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Displaying 2092 contributions
Public Audit Committee
Meeting date: 20 June 2024
Jamie Greene
I appreciate that update.
The problem with delayed discharge, or bed blocking, as it is commonly called, is that it is exactly that—it is bed blocking. I presume that that is bad for two reasons. The person who is languishing in hospital, who should not or does not need to be there, would rather be, and should be, somewhere else, wherever that is. Equally, there is someone at the other end of the spectrum who could be occupying that bed but is on a waiting list—and we all know what waiting lists look like at the moment.
It seems to me that half of the job is yours, and you are doing your best, but the other half of the solution is not working, because you cannot discharge people if you have nowhere to put them and there is no plan in place to look after them. You have a duty of care to look after your patients, and you would not want to send them out to their homes with no care package and with nobody to look after them, so you keep them—I understand that.
Is that your mitigation? Are you saying, “We’ve done as much as we can, but local authorities haven’t got the money to look after folks, so we have to keep them.”?
Public Audit Committee
Meeting date: 20 June 2024
Jamie Greene
Mr McCallum, this must make for very uncomfortable listening. You are director of health and social care. We have heard from health professionals what the issue is. They cannot get people out of hospital because the social care system is not delivering, but people in the social care system will say, “There are simply far too many people being put into our system and we haven’t got the money to deliver the care.” From a holistic point of view, have you got this all wrong?
Public Audit Committee
Meeting date: 20 June 2024
Jamie Greene
I was trying to let you off the hook a little bit there, but okay.
Public Audit Committee
Meeting date: 20 June 2024
Jamie Greene
Anybody who speaks to local authorities will know that they are really struggling. For example, there are simply not enough places in care homes and there are not enough staff to treat people in their own homes. Frankly, when someone is in a hospital environment, that is not seen as the local authorities’ problem; it is the NHS’s problem. There does not seem to be any joined-up thinking. I appreciate what you say about integration boards but, for far too many people, the system is simply not working. If it was working, we would not have so many people in delayed discharge or struggling to get a place in a care home, and we would not have so many people having to pay to go private.
Do you admit that there is an issue? Given the numbers that we have just spoken about and that things are getting worse, not better, it sounds a bit like an emergency that we need to deal with.
Public Audit Committee
Meeting date: 20 June 2024
Jamie Greene
Just before you go on, that is way off target.
Public Audit Committee
Meeting date: 20 June 2024
Jamie Greene
Yes, but not everyone who presents at A and E will need to stay overnight or will need a bed. They simply need to be seen by somebody. Are you looking at that?
10:15Public Audit Committee
Meeting date: 6 June 2024
Jamie Greene
Just to be clear, it was not a performance-related issue. There were no operational issues. It was solely, as you said, a policy decision. I will not use the word “political”, as that would not be fair on you, but it was certainly a ministerial decision that the Government wanted to go in that direction of travel, irrespective of the cost.
Public Audit Committee
Meeting date: 6 June 2024
Jamie Greene
In your previous appearance before the committee, which I will not revisit, we talked quite extensively about the pressures on the prison population. Where is HMP Kilmarnock in that regard? Is it one of the ones in the red? Is it nearing capacity? Do we have any issues there?
Public Audit Committee
Meeting date: 6 June 2024
Jamie Greene
You cannot go through a supermarket without being greeted by somebody with a body-worn camera. It seems odd that our prison staff do not have them.
Public Audit Committee
Meeting date: 6 June 2024
Jamie Greene
We look forward to that.
My second question is about PFI contracts, where there is still a bit more digging to be done and other members might do that. I am still a bit confused about how many such contracts are coming to an end in the next couple of years and what the cost to the public purse will be. We may revisit that before we end this evidence session, but do you expect those contracts to come to a natural end or are ministers mooting an early contract termination on some of them? There is a difference there and I presume there is a cost.