Plans to overhaul Scottish hospitals will leave the country with a very different health service to that in England, Scottish health minister Sam Galbraith said this week.

Speaking at the launch of the report of a year-long review of acute services led by chief medical officer Sir David Carter, Mr Galbraith said there was 'much work to do'.

He added: 'But when achieved, we will have delivered a health service to the Scottish parliament which is as distinctive from the NHS south of the border as Holyrood will be from Westminster.'

NHS Confederation chief executive Stephen Thornton said he was 'struck' by the admission that 'creating something very Scottish is... an important motivation'.

'I think that should be welcomed. It will let us see how things are done differently and learn from what works,' he said.

Mr Galbraith immediately made four of the report's recommendations 'a priority for action'.

Walk-in, walk-out centres would provide 'fast, one-day treatment for common ailments'.

A taskforce would be set up to tackle coronary heart disease.

There would be a 'unique' system of quality assurance and accreditation.

Raigmore Hospital in Inverness would become a 'resource centre' to meet the needs of more remote communities.

The review was set up in the wake of a report looking at a sudden rise in emergency admissions at the end of 1995. Its remit was to examine acute care, although it was 'not undertaken on the premise that widespread hospital closures were necessary or desirable'.

Sir David said he had considered recommending a cut in the number of Scottish health boards, but eventually decided this would mean a loss of local identity.

But he said there was 'widespread recognition that the status quo is no longer an option' and changes would have to be made 'in the way services are delivered from existing facilities'.

The report calls for 'managed clinical networks'. These would be'virtual service organisations' in which 'the skills of professionals are grouped around population and service needs'.

It suggests that networks, rather than trusts, could employ staff and proposes that a 'lead clinician' should ensure service quality.

Mr Thornton noted this was 'very different' from the super-hospitals backed last week by the British Medical Association and royal colleges. 'In principle, it is a very good response to the geography, which means you cannot centralise everything in Glasgow and Edinburgh,' he said.

The report also recommends that child health services should be improved with the creation of a 'virtual' institute for child health. Recruitment and retention problems should be addressed and information technology and telemedicine used.

Clinicians welcomed the report. The Royal College of Surgeons of Edinburgh said it was 'refreshing' that the report sought Scottish solutions to Scottish problems. It 'fully supported' the idea of healthcare networks.

Arthur Morris, chair of the BMA Scottish council, said the report 'recognises that no solution has been found to difficulties faced in the continuing provision of hospital care'. He welcomed opportunities to discuss solutions with the Scottish Office.

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