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It is not difficult. It does not require a lot of capital investment in infrastructure. It just means that there will be a little bit of joining up in how you inform people about things such as appointments. I am pleased to say that I was able to speak to the right people and, luckily, I got a last-minute cancellation for the following week, but how many people are out there waiting on those letters?

I have one final proper question about the national treatment centres. We have spoken a lot about reform and about innovative new ways of doing things to get through the backlogs. However, the NHS capital budget has been cut by 22 per cent in the past five years and my understanding is that five of the national treatment centres are on pause. The Royal College of Surgeons thinks that four of them have been canned completely and are never going to happen.

We have talked a little bit about NHS Ayrshire and Arran and some of the problems that it is having, and its national treatment centre is one of those that have been paused. That does not make sense.

11:15

Would it not be better just to say, “We’ll just write that off”, in the way that many other Government debts have been written off in recent years where the Government has stepped in to support specific sectors and there is just no expectation that it will get that money back? After all, the money has gone; it is off your balance sheet, and it has been spent by the health board. Let us not pretend that you are going to get it back.

But the board does not have to make non-recurring savings in year in order to get the cash.

I guess that the premise of my question is this: is it worth rethinking how we support and fund boards? If many of them can make ends meet but many cannot, does that show that their governance arrangements are lacking? Do they have specifically difficult areas to manage when it comes to patient care, or does the model just not work for them, given the nature of the services that they are required to provide?

Ms Lamb, if the Scottish Fiscal Commission’s forecasts are accurate, the level of spend on health and social care will rise to 40 per cent of Government spending in the coming years and up to 55 per cent not that far down the line. It could hit 50 per cent-plus during the next parliamentary cycle. That is half of all devolved spending. Surely that is unsustainable.

I am sure that my good friend Mr Simpson will come on to talk about technology.

It has huge potential in healthcare.

Before I finish, I must talk about general practitioner walk-in centres, which have been in the news for the past few weeks since the committee last met. I have no political view on them, but we have to note the concerns that have been raised about them. I would say that the British Medical Association in Scotland and the Royal College of General Practitioners have been unusually critical of the plans. We are talking about a lot of money. They claim that the approach was tried and tested in England, but that it failed, and that no lessons will have been learned from it.

I can see the benefit of walk-in GP or nurse appointments, particularly if they are open until 8 o’clock in the evening; it makes complete sense for most of the working-age population. However, those services have been heavily criticised by the very people who will be tasked with delivering them. What is your response to that?

I imagine that those NTCs would be quite expensive projects to build, but they would be new build and so would take time, and we know that everything costs more and takes forever. If there is capacity in the existing estate that can be used to get through the backlog, I understand why that would be a priority.

:Audit Scotland reflected on that: it noted that the issue is not only about cost cutting and making efficiencies. It believes that the board’s reform of services has been slow.

We are tight for time, but I want to briefly cover the issue of staffing. I am aware that there is a higher than average workforce sickness rate. I have also been working closely with local union members who have done many surveys of the staffing; the results of the surveys have been disappointing and worrying. In particular, many of those who were surveyed—I believe that the figure was 78 per cent, which is substantially high—believe that they are so short-staffed that they are putting the safety of their patients at risk. Many more reported discomfort about raising concerns with leadership and management, a high percentage said that they did not receive appropriate or timeous feedback to their concerns and 90 per cent said that safe staffing legislation had made absolutely no difference to their day-to-day level of care. Those are worrying pieces of feedback. What are you doing to improve staff morale, patient and staff safety and—given that the sickness rate is so high—the welfare of staff?

:We have only heard from the Government about the good bits. Just out of interest, what are the bad and the ugly?