Rt Hon Alex Salmond MSP First Minister of Scotland St Andrew's House, Regent Road, Edinburgh EH13DG T: 08457741741 ~ The Scottish Government Mark Leishman Esq Deputy Private Secretary to HRH the Duke of Rothesay Clarence House / (bye-mail) 16 November 2007 Thank you for your letter of 5 October. We have been in touch more recently about the various items of action following the First Minister's discussions with His Royal Highness. Health We were investigating what initiatives there were relating to alternative therapies in Scotland and whether there were any plans to trial the availability of alternative therapies to see whether it would provide an effective and cost effective outcome for patients. In terms of current initiatives in alternative therapies, NHS Greater Glasgow and Clyde operates a homeopathic hospital and NHS Boards are free to use alternative therapies if they choose to - as outlined in a circular issued to all NHS Boards. This document also notes the (then) Scottish Executive's move to make "Complementary Healthcare - A Guide for Patients", published by the Prince of Wales Foundation for Integrated Health, available to NHS Boards. I attach both a background note on NHS Greater Glasgow and Clyde's homeopathic hospital (Annex A) and the circular on alternative therapies issued to all Health Boards (Annex B). In addition to this, the Chief Scientist's Office (CSO) has in the past funded several research projects in the area of alternative and complementary therapies. These have included a trial of reflexology for constipation in children, use of essential oils to reduce anxiety in patients awaiting biopsy results, use of music therapy for children with Attention Deficit - Hyperactivity Disorder, and a trial of spiritual healing in asthma. The CSO supports research projects initiated by the research community in Scotland which are of a sufficiently high standard. This role is well known and advertised throughout the healthcare and academic community. The CSO is not currently funding any research in this area, but would be glad to consider further research proposals into complementary and/or alternative therapies. I also attach for HRH's information a table (Annex C) outlining the gross ingredient cost for homeopathic medicines to each NHS Board in Scotland, which refers to prescriptions dispensed by community pharmacists and dispensing doctors. This does not however take into account medicines dispensed by hospitals or hospital-based clinics. Housing As you know, the First Minister instructed that some of the ideas on affordable and sustainable housing that he discussed with HRH should be included in the Scottish Government's Green Paper on Housing. The Green Paper was published on 31 October under the title "Firm Foundations: the future of housing in Scotland". You can find a copy at http://www.scotland .qov.uk/Resource/Doc/201716/0053780.pdf . Chapter 2 of Firm Foundations, focusing on our priorities for action on housing supply, contains a section on housing in rural Scotland. It commends the Prince's Rural Housing Initiative for its active pursuit of sustainable rural housing, and it suggests that lessons should be learned from the Initiative's range of good practice. In particular, it highlights the Initiative's promotion of the role of the private sector in creating balanced and sustainable communities. On sustainable urbanism, Firm Foundations signals the launch of the Scottish Sustainable Communities Initiative which will seek proposals from local authorities and their partners for new communities. The principles of sustainable urbanism - environmental, social and economic sustainability - underpin the criteria that will be used to select successful proposals. Details of how the Initiative will operate are being developed and will be set out in a document to accompany the consultative draft of the National Planning Framework to be published later this year. The Scottish Sustainable Communities Initiative could be supported by a major international conference in Spring 2008 on sustainable urban expansion showcasing practice with a focus on developments in other countries, such as in Scandinavia, with similar climates to Scotland. We are considering this further. Agriculture and Environment I understand that a meeting with Richard Lochhead and Michael Russell is planned for January in Ballater. You asked for guidance on how funding might be sought from the Scottish Government on developing MSC Certified Fisheries. The First Minister supports sustainability certification schemes such as the Marine Stewardship Council. He was pleased to hear about the fisheries under consideration in the North Highland area and that the vessels concerned are going to be encouraged to join the Seafish Responsible Fishing scheme. Several other Scottish fisheries are in the process of seeking MSC certification, including the Scottish mackerel and herring fisheries and Scottish langoustine fisheries in the Clyde and the Western Isles. We are also aware of interest from other parts of the Scottish industry. The Scottish Government is happy to support any