The health minister set out his priorities for the next 10 years

He told MSPs there would be more emphasis on preventive medicine, with teams of health workers offering people health tests in deprived communities.

More specialised services will be centralised, but there will also be a network of local general hospitals.

And Mr Kerr said chronically ill patients would be helped to manage their own care at home.

His proposals were based on the recommendations made by an expert group, led by top cancer specialist Professor David Kerr.

I want to see healthcare that gets out into communities and into workplaces, knocking on doors and talking to people Andy Kerr Health Minister

As part of the formal response to its report, the health minister outlined his priorities for the next decade during a debate at Holyrood.

"This is a fundamental shift in the way we want our NHS to work," he said.

"As good as the work is that goes on in our hospitals, we have to try to help people avoid having to use those services.

"I want to see healthcare that gets out into communities and into workplaces, knocking on doors and talking to people, to identify who is at risk of a heart attack, cancer, diabetes or high cholesterol and helping them take action early to stop that happening."

Chronic conditions

He said resources needed to be targeted at people living in areas with the worst health record.

"And for our vulnerable citizens or those with long term chronic conditions like coronary heart disease or asthma, I want to see them get the intensive case management they need to manage their condition year on year, so that they can maintain health and keep a good quality of life," he added.

The proposals also envisage the separation of accident and emergency units from those offering planned care.

For many people with pressing needs the national targets are too long to wait Shona Robison SNP spokeswoman

The minister said this would see a system with more local A&E units, backed up by larger central units.

Scottish National Party health spokeswoman Shona Robison agreed that services should be local where possible, rather then centralised.

"Each patient should be given a statutory right to an individual waiting time guarantee, which could be much shorter than the national waiting time guarantee if deemed appropriate," she added.

"For many people with pressing needs the national targets are too long to wait.

"This would put the patient right at the heart of the process and ensure the NHS better delivers for their needs."

More freedom

Tory health spokeswoman Nanette Milne said: "Kerr's recommendations will not solve the basic problem in today's NHS because it still remains largely a monopoly provider where decisions are made centrally by government.

"We believe this top-down approach must be overturned."