greater Glasgow Drug Action Team % New Outpatient Consultant Referrals seen within Guarantee. March 2000 September 1999 March 1999 The Health Board plays an active part in the work of the Other major initiatives included:- Greater Glasgow Drug Action Team. A revised Strategy was • establishing an addiction psychiatry team for drug users Glasgow 81 85 86 published in 1999 describing the main features of the drug with mental health problems; Scotland 75 77 77 problems in Greater Glasgow and set out action plans for • a young people’s arrest referral scheme for drug-related research, prevention, treatment and rehabilitation, reducing the offending; During 2000/01 we will continue work with Trusts to make further improvements in the waiting times in Greater Glasgow. availability of drugs and better co-ordination. Thanks to extra • improved facilities for health advice in community pharmacies; Details of inpatient, outpatient and day case activity together with the length of wait are shown on pages 31-35. funding from the Scottish Executive, and an initiative by the • a pilot scheme for immunisation against Hepatitis B; and Health Board to provide matched funding from our own • strengthening drug worker resources in all local authority areas. resources and from our local authority partners, major new services Drugs pose enormous problems in Greater Glasgow and were initiated in 1999/2000. much needs to be done to further expand services, especially in One key element in the new initiatives was collaborative planning rehabilitating drug users, but it is heartening that determined and with Mothers Against Drugs to commission a comprehensive concerted action between us and our partners on the Drug new range of drug treatment and support services in Greater Action Team can result in significant improvement to services. Easterhouse. The new services come on stream in 2000 and will A real case of putting our money where our mouth is. be operated by the City Social Work Department. Leaflet for youngsters explaining how different things affect the body.

12 13 ANNUAL REPORT 1999-2000

Consultation Greater Glasgow Health Council 44 Florence Street Glasgow G5 0YZ Tel: 0141-429 7698 Fax: 0141-429 6367 We undertook 9 formal consultations during the year, discussions took place around the draft proposals. Consultation each carried out over a period of at least 6 weeks. As well as documents are made available in Chinese (Cantonese), Punjabi Greater Glasgow Health Council is an independent consumer Convener Peter Hamilton distributing the documents to our 900 statutory consultees and and Urdu and produced on audio tapes for blind residents. organisation set up to represent the interests of the public in the Vice Convener Caroline McCalman those who requested them, many meetings, seminars and other Details of the written responses received are as follows:- NHS. There are 20 voluntary members of the Council supported Chief Officer Danny Crawford by seven staff. The Council considers a variety of issues that affect

Document Period of Consultation No. of Responses xpatients. The meetings, which are open to the public to attend, are held on the first Tuesday of each month (except January and Replacement of the Balvicar Child Development July) at 7pm in Glasgow’s City Chambers. Centre Serving the South of Glasgow April - May 1999 5

Volunteering in the NHS June - September 1999 45

Maternity Services Strategy Review August - October 1999 30 Audit Commitee as at October 2000 Modernising Genito-Urinary Medicine Services December 1999 - February 2000 15 Responsibilities Membership Modernising Mental Health Services December 1999 - April 2000 85 Review and evaluation of the Board’s systems of internal Gordon Dickson (Convener) Health Improvement Programme 2000-2005 December 1999 - March 2000 27 control and corporate governance; ensuring the provision of an Fiona Marshall effective internal audit service; receiving external auditors reports 2 vacancies Joint Strategy for Services for People with and letters; and reviewing the Board’s annual accounts. a Learning Disability in Glasgow City February - April 2000 73

Relocation of Family Planning and Well Woman Clinics February - March 2000 16

Modernising Glasgow’s Acute Hospital Services (Phase 1) March - September 2000 3446 Openness

We take the process and spirit of consultation very seriously. disordered offenders, we did not get the next steps of consulting We operate under the Code of Practice on Openness in the Since the launch of the Code the Board has met all requests Making judgements about priorities and choices can often involve about choice of location right. The Health and Community Care NHS in Scotland. The Code aims to ensure that information is for information under the Code, or given an indication of when balancing opinions and factors that are difficult to reconcile. Committee of the Parliament criticised us and we are now working publicly available on:- the information would be available within the national target set We learnt some hard lessons from the difficulties we experienced with the Greater Glasgow Primary Care NHS Trust to implement of 20 working days. • waiting time guarantees over proposals to locate a Secure Care Centre at Stobhill recommendations made by the committee aimed at building If you have any complaints about a delay in dealing with your • performance against set targets Hospital. Although in a previous year we had conducted an public confidence in the proposed service. request for information, or a failure to supply information, then • NHS services and their cost exemplary consultation about policy for services for mentally please contact John C Hamilton, Head of Board Administration, • quality standards at the same address or telephone 0141-201 4608, fax 0141-201 4601 • proposed service changes or e-mail: [email protected]. If you would like information about the Board please contact: Complaints Elaine McKean, Press Officer Greater Glasgow Health Board, Dalian House Between April 1999 and March 2000 we received 10 complaints, The responsibility for the collation of statistics in respect of 350 St Vincent Street Glasgow G3 8YZ all of which were dealt with within the national timescale of 20 Family Health Service complaints has transferred to the Greater Tel: 0141-201 4429 Fax: 0141-201 4426 Textphone: 0141-201 4400 working days. There were no requests for an Independent Review. Glasgow Primary Care NHS Trust. e-mail: [email protected]

