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Are you able to say more about the change of procedure that you mentioned a few minutes ago?

This might be superseded now, but the Government was telling boards that there was a savings cap of 3 per cent. That has now been overtaken by the Government saying that brokerage is not going to be available, so they should not bother asking.

Yes, the deputy convener helpfully touched on some areas that I want to ask you about.

Let us return to the so-called “national conversation”. You say repeatedly, in report after report, that we need reform. You have made that point very clear in this report, and you touch on this “national conversation”.

I do not know whether such a national conversation has been going on. The health secretary announced that there was to be one—I know that he spent some time talking to football fans, but I am not aware that a national conversation around the health service is actually starting. Have you seen any evidence of that?

My problem is that the phrase “national conversation” is thrown about by the Government and has almost become a new buzz phrase that does not actually mean anything. I am not clear who the Government is meant to be talking to or what the conversation is meant to be about. Do you have any clarity on what that phrase actually means in relation to the health service?

If the Scottish Government is saying that one in five of the things that happen in the NHS—let us express it that way—is of limited clinical value, whatever that means, is it up to the Government to tell us what it means by that—in other words, to spell it out?

Okay. Thank you for that. I have a feeling that we will come back to that, whatever the Government says.

When we talk about reform, we are potentially talking about making choices. One of your recommendations is:

“The Scottish Government and NHS boards should: Ahead of 2025/26, jointly identify areas of limited clinical value and consider how services can be provided more efficiently, or withdrawn.”

Did you have anything particular in mind? Can you give an example of something that, in your view, is of limited clinical value?

Yes, but every single board would, presumably, try to stay within budget. The reason that they ask for more money is that they do not achieve that.

It is all very well for the Government to say, “Sorry, lads, there is no brokerage this year.” Some boards will, inevitably, not hit their budget targets and will come to the Government to ask for more money. What happens then?

Turning to the issue of boards being given brokerage loans, it could be said that boards have been bailed out—I have used that phrase before. In the report, you say that, in 2022-23, five boards needed that extra money from the Government to break even and that, in 2023-34, the number increased to eight boards. My initial question is: in your view, why have things got worse?

Looking through exhibit 6 in the report, I see that, in the column titled “Primary factor for escalation”, the phrase “Mental Health Performance” comes up time and time again. That appears to be a factor with a lot of boards: big spending on mental health services is perhaps pushing them over budget.