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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 11 May 2025
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Displaying 1514 contributions

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Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

Here is the problem: the situation that I found myself in was not an accident or, indeed, an emergency. Many people will present at hospital simply because there is no other option available to them, and that is adding a huge amount of pressure to our accident and emergency departments.

There is a situation, when someone has taken unwell, that falls outside a regular GP visit or appointment but in relation to which, between 3 minutes past 8 in the morning and 8 o’clock the following morning, there is simply no option other than to spend three hours on the phone to 111 and not achieve anything, or to turn up at hospital. That is my point. The system feels broken, and there are thousands of people out there who feel the same way.

Are we looking at this in the right way? Is there any fresh or blue-sky thinking about how we deal with people who want to speak to a clinician as quickly as possible but do not want to burden the hospital system and absolutely cannot get an appointment with their GP, sometimes for weeks on end? There has to be a middle ground somewhere, and it does not sound as though there is one.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

Where are we at with A and E at the moment? There has been a lot of discussion recently about how long people have to wait once they get to A and E. There is a four-hour waiting time target, which I believe means that 95 per cent of people should be admitted, discharged or transferred for treatment within four hours of presenting. What is the current statistic?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

That is so way off target. You are 30 percentage points off the target. What is going wrong?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

I can tell you that, anecdotally, when I speak to care homes, workforce is the issue, and getting staff is part of the problem.

On people, which is my final topic, where are we at with head count? Let us look at three statistics. First, let us look at the total head count in the NHS now in comparison with the number in the past couple of years. Just to give you a heads up, secondly, I will ask about the sickness absence rates in the workforce and, thirdly, I will look at turnover rates. What statistics do you have to share with us on those three issues?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

It has dropped since September 2023, when it was sitting at above 70 per cent, and it has dropped considerably since September 2018, when it was 92 per cent—in fact, you almost made the target. However, we are now saying that two in three people will not be seen within four hours. Is that right?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

Do not worry—I am coming to that.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

Can I stop you there for a second? I am still trying to get my head around this. According to what you have just said, there are two reasons why we are so far under the target. Overall, you said that there were three points, but the first one is a positive—the number of emergency admissions is going down, which is good news. However, the other two points are not positives. You are saying that the age profile of people and the fact that they stay in hospital a little bit longer than they used to are the reasons why so many people are sitting in accident and emergency for eight or nine hours. I do not see the link. Please explain it to me.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

I have a final question. How much is being spent on agency staff?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

I have some numbers. That is in the hundreds of millions of pounds. It is a lot of money, and having agency staff is way more expensive than having full-time equivalent staff. There is all this talk about privatising the health service. You are already privatising it if you are outsourcing work to agencies that charge hundreds of pounds per hour.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

If and when you discover that newer data is available, please share it with us. We are looking for trends, as we often do, and we want to interrogate that information.

It looks as though the overall head count is on the rise. The figure of 187,000 is up from 183,000 last September. People will say that there are far more people in the NHS than there were before, yet everything that we have discussed—such as waiting times, delayed discharges and staff shortages—is still happening. There are more people in the system, and the Government is spending more money on it, but outcomes are poor. My question is: why is that the case?