14 15 Board Members ANNUAL REPORT 1999-2000

as at October 2000 Fiona Marshall was appointed Chris Spry was appointed Chief Non-Executive Director in April Carol Tannahill joined the Executive in July 1996. He had 1995. Fiona is a General Gordon Dickson was appointed Health Board in 1990, and has Ronnie Cleland was appointed previously been the NHS Practitioner in the south side of Non-Executive Director in April held various posts within the Chairman of the North Glasgow Executive’s Regional Director for Catriona Renfrew joined the the City and Chairs the 1995. He is Pro Vice-Chancellor Health Promotion Department. University Hospitals NHS Trust, South Thames, based in London. Board in February 1997. Catriona Maternity Services Liaison and formally Dean of the Faculty She was appointed Director Scotland’s largest acute hospitals Chris became the Chair of the has worked in the Health Service Committee and the Forum for of Health at Glasgow Caledonian of Health Promotion in 1997 trust, in April 1999. Prior to this Greater Glasgow Drug Action Team since 1985. She is responsible for AIDS and Blood Borne Viruses. University, where he also Chairs and became an executive board Ronnie was Chairman of West in January 1997. He represents commissioning health services, She is a member of the the University’s Research member in May 2000. Carol is Glasgow Hospitals NHS Trust the Board on the Glasgow Alliance coordinating the development Consultative Panel on the Committee. Gordon is a Non- closely involved in the work of and formerly a Non-Executive and also Chairs the National of the Health Improvement Registration of Nursing Homes Executive Director of Commercial the Glasgow Alliance and the Director of Yorkhill NHS Trust. Services Advisory Group. Chris is Programme, and performance and Independent Hospitals. General Union Risk Management Glasgow Healthy City Partnership, He is a Partner in the recruitment also a member of the Scottish management. Catriona is a member Fiona is also Chair of the Inter- PLC. He is currently Vice and is responsible for the Board’s consultancy Thomson Partners Social Inclusion Network and the of the Woman’s Counselling Agency Review Group for Child Chairman of GGHB and Chair community development and Limited. Ronnie joined the Board Scottish NHS Partnership Forum. & Therapy Service (Leeds). Protection Services at Yorkhill. of the Audit Committee. health promotion programmes. at GGHB in November 1999.

David Hamblen was appointed Forrester Cockburn was Chairman in July 1997. He appointed Non-Executive retired as the Professor of Director in November 1999. Orthopaedic Surgery at the He is Chairman of Yorkhill NHS University of Glasgow in Trust and Emeritus Professor September 1999. He is of Child Health at the University Chairman to the Council of the of Glasgow. Forrester is also Management and Editorial Board Chairman of the Board’s Clinical of the British Volume of the Governance Committee. Journal of Bone and Joint Harry Burns was appointed Scott Haldane took up post as Brian Whiting was appointed John Gray is a Labour Councillor Elinor Smith was appointed Andrew Robertson OBE is Surgery, and a Visiting Professor Director of Public Health in 1993 Director of Finance with effect Non-Executive Director in representing the Keppochhill Chairman designate of the South senior Partner in the Glasgow legal at the University of Strathclyde having previously been the from June 1997, having previously September 1994. Brian is the Dean Ward on Glasgow City Council. Glasgow University Hospitals firm of Messrs TC Young & Son. National Centre for Training and Deputy Director of Planning and been Director of Finance and of the Faculty of Medicine at He is Convenor of the Social Work NHS Trust in November 1998, His firm has been closely involved Education, Prosthetics and Contracts since June 1992. Information at West Lothian the University of Glasgow and Services Committee and has and took up position of Chairman with the Community Based Housing Orthotics. Prior to that he had been the NHS Trust. Prior to West Lothian is the statutory representative worked with the Health Board in April 1999. She is a former Association movement in Glasgow Medical Executive at Glasgow NHS Trust, Scott was Director of on the Board representing and Trusts on the Joint Planning director of Business Banking since the early 1970s. Royal Infirmary and a Consultant Finance at Edinburgh Sick University interests. Forum and the Joint Group on in the Bank of Scotland. Andrew is Chairman of the Greater Surgeon and Senior Lecturer Children’s NHS Trust. Learning Disabilities. He previously Glasgow Primary Care NHS Trust. in surgery. worked as an electrician in the He is also Secretary of Erskine shipbuilding engineering Hospital, Founding Secretary of the electricity supply, local authority Princess Royal Trust for Carers and health sectors. and Non-Executive Director of the Scottish Building Society. 16 17 Report by the Director of Finance ANNUAL REPORT 1999-2000

