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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 13 September 2025
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Displaying 1631 contributions

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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

Yes—I was called back at 2 in the morning. I have to say that all the people whom I spoke to were lovely. I am really grateful to every one of them: it was clear that they were all really overworked and were doing their best.

However, I think that you get the gist of my point. People end up in a vicious circle in which the only option is to present to A and E, and we all know the problems that A and E departments are facing.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

I will move on, because there is a lot to cover.

We have to talk about delayed discharge. I know that this is not a political setting, but ministers have promised to eradicate delayed discharge. That is ambitious and probably not achievable. There are targets—official and unofficial—but the statistics do not seem to bear out that progress is being made on that.

That can be analysed in a number of ways, such as by using the average number of people per month who are waiting to be discharged or the number of days that are spent in hospital by people who are ready to be discharged. I will not go into all the numbers, but where are we at with delayed discharge in Scotland at the moment? Are we making any progress at all, or are things getting worse?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

There is not continual improvement; it is continually getting worse.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

That goes back to my first question. If no other options are available, it is no surprise that people present at hospital. Therefore, the rest of the system needs to be working in order to take the pressure off. However, that is not a new problem. We have been talking about that problem in the Parliament for more than a decade—it has definitely been talked about in the Parliament for longer than I have been an MSP. Why have we not got to the bottom of that? Is it simply the case that people are getting sicker? Are there more sick people or not enough doctors? What on earth is going on? Why do we still face endless missed targets and waiting times that are going up and up?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

So the current performance rate is about 65 to 70 per cent.

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?

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

Do not even start me on dentistry—otherwise, we will be here all day.

I will park my question on digital records, in case others want to come in.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

Yes, but I am not interested in every other part of the UK. This is the Scottish Parliament, and you are the chief executive of NHS Scotland. I mean this respectfully: I simply want to know what is going wrong in Scotland’s A and Es.

Public Audit Committee

Section 23 Report: “NHS in Scotland 2023”

Meeting date: 20 June 2024

Jamie Greene

I appreciate that update.

The problem with delayed discharge, or bed blocking, as it is commonly called, is that it is exactly that—it is bed blocking. I presume that that is bad for two reasons. The person who is languishing in hospital, who should not or does not need to be there, would rather be, and should be, somewhere else, wherever that is. Equally, there is someone at the other end of the spectrum who could be occupying that bed but is on a waiting list—and we all know what waiting lists look like at the moment.

It seems to me that half of the job is yours, and you are doing your best, but the other half of the solution is not working, because you cannot discharge people if you have nowhere to put them and there is no plan in place to look after them. You have a duty of care to look after your patients, and you would not want to send them out to their homes with no care package and with nobody to look after them, so you keep them—I understand that.

Is that your mitigation? Are you saying, “We’ve done as much as we can, but local authorities haven’t got the money to look after folks, so we have to keep them.”?