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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 21 April 2025
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Displaying 1828 contributions

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Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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?

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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?

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

This might be superseded now, but the Government was telling boards that there was a savings cap of 3 per cent.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.

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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?

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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?

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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.

Public Audit Committee [Draft]

“NHS in Scotland 2024: Finance and performance”

Meeting date: 12 December 2024

Graham Simpson

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?

Public Audit Committee

“Fiscal sustainability and reform in Scotland”

Meeting date: 5 December 2024

Graham Simpson

Perhaps that is something that we could look at here.

Auditor General, you are very critical—and you have been for some time—of the short-term nature of the budgetary decisions that are taken here in Scotland. You said earlier that that means that we balance the budget, because we must balance the budget every year, but is that approach fit for purpose, in your view?