The Board is required to submit Statutory Accounts to the Scottish Executive National Health REVENUE ACCOUNT Service Management Executive in a form laid down by Regulations. Note 1999/00 1998/99 Movement £m £m £m % The accounts are prepared on a historical cost basis modified to reflect changes in the value of fixed assets in accordance with the Total Income 912.9 873.5 39.4 4.5 Accounting Standards for the NHS in Scotland as approved by the First Minister. Cash advances from the Scottish Executive are the main Expenditure source of funding. To the extent that our cash limited allocations have not been drawn, the balance carried forward to be drawn in the following year is accrued as income in the current year. For non-cash limited expenditure, a notional allocation is assumed, equal to actual Health Care Purchases: expenditure. The accounts have been given a clear audit certificate by our external auditors, PricewaterhouseCoopers. Hospital & Community 653.7 635.5 18.2 2.9 Family Health (i) 244.1 221.5 22.6 10.2

The following commentary highlights the main issues and details are provided in the attached tables 1 - 9. Total 897.8 857.0 40.8 4.8 A full set of accounts can be obtained from Management Costs (ii) 6.7 9.3 (2.6) (27.9) Director of Finance Greater Glasgow Health Board Other Board Services (iii) 11.7 9.2 2.5 27.2 Dalian House P O Box 15326 Total Expenditure 916.2 875.5 40.7 4.6 350 St Vincent Street GLASGOW G3 8YT (i) A more detailed analysis of Family Health Service expenditure is provided on page 21.

(ii) The reduction is principally due to the transfer of staff to the Greater Glasgow Primary Care NHS Trust and the Common Services Agency (CSA) Cash Limit Out-Turn as part of the reorganisation of the administration of Family Health Services.

The financial out-turn for Hospital and Community Services and the Capital Programme as measured against the Cash Limited (iii) This includes expenditure on Compensation Payments of £5.2m, a net increase of £2.8m over 1998/99. This includes £4.6m of an increase allocation issued by the Scottish Executive was as follows: in the provision for unresolved claims to reflect the re-assessment of individual cases. This accounting provision is based on assessments made by the Central Legal Office and does not reflect any acceptance of liability of the Board. The total is then offset by a lower level of actual expenditure 1999/00 during 1999/2000 than in the pervious year. £’000

In 1999/00 we spent the equivalent of £1,012 on Health Services for every person within our catchment population: Hospital and Community Revenue Cash Spend 793,981 Capital Programme Cash Spend 53 Revenue Expenditure Total Spend against Cash Limit 794,034 (per head of Population) Cash Limit 800,175

Available for Carry Forward into 2000/01 6,141 ■ £722 (71%) on Hospital and Community Healthcare

■ £270 (27%) on Family Health Services

■ £13 (1%) on Other Board Services

■ £7 (1%) on Management Costs

18 19 ANNUAL REPORT 1999-2000

HOSPITAL AND COMMUNITY HEALTHCARE FAMILY HEALTH SERVICES (FHS)

Expenditure on Hospital and Community Healthcare was £653.7m, an increase of £18.2m (2.9%) over 1998/99. Family health practitioners (GPs, Community Pharmacists, Dentists and Opticians) represent the first point of contact with the NHS for most patients. 400 These four groups are each independent, professional contractors who are self-employed and contract with the Health Board to provide specific services to their NHS patients. Their remuneration levels are set on a national basis by the Government, following 350 348.37 Darker Colour Represents 1998/99 326.15 Lighter Colour Represents 1999/2000 consultation with representatives of the relevant professional group. 300 The expenditure on Family Health Services can be analysed as follows: -

250 1999/00 1998/99 Movement £m £m £m % Medical 67.4 64.5 2.9 4.5 200 Pharmaceutical 133.0 114.3 18.7 16.3 Dental 35.7 34.8 0.9 2.6 Ophthalmic 8.0 7.9 0.1 1.3 150 141.09 141.12 Total Gross Expenditure 244.1 221.5 22.6 10.2 100 Significant changes took place in the administration of the payments to family health practitioners and to the responsibility for the 49.45 49.80 50 35.76 35.00 24.81 24.78 management and control of this category of expenditure. 26.04 27.61 21.14 15.53 11.07 11.51 0 • Responsibility for the administration and payment transferred from Health Boards to the CSA on 1st April 1999 with the creation of Acute Mental Health Other Continuing Maternity Additional Research three regional centres to cover all Scotland’s Board areas; Services Services Community Other Care Services Cost of and Services Services Teaching Development • Responsibility for the management and control of the expenditure transferred to the newly formed Greater Glasgow Primary Care NHS Trust on 1st April 1999. Hospital and Community Services represents 71% of all GGHB expenditure, with the equivalent of £722 spent per head of population.

