An Audit Scotland report, Health inequalities in Scotland, says that while overall health has improved in the past 50 years, deep-seated inequalities remain. Deprivation is the key determinant, although age, gender and ethnicity are also factors. Men in the most deprived areas die 11 years earlier than those in the most affluent, and the gap is 7.5 years for women. People in deprived areas also have higher rates of heart disease, obesity, diabetes, drug and alcohol misuse, and mental health problems.

The report reviews developments at the comhairle since the Accounts Commission reported on its performance in November 2011. At that time, the Commission had ‘serious concerns’ about the slow pace of improvement at the comhairle and asked Audit Scotland to produce a follow-up report in a year’s time.

A public hearing held in Lerwick in June 2010 led to the council producing an improvement plan and the Commission considering progress reports from the Controller of Audit. Its findings today are in response to the most recent follow-up report carried out by the Controller of Audit.

General Practice (GP) prescribing accounts for 70 per cent of all National Health Service (NHS) spending on drugs in Scotland. This amounts to almost £1 billion a year. Audit Scotland has published Prescribing in general practice in Scotland, its third report on the subject. The report says the health service has improved its management of GP prescribing, and family doctors are getting more support and guidance on their prescribing. Spending fell by 11 per cent in real terms between 2004 and 2011, despite the volume of prescriptions rising by a third during that time.

Protecting Consumers looks at trading standards and food safety services provided by Scotland’s 32 councils to protect the public in areas ranging from food poisoning to doorstep cons and internet fraud. People depend on these services more in tough economic times – vulnerable groups such as older people and low-income families are particularly at risk.

Audit Scotland has published the findings of its audit of the management of patients on waiting lists at NHS boards. This was carried out following the discovery of manipulation of waiting lists and misreporting of performance by NHS Lothian during 2011. Inappropriate use of waiting list codes has been reported at NHS Tayside.

Councils spend significant amounts of money on building and maintaining infrastructure - more than any other part of the public sector - but lack sufficient information for fully effective scrutiny, says the Accounts Commission.

Community Planning Partnerships (CPPs) have not met the ambitious goals set for them, but with the right leadership and support, could make big inroads to achieving them in the future.

Improving Community Planning in Scotland is a national review which draws on detailed pilot work. Community planning was introduced a decade ago with the aim of bringing councils, health boards and other public, business and voluntary bodies together to tackle complex problems in local communities.

Councils face tougher challenges in the year ahead, particularly in dealing with budget pressures, says the Accounts Commission in its annual overview report.

Pressures on resources and demands on services mean that councils may now have to consider decisions, which they had previously ruled out, to balance their budgets. Councils spent a total of £21 billion providing a range of essential local services and most councils are predicting substantial funding gaps over the next three years.

John Baillie, chair of the Accounts Commission, said:

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