The Conservatives said that social breakdown in general is clearly linked to family breakdown and that it is the job of government to put in place the structures to reverse family breakdown and encourage stability and commitment.

The Lib Dems said they would begin to measure the wellbeing of children, with an annual report on progress set against that of other nations. They would also introduce a Children’s Rights Impact Assessment to show how political decisions impact on the rights and wellbeing of children.

The Lib Dems would introduce a strategy for early intervention with vulnerable young people, for example those in care and those living with a parent who has a drug problem.

The Greens said they would aim to support families through the extension of maternity and paternity leave, and build on universal services that parents receive such as child benefit, rather than means-testing.

Pregnancy

The SNP promised that to provide free fruit for pregnant women and pre-school children using the model of market-led pregnancy cards from the major supermarkets.

The Lib Dems want to pilot the Nurse Family Partnership model used in the US in supporting mothers before, during and after pregnancy.

Services

The SNP would work to expand family group conferencing from the councils which currently use it out to the whole country.

The SNP said that they would make sure that all agencies share information and intervene promptly to identify and support children at risk. They will also review the funding of children’s services to ensure it meets needs and that there is greater integration of service delivery. Labour would create a statutory duty for all public agencies with responsibility for children to share information in the interests of protecting the child.

Labour said they wanted to improve and integrate national parenting programmes to ensure families receive support. They wanted to reform Sure Start, merging it with Working for Families programmes and creating a “Sunrise” fund for better delivery of services targeted at improving life chances for young children and their families. The Lib Dems and the Greens also wanted to increase the support for Sure Start in order to expand its capacity. Meantime, the Lib Dems would extend the use of early years centres and family centres, and develop a National Parenting and Family Support Strategy to help parents to help themselves with more support groups and information. The Greens would restore community decision-making to Sure Start and seek to ensure higher take-up rates.

The Greens would establish additional dedicated support services for parents, available before families reach crisis point, which would first work to build parenting skills, nutrition, and home support for education. Such services would also look at all of the different stresses on the family and take action to reduce them, in partnership with other agencies.

The Greens would "restore the balance" between provision of childcare and home parenting, ensuring the provision of high quality childcare meets the needs of children and parents.

 

HEALTH

Addictions

The SNP and Lib Dems want to tackle inappropriate drinks promotions in off-sales premises, such as shops and supermarkets. The SNP would do this through Ministers using powers to set national licence conditions for the off trade. Labour said it would encourage licensing boards and licensees to negotiate voluntary agreements to limit discounted prices.

The SNP want clearer labelling of the unit content on alcoholic products.

The Greens would use the licensing system to restrict the growth of megapubs.

The SNP, Conservatives and Lib Dems want to increase drug treatment and rehabilitation programmes. The SNP would give a 20% increase in funding for this; the Conservatives would allocate £100m per year and the Lib Dems would use more than £100m of additional funding.

Labour would create a National Drug Free Lives Unit within the centre of the devolved Government, which would set national priorities for preventative, educational and rehabilitation services.

The Conservatives want to introduce a Scottish Directory of Rehabilitation Facilities and the Lib Dems would establish a national register of drug and alcohol services, including residential placements.

The SNP would establish a national Drugs Commission to develop and agree a long term national strategy backed up by a more robust evidence base.

The SNP would restore ring-fenced funding for drugs education, with £10m of dedicated funding for drugs education in classrooms.

The Conservatives would require every methadone prescriber to record how long a patient has been on methadone and, in consultation with the patient, determine a future treatment plan designed to take the user off heroin and methadone for good. 

The Greens would increase flexibility in treatments for those with addictions, providing quick access to rehabilitation services, widening the prescribing options where appropriate, and investigating the effectiveness of other treatments.

The SNP, Labour and the Greens would all raise the minimum age for sale of cigarettes to 18.

Labour would make smoking cessation programmes available in secondary schools.

Health boards

The SNP would introduce direct elections to health boards, while Labour would pilot direct election of a majority of health board members. The Lib Dems however want to see a much greater scrutiny role for local government over health services in their area, with local scrutiny panels). The Greens also do not mention direct elections but would like health boards to commit to national standards for community engagement and agree voluntary sector compacts.