This can be further analysed across service areas as: The other significant change was that the drug cost element of Pharmaceutical expenditure is now part of the cash limited unified budget allocated to the Health Board. These funds are made available to the Primary Care Trust to meet the costs of prescribing expenditure. Hospital and Community Healthcare Expenditure In prior years only the GP Fundholder drug costs were cash limited. The Primary Care Trust therefore has to manage this element within (per head of Population) its overall financial resources. In 1999/00 we spent the equivalent of £270 on family health services for every person within our catchment population:

■ £384 on Acute

■ £156 on Mental Health Services Family Health Services Expenditure (per head of Population) ■ £55 on Community

■ ■ £39 on Continuing Care £148 (54%) on Pharmaceutical Services

■ ■ £31 on Maternity £74 (28%) on General Medical Services

■ ■ £27 on Additional Cost of Teaching £39 (15%) on General Dental Services

■ ■ £17 on Other Services £9 (3%) on General Ophthalmic

■ £13 on Research & Development

20 21 ANNUAL REPORT 1999-2000

GP FUNDHOLDING REVENUE INCOME AND EXPENDITURE ACCOUNT For the year to 31 March 2000 GP Fundholding came to an end on 31st March 1999. At that time there remained a balance of unspent savings of £4.5m. TABLE 1 Due to expenditure incurred during 1999/00 this has now reduced to £3.0m. This balance is still available to fundholders until 31st March 2001. Any unspent balance at that time will become available to be utilised by the Board. 1998/99 1999/2000 £000’s £000’s £000’s

PUBLIC SECTOR PAYMENT POLICY Income 859,714 Allocations from ME 897,833 13,771 Miscellaneous Income 15,101 We endeavour to comply with the principles of the Late Payment of Commercial Debt (Interest) Act 1998 by processing suppliers’ invoices for payment without unnecessary delay and by settling them in a timely manner. In 1999/00 average credit taken was 41.6 days, 873,485 Total Income 912,934 we paid 78% by value and 46% by volume within 30 days. We recognise and aim to comply with the credit terms requested Expenditure by suppliers. Where no terms are stated we apply our standard which is 20th of the month following invoice. Health Care Purchased 635,500 Hospital and Community 653,720 221,537 Family Health 244,096

CONCLUSION 857,037 897,816

The financial out-turn for 1999/00 is regarded as satisfactory. The deficit was managed within the Health Improvement Plan forecasts 9,290 Purchasing and Administration 6,665 and will be recovered in 2000/01 to achieve a position of balance. The deficit of £3.2m is arrived at after making a significant increase Other Service Expenditure in the provision for Clinical Negligence claims and the income from receipts on disposal of surplus properties. 191 Local Health Councils 198 The Board achieved the main financial target and remained within the cash limit with £6.1m being available to carry forward 8,956 Other Board Services 11,494 into 2000/01. This was to cover specific projects and expenditure committed in 1999/00 but that will not begin or be completed 9,147 11,692 until 2000/01. Cover is also required for the accrued GP Fundholder savings referred to above. 875,474 Total Revenue Expenditure 916,173 I wish to express my appreciation for the ongoing support of all staff involved in managing the Board’s finances, and in particular those who contribute to the financial planning and monitoring process and the preparation of the Board’s Statutory Annual Accounts. (1,989) Board Surplus/(Deficit) for Year (3,239) (1,989) Net Movement in Funding Balance - ME (3,239)

Scott Haldane DIRECTOR OF FINANCE

22 23 ANNUAL REPORT 1999-2000

BALANCE SHEET CASHFLOW STATEMENT As at 31 March 2000 For the year to March 2000

TABLE 2 TABLE 3

1999 2000 1998/99 1999/2000 £000’s £000’s £000’s £000’s £000’s

Fixed Assets Funds Received 5,758 Net Book Value 1,060 (861,364) Net Cash Received (896,108) 0 Superannuation Contributions 0 Current Assets (1,602) Capital Charges (144) 0 Stocks 2,356 (141) Hospital & Community Income (1,125) 29,745 Debtors 33,436 (12,933) Practioner Services and Prescriptions (12,429) 115 PGO Account Balance 11 22 Cash at Bank and in Hand 1 (876,040) (909,806)

29,882 35,804 Funds Applied

Current Liabilities Cash Limited (28,032) Creditors due within one year (34,564) 590,168 Healthcare Purchases 655,998 27,933 Purchaser and Other Costs 15,308 1,850 Net Current Assets/(Liabilities) 1,240 16 Capital Projects below £1m 53 116,245 Family Health Services 128,540 7,608 Total Assets less Current Liabilities 2,300 219 Associated Services 196

