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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 4 May 2021
  6. Current session: 13 May 2021 to 5 January 2026
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Displaying 1837 contributions

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Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Jamie Greene

I draw your attention to paragraph 14 of the report, which I read with interest. We have spent a lot of time talking about the finances of the board, but it seems that that is not the only issue here. There are concerns about performance, services, quality and the existence of “significant operational pressures”. Could you talk us through the concerns that you identified, other than those to do with the financial problems at NHS Grampian?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Jamie Greene

Thank you, Auditor General. How can a hospital run out of beds? Is it that suddenly and very quickly there is an unexpected wave of people who are very unwell or is it because of poor planning and forecasting capacity?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Jamie Greene

Thank you. That is a very succinct analysis of the wider problem. Is the solution to the bed issue a new hospital or a new site? You state that there are physical issues in the estate, so the answer to that clearly is a new building, more beds and more people.

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Jamie Greene

The assurance board has a role to play in all this and will be there for the foreseeable future until things have turned around.

Is the improvement plan forthcoming? Where are we at with that? Has it been signed off? Has it been ratified? Are people happy with it?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Jamie Greene

I am trying to get my head around who is to blame here. NHS Ayrshire and Arran has been on level 3 for eight years, so there is financial intervention every single year. The idea that that is a loan is nonsense; I would put money on the fact that it is never going to pay this stuff back. The model is broken, in my view. Something is clearly going wrong, but I cannot quite work out who is to blame. Is it governance issues? Is it the board? Is it the management team? Is it the Government? Is it ministers? Is it all of the above?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Jamie Greene

Can we cut to the chase? Are we just dancing around the issue that the current model is not working? The unsustainability that you highlight in your audit is a long-term issue; it is not a one-off. It has been happening for nearly a decade, and it is probably going to continue in the same direction, if not get worse.

The idea is that the Government is somehow helping out by stepping in and plugging financial holes, painting the picture of it saving the board. Do you think that the Government needs to have a fundamental look at the entire model to rephrase it, reframe it and be a bit more honest with the public and the health board about how it is funded and what it expects of the board?

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Jamie Greene

I have one final question. The idea of brokerage is political lingo, but is there a reason why the Government frames it in that way? Essentially, it is saying to boards that, if they are spending more than they have, the Government will make up the difference in the form of a loan. Are there financial or audit reasons why it would do that? Is someone sitting in a civil service room saying, “Minister, do not just give them cash—give them loans”, because it has a financial benefit or some knock-on effect down the line or in the way that the Government reports its accounting?

If we multiply the approach across all boards, it is a substantial sum of cash. Why would ministers not simply say, “Look, if you need £30 million to meet your health objectives, we will give you that”, rather than continue a pretence that the money is a loan? It is never going to be paid back.

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Ayrshire and Arran”

Meeting date: 26 November 2025

Jamie Greene

It is not really a loan; there is no expectation that it will be paid back.

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Jamie Greene

Is any of that a surprise to anyone? We know that there is an ageing population, particularly in this health board area. Demographic analysis has been done—using data, presumably. It would not have been a new problem, but would have been known to the board and, indeed, to ministers for some time.

The idea that it is a surprise that lots of people who are elderly and unwell might present at A and E—setting aside the issue of Covid or an unexpected health issue, which clearly people were not prepared for—seems surprising; I am surprised that this is a surprise to people.

Public Audit Committee [Draft]

“The 2024/25 audit of NHS Grampian”

Meeting date: 26 November 2025

Jamie Greene

That leads nicely into what the solution is. Is it just throwing more cash at the problem? Is it the end-to-end fixing of all the problems that response times for A and E, bed-blocking and delayed discharge present? Do we need more staff? How do we solve these issues? You can either write cheques endlessly to health boards or have a systemic root-and-branch review of the entire journey from being ill to getting home again.