Leadership in health and social care questioned by parliamentary committee

29.10.2018

Transformational change in health and social care is not being achieved in part due to the leadership in the organisations set up to deliver integration not exercising the powers given to them according to a report by the Health and Sport Committee.

There are 31 integration authorities across Scotland, bringing together NHS and local council social care services. MSPs found that leadership in some of these bodies was failing to deliver the transformational change required, and that the best practice in some areas was not being replicated in others. This is just one of the conclusions that has been reached by the Committee which has been looking at areas they wish to be included in the Scottish Government’s health budget for 2019/20.

The Committee found it unacceptable that integration authorities, who are responsible for spending around £8 billion in public funds, are taking decisions on spend without any link to health and social care outcomes or assessing the effectiveness of their spend.

The Committee’s report has been published in advance of the Scottish Government’s 2019/20 budget so that the Government is given an opportunity to consider implementing the recommendations as part of their spending plans.

Convener of the Health and Sport Committee Lewis Macdonald MSP said:

“The successful integration of health and social care is one of the biggest challenges facing us. It is clear that transformational change is required in the sector in order for us to meet long term challenges such as our aging population. This requires those in charge to use the powers Parliament has given them and drive change.

“It is vital that the significant budget for health and social care is spent efficiently and effectively. It is unacceptable that this is not happening and the Committee is calling on this to change.

“It is the role of the Parliament and this Committee to approve spending decisions of this Government and thereafter scrutinise what is delivered. In order for us to do that we need to have the right information so the Committee is looking for significantly better data with a greater focus on outcomes.

“We also seek assurances in relation to the recent announcement that loans to health boards are being written off. This offer should not be a blank cheque nor be open to misuse.”

On the issue of brokerage – loans provided to health boards by the Scottish Government - the Committee is asking the Scottish Government what is being done to reduce the need for brokerage this year given the commitment that all outstanding brokerage expenditure will be written off. The money to write off outstanding brokerage has yet to be approved by Parliament and the Committee wants to know what measures are in place to ensure the announced open-ended guarantee is not subject to any misuse by NHS boards.

The report also looked at investment in mental health services. The Committee has continued to hear concerns regarding access to services and support for those with mental health conditions since the publication of the Scottish Government’s mental health strategy in 2016. Whilst the Committee welcomed the additional investment in this area, to date it does not appear to be reaching health boards allowing delivery of the outcomes that announcements required. The Committee has continued to hear concerns regarding access to services and support for those with mental health conditions since the publication of the Scottish Government’s mental health strategy in 2016.

The Committee also looked at spend on alcohol and drug partnerships. They concluded that the high number of drug deaths in Scotland should be considered a priority. MSPs welcomed the additional investment but are looking for assurances that the funding will be invested effectively.

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