0 Creditors Due After More Than One Year 0 734,581 800,095

(9,743) Provisions for Liabilites and Charges (12,372) 141,453 FHS Non Cash Limited 109,837

(2,135) (10,072) 876,034 Total Funds Applied 909,932 6 Bank Balances (126) Financed by: 17,790 Revaluation Reserve (364) 876,040 909,806 (23,533) Capital Reserve (686) (15) Donation Reserve (10)

Balance due to/(from) ME Brought Forward 7,893 Current Year I & E A/C 3,239

7,893 Carried Forward 11,132

2,135 10,072

24 25 ANNUAL REPORT 1999-2000

PURCHASES OF HOSPITAL AND COMMUNITY HEALTHCARE PURCHASE OF HOSPITAL AND COMMUNITY SERVICES For the year to March 2000 For the year to 31 March 2000

TABLE 4 TABLE 6

1998/99 Purchases From: 1999/2000 Resource £000’s £000’s Inpatients Daycases Outpatients Daypatients A&E Community Transfer Other Total Total £000’s £000’s £000’s £000’s £000’s £000’s £000’s £000’s £000’s % 529,357 NHS Trusts - Glasgow 553,611 20 Directly Managed Units - Scotland 32 Acute 216,338 19,855 62,222 15,848 314,263 48.07% 17,696 NHS Trusts - Scotland 16,446 Maternity 24,040 3,568 27,608 4.22% 9,115 Direct Access Services 9,215 Geriatric Assessment 30,300 1,746 2,061 34,107 5.22% 7,132 Ambulance Service 1 Mental Illness 54,261 3,500 4,824 20,300 15,707 98,592 15.08% 1,594 NHS Trusts - Outside Scotland 251 Learning Difficulties 20,152 4,300 18,075 42,527 6.51% 3,506 NHS Trusts - Expenditure on AIDS 3,483 Geriatric (Continuing Care) 23,090 7,885 30,975 4.74% 687 Primary Care Bodies 176 Young Physically Disabled 1,112 2,912 4,024 0.62% 13,247 Voluntary and Private Sector 12,754 Community 49,803 49,803 7.62% 3,516 Hospice and Elderly Care 3,558 Health Promotion 4,064 4,064 0.62% 392 Community Care 321 Additional Cost of Teaching 24,776 24,776 3.79% 3,975 Health Promotion 4,064 Research & Development 11,511 11,511 1.76% 40,382 Support Finance & Resource Transfer 44,650 Direct Access Services 9,215 9,215 1.41% 2,818 Drugs Misuse & AIDS 2,129 Other 2,255 2,255 0.34% 1,324 HIV & AIDS Board 1,822 739 Care in the Community - Other Agencies 1,207 Total 369,293 25,101 72,675 15,848 74,403 44,579 51,821 653,720 100%

635,500 653,720 % 56.49% 3.84% 11.12% 0.00% 2.42% 11.38% 6.82% 7.93% 100%

MANAGEMENT COSTS For the year to March 2000

TABLE 5

1998/99 1999/2000 £000’s £000’s

370 Board Members Remuneration 388 5,248 Other Salaries & Wages 3,512 647 Supplies and Services 303 834 Office Expenses 485 229 Transport and Staff Travel 142 1,100 Premises and Fixed Plant 1,264 651 Agency Services 372 87 Audit Fee 82 124 Others 117

9,290 6,665

26 27 ANNUAL REPORT 1999-2000

FAMILY HEALTH SERVICE OTHER BOARD SERVICES For the year to 31 March 2000 For the year to March 2000

TABLE 7 TABLE 8

1998/99 1999/2000 1998/99 1999/2000 £000’s £000’s £000’s £000’s £000’s £000’s

General Medical Services 362 Nurse Teaching 0 41,713 Non-Cash Limited 46,429 22,777 Unified Budget 20,995 563 Closed Hospital Charges 416 2,427 Compensation Payments 5,187 64,490 67,424 572 Pension Enh & Redundancy - Provider 632 1,753 Pension Enh & Redundancy - Purchaser 1,777 Pharmaceutical Services 114,330 Supply and Dispensing of Drugs & Appliances 132,950 261 Patients’ Travelling Expenses 245 (5,188) Pharmaceutical Charges (4,265) 384 Clinical Audit 221 109,142 128,685 Other Services General Dental Services 285 Public Health Medicine Trainees 375 34,782 Cost of Treatment and Dentures 35,732 33 Emergency Planning 29 (7,930) Dental Charges (8,164) 2,832 Other 2,503 (517) Movement in GPFH Savings 109 26,852 27,568 2,633 3,016 7,935 General Opthalmic Services 7,990

