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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 8 November 2025
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Displaying 3464 contributions

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SPCB Supported Bodies Landscape Review Committee

SPCB Supported Bodies Landscape Review

Meeting date: 30 January 2025

Richard Leonard

My final question relates to the performance issue. How does the Standards Commission measure and demonstrate its outcomes? Do you have any kind of evaluation process that leads you to identify any improvements that can be made?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

In the speech that the First Minister made on Monday, he said:

“we”

need to

“put in place clear milestones and targets”,

which is music to the ears of the Public Audit Committee and, I am sure, the Auditor General.

The problem is, however, that we have heard that so many times before. Let us look at the areas where the Auditor General identifies that there has been no progress. The annual recovery plan update, and the whole recovery plan, was first instituted in August 2021, and there is a real lack of transparency around that. The Auditor General also notes that the annual updates that we expect on service reform are not there either.

Why, only now—that is, two days ago—is it once again necessary to say that we need a new clear direction and we are going to set out milestones, when the evidence before us appears to show that, even when ambitions are set, progress reports are not made, milestones are not clear and there is no real sense that progress is being made? Why is it going to be any different this time?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

Thank you very much indeed. I begin by asking you that perennial question: do you accept the findings and recommendations of the Auditor General’s report?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

You mentioned regional variations. Appendix 3 of the Audit Scotland report shows quite marked variations in some of those measures. For example, on referrals for suspected cancer within the 62-day treatment guarantee, the figures for the two health boards in the area that I represent are 83 per cent for NHS Forth Valley and 89 per cent for NHS Lanarkshire against a target of 95 per cent. For NHS Shetland, the figure is 50 per cent against that target, and both NHS Tayside and NHS Grampian are at just 60 per cent. What analysis have you done to understand why there is such a variance between different health boards and health board areas?

09:45  

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

To give a fuller picture, if I look at the A and E stats, NHS Forth Valley and NHS Lanarkshire perform very poorly, do they not? The statutory target is for 95 per cent of people to receive treatment within four hours, but Lanarkshire’s performance is 55 per cent and Forth Valley’s is 54 per cent.

I will ask you a question that was posed to the Auditor General when he was here. Is there any correlation between poor performance in A and E and better performance in some of those other indicators?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

We are going to touch on some of those performance measures as the morning progresses. Before I take us to another area, I place on record my membership of two trade unions that organise in the national health service.

I turn to staff sickness absence rates, which is recorded in this annual performance report on the NHS in Scotland as being at a 10-year high. What is your assessment of that issue, what are you doing to address it, and how are you going to turn it around?

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

Yes—the Public Audit Committee is indeed very interested in tackling digital exclusion.

I am conscious of the time, so I will bring in Stuart McMillan.

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

We have covered an awful lot of ground this morning. If the budget is passed in a few weeks, the NHS budget will rise to £21 billion, for which you, Caroline Lamb, will be the accountable officer. Because it constitutes 40 per cent of the entire Scottish budget, it is important that we, as the Public Audit Committee, scrutinise what you are doing and examine areas where things are not going quite as well as we would like.

There is also a great deal of public interest in health and social care, and I think the national health service remains probably the best-loved public institution that we have.

I thank Caroline Lamb, Alan Gray and John Burns very much for their time and co-operation this morning, in answering our questions.

11:43 Meeting continued in private until 12:15.  

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

Our main item is consideration of the Auditor General for Scotland’s section 23 report, “NHS in Scotland 2024: Finance and performance”, which covers the national health service’s financial position and performance measures.

I welcome our witnesses to the committee. We are joined by Caroline Lamb, who is the chief executive of NHS Scotland and director general of health and social care in the Scottish Government. Alongside her is Alan Gray, who is the director of health and social care finance in the Scottish Government. We are also joined by John Burns, who is the chief operating officer of NHS Scotland.

We have questions to put to the witnesses over the next hour and a bit, but before we get to those, I ask Caroline Lamb to provide us with a short opening statement.

Public Audit Committee

“NHS in Scotland 2024: Finance and performance”

Meeting date: 29 January 2025

Richard Leonard

Let us have a look at a couple of those points. In his speech on Monday, the First Minister reminded us that, last year, he referred to delayed discharge as

“the canary in the coal mine of our National Health Service.”

Paragraph 80 of Audit Scotland’s report says that delayed discharge rates are at the highest levels on record, so what is the state of the canary at the moment?