group wishing to seek certification for a Scottish fishery, both in terms of funding and assistance in meeting the governance criteria for certification. Officials would be interested to discuss the North Highland Initiative's plans in relation to the specific fisheries in their area in more detail, not only in relation to any assistance we might be able to provide but also because there may be synergies between other work we are progressing on fishing communities and inshore fisheries management. The principal contact on sustainability certification is Colin Faulkner. Colin leads the team dealing with fisheries conservation. He can be reached on 0131 244 6432 or via Colin. Faulkner@scotland.qsi.qov.uk I hope these notes are helpful. The First Minister is looking forward to seeing you, along with Mark Johnson and other representatives of the Prince's Trust, next week. Please let us know if there is any more we can do in the meantime. IAN DONALDSON Private Secretary " ANNEX A MEETING WITH HRH THE DUKE OF ROTHESA Y: ALTERNATIVE THERAPIES Background Glasgow Homoeopathic Hospital A new custom built facility within the main Gartnavel General site was opened in 1999, with significant funding provided via charitable donations. The Homoeopathic Hospital provides a holistic, person-centred approach to a range of chronic conditions, including low back pain, rheumatoid arthritis and multiple sclerosis (MS). Many of its inpatients have multiple diagnoses with over 70% suffering some form of psychiatric distress and 41 % from uncontrolled pain. In additional to conventional medical practice, treatments provided by the Hospital include homoeopathy and acupuncture, physical therapies including manipulation, neural therapy, 'mind-body' approaches (such as relaxation training and hypnosis), artistic/self-expression work, massage, electro-stimulation therapy, counselling, autogenic therapy, iscador treatment, bowen therapy and dietary/nutritional advice. The hospital provides inpatient services in the form of 15 beds (7 at weekends). Admissions are typically for patients experience a flare-up of their chronic disease condition (e.g. pain management, mental health crises, MS relapses and arthritis). On occasion the hospital will provide terminal care. Of the five major NHS homoeopathic centres in the UK (the others being in Bristol, London, Tunbridge Wells and Liverpool), only Glasgow provides inpatient care. Outpatient services are provided via 53 weekly clinic sessions located within the Hospital or at network clinics held in hospitals and health centres across Central Scotland. Off-site clinic locations are Baillieston, Coatbridge, Carluke, Hairmyres (East Kilbride), Strathclyde Hospital (Motherwell), Stirling and St John's Livingston. Weekly clinics are also provided at the Western Infirmary and Royal Hospital for Sick Children in Glasgow. From April 2006, NHS Greater Glasgow and Clyde was restructured on a functional service basis away from former Trust territorial structures. The Glasgow Homoeopathic Hospital is now part of the Acute Services Division, specifically managed from within the Regional Services Directorate (which is also responsible for the Beatson West of Scotland Cancer Centre, Cardiothoracic Services, Spinal Injuries and Neurosciences among other services). The new Directorate has now conducted a review of day-to-day operational management structures and practices within the Homoeopathic Hospital. This is unlikely to have any impact on direct patient care, though it will strive for greater efficiencies. ANNEX B )JHS Circul1r: HDL(~005) 37 SCOTTISH EXECUTIVE Health Dep for Scotland, England. \Vales and -::-Iorthem Ireland. The Executive '•••. ill work wirh the CK Government and the other devolved administrations ro inrroduce legislarion to establish such a counciL 24 Allg".l:>t 2005 .: or actiou -: or uofc:rm;;.tiou Chier E"""'.lti':ec.. Sp""ial Ee;u~ Beard: Cc=mri:y Hea2th Pa1tner:.b.tp~ ~a~""'" G]••~· ?l1bJic Health St _~ .•••. 'i'~ :fcnlOe :::DINBL'XGEEH! 3DG Te1. OBI-24-1-25++ Ea.,,: 0131-24-1 286<> ~a~eu.G1..=ya ~cotbJ)dg~i.gc'::.:.k ~HS Circular: HDL(2005) 37 4. Recently the Executive made available to NHS Boardc, copies of a booklet produced by the Prince of \Valec,' Foundation for Integrated Health, Complememm~' HealrhcGre - A GlIidefor Pariems. An electronic vef'>ionic,available ar www.f1health.org.uk 5. Complementary and Alternative 1,'{edicine ic, an area in which there is increasing public interest. Chief Executivec, are asked to take this into account in the planning of sen'lces. The Executive ic,aware that a number of ~HS Boardc, already provide c,omeforms of CA~1. Yours sincerely PAM 'WHITTLE DIRECTOR ANNEX C Gross Ingredient Cost for Homeopathic medicines as at 31st March 2007 NHS NHS NHS NHS NHS NHS NHS NHS NHS NHS NHS NHS NHS NHS NHS Board Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasqow & Clyde Hiqhland Lanarkshire Lothian Orkney Shetland Tayside Western Isles Year ending 31st March 2007 £13,040.36 £1,796.73 £3,667.96 £8,787.46 £4,967.99 £95,454.50 £52,385.85 £8,759.08 £13,677.78 £31,058.14 £260.00 £546.39 £21,115.66 £86.83