208,419 231,667 8,955 11,494

28 29 ANNUAL REPORT 1999-2000

BOARD MEMBERS AND SENIOR STAFF EMOLUMENTS INPATIENTS BY SPECIALITY AND PROVIDER UNIT (GGHB RESIDENTS) For the year to March 2000 Year Ending March 31, 2000

TABLE 9 Comm/ 99 GRI WES VIC STOB RHSC S GEN Ment Total Total 1998/99 Salary / Fee Pension Employers Expenses & Benefits 1999/2000 ACUTE SPECIALTIES Share Total General Surgery 5,222 6,432 5,745 4,175 - 2,352 - 23,926 24,990 £ £ Orthopaedic Surgery 2,490 2,827 2,972 516 1,056 1,888 - 11,749 12,315 ENT Surgery 118 1,565 2,049 794 736 - - 5,262 5,754 25,140 The Chairman 26,981 26,981 Ophthalmology - 923 - 342 58 710 - 2,033 2,267 103,648 Chief Executive 101,543 3,930 2,884 108,357 Urology 1,660 1,361 - 1,399 - 2,311 - 6,731 6,795 Oral Surgery & Medicine 305 16 273 239 97 8 - 938 1,328 Other Board Members whose remuneration fell within the following ranges: General Medicine 12,018 13,720 11,282 9,773 - 7,545 - 54,338 53,362 Dermatology - 280 - - - 252 - 532 520 7 £0 - £5000 9 Surgical Paediatrics - - - - 2,343 - - 2,343 3,138 2 £60,001 - £65,000 1 Medical Paediatrics - - - - 4,551 - - 4,551 5,138 0 £65,001 - £70,000 1 Gynaecology 1,026 1,371 2,065 1,128 - 1,252 - 6,842 7,527 1 £80,001 - £85,000 0 0 £100,001 - £105,000 1 Sub Total 22,839 28,495 24,386 18,366 8,841 16,318 - 119,245 123,134 Obstetrics 4,437 - - - 2,256 4,278 - 10,971 11,218 Senior employees whose remuneration fell within the following ranges:

6 £40,001 - £45,000 11 SUPRA AREA 2 £45,001 - £50,000 2 Neurosurgery - - - - - 949 - 949 1,061 4 £50,001 - £55,000 4 Cardiothoracic Surgery 666 707 - - 75 - - 1,448 1,621 8 £55,001 - £60,000 3 Plastic Surgery 2,220 ------2,220 2,224 1 £60,001 - £65,000 3 Neurology - - - - 155 831 - 986 1,092 0 £65,001 - £70,000 3 Radiotherapy - 2,536 - - - - - 2,536 2,446 1 £70,001 - £80,000 1 Spinal Paralysis - - - - - 65 - 65 65 2 £80,001 - £90,000 1 1 £90,001 - £100,000 1 Sub Total 2,886 3,243 - - 230 1,845 - 8,204 8,509 0 £100,001 - £110,000 1

25 30 OTHERS Communicable Disease - 1,014 - - - - - 1,014 1,062 Spec/Intens Baby Care 660 - - - 1,022 331 - 2,013 2,111 ITU & CCU 592 964 1,172 1,026 217 819 - 4,790 4,621 A & E 1,654 484 - - - 70 - 2,208 2,411

Sub Total 2,906 2,462 1,172 1,026 1,239 1,220 - 10,025 10,205

LONG STAY SPECIALTIES Geriatric Assessment 2,468 2,014 1,446 2,515 - 1,856 - 10,299 9,404 Geriatric Long Stay 323 287 257 345 - 136 - 1,348 1,318 Young Phys Disabled - - - 35 - 105 - 140 202

Sub Total 2,791 2,301 1,703 2,895 - 2,097 - 11,787 10,924

PSYCHIATRY Mental Illness ------4,980 4,980 4,155 Geriatric Psychiatry ------1,484 1,484 1,531 Child Psychiatry - - - - 28 - - 28 47 Adolescent Psychiatry ------28 28 21

Sub Total - - - - 28 - 6,492 6,520 5,754

LEARNING DISABILITIES ------306 306 239

TOTAL 35,859 36,501 27,261 22,287 12,594 25,758 6,798 167,058 169,983

30 31 ANNUAL REPORT 1999-2000

OUTPATIENTS BY SPECIALTY AND PROVIDER UNIT (ALL PATIENTS) OUTPATIENTS BY SPECIALTY AND PROVIDER UNIT (ALL PATIENTS) Year Ending March 31, 2000 Continued

