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All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
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Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
You said that last year, and the year before, and the year before. This is an on-going theme, as the Auditor General has reported.
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
What are you going to spend the £200 million on? That is a big number, and it is welcome, but I do not quite understand how that translates into getting waiting times down.
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
Let us look at some of the detail on that. In orthopaedics in particular, there are huge numbers of people waiting for treatment—many for more than 18 months. Let us cut to the chase: those people are in pain. You will be aware that there are various models for treating people. In England, there is a more flexible approach, which includes the use of private care funded through the NHS. If a patient is waiting on a new hip or knee, do they really care where they get it, as long as they get it sooner? If they have the choice of getting it in three months or in three years, which would they choose? How open are you to new ways of delivering service to people more quickly?
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
Is that because accident and emergency departments are chock-a-block? Ambulances are queuing outside with people in the back of them. What sort of experience is that? If someone is sitting in the back of an ambulance for hours, or even being treated in an ambulance because there is no space elsewhere, that ambulance cannot be freed up to go out to someone else and it is not a good experience for the patient. It is a lose-lose scenario. What are you doing at the other end to unblock that?
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
You keep saying that, but how are we going to fix it?
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
Thank you very much for that.
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
I am not talking down nurses.
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
Let us do a reality check. You agree with the First Minister that the NHS is “resilient” and “robust”, but not a single NHS board in Scotland is meeting its 12-week out-patient target or their in-patient target—not a single NHS board in Scotland is meeting its 18-week planned care target. One in six Scots is sitting on an NHS waiting list—that is nearly 900,000 people, of whom nearly 10,000 have been on a waiting list for over two years. To top it all off, Scotland has one of the lowest life expectancies in western Europe. Does that sound like a “resilient” and “robust” health service that is fit for purpose and that is delivering for the public?
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
The target for A and E treatment is that 95 per cent of people are dealt with within four hours. That can mean that someone is admitted to hospital, if that is considered necessary, then discharged, or treated then discharged. The current average performance is 69 per cent, which exactly marries up with what you have just said—far too many people in A and E are not being treated, moved on or moved out of that environment, which has a knock-on effect on ambulances.
What is the issue in A and E specifically? Are people turning up when they should not? Is it understaffed? What is the problem? What is causing the delay?
Public Audit Committee
Meeting date: 29 January 2025
Jamie Greene
The figures are atrocious. I point you to page 48 of the Audit Scotland report, which I flagged at a previous meeting of the Public Audit Committee. What you would normally expect to see on that page—as I am pleased to see in other tables—are little green ticks where targets have been met. However, there is not a single green tick anywhere on that page.
The numbers speak for themselves. The targets are 95 per cent, 100 per cent and 90 per cent for beginning treatment within given timescales. They are ambitious. I get that. I know that the health service is very challenging across the UK, but look at the performance measures on that page. Look at in-patient treatment within 12 weeks of a decision to treat. The poor people in Grampian are sitting at 46 per cent of the 100 per cent target. Fife and Forth Valley are at 47 per cent. For the three targets, Lanarkshire is at 61 per cent, 46 per cent and 60 per cent—nowhere near the targets. There are huge numbers of people waiting for far longer than they should, and £100 million is not going to scratch the surface, is it?