Mental health

All five of the parties expressed a commitment to help those with mental health problems: The SNP want funding for mental health and wellbeing services in each community health partnership area to be ring-fenced, and aim to reduce the use of anti depressants by 10% by 2009. Labour would particularly like to reduce suicide amongst young men, self harm and eating disorders amongst young women and to identify mental health problems early in children. The Conservatives would allocate an extra £10m to be used exclusively to improve treatment and services for people with a mental health problem (with the voluntary sector as the driving force behind  provision of support). The Lib Dems said that they would implement the Delivering for Mental Health plan and they would build the capacity of service users so they can be meaningfully involved in the design, delivery and evaluation of policy and services. The Greens want to promote and resource the development of accessible alternative care and treatment approaches across both the public and voluntary mental health sectors.

 

Older people

Labour would like to create a ‘care at home’ scheme in each local area to identify those older people most at risk of harm or significant ill-health in the community, and would introduce a national helpline for older people modelled on ‘child-line’.

The Lib Dems said that the latest technology must be used to support older people to live longer in their own homes.

The Green Party would support a fundamental review of NHS and social services for the elderly, and would fund a pilot programme of time banks for the elderly, where participants give and receive time, as and when they need it.

Personal & community care

The SNP would increase payments for free personal and nursing care in line with inflation as "an immediate priority", with an independent review to investigate both the level and distribution of resources to local authorities. They would also invest an additional £6m each year to ensure an appropriate availability of care home places for those who need residential care.

The Lib Dems would review the free personal care settlement to ensure that the next spending review is used to address issues of differential implementation across Scotland.

Prescription charges

The SNP would immediately abolish prescription charges for people with chronic health conditions, people with cancer, and people in full time education or training, and would phase out prescription charges for the rest of the population by 2012.

Labour and the Lib Dems would not phase out prescription charges but would make the system fairer and more consistent. Labour would ensure that people can afford the medicines they have been prescribed and for people who depend upon repeat prescriptions, Labour would reduce the annual total amount payable. The Lib Dems would limit the maximum amount that anyone has to pay to one prescription per month, with any prescriptions beyond that free to all.

Preventative care

The SNP would introduce ‘Life begins’ health checks and individual health plans for all men and women when they reach the age of 40 with the aim of extending this initiative to those reaching retirement age by the end of their first term in government. Labour would introduce a free full health check for men aged 40 and expand walk-in centres across Scotland to allow easier access to health services for all. The Lib Dems said that new ways should be developed to get men to screening and health check services in the community.

Labour would like more done to improve the availability of healthy food and nutritional information for people in deprived areas, including support for the establishment of food cooperatives. The Lib Dems would also consider supporting social enterprises to run their own healthy, low cost food shops from council premises at zero rent.

The Lib Dems said they would evaluate the 12 anticipatory care pilots operating through Community Health Partnerships at the earliest possible opportunity, setting clear national objectives, and providing resources to roll these out across Scotland.

Structures

The SNP said they would improve the quality of NHS24 by delivering the service through more local mini-centres co-located with out-of-hours services in each health board area. The Conservatives want to hold an immediate review of NHS 24 with a view to investigating alternative methods of delivery, including local centres led by local clinicians.

The SNP and Conservatives said that there should be a presumption against centralisation of core hospital services to protect local access to healthcare. The Conservatives said that where the centralisation of the health service has contributed to poorer facilities for rural people, they would seek to reverse it. 

Labour said they were committed to building more community hospitals, and would introduce walk-in treatment centres in the main commuter hubs and expand the hours of nurse-led health centres.

The Lib Dems would introduce a strategy for sustaining small rural and community hospitals as part of a network of rural hospitals to support remote communities. They would also establish a Clinical School for Rural Health Care to ensure workforce development and promote the use of general consultants undertaking routine procedures.

The Lib Dems would establish a "Tele-health Technology Resource Centre" based in Aberdeen, to develop nationally applicable approaches to tele-health. They would establish a dedicated social enterprise unit in the health department to encourage the development of the sector in Scotland.

The Lib Dems said that investment in new local health centres would create a shift to more diagnostic investigations in the primary care sector, with local health workers undertaking more tests at the time of referral which will make first specialist appointments more meaningful.

The Conservatives want patients to have a say when and where they should have an operation and to that end, patients should be able to choose from a menu of hospitals which can perform the relevant procedure. They say that this system would mean that healthcare providers would have to raise their game in order to attract patients and any healthcare facility for which there was demand, borne out by people exercising their choice to use it, would remain open and viable.

Waiting times

SNP, Labour and Lib Dems all continued to focus on waiting times, with the SNP and Labour setting a target that no patient should wait longer than 18 weeks from GP referral to treatment by 2011, and Lib Dems introducing a new Total Waiting Time Guarantee of: first day treatment for primary care; maximum 5 day wait for GP consultation; maximum 90 day wait for diagnosis; and maximum 90 day wait for treatment.