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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 4 May 2021
  6. Current session: 13 May 2021 to 5 November 2025
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Displaying 3464 contributions

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Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

As a committee, we are used to delays. Sometimes, they are not as inevitable as you perhaps suggest. What does the delay do to the cost of those projects? Will they come in on budget, or will they be over budget because of that delay?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

I have a quick follow-up question that is based on the Audit Scotland report. You said that you agree with its findings and recommendations. One of the headline findings of the report is:

“The proposed National Care Service will place a huge strain on the health and social care budget”.

Do you accept that conclusion?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Yes, but the conclusion that has been drawn by the Auditor General is that you need to work more closely with the NHS boards.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Okay. Thank you. We will watch that with interest.

You used the word “challenging” a few times. It is worth noting, for the record, that the word used by the Auditor General is “concerning”. In paragraph 17 of the report, he said:

“The financial position of the NHS in Scotland is concerning.”

There is, I think, a suggestion there that things are not as they should be and that there are potential consequences for the kind of treatment that people can expect to get.

I will turn to what is, I suppose, at the heart of many of the questions that we are asking you this morning. How long does the Scottish Government think that it will take to clear the current backlog and fully recover healthcare services to a pre-pandemic level?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Mr Burns, you are using the language of progress and improvement but, to give two examples from the Audit Scotland report, the percentage of A and E attendances seen within four hours dropped from 83 per cent in December 2019 to just 62 per cent in December 2022, and paragraph 37 of the report states that delayed discharges

“increased to the highest level since 2014/15”.

That does not sound like progress and improvement to me. It sounds as if we are going not forwards but backwards.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Thank you.

10:00  

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Okay, but the Audit Scotland report came out in February, yet, just two days ago, in this Parliament, the chief executive of NHS Dumfries and Galloway told the Health, Social Care and Sport Committee:

“I have worked in the NHS since the 1980s. I am a finance director by background and I have never seen a position as challenging as this.”

He then went on to speak about

“an existential challenge to our current service models”.

He also said:

“technically, I cannot afford one in 10 of my workforce”.—[Official Report, Health, Social Care and Sport Committee, 2 May 2023; c 13-14.]

There is severe pressure on territorial health boards, is there not? It looks a bit more like the picture painted by Audit Scotland than the one that you have painted for us this morning.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Okay. Obviously, as the Public Audit Committee, we are interested in the public accountability of the service, and the only way for us to achieve that is to have the data and that degree of transparency. You might share our frustration, but I re-emphasise to you that we think that it is extremely important, because, for many people, general practice is their access point to the national health service.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

That pretty much brings us to the close of the session. There are two things in the report that I want to highlight, on which I would welcome your views. One is the agenda for reform. The clear message from the Auditor General is that the level of funding for the NHS is at a record level—£19 billion—yet we continue to see suboptimal outcomes. I guess that the debate about what we need to do to change and reconfigure services is central to that.

Some of this goes back to the Christie commission of over 10 years ago and what it said about having a preventative agenda and taking a broader view of public health, rather than just having a view of the institution of the national health service. That rests on public debate and engagement, so, in closing, it would be useful to find out your perspective on that and what your plans are in that regard.

The other issue is related to that. One of the key recommendations in the report—you said that you accepted the recommendations—was that you publish annual progress updates on service reform. Is it your intention to do that?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2022”

Meeting date: 4 May 2023

Richard Leonard

Okay. A lot of this morning’s discussion will be about the financial pressures on the national health service. Caroline Lamb, you are the accountable officer responsible for £19 billion of public money, so it is quite important that we get an understanding that you are on top of the pressures that you face. I will turn to Craig Hoy, who has some questions to put to you.