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Seòmar agus comataidhean

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 4 December 2025
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Displaying 2424 contributions

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Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Graham Simpson

I know that we are not here to talk about NHS Tayside but do you know why it did not? What happened?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Graham Simpson

The report also says that

“One of the key areas of financial pressure was staff costs.”

We discussed that earlier in relation to NHS Ayrshire and Arran. Do you know the extent to which NHS Grampian relies on agency staff?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Graham Simpson

This is my final question. Looking ahead, given the situation that NHS Grampian appears to be in, how realistic is it that it will ever break even? In paragraph 21 of your report, you say that the board is predicting an increase in costs of £370 million over the next five years. That seems to be a massive challenge. The board must cut costs, but costs are going to rise by £370 million.

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Graham Simpson

Listening to the questions and answers so far, I was reflecting that we have had NHS Scotland at the committee before and my recollection was that it told us that there was to be no more brokerage. I hoped that my memory was not playing tricks on me, so I looked it up. The response to a freedom of information request on brokerage was published in September. Eight health boards needed brokerage in 2023-24. The response confirms that

“Alan Gray, Director of Health and Social Care Finance, wrote to Chief Executives of NHS Scotland on 04 December 2024 to provide the details of the indicative funding settlement for NHS Boards in the Scottish Government Budget 2025-26. The letter confirmed that brokerage would not be available for 2025-26 and that NHS Boards would be expected to work towards a breakeven trajectory in their three year financial plans”—

not five-year plans, as we have heard mentioned here, so I do not quite know how that figure has come about.

The Scottish Government’s stance appears to be “no more brokerage”. As you have said, no board has repaid any brokerage money, therefore there seems to be very little incentive to even save money—the boards have got used to having brokerage. NHS Ayrshire and Arran, as you have said, has had seven years’ worth of brokerage. Where is the incentive? It is all very well the Government saying that there will be no more brokerage, but if boards cannot meet their savings targets, there will be some more, will there not?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Graham Simpson

Okay. Your report says there is a need for “more radical reform”. What did you have in mind when you used that phrase?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Graham Simpson

I want to ask about staffing and workforce. Paragraph 20 of the report states:

“The board also continues to face workforce challenges. The rate of sickness absence in 2024/25 was 5.6 per cent ..., well above the ... national standard, and reliance on temporary staff continues to come at a high cost to the board. This will have a significant impact on the board’s plans to achieve the savings needed for longer-term financial sustainability.”

That is something that we have discussed before at this committee. It continues:

“nursing pay was overspent by £13.5 million, £7.9 million of which was on agency nursing in acute services”

and

“medical pay was overspent by £7.7 million, £5.8 million of which was on agency doctors.”

Do you know whether the board has done any work to identify the underlying reasons for staff sickness levels? Is there any way that it can cut the reliance on agency and locum staff?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Graham Simpson

It gives the board flexibility but it also costs it a lot of money. It is surely better to reduce the use of agency staff, is it not?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Graham Simpson

Have you seen any plan to do that?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Graham Simpson

Auditor General, at the end of the earlier evidence session you rightly said that not all boards need extra money from the Government. For 2023-24, there were eight boards that needed that money: NHS Ayrshire and Arran; NHS Borders; NHS Dumfries and Galloway; NHS Fife; NHS Grampian; NHS Highland; NHS Orkney; and NHS Tayside. Do you know whether that is the position for 2024-25?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Graham Simpson

Okay. The report into NHS Grampian’s overspend says that it has the largest overspend by value of any health board in Scotland and the fifth highest in percentage terms. Do you have figures for the overspends of other boards that could give us an indication of the extent to which NHS Grampian has the highest overspend?

11:00