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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 14 May 2025
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Displaying 2443 contributions

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Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

Are there any indications that the drive for efficiency savings is impacting on service delivery or performance?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

I have one final question, which is on brokerage. The Scottish Government wants to put a cap on the additional financial support that might be available to boards in 2024-25. What happens if they exceed that cap?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

I would like to cover various aspects of financial sustainability. NHS funding in 2023-24 grew by 2.5 per cent in real terms, but that increase mainly went on pay rises and inflation. Health is the biggest single area of Government spending. In 2023-24, it was 40 per cent of the Scottish budget. The affordability of healthcare spending was always a big issue, but it is now even more urgent and needs to be addressed. The scale and pace of reform need to increase. That was emphasised in the First Minister’s speech on Monday.

I would like to look at some different aspects of financial sustainability. One is the cost of drugs and prescriptions. The Auditor General has told us that some analysis of pay awards has been done, but nothing seems to have been done on drug costs and what drives them. As a society, we are getting older and we have longer-term illnesses and so on, but we do not know what proportion of spend drugs, for example, takes up. What is the cost and what are the projections? Do you have any information on that?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

I will move on to another aspect. Different health boards have been under different pressures over the years, and the committee has been very much involved in looking at those situations. Eight territorial boards required brokerage in 2023-24 and some boards are forecasting recurring deficits over the next three years, which must create a risk to their financial sustainability.

Why do those recurring brokerage issues come up? Why are those boards under the pressure that they are under? It seems that Scottish Government policy is to try to do away with brokerage over a fairly short period, but that is not evidenced by what we are being told in the Auditor General’s report.

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

I move on to an issue that affects every single board, which is non-recurring costs. They seem to be embedded as an area where boards achieve a high percentage—sometimes the majority—of savings every year. That is not necessarily anything to do with brokerage; it is across the board. How far is it possible to move boards away from that? In the long term, that is not sustainable.

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

The problem is that, for years now, this committee has been seeing the reports coming in about non-recurring expenses—it is almost a core part of every board’s annual activity. How are you going to get away from that? You talk about reform and changing the health service, and the way that delivery is made and all the rest of it, but with such a significant proportion of non-recurring expenses, how are you going to balance the books? You are just playing about with numbers, really.

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

In previous reports that have come to the committee, there has been no indication of any significant improvement in non-recurring expenses. What is happening now that is going to make a difference?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Colin Beattie

Eighteen months ago.

Public Audit Committee

Section 22 Report: “The 2023/24 audit of the Scottish Government Consolidated Accounts”

Meeting date: 22 January 2025

Colin Beattie

Permanent secretary, to start with an obvious aspect of the management of the finances, the consolidated accounts show a net expenditure in 2023-24 of £53.98 billion, which is £277 million less than was budgeted, and that is split between the resource budget at £193 million and the capital at £84 million.

What were the main reasons for the underspends?

Public Audit Committee

Section 22 Report: “The 2023/24 audit of the Scottish Government Consolidated Accounts”

Meeting date: 22 January 2025

Colin Beattie

I think that you are optimistic about the level of non-recurring expenditure in organisations such as the national health service. We have seen report after report from the Auditor General clearly stating that the majority of savings achieved by NHS boards come from non-recurring expenses. That is a huge thing to tackle and I am not hearing how it will happen. What is the initiative that will change that? What is going to transform those boards?