Health in Scotland 2003
FOREWORD
Dear First Minister
It is my privilege to present my annual report, Health in Scotland 2003.
I have commented on the current health status of the people of Scotland and on the determinants of health in Scotland. These include the social circumstances in which people live, the lifestyles they adopt and the choices they make in their daily lives. Taken together, these are the determinants of the risks which threaten our mental and physical well-being and which materialise as the toll of mental illness, cancer, coronary heart disease, stroke, diabetes and the other acute and chronic diseases which affect the people of Scotland.
As I said in my last annual report, the single greatest of those risk factors is tobacco use. I have devoted a whole chapter in this report to the true cost of tobacco in Scotland. I have sought to highlight the way in which the burden of tobacco-related disease and disability disproportionately exploits the most excluded and vulnerable in our society and their children. The momentum of tobacco control policy development has been sustained throughout 2003. I particularly welcome the publication of the joint ASH Scotland/NHS Health Scotland Report Reducing Smoking and Tobacco-Related Harm and the prompt and comprehensive Scottish Executive response. The consultation should gauge the degree of support among the people of Scotland for real, sustained and co-ordinated action over a considerable period to control and eliminate the scourge of tobacco from our lives. There can be no single goal which is more worthwhile in terms of its overall contribution to the health and well-being of people in Scotland.
Health in Scotland 2003 also focuses on the area of health protection. The developed world at the start of the 21st century is facing a double burden of disease. Not only are we having to cope with a mounting toll of chronic disease but we face new and re-emerging communicable diseases and environmental threats. The report sets out the current situation in a number of key problem areas and outlines the steps we are taking to enhance and develop our health protection capacity in Scotland in partnership with colleagues elsewhere in the UK and internationally.
I have included, as in previous reports, key points from the major programmes on cancer, coronary heart disease and stroke, mental health and diabetes. These programmes are beginning to demonstrate real progress, not only in more sophisticated processes to guide patients through an increasingly complex journey of care, but in better outcomes in terms of lower mortality, better quality of care and improved quality of life for people with these problems. Getting the best outcomes for patients in a modern, complex healthcare system requires health professionals to work together in new ways, underpinned by quality assurance systems at every level.
I very much welcome, therefore, the contributions to this report from the Chief Nursing Officer and the Chief Dental Officer on developments in nursing and in improving children's oral health in Scotland and the contributions to the Chapter on Health Quality. Given the complexity of modern health and healthcare, this report cannot be comprehensive. Health in Scotland 2003 is the product of contributions from many colleagues, in many fields, and is backed by a wealth of detailed information and by reports which are now publicly available, many of them on Scotland's Health on the Web (SHOW), www.show.scot.nhs.uk.
Pulling all this together in a single document has been an immense task and my grateful thanks are due to one of my Senior Medical Officers, Sandra Campbell, who has done the editing, to Marion Collins and to my own office staff, who have managed the process so well.
Yours sincerely
DR E M ARMSTRONG