Comm/ DENT 99 Comm/ DENT 99 GRI WES VIC STOB RHSC S GEN Ment HOSP Total Total GRI WES VIC STOB RHSC S GEN Ment HOSP Total Total ACUTE SPECIALTIES LEARNING DISABILITIES General Surgery 21,916 30,462 15,397 13,209 - 9,572 - - 90,556 92,954 ------162 - 162 553 Orthopaedic Surgery 25,344 23,190 23,334 8,645 12,429 17,781 - - 110,723 114,999 ENT Surgery 8,513 5,860 11,839 7,320 5,189 4,161 - - 42,882 45,817 Ophthalmology 8,165 41,873 11,698 9,772 3,636 11,237 - - 86,381 86,482 OTHER Urology 9,750 11,389 4,586 8,658 - 5,175 - - 39,558 39,729 Diagnostic Radiology 74,720 76,053 71,769 53,625 27,614 61,260 - 20,154 385,195 375,209 Oral Surgery & Medicine 8,144 1,053 3,366 3,243 3,100 619 - 103,843 123,368 132,265 Physiotherapy 53,300 65,508 30,794 21,098 13,208 37,484 866 - 222,258 219,891 General Medicine 91,738 103,737 36,958 59,323 - 46,602 - - 338,358 340,635 Radiotherapy (Treatment) - 64,756 ------64,756 65,202 Dermatology 16,950 15,295 9,591 8,013 5,320 6,062 - - 61,231 69,099 Electrocardiography 22,333 17,032 7,658 16,819 4,266 9,560 - - 77,668 71,055 Surgical Paediatrics - - - - 10,630 - - - 10,630 12,080 Speech Therapy 3,028 3,183 2,201 1,716 581 1,161 - 1,166 13,036 15,196 Medical Paediatrics 1,795 - - - 37,151 721 - - 39,667 39,974 Occupational Therapy 1,250 2,402 2,462 2,320 5,651 8,213 17,603 - 39,901 39,503 Gynaecology 14,847 9,908 9,664 12,910 119 8,632 - - 56,080 59,565 Chiropody 4,139 1,700 1,290 6,917 306 27,448 280 - 42,080 43,664 Audiometry 6,408 11,739 4,685 2,970 4,458 1,727 - - 31,987 32,949 Sub Total 207,162 242,767 126,433 131,093 77,574 110,562 - 103,843 999,434 1,033,599 Others 61,303 85,293 24,121 27,663 45,601 49,390 16,517 9,530 319,418 288,866 Obstetrics 21,387 - - - 17,390 12,964 - - 51,741 58,806 Sub Total 226,481 327,666 144,980 133,128 101,685 196,243 35,266 30,850 1,196,299 1,151,535

SUPRA AREA Neurosurgery - - - - - 3,742 - - 3,742 3,895 DAY HOSPITAL ATTENDANCES Cardiothoracic Surgery 3,282 3,101 ------6,383 6,756 29,760 46,533 10,226 32,614 2,411 4,004 61,405 - 186,953 229,488 Plastic Surgery 27,283 - 1,151 1,257 - - - - 29,691 32,327 Neurology 1,156 - - - 2,740 12,254 - - 16,150 15,110 TOTAL 592,775 724,167 364,060 352,389 245,722 393,678 141,877 155,777 2,970,445 3,011,006 Radiotherapy 717 23,305 2,744 - - 799 - - 27,565 25,036 Spinal Paralysis - - - - - 6,811 - - 6,811 3,812

Sub Total 32,438 26,406 3,895 1,257 2,740 23,606 - - 90,342 86,936

OTHERS Communicable Disease - 6,396 ------6,396 6,430 A & E 73,700 72,100 73,307 53,509 37,555 45,621 - 21,084 376,876 374,774

Sub Total 73,700 78,496 73,307 53,509 37,555 45,621 - 21,084 383,272 381,204

LONG STAY SPECIALTIES Geriatric Assessment 1,847 2,299 3,198 788 - 678 - - 8,810 8,548

Sub Total 1,847 2,299 3,198 788 - 678 - - 8,810 8,548

PSYCHIATRY Mental Illness - - 2,021 - - - 35,772 - 37,793 45,063 Geriatric Psychiatry ------5,815 - 5,815 5,527 Child Psychiatry - - - - 6,206 - - - 6,206 6,147 Adolescent Psychiatry - - - - 161 - 3,457 - 3,618 3,600

Sub Total - - 2,021 - 6,367 - 45,044 - 53,432 60,337

32 33 ANNUAL REPORT 1999-2000

DAY CASES BY SPECIALTY AND PROVIDER UNIT (GGHB RESIDENTS) LENGTH OF WAIT FOR GGHB RESIDENTS: Year Ending March 31, 2000 SMR3 Comparison March 1999 - March 2000

