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All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
All Official Reports of public meetings of committees.
Displaying 3697 contributions
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
The convener touched on various areas, and I want to explore the integration authorities a little more.
This might be my ignorance, but a lot of terms are floating around. We used to talk about integration joint boards; in Glasgow, we talk about the health and social care partnership; and now we are talking about an integration authority. Are those just three different names for the same thing?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
Okay—that is helpful. I will probably explore that on my own at some future point.
Some of the points that have been made refer back to the way in which funding has worked for integration joint boards or integration authorities. Sometimes, it seems that the council and the health board have put in funding and then almost taken it back. There is a suggestion—if I can find the wording—that it is an almost circular process. At one point, the business case document says:
“funds were ceded to IAs and then largely given back to the hosts”.
At another point, it says:
“In practice much of the funding appears to be ‘circular,’ with funding allocated to the IJB from the local authority and health board, which then directs it back to the local authorities and health boards (and Health and Social Care Partnerships)”.
Will the new system work better? Will there be better integration? On the one hand, integration is a good thing, but it can also make it difficult for councils and health boards to follow the pound.
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
I was thinking of practical issues. It is a slightly different topic, but we had an issue in Glasgow with link workers, who are linked to general practices. The local general practitioner opinion—that is, the NHS—said that link workers were good and that we needed to fund them, but the HSCP said that it could not fund them and the Government came in with more money. Would that kind of decision making change in future?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
In the programme business case, you contrast what would happen if we carried on as usual with what could happen if we had the new system. It says that a new system could enable various things, such as
“strategic integration, national oversight, accountability and opportunities to invest in preventative care rather than crisis responses,”
and the possibility of avoiding
“expenditure on poor outcomes such as those that are experienced by people who are delayed in hospital”.
The business case goes on to say:
“there could be considerable costs that are avoidable if the current system can be improved”.
Can you go into that a little bit more? Are we saying that passing the bill and having the national care service will automatically produce savings that we can put into preventative care? The committee has been looking at that issue for quite a long time now. Alternatively, is it just that there is a possibility of savings?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
Surely, information sharing cannot in itself lead to big savings, can it?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
I have one other question about integration authorities. I note that VAT is mentioned. If money went directly to the integration authorities, would that create a VAT problem?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
This will be my final question. You mentioned the programme business case. Am I right in saying that the programme business case will be updated when there are significant changes? Will we see a new version every quarter, every month or every six months? How does that work?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
If the chief executive or the board of the integration authority wants to stop doing something, to whom will they be answerable? Will the new national body, the health board or the local council be able to say no or veto them, or will they have to keep pleasing all three bodies?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
It has been suggested that integration authorities could amalgamate. Would that be an entirely local decision or would there be national input?
Finance and Public Administration Committee
Meeting date: 23 January 2024
John Mason
We have not yet touched on the idea of integrated social care and health records. According to the papers, they
“don’t yet exist and as such will require major investment in their own rights”.
Am I right in saying that no money is set aside for those records, as there could be data sharing without them?