Scotland’s public places could be smoke-free by spring 2006.

The government proposes:

• To seek a comprehensive ban on smoking in all enclosed public places in Scotland
• To enforce the legislation through environmental health and local licensing officers
• To impose fines of up to £2,500 to licensees or employers who fail to enforce the law
• To remove the drinks licence of licensees who persistently refuse to comply with the law
• To issue fixed penalty notices for individuals who break the law
• To impose fines of up to £1,000 to individuals who persistently refuse to comply with the law

The decision to ban smoking was made unanimously by Scottish ministers. The legislation will now be introduced to Parliament before Christmas.

First Minister Jack McConnell said:

‘A comprehensive ban will be a clear signal that Scotland has changed. It will reduce smoking, save lives and help transform our national health. It will be easier to enforce and simpler to understand than other options that would fall short of that.

‘No longer will Scotland be the place in Europe most associated with poor health, and no longer does Scotland need to wait for someone else to take responsibility for difficult decisions.’

Doctors and anti-tobacco groups are delighted with the news, but licensees are planning to fight the ban. The move puts added pressure on Health Secretary John Reid to make similar plans for England — the Department of Health’s White Paper on public health is expected to be published next week.

A consultation has been launched to discover what the public thinks of getting involved in health issues.

Views are sought on patient and public involvement (PPI) forums and:

• how members should be recruited
• the support and guidance they need
• the processes, structures and relationships they need

There are 572 PPI forums — one for every NHS trust and PCT in England.

The results of the consultation will help the Department of Health transfer responsibility for making forum appointments to the NHS Appointments Commission.

Opinion Leader Research, an independent market research organisation, is conducting the survey.

Foundation trusts will be publicly rated red, amber or green under new proposals by their regulator.

Monitor, the independent regulator of NHS foundation trusts will regularly measure financial strength, clinical performance and management systems. Foundation trusts will be graded from one to five for their financial situation (see financial risk rating table, below), and on a traffic light system for other aspects of their performance (see governance/mandatory services risk rating table, below).

The regulator has the power to intervene when trusts are under-performing.

Nigel Edwards, policy director at the NHS Confederation has said patients will be confused by the new system.

Consultation on Monitor’s proposals ends on 31 January 2005.

Governance/mandatory services risk rating

Financial risk rating

Commuters in London, Newcastle, Manchester and Leeds will benefit from seven new NHS walk-in centres.

Health minister John Hutton has announced that £25m will be invested in the seven centres over three years (London is to have four sites). The centres will be open 24 hours a day to commuters and local residents, without the need for prior appointments.

There are currently 57 walk-in centres with doors open to the public. A further 25 are under development in:

Care for men with prostate cancer is improving, health minister Lord Warner announced as he launched a report on the condition.

The good news came at the national prostate cancer conference on 9 November. The report sets out progress on the NHS prostate cancer programme four years after its launch.

The programme, the first of its kind, was an attempt to focus attention on the most commonly diagnosed cancer in men in England and the second biggest cancer killer in men. It called for advances in prostate cancer research and NHS services and information.

Its achievements so far are:

• Prostate cancer is the only cancer with a government spending target for research — the £4.2m mark was reached in 2003/04
• In 1997, just 40 per cent of patients with suspected prostate cancer were seen by a consultant within two weeks of being urgently referred. The figure is now more than 98 per cent
• There are now 503 consultant urologists — up from 343 in 1997
• All GPs have resources to help them counsel men concerned about the cancer
• From next year masterclasses for surgeons will teach the latest specialist techniques

Lord Warner said:

'We take prostate cancer very seriously. That is why four years ago we published the NHS Prostate Cancer Programme to give prostate cancer the priority it deserves. As a result a lot of excellent progress has been made. Patients are being seen more quickly and are getting better care.

'Making sure patients have access to the latest treatments is key to reducing the suffering caused by this condition — that is why prostate cancer is the only cancer to have a specific target for government spending on research. This will help to ensure that patients get the benefit of pioneering new techniques like high intensity focused ultrasound for which clinical trials are due to begin early next year.

'There is, of course, more to do. But the advances made in the last few years show what can be achieved when the government, voluntary sector and the NHS work in close partnership to tackle this problem.'

John Neate of the prostate cancer charity, welcomed the progress but called for more action:

'We believe the government, the NHS and health professionals are genuinely committed to changing our approach to tackling prostate cancer.

'We are encouraged by what has already been achieved, but a lot remains to be done. We are still in the foothills of the battle against prostate cancer, with a mountain still to climb. We need to see a continuing revolution in our approach to this major disease — with increased investment in professional staff, strengthened NHS team working, ‘male friendly’ primary care services and focused research to secure improved prostate cancer testing and treatments.

'The prostate cancer charity is firmly committed to working constructively with the Department of Health and with other charities through The prostate cancer charter for action in driving forward the changes we need to see.'

The public services union UNISON has voted to accept the agenda for change pay system.

Members voted by three to one in favour of the proposals, which included restructuring of salaries and conditions for a million English NHS staff.

More than a million NHS staff will get infection control training to help in the battle against hospital superbug MRSA (methicillin resistant staphylococcus aureus).

All staff covered by agenda for change — the new pay structure — must show they are able to reduce the risk of healthcare associated infection.

Staff involved will include:

• nurses
• porters
• cleaners
• healthcare assistants

A key part of agenda for change is the knowledge and skills framework, and cleanliness will form part of this. In order to progress up the pay ladder, staff must show they have developed skills to reduce the risk of healthcare associated infections.

Chris Beasley, chief nursing officer, made the announcement at the chief nursing officer's conference held this week in Manchester.

Public services union UNISON welcomed the move, but reiterated a plea for cleaning contracts to come back in-house.

Also announced this week was Health Secretary John Reid's plan to halve the number of MRSA infections by 2008.

Anna Walker, chief executive of the Healthcare Commission welcomed the target, saying:

'MRSA and hospital acquired infection are extremely serious health concerns and it is right that the government has decided to tackle this as a priority. We welcome the opportunity to monitor the implementation of this target and we will be reporting publicly on what we find.

'In addition to monitoring implementation of the new target, the Healthcare Commission will be carrying out reviews on cleanliness and hospital acquired infection with a view to identifying good practice and driving improvement where there is still more work to be done.

'We will be working in partnership with the NHS and the National Patient Safety Agency to ensure understanding of how to reduce hospital acquired infection is implemented to provide a safer healthcare environment for patients.'

Chris Beasley also hinted that undercover dirt detectives posing as visitors may be soon sneaking into hospitals to check up on cleanliness.