The Official Report is a written record of public meetings of the Parliament and committees.
All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
All Official Reports of public meetings of committees.
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Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
But there is not one in each A and E department, of course.
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
At our meeting on 7 January, the Auditor General highlighted the fact that we are now entering a cycle in which private finance initiative—PFI—contracts are starting to fall due. Obviously, they are very complex. I have read through one of the contracts for the Edinburgh royal infirmary, and the financial options that are woven into the end of the contract are quite complex when it comes to what the outcomes might be and what the best option is to take. According to the Auditor General, it is not unusual for each PFI contract to have many different terms at the end, as to how the handover takes place and so on. There is no template. It is a bit surprising that they are not more similar, but, clearly, they were all negotiated individually. What financial risks arise from PFI contracts that are now reaching maturity? How are the boards preparing for the potential handover costs and the long-term liabilities that might go with that?
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
So that has been 100 per cent covered.
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
From my perspective, looking in, the big issue seems to be the availability of care in the community that you can discharge into—you can improve efficiencies and so on within the NHS, but that is still the fundamental problem. The councils, certainly in my area, seem to have a big deficit every year on their social care side, running into millions of pounds over budget every year, yet the availability of social care is very restricted and they have difficulty recruiting people into that service, even when the money is there. You are working on this with local authorities and so on. Do you feel that it is improving? Are we heading in the right direction with it?
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
Let me clarify my understanding on that. You said that there is a frailty unit in each area.
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
Do the local boards have that expertise? I am basing this on the one contract that I have read, but the options are complicated and the outcomes are a bit uncertain—a bit back of the envelope. How do the boards get the skills that you say they have to take this through? You have talked about the Scottish Futures Trust, but there are also difficult legal aspects to deal with.
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
The PFI contracts are about the management of the estate, which is quite a complex business. There must be few companies that can take that on, unless the NHS takes it in-house, which is an administrative issue for the NHS. How is the NHS approaching that?
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
If that has been done years in advance of the end of a contract, some of them should already have been decided.
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
Okay—thank you.
Delayed discharges and waiting times are an on-going issue. How are delayed discharges and wider system-flow pressures being addressed to support reductions in waiting times and reduce pressure on acute care?
Public Audit Committee [Draft]
Meeting date: 4 March 2026
Colin Beattie
Clearly, more work needs to be done in that regard.
I will move on to emergency and unscheduled care. In our evidence session on 7 January, the Auditor General said:
“The presenting symptom is that hospitals are unable to receive ambulances and people are not being handed over within 15 minutes. If ambulances are hovering for about an hour, it is because there is a backlog.”—[Official Report, Public Audit Committee, 7 January 2026; c 58.]
There has been talk about some progress having been made in that regard. What actions are under way to address backlogs in the system that result in ambulances being delayed in their turnarounds?