DENT 99 Specialty 0 to 3 months 3 to 12 months 12 to 18 months Over 18 months TOTAL Mar-99 Mar-00 Diff Mar-99 Mar-00 Diff Mar-99 Mar-00 Diff Mar-99 Mar-00 Diff Mar-99 Mar-00 Diff GRI WES VIC STOB RHSC S GEN HOSP Total Total Nos Nos Nos Nos Nos Nos Nos Nos Nos Nos ACUTE SPECIALTIES 6 Core Specialties General Surgery 2,872 3,753 753 2,489 - 1,149 - 11,016 11,778 General Surgery 1673 1759 86 979 1137 158 1 0 -1 0 1 1 2653 2897 244 Orthopaedic Surgery 298 594 401 147 62 339 - 1,841 1,873 Orthopaedics 1097 1168 71 1130 1436 306 2 11 9 0 0 0 2229 2615 386 ENT Surgery 157 5 323 189 438 2 - 1,114 1,120 ENT 876 714 -162 1011 849 -162 2 4 2 1 1 0 1890 1568 -322 Ophthalmology - 1,374 - 1,116 247 854 - 3,591 2,931 Ophthalmology 858 902 44 381 692 311 0 0 0 0 0 0 1239 1594 355 Urology 493 2,131 1 1,948 - 2,812 - 7,385 7,08 Urology 756 973 217 175 314 139 1 0 -1 0 0 0 932 1287 355 Oral Surgery & Medicine 177 - 124 54 9 64 3,389 3,817 3,311 Gynaecology 630 609 -21 61 54 -7 0 0 0 0 0 0 691 663 -28 General Medicine 7,334 6,910 5,295 4,075 - 2,082 - 25,696 25,689 Dermatology - 14 - - - 1 - 15 16 TOTAL 5890 6125 235 3737 4482 745 6 15 9 1 2 1 9634 10624 990 Surgical Paediatrics - - - - 880 - - 880 914 Medical Paediatrics - - - - 1,288 - - 1,288 793 Gynaecology 1,386 1,130 1,051 1,304 - 587 - 5,458 6,117 OTHERS Neurosurgery 28 40 12 2 9 7 0 0 0 0 0 0 30 49 19 Sub Total 12,717 15,911 7,948 11,322 2,924 7,890 3,389 62,101 61,628 Cardiothoracic 97 70 -27 189 84 -105 2 5 3 0 0 0 288 159 -129 Obstetrics 876 - - - 1,596 1,474 - 3,946 4,334 Plastic Surgery 590 445 -145 695 561 -134 1 0 -1 0 0 0 1286 1006 -280 Dental Surgery 177 163 -14 68 63 -5 0 0 0 0 0 0 245 226 -19 SUPRA AREA Cardiology 234 237 3 18 67 49 0 0 0 0 0 0 252 304 52 Neurosurgery - - - - - 26 - 26 46 Neurology 57 78 21 1 2 1 0 0 0 0 0 0 58 80 22 Cardiothoracic Surgery 28 1 - - - - - 29 12 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Plastic Surgery 3,382 ------3,382 3,165 Nephrology 5 0 -5 6 0 -6 0 0 0 0 0 0 11 0 -11 Neurology - - - - 12 69 - 81 45 Respiratory 0 5 5 0 27 27 0 0 0 0 0 0 0 32 32 Radiotherapy - 4,407 - - - - - 4,407 4,091 Rheumatology 11 18 7 7 7 0 0 0 0 0 0 0 18 25 7 Spinal Paralysis - - - - - 233 - 233 205 Radiotherapy 1 0 -1 0 0 0 0 0 0 0 0 0 1 0 -1 Medical Oncology 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sub Total 3,410 4,408 - - 12 328 - 8,158 7,564 Homoeopathy 16 16 0 6 4 -2 0 0 0 0 0 0 22 20 -2 Endocrinology 0 0 0 0 2 2 0 0 0 0 0 0 0 2 2 Geriatric Long Stay 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OTHERS Gastroenterology 61 91 30 27 10 -17 0 0 0 0 0 0 88 101 13 Communicable Disease - 88 - - - - - 88 58 General Medicine 22 26 4 1 0 -1 0 0 0 0 0 0 23 26 3 ITU & CCU 45 - 80 - - - - 125 118 Pain Relief 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 A & E - - 1 - - - - 1 1 Psychogeriatric 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Sub Total 45 88 81 - - - - 214 177 TOTAL 1299 1190 -109 1020 836 -184 3 5 2 0 0 0 2322 2031 -291 TOTAL 17,048 20,407 8,029 11,322 4,532 9,692 3,389 74,419 73,703 ALL SPECIALTIES 7189 7315 126 4757 5318 561 9 20 11 1 2 1 11956 12655 699

Paediatric Dentistry 36 47 11 11 12 1 0 0 0 0 0 0 47 59 12 Medical Paediatrics 2 14 12 0 21 21 0 0 0 0 0 0 2 35 33

ALL SPECIALTIES INCLUDING PAEDIATRIC DENTISTRY & MEDICAL PAEDIATRICS 7227 7376 149 4768 5351 562 9 20 11 1 2 1 12005 12749 744

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