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Displaying 565 contributions
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
That is not what I asked. I asked whether, in broad terms, the money that is used to set up the NCS will be recouped through savings or whether it will simply be additional cost. As we sit here this morning—unless you correct me, minister—even as regards the current scope of the bill, which covers the setting up of the national apparatus, what you are saying is that the financial memorandum does not include the full costs of that, because it does not include things such as the cost of the IT, which, as you have recognised, is an important element of public service delivery. We do not know what the cost of that will be.
The convener set out the costs that the Fraser of Allander Institute said are missing, which include the costs of the national care boards; the cost of transition; the cost of the impact of VAT, which you have acknowledged that we do not have; the cost of the impact of any change to the pension schemes; the cost of potential changes to capital investment in maintenance costs, the extent of which we do not know; and the cost of the health and social care information scheme. Some of those things are about service delivery, but many of them are about the national apparatus itself.
Likewise, NHS Scotland has said that we do not know what the cost of the phasing of the functions will be and has pointed out that we do not know what the size of the wider savings and benefits will be. We do not know whether the transfer will include children’s and criminal justice social care as well as adult social care, we do not have a list of the health functions that will be transferred and we do not have clarity about future demand.
There are quite a lot of unanswered questions about the specifics of running the national apparatus and about whether—even just in broad terms—having the NCS is likely to make service delivery more or less expensive. Am I wrong?
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
Minister, you have been at pains to point out that, in essence, the detail of service delivery will be subject to the co-design phase. Fine—let us park that for a moment.
Can I raise some points of clarification? You said at the beginning that the point and purpose of the bill was standardisation and accountability. For clarity’s sake, it is not just about those two elements, is it? It is also about commissioning, rather importantly. The purpose of the bill is to set up the national apparatus to make possible, and to nationalise, centralised commissioning. Is that correct?
Secondly, you are saying that, notwithstanding the points around what costs may arise from service delivery or additional services, the costs for setting up that national apparatus are all contained in the financial memorandum.
Are those points correct?
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
Okay—correct me.
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
I am sorry if people thought that I was putting words in the minister’s mouth. I believe that the words that the minister used were that he “could not conceive of a situation where there would be more care boards than IJBs.” I was merely making the inference that—
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
I was not getting at cost overruns. Without plucking numbers out of the air, I was just giving what I thought were fair and recent comparators.
Coming up a layer, will IT be an important element and is it likely to be a substantial cost component of what is finally delivered?
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
Looking at the overall business case, we are talking about a set-up cost for the national apparatus of £500 million-plus. At the moment, that does not include IT or a number of other items. Will that cost be recouped in benefits? Currently, £7 billion is spent on social care and £8.9 billion on community health. Will this drive benefits and efficiency on the current footprint, excluding improvements or increases in the standards of care? In terms of the as-is—the baseline business case—will that cost be recouped, or will it be additional? Do you expect costs to go up or down on the basis of the planned investment?
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
Why not?
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
In the interests of time, I was really just asking for brief confirmations of my assumptions. I understand the different words, but I do not think that I was suggesting anything different. If it is not about centralised commissioning, can you conceive of a situation in which there will be more commissioning boards than the current number of IJBs, or are you clear that there will be fewer?
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
That brings us back to the process. Answer this for me, minister, because I really do not understand it. I can understand why you might not want to legislate for service delivery prior to having the framework in place. That bit makes sense.
However, what would have prevented you from doing the co-design work and bringing forward a white paper, and then bringing forward the framework bill, with that white paper clearly in mind? That would have enabled you to do the co-design and answered many of the questions that we have in front of us, and it would have given us certainty about the scope. Right now, we do not even know—because the co-design work has not been done—what functions the national apparatus will need to facilitate. Why not do it the other way round? Why not do the co-design work and bring forward a white paper, and use that as the basis, and the context, for the framework bill? I do not understand why you did not do it that way round.
Finance and Public Administration Committee
Meeting date: 8 November 2022
Daniel Johnson
I will leave it there, convener.