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Our principal agenda item is further consideration of the Auditor General’s report, “NHS in Scotland 2025: Finance and performance”, which is an annual audit report. We are pleased to welcome, to give evidence on the report, Caroline Lamb, accountable officer for the national health service and director general for health and social care; Fiona Bennett, chief finance officer, Scottish Government health and social care directorate; and Christine McLaughlin, chief operating officer and deputy chief executive, NHS Scotland.

We have quite a number of questions to put to you on the report. Before we get to those, I invite Caroline Lamb to make a short opening statement.

I want to ask about an item that you touched on towards the end of your opening statement: the support and intervention framework that you operate. You are right that we had NHS Grampian and NHS Ayrshire and Arran before us, because they were both the subject of section 22 reports. Section 22 reports are produced when things are not going terribly well.

One thing that stood out to us was that NHS Ayrshire and Arran, for example, has been in deficit for, I think, seven years and has been at a high level of escalation for a long time. Our working assumption would be that, if a board is escalated, that is in order for it to be turned around and de-escalated. Some of us have experience with boards where that has happened—it happened with NHS Forth Valley, for example. Why has NHS Ayrshire and Arran been allowed to sit at a high level of escalation for as long as seven years?

But it has not happened in this case, has it?

Other members of the committee will ask about the allocation formula and so on.

An issue that we have raised previously in evidence is that it would be one thing if it was the case that the health boards that are in financial deficit and that regularly require brokerage were in that position because they were exceeding targets, outperforming other health boards and going above and beyond in meeting the needs of their population, but we discovered that those health boards are not only in financial difficulty but underperforming on targets compared with similar health board areas. What are your reflections on that?

That leads me on to my final question for this part of the discussion, which is about governance arrangements. It is not simply a question of you, from the centre, stepping in, escalating and providing extra resource, such as consultants or people from other health boards to work with the affected health board. It is also about the territorial arrangements at board level, is it not?

Do you think that there is sufficient support, training and understanding at the level of territorial health boards when it comes to their role in overseeing the financial management of the health board and ensuring that it is performing to the level that we would expect and is not breaking the rules that Healthcare Improvement Scotland would come down hard on? Do you think that that system is working well?

Agenda item 2 is consideration of “The 2024-25 audit of NHS Ayrshire and Arran” and “The 2024-25 audit of NHS Grampian”. I am pleased to welcome representatives from each of those health boards to speak to the committee about the situation that they find themselves in and their response to the Audit Scotland reports. From NHS Ayrshire and Arran, I welcome Gordon James, the interim chief executive; Lesley Bowie, the chair of the board; and Dr Crawford McGuffie, the executive medical director. From NHS Grampian, I welcome Laura Skaife-Knight, the chief executive; Alison Evison, the chair of the board; and Alex Stephen, the director of finance.

The committee has questions for you, based on the reports and on the evidence that we have taken previously, but, first, I invite Gordon James to make a short opening statement.

I am conscious that we are three minutes away from our allocated time slot expiring and we still have two members of the committee who want to ask questions, so I ask our witnesses to try to keep their answers succinct—I know that the questions will be succinct, of course.

I invite the deputy convener, Jamie Greene, to put some of those questions to you.

I have a final question out of curiosity. Did you share the improvement plan when you arrived in the Parliament this morning, while you were discussing giving evidence, or would you have done that anyway?

I am afraid that I cannot bring you back in, Mr James. I am sorry but I am applying the Walter Citrine rules from “The ABC of Chairmanship”, so you can only come in once.

I thank you all for sharing your experience and giving us evidence this morning to illuminate our picture of where you stand and where things are in the wake of the two section 22 reports. We very much appreciate your time this morning. I formally thank Alex Stephen, Alison Evison and Laura Skaife-Knight from NHS Grampian, and Gordon James, Lesley Bowie and Crawford McGuffie from NHS Ayrshire and Arran.

I suspend the meeting to allow for a change of witnesses.

11:18

Meeting suspended.

11:26

On resuming—

So, there is one owner. Is there one director, or is there a board of directors?